Piccoli Giorgina Barbara, Garcia-Garcia Guillermo, Salomone Mario, Chavez-Iñiguez Jonathan Samuel, Gómez-Fregoso Juan Alberto, Torreggiani Massimo
Néphrologie et Dialyse, Centre Hospitalier Le Mans, Le Mans, France.
Division of Nephrology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Mexico; Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud CUCS, Guadalajara, Jalisco, Mexico.
Kidney Int. 2025 Apr;107(4):628-639. doi: 10.1016/j.kint.2024.08.040. Epub 2025 Jan 23.
Kidney replacement therapy is one of the most energy-consuming and waste-producing medical treatments. Reducing the need of dialysis is therefore an environmentally friendly choice. However, preferring prevention, lifestyle-related interventions and patient education to drugs is time consuming, and most physicians are already overburdened by the many demands of routine clinical practice. In this mini review, we discuss the role that could be played by prevention, diet, and nonpharmacologic interventions in reducing the impact of care of chronic kidney disease and kidney replacement therapy. Although evaluating the environmental impact of chronic kidney disease and kidney replacement therapy is extremely complicated, the need for rethinking all the steps in current nephrology practice to preserve our planet's health is urgent, and shifting from a "drug prescription" model to a "time prescription" one would benefit both our patients and the environment.
肾脏替代疗法是最耗能且产生废物最多的医学治疗方法之一。因此，减少透析需求是一种环保选择。然而，相较于药物治疗，更倾向于预防、生活方式相关干预措施和患者教育耗时较长，而且大多数医生已经因日常临床实践的诸多要求而负担过重。在这篇小型综述中，我们讨论预防、饮食和非药物干预措施在减轻慢性肾脏病护理及肾脏替代疗法影响方面可能发挥的作用。尽管评估慢性肾脏病和肾脏替代疗法对环境的影响极其复杂，但迫切需要重新思考当前肾脏病学实践中的所有环节以维护我们星球的健康，从“药物处方”模式转向“时间处方”模式将使我们的患者和环境都受益。
