Piccoli Giorgina Barbara, Murea Mariana, Ben Hmida Mohamed, Berman-Parks Nathan, Bonnet Carole, D'Alessandro Claudia, Pavlovic Drasko, Rho Elena, Tarrass Faissal, Avesani Carla Maria, Torreggiani Massimo
Néphrologie et Dialyse, Centre Hospitalier Le Mans, Le Mans, France.
Section of Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Clin J Am Soc Nephrol. 2025 Apr 16;20(6):889-901. doi: 10.2215/CJN.0000000731.
Green nephrology, also often called sustainable nephrology, has become a field of interest in our discipline in recent years. Although several reviews have been published, comparatively few original articles have appeared, witnessing interest but also lack of original data. Greater awareness of the effect nephrology has on the planet, including, but not limited to its carbon footprint, is needed to promote education and research on these issues. Increasing awareness entails increasing knowledge at various levels, and it is for this reason that we are presenting this review focusing on educational activities that have been and could further be undertaken to spread knowledge of these topics. We start from a description of the various approaches to green nephrology: technical, mainly focused on dialysis, clinical, encompassing medical and nonmedical treatments in all CKD phases, and comprehensive, embedding kidney care in the society. We further summarize what is known and the fundamental needs and problems we presently face in reducing dialysis carbon-print, optimizing the pathways of care, avoiding futility in clinical work and research, and implementing lifestyle interventions and education. We further acknowledge the lack of data on lifecycle of items and procedures, including commonly used drugs, and identify research needs at various levels. We finally discuss some examples of educational programs on green nephrology that are already available at various levels, from medical schools (an educational game), to medical meetings (healthy eating and reduction of plastic and paper waste), and daily clinical practice, in which teaching passes also through examples (personalizing dialysis and adapting schedules to each patient). Finally, we identify some barriers that educational approaches may offer ways to overcome, to promote effective, targeted interventions that will make us advance on the road to reduce nephrology's carbon footprint.
绿色肾脏病学，通常也被称为可持续肾脏病学，近年来已成为我们这个学科中一个备受关注的领域。尽管已经发表了几篇综述，但原创文章相对较少，这既显示出人们对该领域的兴趣，也表明缺乏原始数据。为了推动关于这些问题的教育和研究，需要提高对肾脏病学对地球影响的认识，包括但不限于其碳足迹。提高认识需要在各个层面增加知识，正因如此，我们撰写了这篇综述，重点关注已经开展以及可以进一步开展的教育活动，以传播这些主题的知识。我们首先描述绿色肾脏病学的各种方法：技术层面，主要侧重于透析；临床层面，涵盖慢性肾脏病各个阶段的医疗和非医疗治疗；综合层面，将肾脏护理融入社会。我们进一步总结了在减少透析碳足迹、优化护理路径、避免临床工作和研究中的无效行为以及实施生活方式干预和教育方面已知的情况、基本需求和当前面临的问题。我们还承认缺乏关于物品和程序生命周期的数据，包括常用药物，并确定了各个层面的研究需求。最后，我们讨论了一些不同层面现有的绿色肾脏病学教育项目的例子，从医学院（一个教育游戏）到医学会议（健康饮食以及减少塑料和纸张浪费），再到日常临床实践，其中教学也通过实例进行（个性化透析并根据每个患者调整时间表）。最后，我们确定了一些教育方法可能有助于克服的障碍，以促进有效、有针对性的干预措施，使我们在减少肾脏病学碳足迹的道路上取得进展。
