Hemodialysis is a lifesaving therapy but imposes a significant environmental burden due to its excessive consumption of water and energy and the generation of non-recyclable medical waste. The emerging Green Dialysis movement aims to mitigate these environmental impacts by promoting sustainable practices in nephrology. We summarize current knowledge on the environmental challenges associated with hemodialysis and highlight innovative strategies for reducing its ecological footprint through the Green Dialysis framework.
This review synthesized recent literature on water use, energy consumption, and waste generation in dialysis, evaluating practical and technological innovations, including water recycling, reduced dialysate flow, renewable energy integration, and sorbent-based systems, that aim to improve sustainability in nephrology care.
Key environmental challenges of hemodialysis include excessive water and energy consumption and substantial waste generation. Hemodialysis facilities consume vast quantities of water, with up to 60 percent of treated water being discarded, while energy demands produce considerable carbon emissions. Waste production, particularly plastic waste, poses additional environmental challenges, as much of it is non-recyclable and poorly managed. Through the Green Dialysis movement, there is a concerted effort to promote sustainable practices in nephrology. Innovative solutions such as water recycling, reduced dialysate flow rates, adoption of renewable energy sources, and advanced hemodialysis machine designs may minimize resource use and waste.
The Green Dialysis movement offers a comprehensive and actionable approach to improving the environmental sustainability of dialysis care. By integrating these strategies, the Green Dialysis movement aims to mitigate the environmental footprint of hemodialysis, fostering a sustainable and resilient future for nephrology care.

© 2025 International Society for Hemodialysis.