MINI REVIEW article
Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1635718
This article is part of the Research TopicMoving Towards a Sustainable and Greener DialysisView all 3 articles
Critical care nephrology: opportunities for implementing green practices
Provisionally accepted
Alejandra Molano-Triviño1*
Lilia Rizo Topete2Juan Castellanos De la Hoz1
AKASH NAYAK KAROPADI3Eduardo Zuñiga1- 1Cardioinfantil Foundation, Institute of Cardiology, Bogotá, Colombia
- 2Universidad Autonoma de Nuevo Leon, San Nicols de los Garza, Mexico
- 3Alira Health, Boston, United States
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The intersection between climate change, healthcare, and nephrology is becoming increasingly evident. Globally, healthcare systems contribute approximately 4.4% of greenhouse gas emissions, with intensive care units (ICUs) representing some of the most resource-intensive hospital areas. Within this environment, critical care nephrology plays a central role, particularly in managing acute kidney injury (AKI) and delivering renal replacement therapies (RRT) such as hemodialysis, continuous renal replacement therapy (CRRT), and peritoneal dialysis. Nephrology interventions in the ICU, while life-saving, are associated with high environmental costs, including significant water consumption, energy use, and the production of large volumes of medical waste For instance, a single hemodialysis session can consume over 500 liters of water, while CRRT in critically ill patients may require 10 to 15 large plastic bags daily, most of which are incinerated as hazardous waste Nephrology has pioneered "Green Nephrology" initiatives focused on reducing the ecological footprint of chronic dialysis through water reuse, optimized dialysis fluid flows, and material recycling (8,11), however, similar structured strategies for sustainability within critical care nephrology remain underdeveloped. This article explores the environmental challenges of nephrology practice in ICUs, highlights existing gaps, and proposes opportunities, including artificial intelligence (AI) to promote sustainable, high-quality kidney care for critically ill patients.
Keywords: Green nephrology, Dialysis, Water waste, Plastic, Critical Care
Received: 26 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Molano-Triviño, Rizo Topete, Castellanos De la Hoz, NAYAK KAROPADI and Zuñiga. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alejandra Molano-Triviño, alepatrimoltri@gmail.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.