ReviewClinical kidney journal2026
Environmental footprint of peritoneal dialysis in Europe: a comparative life cycle assessment across four European centres.
Review in Clinical kidney journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Peritoneal dialysis (PD) is a home-based renal replacement therapy offering clinical and quality-of-life advantages, but it also poses environmental challenges due to resource use and waste generation. This study compares the environmental impacts of PD across four European centres to identify regional sustainability differences and evaluate the footprint of continuous ambulatory (CAPD), automated (APD), and incremental (iPD) PD. Methods: A cradle-to-grave life cycle assessment (LCA) was conducted for one year of PD treatment per patient using OpenLCA software and the EcoInvent database across four clinical centres; Madrid, Warsaw, Utrecht, Modena. Data were collected on material use, energy and water consumption, transportation, and waste disposal. Key indicators included global warming potential (GWP), energy use, water footprint. The environmental performance of each centre and dialysis modality was assessed. Results: Environmental impacts varied significantly between centres ranging from GWP 3381 kg CO₂-eq to 1736 kg, reflecting differences in energy mix and efficiency. Energy consumption ranged from 54,710 MJ to 28,894 MJ and water footprint from 6631 m³ to 854 m³. Across all centres, CAPD and APD had higher environmental burdens than iPD. iPD reduced emissions by up to 50% and had a lower-impact profile. Conclusions: PD displays substantial environmental impact variability across centres, driven by differences in material consumption, waste management, energy sourcing, and clinical protocols. Cleaner energy profiles, effective waste management, and reduced reliance on single-use consumables may lower environmental burdens. These findings underscore the importance of integrating environmental performance into clinical decision-making and health system planning.
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