Evidence map›Paper›PMID 42582857›Full record

ReviewClinical kidney journal2026

Finding the sweet spot in green nephrology: the intersection of environmental sustainability and excellence in patient care.

Mariana Murea, Frances Mortimer, Gulay Demirtas, Alina Seman, Rossella Picillo, Ilaria de Barbieri, Alexander Woywodt, Giorgina B Piccoli

Abstract readReview
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mariana MureaWake Forest University School of Medicine, Winston-Salem, USA.
Frances MortimerCentre for Sustainable Healthcare, Oxford, UK.
Gulay DemirtasAntalya Training and Research Hospital, Antalya, Turkey.
Alina SemanFreelance patient, Turin, Italy.
Rossella PicilloFreelance patient, Turin, Italy.
Ilaria de BarbieriUniversity of Padua, Nursery and Midwifery Science,  Padua, Italy.
Alexander WoywodtLancashire Teaching Hospitals NHS Foundation Trust,  Preston, UK.ORCID https://orcid.org/0000-0002-3825-6955
Giorgina B PiccoliNéphrologie et Dialyse, Centre Hospitalier Le Mans, Le Mans, France.ORCID https://orcid.org/0000-0002-2632-4009

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Sustainability in kidney care is often perceived as requiring trade-offs in clinical quality, yet green nephrology can strengthen clinical excellence by identifying "sweet spots" where improved outcomes and reduced environmental impact align. Organized along the chronic kidney disease (CKD) trajectory, this review highlights opportunities for responsible practice at each stage. Dialysis, the most resource-intensive component of kidney care, finds a sweet spot in reducing redundancy, personalizing treatment, optimizing vascular access, and empowering patients. Approaches such as incremental dialysis, water-efficient systems, and well-planned vascular access improve both clinical and environmental performance. Upstream, CKD prevention remains the most powerful strategy for increasing survival and reducing human and planetary burden. The sweet spot on early diagnosis and optimized CKD care may be identified in shifting away from medication escalation toward lifestyle-focused interventions, deprescribing when appropriate, and reducing treatment burden. Research also plays a critical role, with substantial potential to reduce waste by minimizing redundancy, promoting data sharing, adopting efficient trial designs, and leveraging digital tools. Options that are resource sparing are however usually more time-consuming, thus highlighting the central role of the nephrologists in individualized kidney care. In essence, green nephrology is not "less" care; it is better care, sitting at the intersection where clinical excellence and environmental stewardship reinforce one another.

Indexed as

chronic kidney diseasegreen nephrologyhaemodialysissustainability

Identifiers

PMID42582857
PMCPMC13458388

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.