Abstract Background The global rise in dialysis treatments for kidney failure patients has led to growing concern about the carbon footprint of dialysis and the environmental implications of increased consumption of key resources, including water, electricity, and the manufacture and waste disposal of treatment-related consumables. As most environmental studies have reported from temperate climates, we examined the carbon footprint of a hemodialysis center in Singapore, which represents a country with a tropical climate, aiming to assess total carbon emissions quantitatively, systematically identify key components, and provide critical insights along with pragmatic recommendations for enhancing sustainability practices. Methods We measured the direct and indirect carbon emissions using the Greenhouse Gas Protocol Product Standard at our 12-station satellite dialysis center. This study was conducted at the outpatient satellite dialysis center of NUH between October 2023 and January 2024. This 12-station satellite dialysis facility operates three shifts daily, six days a week, and encompasses an area of 210 m². It is equipped with twelve machines, supplied with dialysis water from AquaB Duo Water Treatment System (Fresenius Medical Company, Bad Homberg, Germany). Acid concentrates (dilution 1:34, 5L containers) and bicarbonate powder are supplied in single-use plastic containers. The direct and indirect greenhouse gas (GHG) emissions were measured retrospectively using the GHG Protocol Product Standard, developed by the World Resources Institute and the World Business Council for Sustainable Development. Results Our center dialyzed approximately 60 patients each month, resulting in a total of 8932 sessions over the course of the year. Our total annual emissions were evaluated at 358.52 tonnes of carbon dioxide (tCO₂e), with an average carbon emission of 5.98 tCO₂e per patient. Most of these emissions were due to dialysis consumables, accounting for 147.50 tCO₂e (41.1%). The dialysis consumables contributing the most to carbon emissions were dialyzers, bicarbonate powder, bloodlines, dialysis needles, and acid concentrates. This was followed by electricity, clinical supplies, and pharmaceuticals, which contributed 55.27 tCO₂e (15.4%), 24.35 tCO₂e (6.8%), and 36.24 tCO₂e (10.1%), respectively. Waste generated accounted for 30.94 tCO₂e (8.6%) of the carbon emissions. Conclusions Our study on the carbon footprint of a satellite hemodialysis unit is the first one conducted in an equatorial urban city environment, experiencing high humidity and abundant rainfall, with a tropical climate. Further research into local carbon emissions across other centers in Southeast Asia is essential for validating our findings and informing sustainability policies.
Haroon et al. (Tue,) studied this question.