Background Hemodialysis generates a warm effluent stream (25°C) that is discarded, representing a continuous loss of low-grade thermal energy while clinics expend significant energy for water heating, contributing to operational costs and carbon emissions. Methods A transient mathematical model was developed to simulate a passive shell-and-tube heat exchanger for integration into a dialysis drain line. The model was validated experimentally (normalized root mean square error (NRMSE) = 3.4%). A techno-economic assessment for a 4-station clinic was performed, evaluating recoverable energy, effectiveness, and payback period based on key parameters including a 4 h 30 total machine operating cycle (4 h treatment at 25°C + 30 min thermal disinfection at 90°C) and an effluent flow rate of 0.05 kg/s (design value for 4 machines). Results The optimal 8-tube heat exchanger design recovers over 15 kWh/ session with >80% effectiveness. For a modeled 4-station clinic, this yields annual savings of ∼63,200 kWh (15,800 kWh per-machine), a payback period of 1.95 years, and an annual CO₂ reduction of ∼45 metric tons (11.3 tons per-machine). Conclusion Recovering thermal energy from dialysis effluent using the exchanger design described here is technically feasible and economically viable.
Tarrass et al. (2026) studied this question.