Challenges to Implementing Environmentally Sustainable Kidney Care in LMICs: An Opinion Piece
Loading...
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Canadian Journal of Kidney Health and Disease
Abstract
Kidney care, especially dialysis, has a substantial environmental impact through greenhouse emissions and waste generation.1-4 Thus, the Canadian Society of Nephrology implemented a Sustainable Nephrology Action Planning (SNAP) committee to inform best practices in environmentally sustainable kidney care (ESKC).5 The committee outlined the necessity of ESKC, provided an overview of the existing literature, proposed a planetary health care framework of redesigned kidney care, and developed a toolkit called “Creating a Sustainable Canadian Health System in a Climate Crisis.”6-8
Developing and implementing such a framework and toolkit in low- and middle-income countries (LMICs) requires a better understanding of the challenges faced by these health systems as many have substantially lower health expenditure per capita when compared with Canada. However, resource-limited countries are more vulnerable to the impact of climate change and other disasters despite having lower CO2 emissions per capita when compared with many resource-rich countries.9-13 Also, similar to high-income countries, health care in LMICs is a carbon-intensive activity including kidney care as hemodialysis is the only available or most readily available therapy in many LMICs.14 As the prevalence of chronic kidney disease (CKD) is rising, the burden of kidney care will likely grow substantially as more countries commit to the UN Sustainable Development Goal 3.8 of increasing access to health care.15-17 Thus, the increasing prevalence of CKD, a commitment to improving access to health care by many nations and hemodialysis being the main option available to those with kidney failure further necessitates the need to implement ESKC practices in LMICs.
This opinion piece synthesizes the perspectives of health care professionals (HCPs) who work in LMICs. These members were identified from the two cohorts of the International Society of Nephrology’s Emerging Leaders Program.2,18 This program brings together and mentors a worldwide network of future leaders in kidney care who work collaboratively on issues relevant to the nephrology community. Those who participated, shared their perspectives narratively on the challenges and solutions to providing ESKC in their respective regions. Two co-authors synthesized these inductively into themes (D.B. and S.S.). Implications were then developed collectively.
Description
Keywords
Citation
Bajpai, D., Hailu, W., Bagasha, P., Chika, O. U., Hafiz, E., Tannor, E. K., ... & Sandal, S. (2024). Challenges to implementing environmentally sustainable kidney care in LMICs: an opinion piece. Canadian Journal of Kidney Health and Disease, 11, 20543581241246835. https://doi.org/10.1177/20543581241246835