Challenges to Implementing Environmentally Sustainable Kidney Care in LMICs: An Opinion Piece

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dc.contributor.authorDivya Bajpai
dc.contributor.authorWorkagegnehu Hailu
dc.contributor.authorPeace Bagasha
dc.contributor.authorOnu Ugochi Chika
dc.contributor.authorEhab Hafiz
dc.contributor.authorElliot Koranteng Tannor
dc.contributor.authorEranga Wijewickrama
dc.contributor.authorRobert Kalyesubula
dc.contributor.authorSabine Karam
dc.contributor.authorViviane Calice-Silva
dc.contributor.authorIsabelle Ethier
dc.contributor.authorShaifali Sandal
dc.date.accessioned2025-04-07T13:24:35Z
dc.date.available2025-04-07T13:24:35Z
dc.date.issued2024
dc.description.abstractKidney 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.
dc.identifier.citationBajpai, 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
dc.identifier.urihttps://doi.org/10.1177/20543581241246835
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/10397
dc.language.isoen
dc.publisherCanadian Journal of Kidney Health and Disease
dc.titleChallenges to Implementing Environmentally Sustainable Kidney Care in LMICs: An Opinion Piece
dc.typeArticle
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