049 - Saving Lives, Sustaining the Planet: Advancing Environmental Practices in Pediatric Dialysis Units
Friday, April 25, 2025
5:30pm – 7:45pm HST
Publication Number: 49.6128
Leina Kingdom, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Catherine Giroux, McGill University Faculty of Medicine and Health Sciences, Westmount, PQ, Canada; Mallory L. Downie, McGill University Faculty of Medicine and Health Sciences, Montreal, PQ, Canada; Indra Gupta, Research Institute of the McGill University Health Centre, Montreal, PQ, Canada; Bethany J. Foster, McGill University Health Centre, Montreal, PQ, Canada; Marie-Michele Gaudreault-Tremblay, Montreal Children's Hospital, Montreal, PQ, Canada
Medical Student McGill University Faculty of Medicine and Health Sciences Montreal, Quebec, Canada
Background: The healthcare sector is a significant contributor to climate change, responsible for approximately 5% of Canada’s national carbon footprint. Among healthcare services, kidney care has a disproportionately high environmental impact due to the carbon-intensive nature of dialysis therapies, which require substantial water, energy, and single-use plastic consumption. Objective: This study aims to quantify the environmental footprint of a pediatric dialysis unit by measuring water and electricity consumption, waste generation, and transport use, and to implement strategies to reduce these environmental impacts using the Model for Improvement. Design/Methods: The mass (kg) of medical waste generated per dialysis session in the pediatric dialysis unit was tracked over two weeks, both before and after implementing a recycling protocol that separated recyclable materials from non-recyclable waste, allowing for accurate measurement of waste reduction attributable to recycling. Volume of water (L) and electricity consumption (kW) were estimated per dialysis session using data from the reverse osmosis system and the dialysis machine provider. Water consumption was compared before and after introducing dialysate flow reduction strategies including EcoFlow and Autoflow functions provided by the Fresenius 5008 dialysis machine. The dialysate flow was reduced from 500 ml/min using autoflow factors of 1.8, 1.5, and 1.2, meaning that dialysate flow was set at 1.8, 1.5, or 1.2 times the blood flow rate. To ensure dialysis adequacy, Kt/V was measured during the reduced dialysate flow period. Staff transportation habits were surveyed to assess the unit’s carbon footprint related to commuting. Results: The average pre-intervention waste was measured at 2.16 kg per dialysis session, with a significant fraction identified as recyclable. After implementing the recycling protocol in the dialysis unit, the average post-intervention waste was reduced to 1.45 kg per session, representing a 32.87% reduction in waste. Before introducing water reduction strategies, each dialysis session consumed an average of 2,280 L of water and 14.48 kW of electricity. Post-intervention water data collection is currently underway, with results pending. Additionally, 81% of the dialysis unit staff rely on public or active transportation.
Conclusion(s): Implementing waste reduction strategies in dialysis units mitigates environmental impact and demonstrates that simple, scalable interventions—such as recycling protocols—enhance sustainability in healthcare.
