Environmental impacts of a Mexican hemodialysis unit through LCA

Abstract

Hemodialysis, the most common treatment for chronic kidney disease, generates a series of impacts on the environment, particularly on water and greenhouse gas emissions. The effects on the environment from hemodialysis treatment in Mexico have not been quantified. In the world, the studies carried out to date measure the environmental impacts based on CO2eq, so they do not reveal other types of effects generated by this type of treatment. The objective of this study is to estimate the environmental impact of hemodialysis in 17 impact categories using life cycle assessment (LCA). The phases of this study were carried out following the guidelines of ISO 14040–14044, considering as a functional unit the replacement of renal function, artificially employing a hemodialysis machine in a patient for one year. The unitary processes of the system with the highest environmental loads were the patients and staff transportation and hemodialysis. The contribution analysis yielded 17 significant variables greater than 5% of the impact. The carbon footprint of artificial kidney care, by stage of the life cycle, is distributed as follows: transport (36%), kidney service (36%), and end of life (28%). The LCA approach allowed the inclusion of other environmental effects of health services to understand the impacts better. Renal assistance was also shown to represent a considerable environmental impact on water scarcity and contamination beyond global warming.