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What is Green Nephrology?

Green Nephrology is a movement to improve the environmental sustainability of kidney care. We want to make sure that people with kidney disease will continue to receive high quality care into the future, while making the most careful use of finite environmental resources and reducing the carbon footprint.

Patient using a dialysis machine.

Why is this important to kidney patients and carers?

A healthy world is important to everyone - we all depend on having clean air, water, shelter and affordable healthy food. The health sector should be leading the way in protecting a healthy environment, but in fact the NHS is one of the biggest carbon polluters contributing to climate change.

Kidney patients (whether they are on dialysis, have a transplant or still retain some kidney function) may need a lot of care over the long term and we want to make sure that we make the best possible use of resources to provide that care.
Speaking at the Green Nephrology Summit in 2010, kidney patient, Andy Williamson, said :

“I was increasingly shocked at how dependent I was as a kidney patient on finite resources. If you are on dialysis you are using really high quality plastics, often once and then they are getting burned or thrown away or whatever. And although I am now lucky enough to have had a transplant, one day I might have to have dialysis again, one day my daughter may have to have kidney replacement therapy and it is really clear to me that we are in a world where this capital of fossil fuel resources is just being used up without really thinking about it”

Andy Williamson, kidney patient

How can Green Nephrology help to improve patient care?

Patients’ experience of care can be improved by reduced travel (e.g. tele-consultations, blood testing in local rather than regional laboratories, and home-based therapies), more personalised consultations and treatments and by freeing up resources to improve care quality.

Care can also be improved and resources saved by supporting patients in taking an active role in their own management, giving them a greater role in decisions, and responding more quickly when they raise concerns.
Finally, prevention of illness is important too. Green Nephrology has been supporting actions that lead to prevention and early detection of kidney disease.

Using the Patient View website patients can access their own blood results from home enabling some patients to take a greater part in managing their own condition.

What can kidney patients and carers do to make care more sustainable?

There are lots of things that patients and carers can do to help. Here are a few ideas for you to think about - we would encourage you to try those that seem most practical to you :

Save energy - switch off lights when no longer needed. Turn heating down before you open the windows (this is not always possible in hospital!).

Save water - use water carefully at home and avoid leaving the tap running. If you are on home haemodialysis, look out for opportunities to re-use waste water, e.g. in the garden.

Save medicines - drugs have a high carbon footprint but nationally, a significant proportion of drugs that are dispensed are not used. When ordering repeat prescriptions, try to include only the drugs you need and if you have concerns about taking any of your prescribed medications, discuss them with your doctor, don’t stockpile! Return out of date or unused medicines to the pharmacy for correct disposal.

Recycle packaging - paper and plastic packaging can be saved and recycled: at home and increasingly on kidney units too. For people on home dialysis, suppliers may be able to collect boxes and packaging for recycling when they deliver the next batch. Alternatively, many patients recommend the internet resource Freegle (www.ilovefreegle.org), to pass on cardboard boxes to people who will find them useful.

Save fuel - depending on your health and where you live, there may be opportunities to travel to appointments by public transport, walking or cycling.

Look after your health - keeping to your recommended diet, taking exercise and checking your blood pressure will help you to stay as healthy as possible. It is also important to understand your kidney condition, to know what to look out for and how to seek help promptly if you are worried.

Make use of PatientView - through the Patient View website you can access your own blood test results from home without waiting for your next appointment. Many patients find this helpful and are able to take a greater part in managing their condition. If Patient View is not available in your hospital, please ask if it can be provided.

Ask questions - many kidney units are already taking steps to improve sustainability, but there is much more to do. It is important that patients express concern about environmental issues.

Here are some questions that you may wish to put to the staff on your unit :

  • Does the unit have a Green Nephrology staff representative?
  • Are staff using the correct bins? (only hazardous/infectious waste should be going into orange bins for incineration)
  • Does the unit offer telephone appointments?
  • Has the unit investigated the possibilities for more efficient use of water

What can Kidney Patient Associations (KPAs) and Patient Groups, do to support Green Nephrology?

As an individual it could be daunting to raise green issues within your kidney unit - and that is where the KPAs can step in and make a difference. Don’t underestimate the influence that patients can have as a group.

Kidney Patient Associations can work with their members and their local kidney units to raise awareness of sustainability, develop new ideas and introduce changes.

First steps could include :

  • Invite the local Green Nephrology representative to a KPA meeting
  • Introduce Green Nephrology as a standing item at KPA meetings
  • Nominate a green representative to liaise with local kidney units on sustainability issues and act as a point of contact for KPA members with concerns or suggestions

Kidney patient Chris Stait (centre) presenting the Green Nephrology Award in 2012

What can NKF and other charities do to support Green Nephrology?

At a national level, patients and carers provide a powerful voice for sustainability in healthcare and have made an important contribution to Green Nephrology events, online discussions, podcasts and Awards.

Kidney charities can help to raise awareness at a national policy level with the Department of Health, The NHS and Members of Parliament. At the same time, they can also raise awareness among their members through their publications and conference programmes.

What are good examples of promoting sustainable care?

Chris Stait, a kidney patient, contacted the Green Nephrology network and was put in touch with the Green Nephrology representative at his local unit in Derby. The Green Nephrology representative was pleased to hear from him and together they raised the issues of recycling and later the use of Skype within the dialysis unit, which has since led to waste splitting into recyclables and infection waste in the dialysis unit and some remarkable remote support for home dialysis patients.

“The ward staff and those that influence change (ward sisters and consultants) are now more aware, know the possible savings and know that I will pop in to encourage progress. They are trying to do more green best practice and I am keen to join in!.”
Chris Stait, kidney patient.

Patient and Carer, Angela Beale and William Beale, collaborated with their local renal directorate on behalf of the Bristol Area Kidney Patient Association, to promote green action.

By engaging at the planning stages of a new dialysis unit, the group managed to have a system built that will save millions of litres of water each year which otherwise would be lost through the water purification process. In the refurbishment of another local dialysis unit, they campaigned successfully for the installation of bulk acid storage tanks thereby saving on waste and transport emissions resulting from provision of acid in individual cannisters.

Bulk acid storage tanks

Where can I get support for Green Nephrology?

The NKF run the Kidney Patient’s Helpline which is open between 9am-5pm Mon-Fri. By calling 0800 169 0936 patients, carers and Renal Units can receive help, advice and information on all renal related issues.
Copies of this leaflet and further information about Green Nephrology issues can be obtained by ringing the Helpline telephone number.

If you have questions or ideas, or would like to find out more, please Click here to visit the Green Nephrology Network , or contact Frances Mortimer at the Centre for Sustainable Healthcare, e-mail Telephone : 01865 515811.

This information is produced jointly by the Centre for Sustainable Healthcare (CSH), the National Kidney Federation (NKF) and members of the Green Nephrology Network :
Frances Mortimer, CSH Medical Director
Kirit Modi – NKF Chairman, kidney patient
John Stoves – Consultant Nephrologist, Bradford
Andy Connor - Consultant Nephrologist, Plymouth
William Beale – Carer representative
Angela Beale – Patient representative
Pauline Pinkos - NKF Helpline Manager
Leo Bailey – Renal Matron, Berkshire

The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.