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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Using Chronic Kidney Disease as a Model Framework to Estimate Healthcare-Related Environmental Impact
AU - Garcia Sanchez, Juan Jose
AU - Barraclough, Katherine A
AU - Cases, Aleix
AU - Pecoits-Filho, Roberto
AU - Germond-Duret, Celine
AU - Zoccali, Carmine
AU - Embleton, Nina
AU - Wright, Antony
AU - Hubbert, Luke
AU - Nicholson, Lindsay
AU - Barone, Salvatore
AU - Budgen, Nigel
AU - Cabrera, Claudia
AU - Selvarajah, Viknesh
AU - Eckelman, Matthew J
PY - 2025/1/31
Y1 - 2025/1/31
N2 - While the economic and clinical burden of chronic diseases are well documented, their environmental impact remains poorly understood. We developed a framework to estimate the environmental impact of a disease care pathway using chronic kidney disease (CKD) as an example. A life cycle assessment framework was developed for the CKD care pathway and validated by experts. Life cycle stages were characterised for resource utilisation based on a literature review and ecoinvent database inputs, in ten countries. The ReCiPe impact assessment method was used to calculate impacts across multiple environmental dimensions. At CKD stage 5, kidney replacement therapies (KRT) have highest impact; emissions ranged between 3.5 and 43.9 kg carbon dioxide equivalents (CO e) per session depending on dialysis modality, and 336-2022 kg CO e for kidney transplant surgery, depending on donor type. Hospitalisations have a substantial environmental impact: a 1-day intensive care stay had highest impact (66.4-143.6 kg CO e), followed by a 1-day hospital stay (28.8-63.9 kg CO e) and an 8-h emergency room visit (14.4-27.5 kg CO e). Patient transport to and from healthcare sites was a key driver of environmental impact for all life cycle stages, representing up to 99.5% of total CO e emissions. Full care pathways should be analysed alongside specific healthcare processes. Application of this framework enables quantification of the environmental benefits of preventative medicine and effective management of chronic diseases. For CKD, early diagnosis, and proactive management to reduce the need for KRT and hospitalisations could improve patient outcomes and reduce environmental burden. [Abstract copyright: © 2024. The Author(s).]
AB - While the economic and clinical burden of chronic diseases are well documented, their environmental impact remains poorly understood. We developed a framework to estimate the environmental impact of a disease care pathway using chronic kidney disease (CKD) as an example. A life cycle assessment framework was developed for the CKD care pathway and validated by experts. Life cycle stages were characterised for resource utilisation based on a literature review and ecoinvent database inputs, in ten countries. The ReCiPe impact assessment method was used to calculate impacts across multiple environmental dimensions. At CKD stage 5, kidney replacement therapies (KRT) have highest impact; emissions ranged between 3.5 and 43.9 kg carbon dioxide equivalents (CO e) per session depending on dialysis modality, and 336-2022 kg CO e for kidney transplant surgery, depending on donor type. Hospitalisations have a substantial environmental impact: a 1-day intensive care stay had highest impact (66.4-143.6 kg CO e), followed by a 1-day hospital stay (28.8-63.9 kg CO e) and an 8-h emergency room visit (14.4-27.5 kg CO e). Patient transport to and from healthcare sites was a key driver of environmental impact for all life cycle stages, representing up to 99.5% of total CO e emissions. Full care pathways should be analysed alongside specific healthcare processes. Application of this framework enables quantification of the environmental benefits of preventative medicine and effective management of chronic diseases. For CKD, early diagnosis, and proactive management to reduce the need for KRT and hospitalisations could improve patient outcomes and reduce environmental burden. [Abstract copyright: © 2024. The Author(s).]
KW - Environmental impact
KW - Chronic kidney disease
KW - Greenhouse gas emissions
KW - Healthcare
KW - Care pathways
KW - Carbon emissions
U2 - 10.1007/s12325-024-03039-w
DO - 10.1007/s12325-024-03039-w
M3 - Journal article
C2 - 39541083
VL - 42
SP - 348
EP - 361
JO - Advances in Therapy
JF - Advances in Therapy
SN - 0741-238X
IS - 1
ER -