Need for life cycle assessment of pharmaceuticals for kidney healthcare

Global warming is a known risk factor for chronic kidney disease (CKD), and both progression of the disease and its treatment place a burden on the environment. Life cycle assessment (LCA) is an established method for evaluating the global impact of manufactured products, from materials' procurement to disposal. We aimed to examine available reports of its application to pharmaceuticals.

A narrative review focused on LCA studies of any pharmaceuticals according to disease area.

We identified the drug types used for treatment of 13 disease areas described in 51 previous LCA studies, classified using the MIDAS database. Among the drug types, anesthetics, inhalants, and antibiotics have received the most attention. However, LCA studies are lacking for the wide range of pharmaceuticals used in kidney healthcare, in the fields of dialysis therapy, treatment of end-stage kidney disease, and associated cardiovascular, metabolic, and endocrine diseases.

As the proportion of the population affected by CKD increases, there is a particular urgency for LCA research into drugs administered for their kidney protective effects, such as renin--angiotensin system inhibitors and sodium-glucose cotransporter 2 inhibitors. As sustainable practices in drug production and the ability to identify and choose effective drugs with low environmental impact require comprehensive LCA data, clinical physicians and pharmacists involved in kidney healthcare should collaborate with pharmaceutical companies to develop an LCA research system . Incorporating rating of environmental burden of each drug into daily practice is desirable for achieving sustainable kidney healthcare and reducing its environmental impacts.