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Perspectives on Water Utilization in Hemodialysis: Nephrologists' Responsibilities
Rahul Abraham1, David S Goldfarb2,3, David Goldfarb
1Division of Nephrology, NYU Langone Health and NYU Grossman School of Medicine, New York, New York, USA, rahul.abraham@nyulangone.org.
Blood Purification
|May 4, 2025
Summary
Hemodialysis uses significant water, creating waste. Implementing water-saving technologies and reusing reject water can improve sustainability in dialysis care.
Area of Science:
- Environmental Science
- Nephrology
- Water Resource Management
Background:
- Hemodialysis is a water-intensive medical procedure requiring substantial water volumes.
- Large amounts of reject water are generated and typically discarded during dialysis.
- The global water crisis necessitates understanding and improving water utilization in healthcare.
Purpose of the Study:
- To review strategies for enhancing water sustainability in hemodialysis.
- To identify methods for minimizing water consumption and maximizing reject water reuse.
- To highlight the environmental impact of hemodialysis and the need for sustainable practices.
Main Methods:
- Review of existing literature on water management in hemodialysis.
- Classification of sustainability solutions into water use reduction and reject water utilization.
- Examination of technological innovations and reuse applications for reject water.
Main Results:
- Reject water constitutes 50-70% of total water use in hemodialysis, representing significant resource waste.
- Technological advancements (e.g., NxStage PureFlow™SL, Aquaboss, AquaBPlus) can decrease water utilization.
- Reusing reverse osmosis (RO) reject water for purposes like irrigation and toilet flushing is feasible and cost-effective.
Conclusions:
- Hemodialysis significantly impacts the environment due to high water consumption and waste.
- Sustainable practices, including water reduction and reject water reuse, are crucial.
- Increased awareness, participation from healthcare professionals and manufacturers, and supportive government policies are essential for advancing water sustainability in dialysis.
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