Ten tips to preserve and reuse water in nephrology

Water scarcity is an escalating global challenge with growing relevance for healthcare systems. Nephrology is particularly affected, as dialysis is a life-sustaining yet highly water-intensive therapy. Climate change, droughts, and infrastructure vulnerabilities increasingly threaten reliable water access, exposing the fragility of water-dependent kidney replacement therapies.

We reviewed the available evidence and practical experience on water use in nephrology and dialysis care, with a focus on feasible strategies to reduce water consumption without compromising patient safety or quality of care.

We identify key domains of water use in dialysis and nephrology practice and present 10 practical, evidence-informed tips to reduce water consumption. These measures span system-level approaches, technological considerations, staff and patient engagement, behavioral change and are applicable across diverse resource settings.

Integrating water stewardship into routine nephrology practice is essential to enhance the long-term resilience of dialysis services. Proactive water conservation represents a clinically relevant, ethical, and achievable component of sustainable kidney care.