Microplastics and dialysis: a new challenge for green nephrology

Green nephrology has emerged as a pivotal strategy to mitigate the environmental impacts of kidney care. Within this framework, reducing plastic waste and lowering the carbon footprint are closely interconnected, as both aim to minimize unnecessary resource consumption and the environmental burden associated with healthcare delivery. The rapid growth of plastic production and use has led to widespread environmental pollution and the generation of enormous quantities of micro- and nanoplastics (MNPs) through plastic degradation. Increasing evidence suggests that exposure to MNPs may pose potential risks to human health. However, important questions remain unanswered regarding chronic kidney disease (CKD), dialysis therapies, and exposure to MNPs. In particular, the magnitude of exposure, the potential for accumulation in patients with impaired renal function, and the possible clinical consequences remain largely unknown. In this opinion paper, we discuss the emerging challenges and potential opportunities at the intersection of microplastics, dialysis, and green nephrology.