{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:19:55Z","timestamp":1792783195729,"version":"4.5.0"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bond University Limited","id":[{"id":"https:\/\/ror.org\/006jxzx88","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urol Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Haemodialysis is a life-sustaining but resource-intensive therapy with a substantial water footprint, estimated globally at 270 billion litres annually and approximately 78,000 L per patient. Green dialysis strategies increasingly focus on reducing dialysate-related water demand and recovering reverse osmosis RW; however, evidence remains dispersed across clinical studies, service reports and feasibility analyses. This scoping review mapped and synthesised literature on water conservation and reuse strategies in haemodialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered with the Open Science Framework. PubMed, EMBASE, Web of Science, Scopus and CINAHL were systematically searched. Extracted data included study design, setting, participants or dialysis service characteristics, water use measures, reported water savings, safety, and environmental or operational outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      14 studies were included: nine dialysate flow modification studies and five RW reuse studies. Reported water savings ranged from 24 L\/haemodialysis session to 162.3 L\/treatment. Reducing dialysate flow from 500 to 300\u00a0mL\/min saved approximately 48 L\/session without major short-term compromise in dialysis adequacy. Reusable volumes ranged from &gt;250 L\/session to 1.1 million m\n                      <jats:sup>3<\/jats:sup>\n                      \/year nationally. Facility-level reuse ranged from approximately 1.2\u20134.5 million L\/year per centre, with applications including sanitation, autoclave steam generation, horticulture, aquaponics and agricultural irrigation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Water conservation in haemodialysis appears feasible through reduced dialysate flow and reject water reuse, although the magnitude of gross mains water savings depends on reverse osmosis system efficiency and local infrastructure. Evidence is primarily single centre and heterogeneous; further standardised reporting and long-term clinical, operational, environmental and implementation studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11255-026-05378-9","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T08:51:38Z","timestamp":1789721498000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Water conservation and circular water reuse in clinical haemodialysis facilities: a scoping review"],"prefix":"10.1007","author":[{"given":"Arnie","family":"Sen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiren","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0974-524X","authenticated-orcid":false,"given":"Matthew","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelam","family":"Maheshwari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Goldsworthy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"McLean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loai","family":"Albarqouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Titus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"issue":"1","key":"5378_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/membranes12010045","volume":"12","author":"A Abarkan","year":"2022","unstructured":"Abarkan A, Grimi N, M\u00e9tayer H, Sqalli Houssa\u00efni T, Legallais C (2022) Electrodialysis can lower the environmental impact of hemodialysis. Membranes (Basel) 12(1):45. https:\/\/doi.org\/10.3390\/membranes12010045","journal-title":"Membranes (Basel)"},{"issue":"4","key":"5378_CR2","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1111\/j.1440-1797.2009.01255.x","volume":"15","author":"JWM Agar","year":"2010","unstructured":"Agar JWM (2010) Conserving water in and applying solar power to haemodialysis: \u201cgreen dialysis\u201d through wiser resource utilization. Nephrology (Carlton) 15(4):448\u2013453. https:\/\/doi.org\/10.1111\/j.1440-1797.2009.01255.x","journal-title":"Nephrology (Carlton)"},{"issue":"1","key":"5378_CR3","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/j.1542-4758.2009.00332.x","volume":"13","author":"JWM Agar","year":"2009","unstructured":"Agar JWM, Simmonds RE, Knight R, Somerville CA (2009) Using water wisely: new, affordable, and essential water conservation practices for facility and home hemodialysis. Hemodial Int 13(1):32\u201337. https:\/\/doi.org\/10.1111\/j.1542-4758.2009.00332.x","journal-title":"Hemodial Int"},{"issue":"6","key":"5378_CR4","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.55730\/1300-0144.5756","volume":"53","author":"A Akta\u015f","year":"2023","unstructured":"Akta\u015f A, \u00d6zer H, Balo\u011flu \u0130, Tonbul HZ, G\u00fcney \u0130, Sel\u00e7uk NY (2023) Individualized hemodialysis: is similar hemodialysis adequacy possible using less water? Turk J Med Sci 53(6):1863\u20131869. https:\/\/doi.org\/10.55730\/1300-0144.5756","journal-title":"Turk J Med Sci"},{"issue":"2","key":"5378_CR5","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1111\/j.1744-9987.2011.01040.x","volume":"16","author":"A Alayoud","year":"2012","unstructured":"Alayoud A, Benyahia M, Montassir D et al (2012) A model to predict optimal dialysate flow. Ther Apher Dial 16(2):152\u2013158. https:\/\/doi.org\/10.1111\/j.1744-9987.2011.01040.x","journal-title":"Ther Apher Dial"},{"key":"5378_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-015-0013-9","volume":"16","author":"M Albalate","year":"2015","unstructured":"Albalate M, P\u00e9rez-Garc\u00eda R, de Sequera P et al (2015) Is it useful to increase dialysate flow rate to improve the delivered Kt? BMC Nephrol 16:20. https:\/\/doi.org\/10.1186\/s12882-015-0013-9","journal-title":"BMC Nephrol"},{"issue":"1","key":"5378_CR7","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1111\/nep.13191","volume":"24","author":"KA Barraclough","year":"2019","unstructured":"Barraclough KA, Gleeson A, Holt SG, Agar JWM (2019) Green dialysis survey: establishing a baseline for environmental sustainability across dialysis facilities in Victoria, Australia. Nephrology (Carlton) 24(1):88\u201393. https:\/\/doi.org\/10.1111\/nep.13191","journal-title":"Nephrology (Carlton)"},{"issue":"5","key":"5378_CR8","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1016\/j.ekir.2024.02.010","volume":"9","author":"KA Barraclough","year":"2024","unstructured":"Barraclough KA, Moller S, Blair S, Knight R, Agar JW, McAlister S, White A, Sypek M (2024) Updating the data: the resource consumption of modern-day hemodialysis systems. Kidney Int Rep 9(5):1521\u20131524. https:\/\/doi.org\/10.1016\/j.ekir.2024.02.010","journal-title":"Kidney Int Rep"},{"issue":"1","key":"5378_CR9","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.kint.2023.04.008","volume":"104","author":"M Ben Hmida","year":"2023","unstructured":"Ben Hmida M, Mechichi T, Piccoli GB, Ksibi M (2023) Water implications in dialysis therapy, threats and opportunities to reduce water consumption: a call for the planet. Kidney Int 104(1):46\u201352. https:\/\/doi.org\/10.1016\/j.kint.2023.04.008","journal-title":"Kidney Int"},{"issue":"4","key":"5378_CR10","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1177\/039139889201500406","volume":"15","author":"JC Brice\u00f1o","year":"1992","unstructured":"Brice\u00f1o JC, Runge TM (1992) Tubing spallation in extracorporeal circuits: an in vitro study using an electronic particle counter. Int J Artif Organs 15(4):222\u2013228. https:\/\/doi.org\/10.1177\/039139889201500406","journal-title":"Int J Artif Organs"},{"issue":"1","key":"5378_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-37","volume":"7","author":"J Cane","year":"2012","unstructured":"Cane J, O\u2019Connor D, Michie S (2012) Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci 7(1):37. https:\/\/doi.org\/10.1186\/1748-5908-7-37","journal-title":"Implement Sci"},{"issue":"1","key":"5378_CR12","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1007\/s40620-020-00903-0","volume":"34","author":"E Chang","year":"2021","unstructured":"Chang E, Lim JA, Low CL, Kassim A (2021) Reuse of dialysis reverse osmosis RW for aquaponics and horticulture. J Nephrol 34(1):97\u2013104. https:\/\/doi.org\/10.1007\/s40620-020-00903-0","journal-title":"J Nephrol"},{"issue":"2","key":"5378_CR13","doi-asserted-by":"publisher","first-page":"195","DOI":"10.5195\/jmla.2020.834","volume":"108","author":"JM Clark","year":"2020","unstructured":"Clark JM, Sanders S, Carter M et al (2020) Improving the translation of search strategies using the Polyglot Search Translator: a randomized controlled trial. J Med Libr Assoc 108(2):195\u2013207. https:\/\/doi.org\/10.5195\/jmla.2020.834","journal-title":"J Med Libr Assoc"},{"issue":"2","key":"5378_CR14","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/j.1755-6686.2010.00153.x","volume":"36","author":"A Connor","year":"2010","unstructured":"Connor A, Milne S, Owen A, Boyle G, Mortimer F, Stevens P (2010) Toward greener dialysis: a case study to illustrate and encourage the salvage of RW. J Ren Care 36(2):68\u201372. https:\/\/doi.org\/10.1111\/j.1755-6686.2010.00153.x","journal-title":"J Ren Care"},{"issue":"2","key":"5378_CR15","doi-asserted-by":"publisher","first-page":"97","DOI":"10.5414\/CN111466","volume":"104","author":"G Coritsidis","year":"2025","unstructured":"Coritsidis G, Woda C, Papademetriou D, Aragon M, Lim B, Singh A (2025) Effect of lower dialysate flow rates on quality of life and metabolic parameters in hemodialysis. Clin Nephrol 104(2):97\u2013107. https:\/\/doi.org\/10.5414\/CN111466","journal-title":"Clin Nephrol"},{"issue":"6","key":"5378_CR16","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1111\/1744-9987.70072","volume":"29","author":"V David","year":"2025","unstructured":"David V, Au B, Meyer TM, Lehmann K, Kielstein JT (2025) Smart, individualized green hemodiafiltration: effects of individualized dialysate flow through AutoFlow on dialysate consumption and parameters of dialysis adequacy in the setting of online hemodiafiltration. Ther Apher Dial 29(6):885\u2013889. https:\/\/doi.org\/10.1111\/1744-9987.70072","journal-title":"Ther Apher Dial"},{"key":"5378_CR17","unstructured":"Department of Environment and Conservation. Environmental Guidelines: Use of Effluent by Irrigation. Published 2004."},{"issue":"5","key":"5378_CR18","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1007\/s11255-021-02981-w","volume":"54","author":"A Gauly","year":"2022","unstructured":"Gauly A, Fleck N, Kircelli F (2022) Advanced hemodialysis equipment for more eco-friendly dialysis. Int Urol Nephrol 54(5):1059\u20131065. https:\/\/doi.org\/10.1007\/s11255-021-02981-w","journal-title":"Int Urol Nephrol"},{"issue":"5","key":"5378_CR19","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1038\/s41370-025-00766-2","volume":"35","author":"A Goldsworthy","year":"2025","unstructured":"Goldsworthy A, O\u2019Callaghan LA, Blum C et al (2025) Micro-nanoplastic induced cardiovascular disease and dysfunction: a scoping review. J Expo Sci Environ Epidemiol 35(5):746\u2013769. https:\/\/doi.org\/10.1038\/s41370-025-00766-2","journal-title":"J Expo Sci Environ Epidemiol"},{"issue":"4","key":"5378_CR20","doi-asserted-by":"publisher","DOI":"10.3390\/microplastics4040079","volume":"4","author":"A Goldsworthy","year":"2025","unstructured":"Goldsworthy A, O\u2019Callaghan LA, Tronstad O, Suen J, Chen H, Rauert C, Blum CB, Tajouri L, Olsen M, Thomas KV et al (2025) Micro- and nanoplastic-induced respiratory disease and dysfunction: a scoping review. Microplastics 4(4):79. https:\/\/doi.org\/10.3390\/microplastics4040079","journal-title":"Microplastics"},{"issue":"6","key":"5378_CR21","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivaf080","volume":"40","author":"JL Green","year":"2025","unstructured":"Green JL, Field DT, Bennett R et al (2025) Microplastics in cardiopulmonary bypass: quantification and characterization of particles across systems. Interact Cardiovasc Thorac Surg 40(6):ivaf080. https:\/\/doi.org\/10.1093\/icvts\/ivaf080","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"1","key":"5378_CR22","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-025-04508-2","volume":"26","author":"SSA Khamis","year":"2025","unstructured":"Khamis SSA, Tawfeek AR, Ragab MF, Kamal Abd Elkhalk H (2025) Effects of using auto flow factor function on hemodialysis efficacy in regular hemodialysis patients. BMC Nephrol 26(1):594. https:\/\/doi.org\/10.1186\/s12882-025-04508-2","journal-title":"BMC Nephrol"},{"issue":"4","key":"5378_CR23","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1111\/sdi.12785","volume":"32","author":"DL Kirkman","year":"2019","unstructured":"Kirkman DL, Scott M, Kidd J, Macdonald JH (2019) The effects of intradialytic exercise on hemodialysis adequacy: a systematic review. Semin Dial 32(4):368\u2013378. https:\/\/doi.org\/10.1111\/sdi.12785","journal-title":"Semin Dial"},{"issue":"1","key":"5378_CR24","doi-asserted-by":"publisher","first-page":"159","DOI":"10.2307\/2529310","volume":"33","author":"JR Landis","year":"1977","unstructured":"Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159\u2013174. https:\/\/doi.org\/10.2307\/2529310","journal-title":"Biometrics"},{"key":"5378_CR25","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-6-42","volume":"6","author":"S Michie","year":"2011","unstructured":"Michie S, van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 6:42. https:\/\/doi.org\/10.1186\/1748-5908-6-42","journal-title":"Implement Sci"},{"issue":"11","key":"5378_CR26","doi-asserted-by":"publisher","first-page":"635","DOI":"10.5301\/ijao.5000660","volume":"40","author":"A Molano-Trivi\u00f1o","year":"2017","unstructured":"Molano-Trivi\u00f1o A, Wancjer B, Neri MM, Karopadi AN, Rosner M, Ronco C (2017) Blue planet dialysis: novel water-sparing strategies for reducing dialysate flow. Int J Artif Organs 40(11):635\u2013642. https:\/\/doi.org\/10.5301\/ijao.5000660","journal-title":"Int J Artif Organs"},{"key":"5378_CR27","unstructured":"Natural Resource Management Ministerial Council, Environment Protection and Heritage Council, Australian Health Ministers\u2019 Conference. Australian Guidelines for Water Recycling: Managing Health and Environmental Risks (Phase 1). Published 2006."},{"issue":"5","key":"5378_CR28","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1038\/s41370-024-00709-3","volume":"35","author":"L O\u2019Callaghan","year":"2025","unstructured":"O\u2019Callaghan L, Olsen M, Tajouri L et al (2025) Plastic induced urinary tract disease and dysfunction: a scoping review. J Expo Sci Environ Epidemiol 35(5):770\u2013784. https:\/\/doi.org\/10.1038\/s41370-024-00709-3","journal-title":"J Expo Sci Environ Epidemiol"},{"key":"5378_CR29","unstructured":"Osseiran N, Lufadeju Y. (2026) 1 in 3 people globally do not have access to safe drinking water\u2014UNICEF, WHO. World Health Organization news release. June 18, 2019https:\/\/www.who.int\/news\/item\/18-06-2019-1-in-3-people-globally-do-not-have-access-to-safe-drinking-water-unicef-who. Accessed March 7."},{"key":"5378_CR30","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2020","unstructured":"Page MJ, McKenzie JE, Bossuyt PM et al (2020) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"BMJ"},{"issue":"5","key":"5378_CR31","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1177\/03913988251337228","volume":"48","author":"A Parikh","year":"2025","unstructured":"Parikh A, Drake K, Woda C, D\u2019Alessandri-Silva C, Aragon M (2025) Utility of a water-sparing approach for reducing dialysate flow rates in hospitalized patients with kidney failure. Int J Artif Organs 48(5):356\u2013361. https:\/\/doi.org\/10.1177\/03913988251337228","journal-title":"Int J Artif Organs"},{"issue":"6","key":"5378_CR32","doi-asserted-by":"publisher","first-page":"889","DOI":"10.2215\/CJN.0000000731","volume":"20","author":"GB Piccoli","year":"2025","unstructured":"Piccoli GB, Murea M, Ben Hmida M et al (2025) Green, sustainable nephrology: state of the art needs for education and implementation. Clin J Am Soc Nephrol 20(6):889\u2013901. https:\/\/doi.org\/10.2215\/CJN.0000000731","journal-title":"Clin J Am Soc Nephrol"},{"issue":"1","key":"5378_CR33","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1111\/hdi.12117","volume":"18","author":"L Ponson","year":"2014","unstructured":"Ponson L, Arkouche W, Laville M (2014) Toward green dialysis: focus on water savings. Hemodial Int 18(1):7\u201314. https:\/\/doi.org\/10.1111\/hdi.12117","journal-title":"Hemodial Int"},{"issue":"8","key":"5378_CR34","doi-asserted-by":"publisher","first-page":"e1378","DOI":"10.1016\/S2214-109X(25)00198-6","volume":"13","author":"Q Rafferty","year":"1990","unstructured":"Rafferty Q, Stafford LK, Vos T et al (1990) Global, regional, and national prevalence of kidney failure with replacement therapy and associated aetiologies, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Glob Health 13(8):e1378\u2013e1395. https:\/\/doi.org\/10.1016\/S2214-109X(25)00198-6","journal-title":"Lancet Glob Health"},{"issue":"2","key":"5378_CR35","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1159\/000548892","volume":"55","author":"C Ramos","year":"2026","unstructured":"Ramos C, Guti\u00e9rrez JF, Sanabria RM et al (2026) Toward green dialysis: efficacy and sustainability with reduced dialysate flow in expanded hemodialysis. Blood Purif 55(2):148\u2013155. https:\/\/doi.org\/10.1159\/000548892","journal-title":"Blood Purif"},{"key":"5378_CR36","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(26)00647-1","author":"J Rockl\u00f6v","year":"2026","unstructured":"Rockl\u00f6v J, Dunlop S, Chiles TC, Fuller L, Geyer R, Johnson MM, Karasik R, Muncke J, Raps H, Rauert C, Rhodes MG, Spring M, Stegeman J, Symeonides C, Thomas KV, Treskova M, Velis CA, Wagner M, Landrigan PJ (2026) Plastics, plastic chemicals, and microplastics: multiple harms to health. Lancet. https:\/\/doi.org\/10.1016\/S0140-6736(26)00647-1","journal-title":"Lancet"},{"issue":"5","key":"5378_CR37","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1016\/j.ekir.2023.02.1074","volume":"8","author":"K Rossum","year":"2023","unstructured":"Rossum K, Hancock E, Thompson S et al (2023) A randomized trial examining the impact of timing of intradialytic cycling on intradialytic hypotension. Kidney Int Rep 8(5):1002\u20131012. https:\/\/doi.org\/10.1016\/j.ekir.2023.02.1074","journal-title":"Kidney Int Rep"},{"issue":"8","key":"5378_CR38","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae238","volume":"17","author":"A Rydzewska-Roso\u0142owska","year":"2024","unstructured":"Rydzewska-Roso\u0142owska A, G\u0142owi\u0144ska I, Kakareko K, Pietruczuk A, Hryszko T (2024) How low can we go with the dialysate flow? A retrospective study on the safety and adequacy of a water-saving dialysis prescription. Clin Kidney J 17(8):sfae238. https:\/\/doi.org\/10.1093\/ckj\/sfae238","journal-title":"Clin Kidney J"},{"key":"5378_CR39","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2021.104737","volume":"123","author":"J Saunier","year":"2021","unstructured":"Saunier J, Yagoubi N (2021) Investigating the static or dynamic flexural and compressive stresses on flexible tubing: comparison of clamp and peristaltic pump impact on surface damages and particles leaching during infusion acts. J Mech Behav Biomed Mater 123:104737. https:\/\/doi.org\/10.1016\/j.jmbbm.2021.104737","journal-title":"J Mech Behav Biomed Mater"},{"issue":"suppl 1","key":"5378_CR40","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/nep.14362","volume":"29","author":"A Sen","year":"2024","unstructured":"Sen A, Bhatia K, Albarqouni L, Maheshwari N, McLean M, Titus T (2024) Current water conservation methods in clinical haemodialysis: a scoping review. Nephrology 29(suppl 1):65\u2013124. https:\/\/doi.org\/10.1111\/nep.14362","journal-title":"Nephrology"},{"issue":"5","key":"5378_CR41","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.1021\/acsestwater.5c01404","volume":"6","author":"K Shi","year":"2026","unstructured":"Shi K, Okoffo ED, Jiang J, Rauert C, Thomas KV (2026) Detection and quantification of nanoplastics and microplastics in Australian drinking water. ACS EST Water 6(5):2883\u20132893. https:\/\/doi.org\/10.1021\/acsestwater.5c01404","journal-title":"ACS EST Water"},{"issue":"5","key":"5378_CR42","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1016\/j.ekir.2024.02.014","volume":"9","author":"D Solomon","year":"2024","unstructured":"Solomon D, Arumugam V, Sakthirajan R et al (2024) A pilot study on the safety and adequacy of a novel ecofriendly hemodialysis prescription-green nephrology. Kidney Int Rep 9(5):1496\u20131503. https:\/\/doi.org\/10.1016\/j.ekir.2024.02.014","journal-title":"Kidney Int Rep"},{"key":"5378_CR43","unstructured":"Steinbach I (2025) Modelling of greenhouse gas emissions and cost impacts of sustainability interventions in kidney care. Centre for Sustainable Healthcare"},{"issue":"5","key":"5378_CR44","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1007\/s40620-025-02295-5","volume":"38","author":"F Tarrass","year":"2025","unstructured":"Tarrass F, Benjelloun M, Razkaoui A et al (2025) Sustainable reuse of hemodialysis RW for potato farming: a large-scale feasibility study in Morocco. J Nephrol 38(5):1279\u20131286. https:\/\/doi.org\/10.1007\/s40620-025-02295-5","journal-title":"J Nephrol"},{"issue":"3","key":"5378_CR45","doi-asserted-by":"publisher","first-page":"147","DOI":"10.32932\/pjnh.2023.08.254","volume":"37","author":"F Tarrass","year":"2023","unstructured":"Tarrass F, Benjelloun M (2023) Valorization of hemodialysis wastewater: an emerging reality. Portuguese J Nephrol Hypertens 37(3):147\u2013149. https:\/\/doi.org\/10.32932\/pjnh.2023.08.254","journal-title":"Portuguese J Nephrol Hypertens"},{"issue":"6","key":"5378_CR46","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1016\/j.nefro.2020.12.012","volume":"41","author":"F Tarrass","year":"2021","unstructured":"Tarrass F, Benjelloun O, Benjelloun M (2021) Towards zero liquid discharge in hemodialysis: possible issues. Nefrologia (Madr) 41(6):620\u2013624. https:\/\/doi.org\/10.1016\/j.nefro.2020.12.012","journal-title":"Nefrologia (Madr)"},{"key":"5378_CR47","unstructured":"United Nations Children\u2019s Fund (2026) Water scarcity: addressing the growing lack of available water to meet children\u2019s needs. Published 2026. https:\/\/www.unicef.org\/wash\/water-scarcity. Accessed Mar 7, 2026"},{"key":"5378_CR48","doi-asserted-by":"publisher","DOI":"10.18356\/9789211071597","volume-title":"The sustainable development goals report 2025","author":"United Nations Department of Economic and Social Affairs","year":"2025","unstructured":"United Nations Department of Economic and Social Affairs (2025) The sustainable development goals report 2025. United Nations"},{"key":"5378_CR49","unstructured":"United Nations. Goal 6: ensure availability and sustainable management of water and sanitation for all. Published 2018. https:\/\/sdgs.un.org\/goals\/goal6. Accessed Mar 7, 2026."},{"key":"5378_CR50","unstructured":"United Nations Water. Water and climate change. Published 2026. https:\/\/www.unwater.org\/water-facts\/water-and-climate-change. Accessed Mar 7, 2026"},{"key":"5378_CR51","unstructured":"United Nations Water. Water scarcity. Published 2026. https:\/\/www.unwater.org\/water-facts\/water-scarcity. Accessed Mar 7, 2026"},{"issue":"3","key":"5378_CR52","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1007\/s11255-020-02393-2","volume":"52","author":"M Wieliczko","year":"2020","unstructured":"Wieliczko M, Zawierucha J, Covic A, Prystacki T, Marcinkowski W, Ma\u0142yszko J (2020) Eco-dialysis: fashion or necessity. Int Urol Nephrol 52(3):519\u2013523. https:\/\/doi.org\/10.1007\/s11255-020-02393-2","journal-title":"Int Urol Nephrol"},{"key":"5378_CR53","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1038\/d41586-025-00702-2","volume":"639","author":"JL Xu","year":"2025","unstructured":"Xu JL, Wright S, Rauert C, Thomas KV (2025) Are microplastics bad for your health? More rigorous science is needed. Nature 639:300\u2013302. https:\/\/doi.org\/10.1038\/d41586-025-00702-2","journal-title":"Nature"},{"key":"5378_CR54","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-025-04904-5","author":"A Yasar","year":"2025","unstructured":"Yasar A, Larkin J, Steinbach I et al (2025) Advancing green nephrology: a scoping review of sustainability interventions in kidney care. Int Urol Nephrol. https:\/\/doi.org\/10.1007\/s11255-025-04904-5","journal-title":"Int Urol Nephrol"},{"issue":"13","key":"5378_CR55","doi-asserted-by":"publisher","first-page":"6259","DOI":"10.1007\/s11356-026-37686-z","volume":"33","author":"S Ziajahromi","year":"2026","unstructured":"Ziajahromi S, Pratt C, Slynkova N, Leusch FDL (2026) Microplastic uptake and impacts on crops under realistic exposure: implications for soil-plant systems. Environ Sci Pollut Res 33(13):6259\u20136273. https:\/\/doi.org\/10.1007\/s11356-026-37686-z","journal-title":"Environ Sci Pollut Res"}],"container-title":["International Urology and Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11255-026-05378-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11255-026-05378-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11255-026-05378-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T09:19:33Z","timestamp":1791364773000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11255-026-05378-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":55,"alternative-id":["5378"],"URL":"https:\/\/doi.org\/10.1007\/s11255-026-05378-9","relation":{},"ISSN":["1573-2584"],"issn-type":[{"value":"1573-2584","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]},"assertion":[{"value":"30 July 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Generative artificial intelligence tools were used in a limited capacity to support the visual design and editing of selected figures and infographics. All scientific content, data, labels, and interpretations were provided, checked, and approved by the authors, who retain full responsibility for the accuracy and integrity of the final manuscript and figures.","order":2,"name":"Ethics","label":"Artificial intelligence statement","group":{"name":"EthicsHeading","label":"Declarations"}}]}}