{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:00:16Z","timestamp":1787238016155,"version":"build-2736575974"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>the environmental impact of healthcare is a growing concern, and nephrology, particularly dialysis, is a resource-intensive field. Dialysis involves high energy use, water consumption, significant waste generation, and transport-associated emissions. However, the extent to which \u201cgreen\u201d dialysis practices have been implemented remains largely unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive survey assessing the adoption of sustainable practices in dialysis covering water, energy, waste, transport and procurement policies was distributed through the European Rare Kidney Disease Reference Network (November 2024 to January 2025). The questionnaire covered key sustainability domains, including water and energy management, waste reduction, transport, and procurement policies. A \u201cGreen Score\u201d was developed to quantify the implementation of eco-friendly initiatives. Additionally, a patient survey was conducted to evaluate perceptions of dialysis-related environmental impact and willingness to act.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 34 nephrology centers (43% response rate) participated. The mean Green Score indicated that only 39.4% of achievable sustainability measures were in place. Despite widespread awareness, only 26.5% of centers had formal sustainability strategies, 17.6% had dedicated \u201cGreen Teams,\u201d and just 12.1% utilized measurable indicators to track interventions. Water reuse systems were absent. Plastic recycling programs were present in 79.4% of centers, yet waste-saving initiatives were rare. Notably, the presence of a Green Team was significantly associated with higher Green Scores (P\u00a0&amp;lt;\u00a0.05). Patient responses (n\u00a0=\u00a045) revealed strong interest in sustainability, with 95.6% willing to take action.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights critical gaps in sustainable dialysis practices across European nephrology centers. Despite interest, implementation remains limited. The strong association between Green Teams and sustainability scores highlights the need for formalized institutional efforts. Given the significant ecological footprint of dialysis, urgent action is required to integrate sustainable strategies into routine nephrology care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf276","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T11:49:50Z","timestamp":1758196190000},"source":"Crossref","is-referenced-by-count":5,"title":["Green teams drive sustainability: a European Rare Kidney Disease Reference Network Survey on dialysis environmental practices"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0760-5737","authenticated-orcid":false,"given":"Emanuele","family":"De Simone","sequence":"first","affiliation":[{"name":"University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley , ASL Citt\u00e0 di Torino, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Carmelo","family":"Morrone","sequence":"additional","affiliation":[{"name":"University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley , ASL Citt\u00e0 di Torino, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ece Izel","family":"Tatarhan","sequence":"additional","affiliation":[{"name":"University of Turin . Department of Clinical and Biological Sciences, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Pozzato","sequence":"additional","affiliation":[{"name":"University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley , ASL Citt\u00e0 di Torino, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Roccatello","sequence":"additional","affiliation":[{"name":"University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases (ERK-Net Member) with Nephrology and Dialysis Unit and Center of Immuno-Rheumatology and Rare Diseases (CMID), Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley , ASL Citt\u00e0 di Torino, Turin ,","place":["Italy"]},{"name":"University of Turin . 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