{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T09:23:39Z","timestamp":1787390619905,"version":"build-2736575974"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Sustainable nephrology should be recognized not only as an environmental priority but also as an economic and clinical imperative. Kidney care, particularly dialysis, is among the most resource-intensive areas of healthcare, generating substantial costs and environmental impacts through high consumption of water, energy, plastics, and pharmaceuticals. Increasing evidence suggests that strategies such as chronic kidney disease prevention, risk-based follow-up, conservative kidney management, incremental dialysis, lean dialysis practices, circular resource management, and telenephrology can simultaneously reduce resource use, greenhouse gas emissions, and healthcare expenditure while maintaining or improving patient outcomes. Real-world experiences further demonstrate that sustainability initiatives can deliver substantial carbon reductions alongside significant financial savings. However, achieving these benefits requires systematic measurement of environmental performance, life-cycle assessment of technologies, and reimbursement models that reward value, prevention, and resource efficiency rather than healthcare volume. Sustainable nephrology therefore represents an opportunity to align environmental stewardship with economic sustainability and high-quality patient care. Integrating sustainability into kidney care is not simply an ecological responsibility but a practical strategy to improve the long-term resilience, efficiency, and value of health systems.<\/jats:p>","DOI":"10.1093\/ckj\/sfag259","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:10:21Z","timestamp":1786101021000},"source":"Crossref","is-referenced-by-count":0,"title":["Greener care, smarter spending: economic opportunities in sustainable nephrology"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5895-0680","authenticated-orcid":false,"given":"Ivo","family":"Laranjinha","sequence":"first","affiliation":[{"name":"Nephrology Department, Unidade Local de Sa\u00fade de Lisboa Ocidental , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Julie\u00a0Peired","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children\u2019s Hospital IRCCS , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1367-9691","authenticated-orcid":false,"given":"Susi","family":"Knoeller","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, GesundheitNord, Klinikum Bremen Mitte , Bremen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Gracin","sequence":"additional","affiliation":[{"name":"Transplantation Centre, Sahlgrenska University Hospital , Gothenbourg ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1323-5293","authenticated-orcid":false,"given":"Ana","family":"Carina\u00a0Ferreira","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Curry Cabral \u2013 Unidade Local de Sa\u00fade de S\u00e3o Jos\u00e9 , Lisbon ,","place":["Portugal"]},{"name":"Nova Medical School , Lisbon ,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryvonne","family":"Hourmant","sequence":"additional","affiliation":[{"name":"Service de N\u00e9phrologie et Immunologie Clinique , University Hospital of Nantes, Nantes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulay","family":"Demirtas","sequence":"additional","affiliation":[{"name":"Department of Nephrology, SBU Antalya Training and Research Hospital , Antalya ,","place":["T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"2026082204362945900_bib1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12882-019-1268-3","article-title":"Quality of life after the initiation of dialysis or maximal conservative management in elderly patients: a longitudinal analysis of the Geriatric assessment in OLder patients starting Dialysis (GOLD) study","volume":"20","author":"Van\u00a0Loon","year":"2019","journal-title":"BMC Nephrol"},{"key":"2026082204362945900_bib2","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12882-021-02516-6","article-title":"Does conservative kidney management offer a quantity or quality of life benefit compared to dialysis? 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