{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T15:09:57Z","timestamp":1780585797982,"version":"3.54.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global rise in dialysis treatments for kidney failure patients has led to growing concern about the carbon footprint of dialysis and the environmental implications of increased consumption of key resources, including water, electricity, and the manufacture and waste disposal of treatment-related consumables. As most environmental studies have reported from temperate climates, we examined the carbon footprint of a hemodialysis center in Singapore, which represents a country with a tropical climate, aiming to assess total carbon emissions quantitatively, systematically identify key components, and provide critical insights along with pragmatic recommendations for enhancing sustainability practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We measured the direct and indirect carbon emissions using the Greenhouse Gas Protocol Product Standard at our 12-station satellite dialysis center. This study was conducted at the outpatient satellite dialysis center of NUH between October 2023 and January 2024. This 12-station satellite dialysis facility operates three shifts daily, six days a week, and encompasses an area of 210\u2005m\u00b2. It is equipped with twelve machines, supplied with dialysis water from AquaB Duo Water Treatment System (Fresenius Medical Company, Bad Homberg, Germany). Acid concentrates (dilution 1:34, 5L containers) and bicarbonate powder are supplied in single-use plastic containers. The direct and indirect greenhouse gas (GHG) emissions were measured retrospectively using the GHG Protocol Product Standard, developed by the World Resources Institute and the World Business Council for Sustainable Development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our center dialyzed approximately 60 patients each month, resulting in a total of 8932 sessions over the course of the year. Our total annual emissions were evaluated at 358.52 tonnes of carbon dioxide (tCO\u2082e), with an average carbon emission of 5.98 tCO\u2082e per patient. Most of these emissions were due to dialysis consumables, accounting for 147.50 tCO\u2082e (41.1%). The dialysis consumables contributing the most to carbon emissions were dialyzers, bicarbonate powder, bloodlines, dialysis needles, and acid concentrates. This was followed by electricity, clinical supplies, and pharmaceuticals, which contributed 55.27 tCO\u2082e (15.4%), 24.35 tCO\u2082e (6.8%), and 36.24 tCO\u2082e (10.1%), respectively. Waste generated accounted for 30.94 tCO\u2082e (8.6%) of the carbon emissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study on the carbon footprint of a satellite hemodialysis unit is the first one conducted in an equatorial urban city environment, experiencing high humidity and abundant rainfall, with a tropical climate. Further research into local carbon emissions across other centers in Southeast Asia is essential for validating our findings and informing sustainability policies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajaf009","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T09:59:22Z","timestamp":1770112762000},"page":"80-87","source":"Crossref","is-referenced-by-count":0,"title":["Carbon footprint of a Singapore satellite hemodialysis center"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7843-0065","authenticated-orcid":false,"given":"Sabrina Wong Peixin","family":"Haroon","sequence":"first","affiliation":[{"name":"Division of Nephrology, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titus","family":"Lau","sequence":"additional","affiliation":[{"name":"Division of Nephrology, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boon Woei","family":"Lee","sequence":"additional","affiliation":[{"name":"Office of Sustainability, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melody Kwan Ngan","family":"Leung","sequence":"additional","affiliation":[{"name":"Office of Sustainability, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca Ying Ying","family":"Lee","sequence":"additional","affiliation":[{"name":"Office of Sustainability, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4467-6833","authenticated-orcid":false,"given":"Andrew","family":"Davenport","sequence":"additional","affiliation":[{"name":"UCL Centre for Kidney & Bladder Health, Royal Free Hospital, Division of Medicine, University College London , Rowland Hill Street, London NW3 2PF ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia Neng","family":"Tan","sequence":"additional","affiliation":[{"name":"Division of Nephrology, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horng Ruey","family":"Chua","sequence":"additional","affiliation":[{"name":"Division of Nephrology, National University Hospital , 5 Lower Kent Ridge Road, Singapore 119074 ,","place":["Republic of 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