{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T05:06:01Z","timestamp":1777784761093,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"eu horizon","award":["101137054"],"award-info":[{"award-number":["101137054"]}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"crossref","award":["10110449"],"award-info":[{"award-number":["10110449"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>Peritoneal dialysis (PD) is a life-sustaining treatment for end-stage kidney disease but contributes significantly to environmental degradation due to its reliance on single-use plastics, energy-intensive manufacturing and high-volume transport. Redesigning PD products for sustainability is increasingly important as healthcare systems seek to reduce their carbon footprint. In this study, ten high-use peritoneal dialysis (PD) products were redesigned using life cycle thinking. Interventions included low-carbon transport (electric vans), renewable energy and improved waste treatment (pyrolysis). Life cycle inventories (LCIs) were modelled in Open Life Cycle Assessment (OpenLCA)and modelled using cradle-to-gate carbon footprints (kg CO\u2082-eq) to compare redesigned and conventional versions. All redesigned products achieved carbon footprint reductions, with eight showing decreases greater than 40%. The automated PD set and 2\u2009L dialysate bag saw reductions of 63% and 54%, respectively (saving 1.15 and 0.86\u2009kg CO2-eq per item). The APD machine achieved the largest percentage reduction at 87%, primarily driven by the elimination of printed packaging and the use of renewable electricity. Key contributors to emissions savings across products included lower-impact transport, sustainable packaging materials and circular waste strategies. Redesigning PD products using sustainable materials and processes can deliver substantial environmental benefits without compromising functionality. These findings support evidence-based pathways for reducing emissions in kidney care through product innovation and procurement reform.<\/jats:p>","DOI":"10.1177\/03913988251415097","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T05:00:51Z","timestamp":1770613251000},"page":"87-94","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Theoretically redesigning peritoneal dialysis products for sustainability: A life cycle inventory approach"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5152-2414","authenticated-orcid":false,"given":"James","family":"Larkin","sequence":"first","affiliation":[{"name":"School of Dental, Child and Public Health, Trinity College Dublin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Ligabue","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Kidney Transplant Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaetano","family":"Alfano","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Kidney Transplant Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Mart\u00ednez Cadenas","sequence":"additional","affiliation":[{"name":"Universidad Autonoma de Madrid, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abass","family":"Fehintola","sequence":"additional","affiliation":[{"name":"School of Dental, Child and Public Health, Trinity College Dublin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingeborg","family":"Steinbach","sequence":"additional","affiliation":[{"name":"Centre for Sustainable Healthcare, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aycan","family":"Yasar","sequence":"additional","affiliation":[{"name":"Centre for Sustainable Healthcare, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niccolo","family":"Morisi","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Kidney Transplant Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8549-1221","authenticated-orcid":false,"given":"Gabriele","family":"Donati","sequence":"additional","affiliation":[{"name":"Nephrology Dialysis and Kidney Transplant Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett","family":"Duane","sequence":"additional","affiliation":[{"name":"School of Dental, Child and Public Health, Trinity College Dublin, Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000317200"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(17)30180-8"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckaa165.843"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0245-1"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1071\/AH13022"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefroe.2024.11.021"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfae147"},{"key":"e_1_3_3_9_2","unstructured":"Kitnewcare. 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