{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T12:09:34Z","timestamp":1781093374996,"version":"3.54.1"},"reference-count":45,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perit Dial Int"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Incremental peritoneal dialysis (PD) may confer environmental benefits compared to full-dose PD due to reduced resource use. We aimed to quantify and compare carbon emissions, water consumption, and waste generation between incremental and full-dose PD in a cohort of incident PD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We compared environmental metrics, including carbon emissions, water consumption, and waste generation between incremental and full-dose PD, using prospectively collected data between June 2019 and May 2024 at the Western Renal Service, Sydney, Australia. Carbon emissions were quantified using standardized coefficients from a published life-cycle analysis, while water and waste volumes were estimated using literature-based assumptions. Group comparisons were conducted using the Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      test, with a two-sided\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      -value &lt;0.05 considered statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 365 incident patients (187 incremental, 178 full-dose), followed for a median of 20 months (interquartile range 13\u201337), incremental PD had lower median annual per-patient carbon dioxide equivalent emissions (1016 vs. 1360\u2005kg), blue water consumption (24,090 vs. 25,548\u2005L), landfill waste (212 vs. 271\u2005kg), gray water generation (8213 vs. 10,549\u2005L), and recycling volume (73 vs. 131\u2005kg), compared to full-dose PD (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Incremental PD yielded estimated savings of 201,087\u2005kg carbon dioxide equivalent emissions, over 5 million liters of blue water, 1.8 million liters of gray water, 27,223\u2005kg of landfill waste, and 16,219\u2005kg of recyclable materials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incremental PD was associated with a lower environmental impact than full-dose PD, highlighting its potential contribution to environmentally sustainable dialysis care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08968608251399011","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T19:54:26Z","timestamp":1764705266000},"page":"345-354","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of carbon emissions, water use, and dialysis waste between incremental and full-dose peritoneal dialysis: A cohort study"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-0811","authenticated-orcid":false,"given":"Mary Ann","family":"Nicdao","sequence":"first","affiliation":[{"name":"Royal North Shore Hospital"},{"name":"The University of Sydney"},{"name":"The Children's Hospital at Westmead"},{"name":"The University of Queensland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8422-7269","authenticated-orcid":false,"given":"Germaine","family":"Wong","sequence":"additional","affiliation":[{"name":"The University of Sydney"},{"name":"The Children's Hospital at Westmead"},{"name":"Westmead Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0552-6074","authenticated-orcid":false,"given":"Karine","family":"Manera","sequence":"additional","affiliation":[{"name":"The University of Sydney"},{"name":"The Children's Hospital at Westmead"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7648-007X","authenticated-orcid":false,"given":"Kamal","family":"Sud","sequence":"additional","affiliation":[{"name":"Nepean Hospital"},{"name":"Nepean Clinical School, The University of Sydney, NSW, Australia"},{"name":"Nepean Kidney Research Centre, Nepean Hospital, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1805-077X","authenticated-orcid":false,"given":"Maria","family":"Daraoay","sequence":"additional","affiliation":[{"name":"Blacktown Hospital, Western Sydney Local Health District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8973-9538","authenticated-orcid":false,"given":"Allison","family":"Jaure","sequence":"additional","affiliation":[{"name":"The University of Sydney"},{"name":"The Children's Hospital at Westmead"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1067-9807","authenticated-orcid":false,"given":"Scott","family":"Hanson","sequence":"additional","affiliation":[{"name":"Western Sydney Local Health District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9548-2310","authenticated-orcid":false,"given":"Katherine A","family":"Barraclough","sequence":"additional","affiliation":[{"name":"Royal Melbourne Hospital"},{"name":"University of Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3502-9837","authenticated-orcid":false,"given":"Yeoungjee","family":"Cho","sequence":"additional","affiliation":[{"name":"The University of Queensland"},{"name":"Princess Alexandra Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3183-7885","authenticated-orcid":false,"given":"Katrina","family":"Chau","sequence":"additional","affiliation":[{"name":"The University of Queensland"},{"name":"Blacktown Hospital, Western Sydney Local Health District"},{"name":"Blacktown Mount Druitt Medical School, Western Sydney University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9740-712X","authenticated-orcid":false,"given":"Martin","family":"Howell","sequence":"additional","affiliation":[{"name":"The University of Sydney"},{"name":"The Children's Hospital at Westmead"},{"name":"The University of Queensland"},{"name":"Leeder Centre for Health, Policy, Economics and Data, The University of Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2020.09.011"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-020-0296-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-019-0245-1"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2022.11.018"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.08.019"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608251326329"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000000000361"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.04.008"},{"key":"e_1_3_2_10_2","unstructured":"Sydney Water. Water use and conservation https:\/\/www.sydneywater.com.au\/education\/drinking-water\/water-use-conservation.html (2025 accessed 17 May 2025)."},{"key":"e_1_3_2_11_2","unstructured":"Australian and New Zealand Society of Nephrology. The environmental impact of kidney care. https:\/\/nephrology.edu.au\/ocd.aspx?action=printsnippet&snippet=pg_156&code=&menuItem=The+Environmental+Impact+of+Kidney+Care (2023 accessed 22 February 2025)."},{"key":"e_1_3_2_12_2","article-title":"Phthalates and their impacts on human health","volume":"9","author":"Wang Y","year":"2021","unstructured":"Wang Y, Qian H. Phthalates and their impacts on human health. Healthcare (Basel) 2021; 9: 603.","journal-title":"Healthcare (Basel)"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.4319\/lo.2006.51.1_part_2.0356"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1641\/0006-3568(2003)053[0341:TNC]2.0.CO;2"},{"key":"e_1_3_2_15_2","first-page":"23","article-title":"Dialysis and the environment: a call to action for nephrologists","volume":"7","author":"Bourgeois A","year":"2022","unstructured":"Bourgeois A, Reddy P. Dialysis and the environment: a call to action for nephrologists. Kidney Int Rep 2022; 7: 23\u201325.","journal-title":"Kidney Int Rep"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0896860819895364"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608231175826"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/08968608231195517"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-018-00577-9"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-022-01433-7"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.11.019"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3747\/pdi.2010.00239"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2023.03.029"},{"key":"e_1_3_2_24_2","first-page":"012022","volume-title":"The influence of strong reduced water and fresh coconut oil in viscosity of liquid hand soapThe 1st international symposium of Indonesian chemical engineering (ISIChem), West Sumatera, Indonesia","author":"Sulistiawati EAE","year":"2019","unstructured":"Sulistiawati EAE, Santosa I. The influence of strong reduced water and fresh coconut oil in viscosity of liquid hand soap. In: The 1st international symposium of Indonesian chemical engineering (ISIChem), West Sumatera, Indonesia, 2019, p. 012022. IOP Publishing Ltd."},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2022.09.006"},{"key":"e_1_3_2_26_2","unstructured":"Baxter Healthcare. Peritoneal dialysis product catalogue https:\/\/www.baxter.ca\/sites\/g\/files\/ebysai1431\/files\/2024-01\/PD%20Catalogue%20English%20-%202024%20V.3.pdf (2024 accessed 17 May 2025)."},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5001915"},{"key":"e_1_3_2_29_2","unstructured":"Veolia Australia and New Zealand. Your guide to recycling in New South Wales https:\/\/www.anz.veolia.com\/sustainability\/sustainability-blog\/your-guide-recycling-new-south-wales (2025 accessed 17 May 2025)."},{"key":"e_1_3_2_30_2","unstructured":"Baxter Professional Australia. Recycling services for patients https:\/\/www.baxterprofessional.com.au\/sustainability\/recycling-services-patients (2025 accessed 17 May 2025)."},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-017-1647-2"},{"key":"e_1_3_2_32_2","volume-title":"Jamovi (Version 2.3.21)","author":"The Jamovi Project","year":"2023","unstructured":"The Jamovi Project. Jamovi (Version 2.3.21). Sydney, Australia: The Jamovi Project, 2023."},{"key":"e_1_3_2_33_2","unstructured":"United States Environmental Protection Agency. Greenhouse gas equivalencies calculator https:\/\/www.epa.gov\/energy\/greenhouse-gas-equivalencies-calculator (2025 accessed 25 May 2025)."},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0896860819894058"},{"key":"e_1_3_2_35_2","unstructured":"World Health Organization. Overview of greywater management: health considerations https:\/\/applications.emro.who.int\/dsaf\/dsa1203.pdf (2006 accessed 17 May 2025)."},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.2166\/wst.2022.226"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1080\/10934529.2012.707549"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1080\/10937400903094091"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.12.015"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2017.08.012"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfy111"},{"key":"e_1_3_2_42_2","unstructured":"Australian Healthcare and Hospitals Association. Australia needs to consider environmental impacts in healthcare decisions and planning https:\/\/ahha.asn.au\/australia-needs-to-consider-environmental-impacts-in-healthcare-decisions-and-planning\/ (2025 accessed 20 June 2025)."},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462322003282"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfae130"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.18356\/9789210014380"},{"key":"e_1_3_2_46_2","unstructured":"Australasian Kidney Trials Network. STEP-PD: Starting incremental prescription of peritoneal dialysis https:\/\/clinicaltrials.gov\/study\/NCT06642597 (2024 accessed 14 May 2025)."}],"container-title":["Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08968608251399011","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08968608251399011","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08968608251399011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:48:11Z","timestamp":1781092091000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08968608251399011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,2]]},"references-count":45,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1177\/08968608251399011"],"URL":"https:\/\/doi.org\/10.1177\/08968608251399011","relation":{},"ISSN":["0896-8608","1718-4304"],"issn-type":[{"value":"0896-8608","type":"print"},{"value":"1718-4304","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,2]]}}}