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In this review, interrelationships between climate change, kidney health, and peritoneal dialysis (PD) therapies are described, and expansion of duty of care to the environment while maintaining the highest-quality healthcare is explored. Practical, high-yield actions that can be undertaken by patients and providers through the principles of sustainable care are introduced, including medication and single-use plastic consumables optimization, incremental PD, remote health monitoring, innovative PD effluent drainage, waste optimization, and importantly, patient empowerment as partners in sustainability. 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