Climate and the Nephrologist

医学 肾病科 肾脏疾病 透析 血液透析 重症监护医学 气候变化 疾病 急性肾损伤 内科学 环境卫生 生态学 生物
作者
Sarah E. Young,Laveen J. Khoshnaw,Richard J. Johnson
出处
期刊:Clinical Journal of The American Society of Nephrology [Lippincott Williams & Wilkins]
卷期号:18 (3): 411-417 被引量:15
标识
DOI:10.2215/cjn.08530722
摘要

Climate change is upon us, and it will have a major effect on both kidney disease and the nephrology practice. But the converse is also true: our treatment of kidney disease has an effect on the climate. Much attention has focused on how rising temperatures can lead to acute and CKD and health exacerbations in patients with established kidney disease. Climate change is also associated with rising air pollution from wildfires and industrial wastes and infectious diseases associated with flooding and changing habitats, all of which heighten the risk of acute and CKD. Less well recognized or understood are the ways nephrology practices, in turn, contribute to still more climate change. Hemodialysis, although lifesaving, can be associated with marked water usage (up to 600 L per dialysis session), energy usage (with one 4-hour session averaging as much as one fifth of the total energy consumed by a household per day), and large clinical wastes (with hemodialysis accounting for one third of total clinical medicine–associated waste). Of note, >90% of dialysis occurs in highly affluent countries, whereas dialysis is much less available in the poorer countries where climate change is having the highest effect on kidney disease. We conclude that not only do nephrologists need to prepare for the rise in climate-associated kidney disease, they must also urgently develop more climate-friendly methods of managing patients with kidney disease.
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