Green Dialysis

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Original Article
Conserving water in and applying solar power to haemodialysis: 'Green Dialysis' through wiser resource utilization
JOHN WM AGAR
Geelong Hospital, Barwon Health, Geelong, Victoria, Australia
Correspondence to A/Prof John WM Agar, Geelong Hospital, Barwon Health, PO Box 281, Geelong, Vic. 3220, Australia. Email: johna@barwonhealth.org.au
Copyright Journal Compilation © 2010 Asian Pacific Society of Nephrology
KEYWORDS
green dialysis • haemodialysis • reject water • resource conservation • reverse osmosis • solar power
ABSTRACT

Natural resources are under worldwide pressure, water and sustainable energy being the paramount issues. Haemodialysis, a water-voracious and energy-hungry healthcare procedure, thoughtlessly wastes water and leaves a heavy carbon footprint. In our service, 100 000 L/week of previously discarded reverse osmosis reject water – water which satisfies all World Health Organisation criteria for potable (drinking) water – no longer drains to waste but is captured for reuse. Reject water from the hospital-based dialysis unit provides autoclave steam for instrument sterilization, ward toilet flushing, janitor stations and garden maintenance. Satellite centre reject water is tanker-trucked to community sporting fields, schools and aged-care gardens. Home-based nocturnal dialysis patient reuse reject water for home domestic utilities, gardens and animal watering. Although these and other potential water reuse practices should be mandated through legislation for all dialysis services, this is yet to occur. In addition, we now are piloting the use of solar power for the reverse osmosis plant and the dialysis machines in our home dialysis training service. If previously attempted, these have yet to be reported. After measuring the power requirements of both dialytic processes and modelling the projected costs, a programme has begun to solar power all dialysis-related equipment in a three-station home haemodialysis training unit. Income-generation with the national electricity grid via a grid-share and reimbursement arrangement predicts a revenue stream back to the dialysis service. Dialysis services must no longer ignore the non-medical aspects of their programmes but plan, trial, implement and embrace 'green dialysis' resource management practices.

Accepted for publication 16 October 2009.
Accepted manuscript online: 18 November 2009.
DIGITAL OBJECT IDENTIFIER (DOI)
http://www3.interscience.wiley.com/journal/122687259/abstract?CRETRY=1&SRETRY=0