Low- and middle-income countries face a rapidly increasing prevalence of chronic kidney disease in a setting of limited resources and heightened environmental vulnerabilities. Disease prevention strategies, optimization of kidney replacement therapies, technological innovations and adaptation of health policies to local realities is required to enable resilient and sustainable kidney care.
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References
Smyth, B. et al. Green nephrology: a series of mini reviews on minimizing the environmental impact of kidney health care. Kidney Int. 104, 7–11 (2023).
Okpechi, I. G. et al. Building optimal and sustainable kidney care in low resource settings: the role of healthcare systems. Nephrology 26, 948–960 (2021).
Barraclough, K. A. & Agar, J. W. M. Green nephrology. Nat. Rev. Nephrol. 16, 257–268 (2020).
Luyckx, V. A. et al. Providing environmentally sustainable nephrology care: focus in low- and middle-income countries. Kidney Int. 105, 259–268 (2024).
Phua, E. & Shen, Y. The climate impact of dialysis. Curr. Opin. Nephrol. Hypertens. 33, 97–101 (2024).
Backston, K. J., Thompson, C. J. & Raina, M. Green dialysis review: reducing water, energy, and waste. Hemodial. Int. 29, 463–471 (2025).
Barraclough, K. A. et al. Updating the data: the resource consumption of modern-day hemodialysis systems. Kidney Int. Rep. 9, 1521–1524 (2024).
Agar, J. W. M., Perkins, A. & Tjipto, A. Solar-assisted hemodialysis. Clin. J. Am. Soc. Nephrol. 7, 310–314 (2012).
Niang, A. & Lemrabott, A. T. Global dialysis perspective: Senegal. Kidney360 1, 538–540 (2020).
Davison, S. N., Pommer, W. & Brown, M. A. Conservative kidney management and kidney supportive care: core components of integrated care for people with kidney failure. Kidney Int. 105, 35–45 (2024).
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Niang, A., Lemrabott, A.T. Environmentally sustainable kidney care in low- and middle-income countries. Nat Rev Nephrol (2026). https://doi.org/10.1038/s41581-026-01051-7
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DOI: https://doi.org/10.1038/s41581-026-01051-7
