Blue Planet dialysis: novel water-sparing strategies for reducing dialysate flow

Introduction: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously de...

Full description

Saved in:
Bibliographic Details
Published in:International journal of artificial organs 2018-01, Vol.41 (1), p.3-10
Main Authors: Molano-Triviño, Alejandra, Wancjer, Benjamin, Neri, Mauro M., Karopadi, Akash N., Rosner, Mitchell, Ronco, Claudio
Format: Article
Language:English
Subjects:
Clinical trials
Dialysis
Environmental impact
Flow velocity
Fluctuations
Flux
Health care
Hemodialysis
Peritoneum
Pharmacokinetics
Pharmacology
Reverse osmosis
Therapy
Water conservation
Water consumption
Water reuse
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. Methods: We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux. We performed a search in Medline, Pubmed, Scielo, OVID and Biblioteca Redentor, using key words: Dialysate flow rate, Dialysate flux, and decrease; excluding: online, peritoneal, continuous, blood access, needle, hemodiafiltration, acute, pharmacokinetics, increase. We limited our search to adult humans or in vitro trials in English, Spanish, Italian and Portuguese, between January 1980 and June 2017. We found 816 trials. 37 articles were retrieved for review, and 11 articles were analyzed. Results and conclusions: Conservation of water in chronic HD should be considered an important responsibility of healthcare practitioners all over the world. We present a wider usage of dialysate flow rates, considering that it would lead to significant water conservation without much compromise on dialysis efficacy in small patients. We believe that further investigation into the utility of reduced dialysate flux in different populations is needed to broaden our understanding of how we can use these techniques in order to significantly reduce water consumption during chronic HD while still ensuring optimum efficacy and efficiency of the therapy.
ISSN:0391-3988
1724-6040
DOI:10.5301/ijao.5000660