The health care sector worldwide is responsible for as much as 4.6% of total greenhouse gas emissions, which includes carbon dioxide, methane, ozone, and others. In an effort to reduce its own carbon dioxide footprint, DaVita set one of its 2025 Environmental, Social and Governance (ESG) goals to be 100% powered by renewable energy globally.

In alignment with this goal, a DaVita® center based in the city of Emden in northern Germany is one of four dialysis centers in a pilot aimed at measuring carbon dioxide emissions. Installed last year by the Deutsche Gesellschaft fur Nephrologie (DGfN)—or the Germany Society for Nephrology—the DGfN Climate, Environment and Kidney Commission is working to develop solutions to combat climate change.

Prof. Werner Kleophas, chief medical officer for DaVita Deutschland AG, chaired a session in October at the 14^th Meeting of the Germany Society for Nephrology in Berlin where the first year results were presented. The meeting featured panel discussions on the need for new technology developments and innovations, successes in kidney care, sustainability, and the impact of climate change on kidney disease patients.

Germany in particular has not been immune to the impacts of climate change. Historic flooding devastated parts of western Germany in 2021—affecting a DaVita center—and many parts of Europe continue to experience significant heat waves.

“We now have the data to tell us which parts of the dialysis treatment cycle have the largest impact on CO2 emissions,” Prof. Kleophas says. “The next step is determining how to best reduce our footprint.”

For Prof. Kleophas, a co-author of the report and member of the DGfN Climate, Environment and Kidney Commission, an initial takeaway is the large amounts of electricity, heat and water needed to perform dialysis treatments.

One of the first areas they’ve begun looking at is water consumption. By reducing dialysate flow rate to an average of 350 mL/min from 500 mL/min (the standard flow rate), the commission found a way to save 2,820 liters of water every year for a single patient—without impacting a patients’ well-being.

“As far as literature can show for today, efficiency can be maintained and there’s potential to secure our environment and deliver proper treatment to our patients at the same time,” Prof. Kleophas says. “This is one step we are already introducing in our centers.”

According to a study conducted in Spain and a topic of discussion at the annual meeting in Berlin, heat waves around the world are already showing an increase in hypotensive episodes and hospitalizations. This will continue to have an impact on the daily work of nephrologists.

Due to these realities, Prof. Kleophas and the commission have decided to make the first-year results available to the broader public in an effort to help inform other medical specialties of their environmental impact.

“Climate change is showing how unpredictable things can be,” Prof. Kleophas says. “It’s important that we have these results on our minds as we work hand-in-hand to combat these issues and reduce the CO2 footprint in our centers.”