Dialysis is a procedure with a high environmental impact due to its consumption of water and electricity and the generation of waste, making it the fourth non-surgical hospital activity with the highest emissions. In a context where the healthcare sector is responsible for approximately 5% of global emissions—almost three times the impact of aviation—initiatives like this highlight the room for improvement within the healthcare system to move toward more sustainable models, while always ensuring safety and clinical outcomes.
Building a Sustainable Dialysis Process: The Clínic Experience
The project, consisting of a series of strategic lines implemented over the past decade, has been coordinated by Dr. Marta Arias and Gerard Pereda, together with a working team that includes healthcare professionals from various areas, such as Nephrology, Nursing, and Nursing Care Assistants (TCAIs). The starting point has been the systematic measurement of key environmental indicators—water and electricity consumption, waste generation, and CO₂ emissions—to identify areas for improvement and assess the impact of the measures implemented, with the aim of promoting a comprehensive sustainability strategy and embedding it as a core pillar of care delivery, as a shared responsibility.
Based on this analysis, a set of progressive interventions has been deployed, including optimization of dialysis fluid flow, automation of the water treatment plant, digitalization of processes and elimination of paper, improved waste segregation, and the incorporation of more efficient equipment, as well as the promotion of home dialysis and the optimization of patient and supply transport.
The Impact of Dialysis in Figures
Dialysis activity at Clínic illustrates the magnitude of the environmental challenge: each day, between 65 and 70 patients undergo dialysis, and each session involves the consumption of around 400 liters of water—equivalent to four long showers—22 kWh of electricity—equivalent to the daily electricity consumption of a large household—and the generation of more than 2 kg of waste, similar to what two people generate daily in Barcelona.
These figures highlight the need to introduce structural changes in how this service is delivered, adopting a sustainable perspective that integrates environmental impact into clinical and organizational decision-making.
Measuring, Acting, and Delivering Results
The strategy implemented by Clínic has achieved significant environmental outcomes. The year 2025 marks a turning point, with a 22.35% reduction in total CO₂ emissions compared to the previous year—equivalent to 18.725 fewer tonnes—despite increased healthcare activity.
There have also been significant improvements in resource consumption, with 559 m³ less water used and savings of 62,012 kWh of electricity. At the same time, although overall waste increased due to the growth of home dialysis, adjusted indicators show a reduction in waste per session (with the Healthcare Waste Index dropping from 2.3 to 1.79) and improved waste segregation, with more efficient and specific management of materials and pharmaceuticals.
A Model Replicable in Other Centers
The initiative demonstrates that it is possible to measurably reduce the environmental footprint of a high-complexity service without compromising quality of care. The combination of indicator monitoring, process innovation, and staff engagement has generated a model that can be transferred to other units and healthcare centers.
Commitment to Planetary Health
With this project, Hospital Clínic Barcelona reinforces its commitment to sustainability and climate action within the healthcare system. Rethinking procedures such as dialysis—essential in the care of patients with kidney disease—is key to advancing toward a healthcare model that integrates quality care with environmental responsibility and planetary health.
