Developing a framework/model to environmentally sustainable and climate neutral health and care systems using the Kidney care pathway

Project Information

KitNewCare

Grant agreement ID: 101137054

DOI

10.3030/101137054

EC signature date 12 December 2023

Start date 1 January 2024

End date 31 December 2027

Funded under

• Health

Total cost

€ 4 703 738,75

EU contribution

€ 4 703 738,75

Coordinated by

THE PROVOST, FELLOWS, FOUNDATION SCHOLARS & THE OTHER MEMBERS OF BOARD, OF THE COLLEGE OF THE HOLY & UNDIVIDED TRINITY OF QUEEN ELIZABETH NEAR DUBLIN
Ireland

Periodic Reporting for period 1 - KitNewCare (Developing a framework/model to environmentally sustainable and climate neutral health and care systems using the Kidney care pathway)

Reporting period: 2024-01-01 to 2025-06-30

Summary of the context and overall objectives of the project

Kidney care is one of the most resource-intensive areas of healthcare, consuming large volumes of energy, water, and plastics, while treatments like dialysis drive significant emissions and transport demands. With 850 million people worldwide living with CKD and up to 6 million needing kidney replacement by 2030, the EU-funded KitNewCare project positions kidney care as a demonstrator for sustainable, equitable, efficient, and effective healthcare.
The consortium of European academic, clinical, and industrial partners is developing tools to measure, benchmark, and improve sustainability, delivering actionable, evidence-based solutions to guide healthcare planning across Europe and beyond.
KitNewCare supports EU priorities (European Green Deal, EU Climate Law, SDGs 3, 6, and 12) by reducing emissions, cutting costs, and promoting a just transition to low-carbon care. Social sciences and humanities expertise ensures co-design with stakeholders, equity analysis, and behaviour-change support, making interventions both ethical and adoptable.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

Since its launch in January 2024, KitNewCare has undertaken substantial technical and scientific work to advance its aim of improving the sustainability of kidney care across Europe. Clinical pathway mapping has been completed for haemodialysis and peritoneal dialysis across four European countries (Italy, Poland, Spain, and the Netherlands), using a harmonised methodology aligned with ISO standards. This mapping provides the basis for cross-country comparison and intervention design. A 4-factor Life Cycle Assessment (LCA) database has been developed, capturing environmental, social, clinical, and financial indicators of kidney care delivery. This includes baseline data collection and early modelling of high-impact areas. Twelve open-access datasets have been published on Zenodo, including detailed metadata and visual documentation to support reuse, transparency, and future benchmarking.
Sustainability interventions have been piloted at four dialysis centres using Plan-Do-Study-Act (PDSA) improvement cycles. Interventions to date include: fluid bag switching, waste separation trials, procurement modifications, and patient/staff transport optimisation. Early feedback and impact assessments are underway. Technical innovations have been tested in partnership with SMEs and clinical teams. These include reprocessing of dialysate, heat recovery from dialysis machines, and the introduction of lower-carbon packaging. Results are currently being compiled and validated.
A digital benchmarking dashboard has been developed and is undergoing pilot testing at participating centres. This tool will enable ongoing monitoring of environmental, clinical, social, and financial performance.
Work ongoing on systematic reviews, covering health outcomes, cost implications, carbon trade-offs, and social impacts of sustainable kidney care approaches. These technical activities represent strong progress across all core work packages laying the groundwork for full-scale implementation, analysis, and policy translation in the next phases of the project and are underpinned by a multi-layered stakeholder engagement strategy, ensuring that scientific results are co-designed, actionable, and ready for implementation across healthcare systems.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

KitNewCare has delivered several breakthroughs that extend beyond the current state of the art: 4-Factor Benchmarking Dashboard: Unlike existing carbon calculators (e.g. ICHD tool), KitNewCare's dashboard integrates clinical outcomes, financial costs, social impacts, and environmental data—providing a comprehensive tool for decision-making at the healthcare provider and policymaker level. Preve-Renal LCA Study: The first quantified analysis showing the environmental and clinical benefits of a CKD screening program using albuminuria testing. The study shows that early detection significantly reduces carbon emissions and improves patient outcomes.
Dialysis Waste Management LCA: A pioneering study comparing incineration with pyrolysis for dialysis waste. It quantifies the carbon savings of alternative disposal methods and provides a framework for circular economy integration in healthcare waste policy. Redesign of Peritoneal Dialysis (PD) Products: The first detailed, weight-verified life cycle inventory of PD components, including packaging, enabling precise emissions modelling and hotspot analysis. This supports eco-design and sustainable procurement.
On-Site Dialysate Generation Analysis: A comparative study of traditional dialysis fluid delivery vs. on-site systems (e.g. Fresenius Granumix), demonstrating potential for large reductions in transport emissions and packaging waste. The project has produced A harmonised European knowledge base on kidney care sustainability. Case studies showing reductions in energy use, water consumption, and clinical waste. A Sustainability Network to facilitate collaboration and scaling across Europe. Accredited multilingual training modules for healthcare professionals.

Key enablers for further uptake include: Wider deployment of the benchmarking dashboard across EU dialysis units. Policy uptake of LCA results in procurement and waste legislation. Support for scaling pilot innovations (e.g. heat exchangers, dialysate reuse) through EU innovation funding. Standardisation and IPR frameworks to protect and disseminate innovations.Continued cross-sector collaboration, particularly with sister projects and stakeholders contributing to EU-level sustainability dialogue

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