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Sustainable Nephrology: Moving into the mainstream 

Walking through the exhibition halls and conference rooms of European Renal Association (ERA) Congress in Glasgow, the scale was immediately apparent. As the world’s largest kidney conference, the ERA Congress brings together thousands of clinicians, researchers and healthcare professionals from Europe and beyond. 

This year, however, something was different. 

For the first time, sustainability was included as a dedicated workshop within the scientific programme. On paper, that may seem like a small addition. In practice, it felt like an important marker of how far the movement has come. Sustainable nephrology is no longer confined to side discussions between interested individuals. It is increasingly becoming part of the mainstream discourse about the future of kidney care. 

CSH was invited to contribute to the Sustainable Nephrology Committee Workshop, reflecting growing recognition that environmental sustainability, patient outcomes and healthcare quality are deeply interconnected. While there is still much work to do, the conversations in Glasgow suggested a field that is beginning to move from recognising the challenge to exploring practical solutions. 

Bringing the Patient Perspective into the Room 

One of the most memorable moments of the workshop came from someone who was not actually present. 

CSH Medical Director Frances Mortimer was invited to speak as part of the “Sustainable Nephrology Committee Workshop: Dialysis Carbon Footprint Mitigation” session, exploring patients’ perspectives. In doing so, she represented what she described as the most important group in healthcare: patients themselves. 

Although patients were not physically present in the workshop, their experiences and priorities were central to the discussion. Frances shared a moving video testimony from a patient living with end stage kidney disease who reflected on his journey through chronic kidney disease and the lessons he had learned along the way. 

His message was both simple and powerful. If he could turn the clock back, he would want a much greater understanding of his condition much earlier in his disease journey, in order to better manage it himself. 

He described a desire to be informed by healthcare professionals so that he could better understand what was happening to his body, and what actions he could take to influence his future health. Looking back, he felt that greater knowledge and support could have helped him become more empowered in managing his condition and potentially slowing its progression. 

In particular, he spoke passionately about the role of diet in kidney health. Nutrition is known to have a significant impact on kidney function, yet patients can sometimes struggle to access the information and support they need. His view was clear: dietary management should be treated with the same seriousness and rigour as medication management. 

His testimony served as a powerful reminder that sustainable healthcare is not simply about reducing carbon emissions or minimising waste. At its heart, sustainable healthcare is about helping people stay healthier for longer. 

When patients are informed, empowered and supported to manage their health, outcomes often improve. Disease progression can sometimes be delayed. Demand for more intensive interventions can be reduced. Better care for patients and more sustainable use of healthcare resources often go hand in hand. 

For kidney care, where prevention and early intervention can have such profound consequences for long term health, that message resonated strongly. 

Within the same session, Prof. Karin Gerritsen, an internist-nephrologist and clinical scientist from UMC Utrecht, also presented advances on Green Dialysis. Prof Gerritsen is lead on Work Package 4 within KitNewCare, focussing on the Technological Innovations within Kidney Care. As such, she works closely with us at CSH, as we lead on Work Packages 3 & 5, Organisational and Workflow optimisations & Sustainable best practice Guidance and Tools respectively.

A Sign of a Changing Conversation 

The significance of the workshop extended beyond any individual presentation. 

Nephrology is recognised as one of the most resource intensive areas of healthcare. Renal replacement therapy, medications, transport requirements and the infrastructure needed to support kidney services all contribute to a substantial environmental footprint. At the same time, healthcare systems across Europe are facing increasing pressures from rising demand, workforce challenges and constrained resources. 

Against this backdrop, sustainability is becoming harder to ignore. 

What felt significant in Glasgow was not simply that sustainability was discussed, but that it had earned a place within the core scientific programme of the world’s largest kidney conference. 

Conferences often act as a barometer for a profession. They provide insight into the topics that clinicians, researchers and healthcare leaders believe deserve attention. The inclusion of a dedicated sustainability workshop suggests that sustainable nephrology is beginning to establish itself as an important area of focus for the renal community. 

The questions are increasingly shifting from “Why does sustainability matter?” towards “How do we make this happen?” 

Conversations Beyond the Conference Programme 

Some of the most encouraging discussions at ERA 2026 took place outside the formal programme. 

A small informal gathering had been organised for those interested in sustainable nephrology. The expectation was modest. We thought perhaps five or six people might find time to join us for a coffee between sessions. 

Instead, more than fifteen people turned up! 

Around the table were nephrologists, researchers, retired lecturers and other professionals working across kidney care. What began as an informal conversation quickly evolved into something much more substantial. 

People shared projects being developed through ERA and described related work taking place in countries including the Netherlands and Sweden. As experiences were exchanged, common themes quickly emerged. Despite differences in healthcare systems and national contexts, many participants were grappling with remarkably similar challenges. 

There was also a striking degree of overlap in the solutions being explored. 

The conversation soon turned towards collaboration. Rather than multiple groups tackling the same problems independently, there was clear enthusiasm for sharing resources, learning from one another’s experiences and building connections across countries and organisations. 

The discussion highlighted both the opportunities and the challenges facing sustainable nephrology. There is already a significant amount of innovation taking place, but much of it remains fragmented. Bringing people together to exchange ideas and coordinate efforts could accelerate progress considerably. 

Perhaps most importantly, there was a genuine sense of momentum in the room. 

Looking Ahead 

Leaving Glasgow, it was difficult not to feel encouraged. 

The first dedicated sustainability workshop at ERA may appear to be a relatively small development within a large international conference. Yet it felt symbolic of something much larger. Sustainable nephrology is moving from the margins towards the mainstream. 

The patient perspective shared during the workshop reinforced why this matters. Sustainability is not an additional consideration to be balanced against quality care. It is fundamentally about delivering the best possible care for patients, both now and in the future. 

The informal conversations over coffee provided a glimpse of what comes next. Across Europe, clinicians, researchers and healthcare leaders are developing projects and looking for opportunities to work together. There is growing recognition that many of the challenges facing kidney care are shared, and that collaboration will be essential in addressing them. 

For CSH, ERA 2026 was both encouraging and energising. The inclusion of sustainability within the conference programme reflects growing interest across the renal community, while the enthusiasm shown by colleagues from across Europe suggests that this interest is translating into action. 

There is still a long way to go. But if ERA 2026 is any indication, sustainable nephrology is no longer a niche conversation. It is becoming an increasingly important part of how the renal community thinks about delivering high quality, patient centred care in a changing world. 

And for those working in this space, that feels like a significant step forward.

Author: Dr Furat Al-Murani, Clinical Delivery Lead: Capacity Building in Sustainable Kidney Care