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Kidney Health for All: Caring for People, Protecting the Planet

https://doi.org/10.28996/2618-9801-2026-1-9-21

Abstract

The current kidney care model-focused on late-stage disease and in-center hemodialysis – is unsustainable, due to costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly’s recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, Kidney Health for All: Caring for People, Protecting the Planet, calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy (KRT). Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco-friendly without compromising care quality, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality of life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of public, policymakers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.

Translated into Russian by E.V. Parshina, edited by E.V. Zakharova

Translation into Russian initiated by Russian Dialysis Society, and approved by World Kidney Day Steering Committee

About the Authors

R. Vanholder
Ghent University Hospital; European Kidney Health Alliance
Belgium

Raymond Vanholder - Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital; European Kidney Health Alliance.

Ghent; Brussels



D. Abdellatif
Cairo University Hospital
Egypt

Dina Abdellatif - Department of Nephrology, Cairo University Hospital.

Cairo



A. C.S. Dos Santos Jr.
Faculdade Ciencias Medicas de Minas Gerais; Hospital das Clinicas, Ebserh, Universidade Federal de Minas Gerais
Brazil

Augusto Cesar Soares Dos Santos Jr.

Belo Horizonte, Minas Gerais



R. Correa-Rotter
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Mexico

Ricardo Correa-Rotter.

Mexico City



N. Gopalakrishnan
Transplant Authority of Tamil Nadu
India

Natarajan Gopalakrishnan.

Chennai



B. Wang
Hong Kong Kidney Foundation
China

Bill Wang.

Hong Kong, SAR



S. Roumeliotis
AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki
Greece

Stefanos Roumeliotis - 2nd Department of Nephrology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki.



A. Balducci
Italian Kidney Foundation Italy
Italy

Alessandro Balducci.

Rome



Á. Haris
Péterfy Hospital
Hungary

Ágnes Haris - Department of Internal Medicine and Nephrology, Péterfy Hospital.

Budapest



M. Yadla
Gandhi Medical College
India

Manjusha Yadla - Department of Nephrology, Gandhi Medical College.

Hyderabad, Telangana



Li-Li Hsiao
Harvard Medical School
United States

Li-Li Hsiao - Renal Division, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School.

Boston, Massachusetts



References

1. Francis A, Harhay MN, Ong ACM, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nature reviews Nephrology 2024; 20(7): 473-85.

2. Collaborators GBDKFwRT. Global, regional, and national prevalence of kidney failure with replacement therapy and associated aetiologies, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Glob Health 2025; 13(8): e1378-e95.

3. Vanholder R, Annemans L, Bello AK, et al. Fighting the unbearable lightness of neglecting kidney health: the decade of the kidney. Clinical kidney journal 2021; 14(7): 1719-30.

4. Vanholder R, Annemans L, Braks M, et al. Inequities in kidney health and kidney care. Nature reviews Nephrology 2023; 19(11): 694-708.

5. https://apps.who.int/gb/ebwha/pdf_files/EB156/B156_(20)-en.pdf.

6. Vanholder R, Coppo R, Bos WJW, et al. A Policy Call to Address Rare Kidney Disease in Health Care Plans. Clinical journal of the American Society of Nephrology : CJASN 2023; 18(11): 1510-8.

7. Gregg EW. Diabetes-related disability as a target for prevention. The lancet Diabetes & endocrinology 2013; 1(2): 81-2.

8. Vanholder R, Annemans L, Brown E, et al. Reducing the costs of chronic kidney disease while delivering quality health care: a call to action. Nature reviews Nephrology 2017; 13(7): 393-409.

9. https://www.worldkidneyday.org/facts/8-golden-rules/

10. Norton JM, Moxey-Mims MM, Eggers PW, et al. Social Determinants of Racial Disparities in CKD. Journal of the American Society of Nephrology: JASN 2016; 27(9): 2576-95.

11. Ferro CJ, Wanner C, Luyckx V, et al. ABCDE to identify and prevent chronic kidney disease: a call to action. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association – European Renal Association 2025.

12. Heerspink HJ, Desai M, Jardine M, Balis D, Meininger G, Perkovic V. Canagliflozin Slows Progression of Renal Function Decline Independently of Glycemic Effects. Journal of the American Society of Nephrology: JASN 2017; 28(1): 368-75.

13. Cordero L, Ortiz A. Albuminuria-based universal screening for CKD should be implemented now in high-income countries. Kidney international 2025; 108(5): 754-9.

14. Stehle T, Delanaye P. Which is the best glomerular filtration marker: Creatinine, cystatin C or both? European journal of clinical investigation 2024; 54(10): e14278.

15. van Mil D, Kieneker LM, Evers-Roeten B, et al. Participation rate and yield of two home-based screening methods to detect increased albuminuria in the general population in the Netherlands (THOMAS): a prospective, randomised, open-label implementation study. Lancet 2023; 402(10407): 1052-64.

16. Tangri N, Alvarez CS, Arnold M, et al. Suboptimal monitoring and management in patients with unrecorded stage 3 chronic kidney disease in real-world settings: Insights from REVEAL-CKD. European journal of clinical investigation 2024; 54(11): e14282.

17. Pouwels X, van Mil D, Kieneker LM, et al. Cost-effectiveness of home-based screening of the general population for albuminuria to prevent progression of cardiovascular and kidney disease. EClinicalMedicine 2024; 68: 102414.

18. Chavarina KK, Lou-Meda R, Luyckx VA. Strategic rebalancing of kidney-related investments is key to implementing the WHO kidney health resolution. Nature reviews Nephrology 2025; 21(12): 813-4.

19. www.kdsap.org.

20. Afkarian M, Sachs MC, Kestenbaum B, et al. Kidney disease and increased mortality risk in type 2 diabetes. Journal of the American Society of Nephrology: JASN 2013; 24(2): 302-8.

21. Wan EYF, Yu EYT, Chin WY, et al. Burden of CKD and Cardiovascular Disease on Life Expectancy and Health Service Utilization: a Cohort Study of Hong Kong Chinese Hypertensive Patients. Journal of the American Society of Nephrology: JASN 2019; 30(10): 1991-9.

22. Luyckx VA, Ulasi, II. Kidney disease must be counted everywhere. Lancet 2025.

23. Kidney Disease: Improving Global Outcomes CKDWG. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney international 2024; 105(4S): S117-S314.

24. Rama Krishna C, Venkateswar S, Bogdan M, et al. Point-of-Care Testing and Integrated Digital Health Technology for CKD Screening in High-Risk Populations of India. Kidney international reports 2025; 10(7): 2128-39.

25. Guedes M, Dias PT, Rea RR, et al. Patterns of kidney function and risk assessment in a nationwide laboratory database: the Brazilian CHECK-CKD study. BMC nephrology 2024; 25(1): 191.

26. Hajat S, Casula A, Murage P, et al. Ambient heat and acute kidney injury: case-crossover analysis of 1 354 675 automated e-alert episodes linked to high-resolution climate data. Lancet Planet Health 2024; 8(3): e156-e62.

27. Maline GE, Goldfarb DS. Climate change and kidney stones. Current opinion in nephrology and hypertension 2024; 33(1): 89-96.

28. Gopalakrishnan N, Sudharshini S, Sakthirajan R, et al. CKDu-AGRI Study-a population-based cross-sectional study of chronic kidney disease and chronic kidney disease of unknown aetiology among agricultural workers in Tamil Nadu, India. Lancet Reg Health Southeast Asia 2025; 42: 100683.

29. Garcia-Trabanino RA. The Human Burden of Mesoamerican Nephropathy: Diagnosis and Treatment in a Complex Web of Socioeconomics, Context, and Stigma. Seminars in nephrology 2025; 45(1-2): 151601.

30. Chretien JP, Anyamba A, Small J, et al. Global climate anomalies and potential infectious disease risks: 2014-2015. PLoS Curr 2015; 7.

31. Bowe B, Artimovich E, Xie Y, Yan Y, Cai M, Al-Aly Z. The global and national burden of chronic kidney disease attributable to ambient fine particulate matter air pollution: a modelling study. BMJ Glob Health 2020; 5(3): e002063.

32. https://climahealth.info/alliance-for-transformative-action-on-climate-and-health-atach-meeting-on-accessing-climate-finance-for-health/.

33. Talbot B, Fletcher RA, Neal B, et al. The potential for reducing greenhouse gas emissions through disease prevention: a secondary analysis of data from the CREDENCE trial. Lancet Planet Health 2024; 8(12): e1055-e64.

34. Vanholder R, Dominguez-Gil B, Busic M, et al. Organ donation and transplantation: a multi-stakeholder call to action. Nature reviews Nephrology 2021; 17(8): 554-68.

35. Tonelli M, Wiebe N, Knoll G, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. American journal of transplantation: official journal of the American Society of Transplantation and the American Society of Transplant Surgeons 2011; 11(10): 2093-109.

36. Schaapherder A, Wijermars LGM, de Vries DK, et al. Equivalent Long-term Transplantation Outcomes for Kidneys Donated After Brain Death and Cardiac Death: Conclusions From a Nationwide Evaluation. EClinicalMedicine 2018; 4-5: 25-31.

37. Azegami T, Kounoue N, Sofue T, et al. Efficacy of preemptive kidney transplantation for adults with end-stage kidney disease: a systematic review and meta-analysis. Renal failure 2023; 45(1): 2169618.

38. Achkar KA, Abdelnour LM, Abu Jawdeh BG, Tantisattamoa E, Al Ammary F. Evaluation and Long-Term Follow-Up of Living Kidney Donors. Adv Kidney Dis Health 2024; 31(5): 400-7.

39. Barraclough KA, Agar JWM. Green nephrology. Nature reviews Nephrology 2020; 16(5): 257-68.

40. Lenzen M, Malik A, Li M, et al. The environmental footprint of health care: a global assessment. Lancet Planet Health 2020; 4(7): e271-e9.

41. Vanholder R, Agar J, Braks M, et al. The European Green Deal and nephrology: a call for action by the European Kidney Health Alliance. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association – European Renal Association 2023; 38(5): 1080-8.

42. Connor A, Lillywhite R, Cooke MW. The carbon footprint of a renal service in the United Kingdom. QJM: monthly journal of the Association of Physicians 2010; 103(12): 965-75.

43. Piccoli GB, Nazha M, Ferraresi M, Vigotti FN, Pereno A, Barbero S. Eco-dialysis: the financial and ecological costs of dialysis waste products: is a 'cradle-to-cradle' model feasible for planet-friendly haemodialysis waste management? Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association - European Renal Association 2015; 30(6): 1018-27.

44. Tarrass F, Benjelloun M, Benjelloun O. Recycling wastewater after hemodialysis: an environmental analysis for alternative water sources in arid regions. American journal of kidney diseases: the official journal of the National Kidney Foundation 2008; 52(1): 154-8.

45. McAlister S, Talbot B, Knight J, et al. The Carbon Foot-print of Peritoneal Dialysis in Australia. Journal of the American Society of Nephrology: JASN 2024; 35(8): 1095-103.

46. Barraclough KA, Talbot B, Knight J, et al. Carbon Emissions From Different Dialysis Modalities: A Life Cycle Assessment. American journal of kidney diseases: the official journal of the National Kidney Foundation 2025; 86(4): 465-74 e1.

47. Solomon D, Arumugam V, Sakthirajan R, et al. A Pilot Study on the Safety and Adequacy of a Novel Ecofriendly Hemodialysis Prescription-Green Nephrology. Kidney international reports 2024; 9(5): 1496-503.

48. Ramada DL, de Vries J, Vollenbroek J, et al. Portable, wearable and implantable artificial kidney systems: needs, opportunities and challenges. Nature reviews Nephrology 2023; 19(8): 481-90.

49. Lunney M, Bello AK, Levin A, et al. Availability, Accessibility, and Quality of Conservative Kidney Management World-wide. Clinical journal of the American Society of Nephrology : CJASN 2020; 16(1): 79-87.

50. Kurella Tamura M, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE. Functional status of elderly adults before and after initiation of dialysis. The New England journal of medicine 2009; 361(16): 1539-47.

51. Morton RL, Snelling P, Webster AC, et al. Factors influencing patient choice of dialysis versus conservative care to treat end-stage kidney disease. CMAJ: Canadian Medical Association journal = journal de l'Association medicale canadienne 2012; 184(5): E277-83.

52. Stel VS, de Jong RW, Kramer A, et al. Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe. Kidney international 2021; 100(1): 182-95.

53. de Jong RW, Stel VS, Rahmel A, et al. Patient-reported factors influencing the choice of their kidney replacement treatment modality. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association – European Renal Association 2022; 37(3): 477-88.

54. Joosten EA, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CP, de Jong CA. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother Psychosom 2008; 77(4): 219-26.

55. EUPATI. https://eupati.eu/.

56. Sever MS, Luyckx V, Tonelli M, et al. Disasters and kidney care: pitfalls and solutions. Nature reviews Nephrology 2023; 19(10): 672-86.

57. Pawlowicz-Szlarska E, Vanholder R, Sever MS, et al. Distribution, preparedness and management of Ukrainian adult refugees on dialysis-an international survey by the Renal Disaster Relief Task Force of the European Renal Association. Nephrology, dialysis, transplantation: official publication of the European Dialysis and Transplant Association – European Renal Association 2023; 38(10): 2407-15.


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For citations:


Vanholder R., Abdellatif D., Dos Santos Jr. A.C., Correa-Rotter R., Gopalakrishnan N., Wang B., Roumeliotis S., Balducci A., Haris Á., Yadla M., Hsiao L. Kidney Health for All: Caring for People, Protecting the Planet. Nephrology and Dialysis. 2026;28(1):9-21. (In Russ.) https://doi.org/10.28996/2618-9801-2026-1-9-21

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ISSN 2618-9801 (Online)