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논문분류	춘계학술대회 초록집
제목	Impact of Dialysate Flow Reduction on the Carbon Footprint of Hemodialysis
저자	Yoshitaka Kurihara
출판정보	2026; 2026(1):
키워드	Dialysate Flow Reduction, Carbon foot print, Electricity consumption, Water use, Post-dilution online hemodiafiltration
초록	Objectives: As part of our institutional efforts to address environmental issues, we examined strategies to reduce dialysate flow rates. We previously reported that in post-dilution online hemodiafiltration (HDF), solute removal performance is maintained even when the total dialysate flow rate (QD_total) is reduced from 500 to 350 mL/min. This study evaluated the extent to which reducing QD_total contributes to CO₂ emission reduction. Methods: The impact of QD_total reduction was evaluated by comparing electricity consumption, water use and wastewater treatment volume, and dialysate consumption at QD_total values of 500 and 350 mL/min. The CO₂ emission was calculated using annual consumption and CO₂ emission factors. Electricity consumption related to dialysate flow in dialysis machine was estimated by simulation, while water use, wastewater treatment volume, and dialysate consumption were calculated from annual measured data at our institution. Results: Electricity consumption related to dialysate flow was 8.5 t-CO₂ (22,584 kWh) at QD_total 500 mL/min and 6.0 t-CO₂ (15,834 kWh) at 350 mL/min. Water use and wastewater treatment were 12.3 t-CO₂ (6,468 m³) at 500 mL/min and 7.9 t-CO₂ (4,116 m³) at 350 mL/min. CO₂ emissions associated with production of dialysate concentrates were 56.6 t-CO₂ (A concentrate: 20,240 L; B concentrate: 25,500 L) at 500 mL/min and 42.9 t-CO₂ (A concentrate: 15,000 L; B concentrate: 18,900 L) at 350 mL/min. Overall, reducing QD_total from 500 to 350 mL/min reduced emissions by 0.20 t-CO₂ per patient per year and 20.8 t-CO₂ per year for the facility. This corresponds to the annual CO₂ emissions of about 10 average households in Japan. Conclusion: Reducing the total dialysate flow rate from 500 to 350 mL/min while maintaining solute removal performance reduced CO₂ emissions by 0.20 t-CO₂ per patient per year and 20.8 t-CO₂ annually at the facility level.
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