Climate Change, Kidney Health, and Environmentally Sustainable Kidney Care: A Multinational Survey of Health Care Professionals

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Sandal S.; Ethier I.; Onu U.; Fung W.; Bajpai D.; Bilchut W.H.; Bagasha P.; De Chiara L.; Hafiz E.; Smyth B.; Kelly D.; Pippias M.; Jha V.

Journal: Journal of the American Society of Nephrology

Publisher: Wolters Kluwer Health

Publication Date: 20 May 2024

Volume / Issue: Volume 35 / Issue 8

Pages: 1084–1094

ISSN: 10466673

DOI: 10.1681/ASN.0000000000000402

Scopus: View on Scopus

PubMed: 38768364

Document Type: Article

Access: All Open Access; Green Open Access

Authors and Affiliations

Sandal S., Divisions of Nephrology and Experimental Medicine, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada, MEDIC, Research Institute, The McGill University Health Centre, Montreal, QC, Canada; Ethier I., Division of Nephrology, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada, Health Innovation and Evaluation Hub, Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Onu U., Department of Medicine, University of Nigeria Teaching Hospital Enugu, Ituku-Ozalla, Nigeria; Fung W., Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong; Bajpai D., Department of Nephrology, Seth G.S.M.C. and K.E.M. Hospital, Mumbai, India; Bilchut W.H., Department of Internal Medicine, University of Gondar, Gondar, Ethiopia; Bagasha P., Directorate of Internal Medicine, Department of Internal Medicine, Mulago National Referral Hospital L, College of Health Sciences, Makerere University, Kampala, Uganda; De Chiara L., Department of Biomedical, Experimental and Clinical Sciences "mario Serio,", University of Florence, Florence, Italy; Hafiz E., Theodor Bilharz Research Institute, Giza, Egypt; Smyth B., NHMRC Clinical Trials Centre, The University of Sydney, Camperdown, NSW, Australia; Kelly D., Oxford Critical Care, John Radcliffe Hospital, Oxford, United Kingdom; Pippias M., Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom, Renal Unit, North Bristol NHS Trust, Bristol, United Kingdom; Jha V., The George Institute for Global Health, UNSW, New Delhi, India, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India, Faculty of Medicine, Imperial College London, London, United Kingdom

Abstract

BackgroundGiven the threat of climate change to kidney health and the significant environmental effect of kidney care, calls are increasing for health care professionals and organizations to champion climate advocacy and environmentally sustainable kidney care. Yet, little is known about their engagement, and existing literature is primarily emerging from high-income countries.MethodsWe conducted a cross-sectional survey to understand the knowledge, attitude, and practice of health care professionals on the interconnectedness of climate change and kidney health; to identify personal and organizational initiatives in sustainable kidney care and strategies to increase their engagement; and to compare responses by their country's income level as classified by the World Bank.ResultsParticipants (n=972) represented 108 countries, with 64% from lower- or middle-income countries. Ninety-eight percent believed that climate change is happening, yet <50% possessed knowledge about the effect of climate change on kidney health or the environmental effect of kidney care. Only 14% were involved in climate change and kidney health initiatives (membership, knowledge/awareness, research, and advocacy), 22% in sustainable kidney care initiatives (education/advocacy, preventative nephrology, sustainable dialysis, promoting transplant/home therapies, and research), and 26% reported organizational initiatives in sustainable kidney care (sustainable general or dialysis practices, preventative/lean nephrology, and focused committees). Participants from lower-income countries generally reported higher knowledge and variable level of concern. Engagement in sustainable kidney care did not vary by income level. Guidance/toolkit (79%), continuing education (75%), and opportunities (74%) were the top choices to increase engagement. National initiatives (47%), preventative measures (35%), and research endeavors (31%) were the top avenues for organizational engagement. These varied by income level, suggesting that the vision and priorities vary by baseline resource setting.ConclusionsWe have identified knowledge and practice gaps among health care professionals on the bidirectional relationship between kidney disease and climate change in a multinational context and several avenues to increase their engagement. Copyright © 2024 by the American Society of Nephrology.

Keywords

business of nephrology; CKD non-dialysis; clinical nephrology; community engagement and health; health equity, diversity, and inclusion; health policy; social determinants of health; social health justice; Climate Change; Female; Health Personnel; Humans; Kidney Diseases; Male; Surveys and Questionnaires; adult; aged; Article; chronic kidney failure; cross-sectional study; dialysis; health care personnel; health education; health personnel attitude; health survey; high income country; human; kidney transplantation; knowledge gap; low income country; middle income country; practice gap; epidemiology; kidney disease; questionnaire; therapy

Citation Information

Scopus Citations: 19

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