Carbon Emission Calculation in Hemodialysis Patients Using a Carbon Footprint Calculator: A Multicenter Observational Study
Vamshi Krishna *
Department of Nephrology, Gandhi Medical College, Secunderabad, Telangana, India.
Manjusha Yadla
Department of Nephrology, Gandhi Medical College, Secunderabad, Telangana, India.
P. Srinivas
Department of Nephrology, Gandhi Medical College, Secunderabad, Telangana, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Haemodialysis is a resource-intensive treatment associated with greenhouse-gas emissions from repeated treatment delivery, transportation, household energy use, diet and waste. Patient-level carbon-emission data from India remain limited. This study assessed carbon emissions associated with maintenance haemodialysis across centres in Telangana, India.
Methods: This multicentre observational assessment included 489 patients receiving maintenance haemodialysis at 18 dialysis centres during 2025, representing 156,264 haemodialysis sessions. Carbon emissions were estimated using the CarbonClick carbon-footprint calculator and included reported transportation, air travel, dietary habits, household energy use and household waste generation. Emissions were expressed as tonnes of carbon dioxide equivalents (t CO₂e).
Results: The total reported carbon footprint was 1121.7 t CO₂e, with a mean of 2.29 ± 0.18 t CO₂e per participant, a median of 2.30 and a range of 2.00–2.60. Transportation contributed 39.1% of total emissions, housing energy 30.4%, dietary sources 26.0% and other sources 4.5%. Small petrol-powered vehicles predominated. Electricity accounted for 83% of the housing-energy contribution, while LPG and diesel-generator use contributed 12% and 5%, respectively. Among 475 participants with dietary data, the largest categories were vegetarian or very-low-meat and vegetarian diets.
Conclusions: Transportation, housing energy and dietary factors were the main reported contributors. Patient- and centre-level carbon accounting may help identify locally relevant opportunities for more environmentally sustainable dialysis care.
Keywords: Carbon footprint, haemodialysis, carbon emissions, Greenhouse-gas emissions, environmental sustainability, dialysis care, transportation emissions, household energy, dietary emissions, Patient-level carbon accounting