Assessment of environmental sustainability in renal healthcare

Renal health benefits of sustainable diets in Japan: a review

Global warming may reduce food production and force people to adopt dietary habits of inadequate quantity or quality. Such dietary habits could trigger chronic kidney disease through inappropriate nutrition or lifestyle diseases. Livestock farming and other types of food production are responsible for many greenhouse gases. These problems are being emphasized as a diet-environment-health trilemma to be addressed on a global scale, with various methods being proposed toward its resolution. Diets like plant-based and low-protein diets not only potentially prevent the progression of chronic kidney disease, but are also rational from an environmental preservation perspective. Evidence from Japan on resolutions for this trilemma is sparse, but one concrete proposal is the use of traditional Japanese diets like washoku, the Okinawa diet, and the traditional Buddhist diet. However, traditional Japanese diets also have several problems, such as excessive salt content and caloric deficiencies, and need to be modified and incorporated into the current lifestyle. The progression of chronic kidney disease needs to be prevented with appropriate dietary treatment and environmental friendly manner.

Climate change and demand of emergency care in Japan

Both the frequency and severity of heat stress-related health problems have been increasing globally, probably due to global warming. The Intergovernmental Panel on Climate Change published a landmark climate report, the 6th Assessment Report, which shocked the world. It emphasized that anthropogenic activities, such as the combustion of fossil fuels, oil, gas, and coal, were responsible for climate change. The combination of population aging, and increased temperatures has meant that the number of people requiring emergency transport for heatstroke has been increasing in Japan from 2008 to 2020. The increase in ambient temperatures and the number of patients requiring emergency transport were strongly correlated (Spearman correlation coefficient: r=0.669 and P=0.008). Like many human activities, medical care is resource intensive and contributes significantly to climate change through the consumption of energy and water, as well as the emission of greenhouse gases. As healthcare professionals, we need to be cognizant of how our eco-friendly activities both on and off the job can contribute to saving both the patients and us.