About EcoRenal

Methodology & source study

EcoRenal is an academic tool that helps dialysis units in India estimate the carbon dioxide equivalent (CO₂e) emissions generated from their consumables, water use, electricity use, biomedical waste, and patient/staff travel.

All values and conversion factors used by this calculator are based on the study:

"Carbon Footprint Assessment of Hemodialysis Services: A cross-sectional study from an Indian Dialysis Center," published in the Turkish Journal of Nephrology.

Authors

  1. Manjunath Kulkarni, DM — Professor and Head, Department of Nephrology, Father Muller Medical College, Mangaluru, Karnataka, India
  2. Mashud Mohd Essar Husnain Khan, DM — Senior Resident, Department of Nephrology, Father Muller Medical College, Mangaluru, Karnataka, India
  3. Amith Vijay Leon Dsouza — Professor, Department of Nephrology, Father Muller Medical College, Mangaluru, Karnataka, India
  4. Archana Bhat, MD — Associate Professor, Department of Pathology, Father Muller Medical College, Mangaluru, Karnataka, India
  5. Bhargavi Bhojaraju, MD — Senior Resident, Department of Nephrology, Father Muller Medical College, Mangaluru, Karnataka, India
  6. Diljeet Bodra, MD — Senior Resident, Department of Nephrology, Father Muller Medical College, Mangaluru, Karnataka, India
  7. Tilakraj Nayak — Intern, Department of Pharmacology, Karavali College of Pharmacology, Mangaluru, Karnataka, India
  8. Arfa Naaz — Intern, Department of Pharmacology, Karavali College of Pharmacology, Mangaluru, Karnataka, India
  9. Thomas Sunder Singh Kuruvilla — Professor, Department of Microbiology, Father Muller Medical College, Mangaluru, Karnataka, India

Correspondence: Manjunath Kulkarni, Department of Nephrology, Father Muller Medical College, Father Muller Road, Kankanady, Mangaluru, Karnataka, India 575001.

Study summary

The study performed a cross-sectional, life-cycle-based assessment of CO₂e emissions at a tertiary dialysis centre caring for 135 patients in July 2025. Activity data for electricity, water, consumables, waste, and transportation were collected and converted to CO₂e using India-specific emission factors. The facility's total monthly footprint was 106,280 kg CO₂e, averaging 66.5 kg per dialysis session and 10,243 kg per patient per year for thrice-weekly treatment. Consumables produced 75% of total emissions, with heparin alone accounting for 71% of the consumable-related total. Electricity contributed 13.9%, waste 7.6%, transportation 2.7%, and water 0.4%.

Emission factors used by this calculator

CategoryEmission factor
Electricity0.82 kg CO₂e / kWh (India grid, 2024)
Water0.344 kg CO₂e / m³
Waste — incinerated2.85 kg CO₂e / kg
Waste — recycled0 kg CO₂e / kg
Travel — bus0.04 kg CO₂e / km
Travel — car0.17 kg CO₂e / km
Travel — two-wheeler0.06 kg CO₂e / km
Travel — auto-rickshaw0.08 kg CO₂e / km
General medical plastic3 kg CO₂e / kg
Heparin (5,000 IU vial)51.5 kg CO₂e / vial (pig-allocation method)

Consumable-specific factors (dialysers, blood tubing sets, dialysate, needles, catheters, PPE, syringes, etc.) are derived from the study's Supplementary Appendix and applied per unit in the calculator's consumables section.

Important notes & limitations