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How Dialysis is going green

Sustainable renal replacement therapy

Dialysis treatment is a life-preserving therapy. It uses a lot of water and energy. B. Braun is demonstrating how resources can be reduced in own renal care centers at several European locations with their green dialysis concept. We went to the renal care center in Teplice. 

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The new dialysis center in Teplice, Czech Republic. Kidney replacement therapy is carried out here in a particularly resource-friendly way.

“The medical staff here specializes in the health care process, so they don't need to worry about the technical setup as well.”

​ Miloš Kobza, Facility Manager of B. Braun renal care center in Teplice.

Green dialysis is not fundamentally different from conventional dialysis - but it uses less water and energy.

People are, and always will be, the most important thing

However, one thing is also clear: the focus is always on people. “First and foremost, patients should receive high-quality treatment at the centers. At the same time, the negative impact on the environment should be minimized. This is not a contradiction,” explains Dr. Petr Macoun, Managing Director of B. Braun in the Czech Republic and Slovakia—and therefore also responsible for the renal care centers.


Normally, patients are not aware of the green dialysis concept. In the basic process, green dialysis does not differ from conventional dialysis. Blood is drawn through a vascular access port—usually in the patient´s arm—and pumped to the dialyzer. This core component of dialysis is made up of semipermeable membranes that are surrounded by dialysis fluid. “The dialysis fluid flows in the opposite direction through the dialyzer as the blood. Microscopic pores in the fibers filter metabolic waste and excess water out of the patient´s blood,” explains Michal Dušek, Nursing Director of B. Braun in the Czech Republic and Slovakia.

“First and foremost, patients should receive high-quality treatment at the centers. At the same time, the negative impact on the environment should be minimized. This is not a contradiction.”

Petr Macoun, Managing Director of B. Braun in the Czech Republic and Slovakia

Using water intelligently

For example, direct savings can be realized with the potential to reduce water consumption. “About five to six liters of blood flow through the human body. During each dialysis treatment, this amount is usually purified more than ten times,” says Martin Meier.


A large amount of water is required, to purify a total of 60 liters of blood during dialysis. An average renal care center uses 2.5 million liters of water per year, which is about as much water as an Olympic swimming pool. However, a lot of water can be saved with the help of modern water treatment systems, as they discard much less water than older models and are correspondingly more efficient. “With our AQUAboss systems, we could save up to 40 percent water in some of our centers, which is equivalent to about one million liters of water per year,” Meier explains. Furthermore, remaining wastewater from the water treatment system can be used for toilets flushing or for watering the garden.


But that’s not all. “A big step for us in the Czech Republic and Slovakia was the certification of the Environmental Management System according to ISO 14001 in 2012,” says Jitka Pancířová, Global Quality Manager for Dialysis at 

B. Braun. The international standard was originally developed to provide guidelines for efficient environmental management for industry. “Over time, it has become apparent that health care facilities also perform procedures that consume large amounts of water and electricity and produce large amounts of hazardous waste. The renal care centers in the Czech Republic and Slovakia have fully implemented the Environmental Management System and the ISO standard,” says Pancířová. 

Water is a valuable resource. In green dialysis, it is used sparingly, for example by combining rinsing processes smartly and still maintaining hygienic standards.

AQUAboss® (Eco) RO Dia I / II HT

Reverse Osmosis Device

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Green dialysis in numbers

  • Up to


    liters of water are used in conventional dialysis. With a green one, it's only 200 liters at best.

  • More than


    liters of water a green dialysis center can save per year - half an Olympic swimming pool. 

  • Up to


    liters of dialysis fluid can be obtained from one cartridge of dry powder. This saves transporting the 10-liter canisters.

Reducing logistics    

As she talks about this, she walks into a storage room in the renal care center where some voluminous tanks stand. Their size is reminiscent of wine barrels, the liquid inside is plain: a salty water concentrate. With the help of the B. Braun concentrate mixing device ECOMix Revolution, another machine in the same room, the dialysis concentrate is prepared directly at the location. Pancířová sees ECOMix as a crucial technology for the green dialysis concept. “For each dialysis treatment, we need about five liters of A-concentrate, which is usually delivered in disposable plastic canisters.” Previously, we transported a large number of small canisters with A-concentrate to the locations for this purpose. “Now, we only supply large cartridges with dry powder for the B. Braun ECOMix. This powder is mixed with purified water in the machine to produce the dialysis concentrate on site,” says Pancířová.


Compared to a plastic canister with a capacity of five liters, the reusable cartridge is much larger, and it weighs 220kg. It can be refilled by the manufacturer and therefore used multiple times. This means using B. Braun ECOMix uses up to 98% less plastic and reduces deliveries, saving up to 75 percent in CO2e emissions, calculated per liter of concentrate. This is because out of a transport with dry powder in cartridge, more than 3 times as much concentrate can be prepared compared to a comparable transport with canisters.

ECOMix Revolution

Fully automated in-house peparation of hemodialysis acid concentrates

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Jitka Pancířová, global quality manager for dialysis at B. Braun stands in front of the tanks where the dialysis fluid mixed on site is stored.

In Europe alone, dialysis is life-preserving for around 600,000 people. Making it more sustainable is a big win for the environment. 

Elements of green dialysis



Modern construction and building technology can save on heating costs, for example.



Supplying the basic materials needed for dialysis fluid in dry form is more efficient than in liquid form. It also produces less waste. 

Dialysis machines

Dialysis machines

Smart interconnection of equipment during rinsing and efficient allocation prevents idle times. 

Concentrate Mixing

Concentrate Mixing

With the help of the B. Braun concentrate mixing device ECOMix Revolution the dialysis concentrate is prepared directly at the location. ECOMix is a crucial technology for the green dialysis concept.

Reverse Osmosis Device

Reverse Osmosis Device

With their innovative technology, all reverse osmosis devices in the AQUAboss series rank among the world's leading water treatment systems for hemodialysis applications.

Data Management

Data Management

Intelligent data management for dialysis and nephrology. Nexadia is our modern patient data management system.

Get in touch with our experts

The protection of the personal data of our customers is very important to us and we take it very seriously. Your personal data is subject to data protection and will only be collected and stored for approach reasons. Under no circumstances will we pass on your personal data to third parties outside of the B. Braun group or use or store them for any other purposes. Our staff has been trained to handle personal data and is obliged to comply with the data protection regulations.


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Canister to simplify dialysis processes

This new type of canister for hemodialysis concentrate is designed to make renal care nurses’ day-to-day business easier and more comfortable.

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