The ERA-EDTA is the leading society in Europe for physicians working in the field of care for patients with kidney disease. The organization traditionally focuses on a broad range of activities aimed at improving the quality of patient care. Ecological issues have not been on the agenda until now. The ERA-EDTA is the first medical association to try and implement ‘greener’ health care as suggested by the ‘Lancet Countdown’ group, a collaboration among 24 academic institutions and intergovernmental organizations, which tracks progress on health and climate change and provides an independent assessment of the health effects of climate change and the actions that are developed to stop it (1).
“The relation between health care and the environment/climate change is bi-directional. Not only does a polluted environment cause various diseases, but also the converse: at the global level, the health care sector also has a clear negative impact on the environment”, explains Professor Peter Blankestijn, who has just published an editorial on this issue in Nephrology, Dialysis, Transplant (NDT) . ‘This is in conflict with the guiding principle for all physicians of primum non nocere , meaning ‘first, do no harm’. According to Blankestijn: “The health profession not only has the ability but also the responsibility to act as public health advocates by communicating the threats and opportunities to the public and policy makers and ensuring climate change is understood as being central in human wellbeing. Therefore, every doctor needs to contribute to the development and implementation of ‘greener’ health care.”
How does the ERA-EDTA contribute to a more environmentally friendly healthcare sector? First step is to create awareness with its members of the challenges that we are facing in patient care, research and education. Two examples from the field of nephrology are dialysis and self and home care. Hemodialysis is very energy-consuming, uses large quantities of water (usually at least 120 liters per patient per session, which is heated upto 37C and is thereafter discarded!), and creates substantial waste. Various dialysis industries have already launched initiatives in this respect. The ERA-EDTA is open to collaboration with industries to boost these initiatives. A second example is the implementation of e-health, promoting self and home care on a much larger scale in nephrology, reducing the need for patients to come to the hospital. The ERA-EDTA will function as a platform for end-users and industries to support these initiatives.
Another key word is ‘sustainable healthcare education’. “We need to design new educational tools and programs using modern technologies to prepare our students and doctors for the health care of the future. This way, we hope to reduce the ‘nephrologists carbon footprint’, explains Monica Fontana, ERA-EDTA’s executive manager.
 Watts N et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet 2018; 391: 581-630  Blankestijn, Peter et al. ERA-EDTA invests in transformation to greener health care. Nephrol Dial Transplant 2018; published online on 25 May
With more than 7,500 members, the ERA-EDTA (“European Renal Association – European Dialysis and Transplant Association”) is one of the biggest nephrology associations worldwide and one of the most important and prestigious European Medical Associations. It supports basic and clinical research in the fields of clinical nephrology, dialysis, renal transplantation and related subjects. It also supports a number of studies as well as research groups and has founded a special “Fellowship Programme” for young investigators as well as grant programmes. In order to involve young nephrologists in all its activities, ERA-EDTA has created the “Young Nephrologists’ Platform” (YNP), a very active committee whose board includes members who are 40 years old or younger. In addition, it has established various working groups to promote the collaboration of nephrologists with other medical disciplines (e.g. cardiology, immunology). Furthermore, a “European Renal Best Practice” (ERBP) advisory board was established by the ERA-EDTA to draw up and publish guidelines and position statements. Another important goal of the ERA-EDTA is education: The series of CME courses combined with the annual congress offer an attractive scientific programme to cover the need for continuous medical education for doctors working in the fields of nephrology, dialysis and transplantation. The association’s journals, NDT (Nephrology, Dialysis, Transplantation) and CKJ (Clinical Kidney Journal), are currently the leading nephrology journals in Europe; furthermore NDT-Educational is the online educational journal of the society, with free access for all users, as well as being a very important and useful feature of the NDT-Educational “Literature Review”. The ERAEDTA Registry is a large epidemiologic database comparing countries by assessing nephrology practices throughout Europe. ENP, the European Nephrology Portal, is the latest new initiative of ERA-EDTA, where all those interested in the activities of the Society can find everything that is happening, all in one place. Finally, ERA-EDTA is a member of the European Kidney Health Alliance (EKHA), a consortium of patients, nurses and foundations relating to renal issues that actively interacts with the European Parliament.