California (and the rest of the US): You DON’T Have To Waste Dialysis Water!

This blog post was made by Dr. John Agar on May 22, 2015.
California (and the rest of the US): You DON’T Have To Waste Dialysis Water!

I hear that there is a water shortage in California, a region where, in 2012, there were 81,019 citizens being supported by dialysis. Well, assume that:

  • These 81,019 patients have 3 sessions of dialysis a week
  • Use a dialysate flow rate of 500 mL/minute
  • Use city or town mains water for their dialysis processed by a reverse osmosis (RO) plant that “rejects” 60% of the presented tap water to make that 500 mL/minute
  • Have a treatment time equal to the mean US dialysis duration of 211 minutes

In this case, there is a good amount of annual, potable-suitable, high-quality RO reject water that could be re-used, and, for that matter, is quite safe for human consumption as it falls within all EPA requirements for drinking water: 81,019 (patients) x 211 (minutes) x 750 mL (potable water rejected/discarded by the RO system/minute) x 3 (treatments/week) x 52 (weeks per year) = 2,000,116,053,000 mL, 2,000,116,053 litres—or 528,374,762 (more than half a billion) US gallons each year.

Hang on a minute…more than 2 billion litres of usable water are being thrown away!

Yes, it is being thoughtlessly discarded by Californian dialysis units. Indeed, most dialysis units everywhere are throwing it away, too. Yet, with a fun working-bee and one weekend of D-I-Y plumbing, this excellent water could be re-routed to any number of grey water uses, if local regulation does not permit it to be used as drinking water.

Fact: There are 2,500,000 litres in a standard Olympic swimming pool. This means that Californian dialysis services are currently discarding enough water to the drain to fill more than 800 pools. At a standard length of 50 metres each, this equates to an end-on-end stretch of Olympic pools 40,000 metres (or 40 km) long, or, approximately, 25 US miles.

Using a simple system of collect, pump, pipe, and tank, this 2 billion litres could be captured and re-used to:

  • Grow vegies
  • Bathe the baby
  • Wash the dishes
  • Steam the bok choi
  • Shower
  • Flush the toilets
  • Mop the floors
  • Water the animals
  • Make steam to sterilize hospital instruments
  • Water the almond trees (uh-oh!)
  • Make ice with
  • Or, simply add to an awful lot of an end-of-the-day whiskies.

We have been doing this in Australia since 2003 … so, why not in California?

Even further, I have long advocated that dialysis units should combine their roof-top space with:

  1. A renewable solar energy source for dialysis-related power
  2. A roof-top garden where, if a flat top and feasible, yummy and healthy produce for dialysis patient and staff use could be cultivated (see picture)

I think that might be called “killing two birds with one stone,” though as I think about it, that is not the kindest ecological metaphor to use! What has happened to the great American reputation for invention and innovation? Where is it hiding? To be honest, it all seems rather sad! Take a moment to read the following blog article from December 2014 in KidneyViews.

If this can be done by one of the planet's most remote communities, a community of 214 people in the deep Australian Outback…when you read how they are solving their chronic water scarcity, then think what you are missing out on!

Come on California, INNOVATE!


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