Our Planet

We each have a role to play in lightening our impact on the planet. From proper disposal of solid and medical waste to water and energy conservation, at Fresenius Medical Care North America, we are committed to limiting climate change and supporting environmentally sustainable solutions. Successes include solar panel installments, projects to recycle relevant materials, and zero-waste-to-landfill initiatives. As part of a global company, many regions contribute to our collective impact.

Fresenius Medical Care’s Global Environmental Policy summarizes the company’s approach to the environment across our worldwide operations. In the policy, Fresenius Medical Care commits to business practices that promote environmental protection and minimize any adverse impact of the business on the planet.

As an example of the global environmental efforts, Fresenius Medical Care recently established climate targets — committing to become climate neutral by 2040. To reduce the company’s impact on the climate, they have established a plan for the years ahead, and by 2030 Fresenius Medical Care aims to reduce  direct and indirect emissions (Scope 1 and 2) by half as compared to reported emission levels in 2020. 

In our day-to-day business, water plays a highly important role as an essential component of renal replacement therapy by dialysis. The fact that 120-150 liters of dialysis fluid circulate against a patient’s blood three times a week, means that dialysis patients are exposed to 30-40 times more water than the general population. Based on these considerations, it’s critical that dialysis water purity complies with higher standards than conventional tap water to minimize the emerging risks. 

A few years ago, Fresenius Medical Care Renal Technologies assessed its dialysis and water purification systems and identified opportunities for conservation. We started initiatives to reduce the amount of water and power our machines consume and confirm that optimal settings were being used at dialysis centers across the country.

Earlier this year, we shared our commitment to the environment by announcing our global climate targets. As a transition activity toward our global climate goal development, in the U.S. we purchased and retired 140,000 MWh worth of Green-e Certified Renewable Energy Certificates (RECs) for 2021 to reduce our carbon footprint, amounting to about 100,000 CO2e equivalent. 

In 2018, we installed solar panels on seven of our centers. With these solar panels, we have access to energy data that shows us how we are operating most efficiently and helps us optimize our operations. We are committed to sustainable energy solutions, and increasing our reliance on renewable energy resources will play a key role in helping us achieve our climate goals. 

Dialysis machines and water purification systems are indispensable to providing therapy for people with end stage renal disease. In the process, however, this equipment also uses large quantities of water and electricity as part of daily operations. 

In addition to water conservation features, in 2018, Fresenius Renal Technologies upgraded the technology in the flagship 2008T dialysis machine to include “low power mode,” which basically puts the dialysis machine into sleep mode — delivering power to only the machine’s electronics and turning off all pumps, valves, and modules when dialysis is not taking place. As soon as the keyboard, touchpad, or touchscreen is engaged, the machine “wakes up” again. In low power mode, the 2008T BlueStar machine’s run clock is also turned off, which can reduce the annual run time by 200 hours. 

We are committed to reducing our fossil fuel consumption while maintaining a safe and comfortable environment for our staff and patients. As part of this commitment, in 2021 we piloted a new Building Energy Management System (BEMS) that allows us to centrally control the temperature for our dialysis centers. The pilot included 116 centers, and key benefits include energy savings and reduced operational costs, reduced environmental impact, improved maintenance process, and minimized distraction for staff involved in temperature management. We plan to roll out the BEMS to approximately 800 additional centers in 2022.

For more than six years, we have been installing LED fixtures and associated lighting controls in our buildings. We’ve installed or upgraded to LED light fixtures at more than 600 centers and office locations, including 46 new centers in 2021. Along with these fixtures, occupancy sensors and lighting control panels minimize the amount of time that the fixtures are illuminated. In 2022, we plan to install LED light fixtures in around 50 new center locations.

About 67 percent of conventional dialysis machines are composed of recyclable metals such as copper, aluminum, and steel. Often, the plastic, bulbs, and circuit boards can be recycled as well. We use environmentally conscious practices to reduce waste from dialysis machines taken out of service after we purchase new ones. In 2021, we diverted 126 net tons of plastics and metals from landfills by reusing or recycling parts from 1,453 retired machines. This is a 41 percent decrease in retired machines from the previous year due to extending the useful life of a dialysis machine. In this process, we're reducing our environmental impact and extending the life of recovered components.

Plastic containers help dialysis centers safely and efficiently dispose of needles and other sharp objects. In the past, these receptacles were filled once, then autoclaved, shredded, and sent to landfills, releasing thousands of pounds of carbon into the atmosphere as they decayed. We shifted to reusable sharps containers, which can be emptied, washed, disinfected, and reused up to 600 times. In 2021, we reused 1,263,000 containers, eliminating 1,162 tons of waste and preventing 400 tons of carbon emissions.

Dialysis centers use more than 30 million small cups per year to distribute patient medications, and in years past our centers used plastic cups. By switching to paper cups — which decompose 15 times faster than plastic and pose less of a threat to air and water — we reduce the use of plastic cups. During 2021 all centers moved to paper cups, resulting in a decrease of more than 12 million plastic cups.  

Mircera is an agent used to treat anemia associated with chronic kidney disease and is an important component of the dialysis process. In years past, Styrofoam containers with ice packs were used to ship Mircera and disposed of after a single use, creating unnecessary amounts of waste. We’ve since changed to a reusable container that is emptied, returned, cleaned, and put back into circulation. Not only does this create a sustainable cycle, but it also creates less work for our employees and reduces the cost of Mircera shippers. By moving to reusable containers for Mircera, we kept more than 29,600 plastic containers out of landfills in 2021.

Our dialysis centers use 55-gallon blue drums for NaturaLyte® and Citrasate®, two concentrates needed for blood filtration. For several years, our centers have sent empty containers back with the delivery driver after a new shipment. Once returned to the warehouse, they undergo a quality check, get cleaned, and refilled for another use. In 2021, more than 141,300 drums were returned for reuse over the course of the year.

More than 50 percent of centers recycle cardboard, plastic, and other materials, diverting 18,682 net tons of waste from landfills. This is a 7 percent increase in recycling from 2020. We recognize that our acquisitions and new locations give us an opportunity to increase this further.

• Recycling Printer Cartridges — Through Lexmark’s reuse and recycle program for used toners and ink cartridges, we reduce e-waste and support the reuse of cartridges. Even if cartridges are reused one time, it can cut plastic waste by 50 percent, and with millions of cartridges ending up in landfills each year, that simple change makes a tremendous impact. In 2021, we diverted 3361 pounds from landfills, which is equivalent to 774 pounds of CO2.

• Recycling Fluorescent Lights and Batteries — Through Grainger, employees can order prepaid recycling and disposal kits that come with the necessary items to help centers recycle fluorescent lights and standard batteries.

1. This only reflects three quarters for 2021. Q4 reporting is not available.

All sustainability data is from Fresenius Medical Care North America for 2021 unless otherwise noted.