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, 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.


of plastics and metal diverted from landfills and recycled from retired dialysis machines.


containers kept out of landfills through our Mircera reusable packaging program.

250K MWh

worth of Green-e Certified Renewal Energy Certificates purchased to reduce our carbon footprint.


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 established climate targets in 2022 — 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. A 10.5 percent reduction in Scope 1 and Scope 2 emissions footprint was achieved in 2022 compared with 2021.

Ways We Are Reducing Our Environmental Impact


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. It is therefore critical that dialysis water purity meets higher standards than conventional tap water to support safe treatments.

Fresenius Medical Care 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.


In 2022, we created a cross-functional team of water experts to develop an operating strategy and usage minimization road map for the U.S. The team's initial focus is quantifying water usage and determining impact of 354 centers that are currently operating in areas designated as high water stressed regions.


We recognize the importance of protecting one of our most valuable resources, water. Our water experts are actively reviewing the operation of our water purification systems to improve efficiency and reduce our water usage. By utilizing the latest water purification technologies and making small incremental changes to our water system maintenance cycle we can have an enduring impact on our environment.

The quality of water is one of the most important factors in performing safe, effective dialysis treatment and running a dialysis center effectively. Water of the purest quality is key for safe dialysis treatment. In addition, keeping a high level of water pressure can ensure that treatments are not delayed.


In 2022, we completed the process of replacing vinegar with 2% dry citric acid (CitruClean) for cleaning our hemodialysis machines. CitruClean is a powdered chemical used to remove carbonate, calcium deposits, and scale. Among its benefits, CitruClean is a more effective cleaning solution than vinegar as it has more hydrogen ions to break down deposits. We’ve replaced twelve and a half cases of four one-gallon plastic jugs of vinegar with a shoebox of 20 packets of CitruClean powder in every location. This has resulted in significant cost savings for product as well as for shipping and storage. In addition, we’re reducing the number of plastic bottles and cardboard boxes/filler that we’re recycling or diverting to landfills where recycling is not available.



In 2022, we shared our commitment to the environment through the announcement of our global climate targets. As a transition activity toward our global climate goal development, in the U.S. we purchased and retired 250,000 MWh worth of Green-e Certified Renewable Energy Certificates (RECs) for 2022 to reduce our carbon footprint, amounting to about 86,000 metric tons 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. Shifting to renewable energy sources 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, the 2008T BlueStar software is another example of our ongoing efforts to limit the environmental footprint of dialysis. This software, unlike that in similar devices, enables the dialysis machine to switch to idle mode. Using idle mode reduces dialysate and water flow rates by up to two-thirds, saving additional costs. It also enables low power mode, which only directs power to the machine’s electronics when dialysis is not taking place. Pumps, valves, and modules are then turned off.


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 now have a BEMS in 468 centers, and plan to add approximately 700 centers in 2023.


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. Along with these fixtures, occupancy sensors and lighting control panels minimize the amount of time that the fixtures are illuminated.


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 2022, we diverted 96 net tons of plastics and metals from landfills by reusing or recycling parts from 1,301 retired machines. 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 2018, we shifted to reusable sharps containers, which can be emptied, washed, disinfected, and reused up to 600 times.

Dialysis centers use more than 40 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.

Mircera is an agent used to treat anemia associated with chronic kidney disease and is an important component of the dialysis process. We always strive to reduce the waste associated with product packaging. One way we’ve done this is by replacing the containers that were previously used to transport Mircera with reusable packaging. The new reusable packaging is emptied, returned, cleaned, and put back into circulation. Not only does this create a sustainable cycle, it also creates less work for our employees and reduces the cost of Mircera packaging. Through this process, we keep more than 127,000 containers out of landfills each year.

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 are then refilled for another use.

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 impact.



In the course of the dialyzer manufacturing process, the ends of the dialyzers are finely trimmed to specification. These polyethylene fiber/resin “chips” would normally be sent to a landfill. Instead, they are sent to a cement plant 47 miles away in Croydon, Utah. The cement plant prefers to use these chips as an alternative fuel source instead of standard fuel sources with a lower BTU rate. This process reduces our manufacturing waste to landfills and provides the cement plant with an energy recovery incineration process. This partnership with Fresenius Medical Care and the Holcim cement plant has been ongoing for over 10 years. On average, the Ogden, Utah, plant delivers 270 tons of material per month for use as an alternative fuel source.


  • 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 reusing cartridges one time 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 2022, we diverted 600 pounds from landfills, which is equivalent to 1,777 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.



As an administrative assistant in Baraboo, Wisconsin, Charlene Brennan has taken several steps to make a difference at work. Conscious of the collective waste created by single-use items, Charlene ditched the disposables in her center’s break room and encouraged employees to bring in reusable plates, cups, and glasses from home, and bought silverware from a secondhand store, saving the center hundreds of dollars per year. 

Charlene also champions returning shipping boxes and packaging for Mircera (an agent used to treat anemia associated with chronic kidney disease). “Our centers receive as many as 70,000 such containers a year, each with Styrofoam inserts and nearly two dozen ice packs,” notes Charlene. “When sent back to the company, they are cleaned and put back into use. This simple step — returning the box — avoids all of this reusable material from going to landfills.” 

Charlene Brennan, Administrative Assistant, Fresenius Kidney Care

All sustainability data is from Fresenius Medical Care North America for 2022 unless otherwise noted.

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