Academic Journal
A cost-benefit and sustainability model for high-efficiency reverse osmosis implementation in Moroccan Dialysis Centers.
| Τίτλος: | A cost-benefit and sustainability model for high-efficiency reverse osmosis implementation in Moroccan Dialysis Centers. |
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| Συγγραφείς: | Tarrass F; Center of Hemodialysis 2 Mars, Casablanca, Morocco., Benjelloun O; Center of Hemodialysis 2 Mars, Casablanca, Morocco., Habib Allah M; Center of Hemodialysis Targa, Marrakech, Morocco., Benjelloun M; Center of Hemodialysis 2 Mars, Casablanca, Morocco. |
| Πηγή: | Journal of nephrology [J Nephrol] 2026 Aug 20; Vol. 39 (4), pp. 726-732. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer Country of Publication: England NLM ID: 9012268 Publication Model: Print Cited Medium: Internet ISSN: 1724-6059 (Electronic) Linking ISSN: 11218428 NLM ISO Abbreviation: J Nephrol Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2014- : Heidelberg : Springer Original Publication: Rome : Acta Medica |
| Ιατρικοί όροι (MeSH): | Renal Dialysis*/economics , Renal Dialysis*/instrumentation , Water Purification*/economics , Water Purification*/methods , Conservation of Water Resources*/economics , Models, Economic*, Water Supply/economics ; Morocco ; Cost-Benefit Analysis ; Osmosis ; Humans ; Time Factors ; Fresh Water ; Cost Savings |
| Περίληψη: | Background: Standard reverse osmosis systems for hemodialysis operate at 60-75% recovery rates, wasting 25-40% of feed water as brine. This inefficiency poses a critical challenge in water-scarce regions like Morocco, where freshwater availability is projected to fall below 500 m³ per capita by 2030. Methods: This study assessed all 437 dialysis centers across Morocco, analyzing current reverse osmosis system capacity, water rejection rates, and operating hours to calculate the potential benefits of switching to high-efficiency systems with rejection rates below 15%. Results: Upgrading to high-efficiency reverse osmosis systems could reduce annual reject water by 576 850 m³ (52.4%) relative to baseline, conserve 1.92 × 106 m³ of freshwater, cut 1340 t CO₂-eq annually, and generate 13.15 million Moroccan Dirhams (MAD) (€1.2 million) in yearly savings. Comparative analysis of various manufacturers revealed investment payback periods of 8.36 years for Riv-ROS, 10.24 years for DWA-MS, and 12.11 years for Nip-Ph1, with sensitivity analyses accounting for water price fluctuations (±20%) and equipment lifespan variations, confirming Riv-ROS and DWA-MS as the best financially viable options. Conclusion: These findings present a compelling case for nationwide implementation, offering Morocco's healthcare sector a scalable solution to address water sustainability and operational costs while maintaining treatment quality standards. The projected 52.4% reduction in reject water and associated savings support urgent policy action to modernize hemodialysis water purification systems as a model for water-scarce regions. (© The Author(s) 2026. Published by Oxford University Press on behalf of Societa Italiana Nefrologia/Italian Society of Nephrology; Society ownership. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Competing Interests: | Conflicts of interest: On behalf of all the authors, the corresponding author states that there are no conflicts of interest. |
| Contributed Indexing: | Keywords: cost-benefit analysis; green nephrology; reverse osmosis; water conservation |
| Entry Date(s): | Date Created: 20260625 Date Completed: 20260820 Latest Revision: 20260820 |
| Update Code: | 20260820 |
| DOI: | 10.1093/joneph/aajaf011 |
| PMID: | 42345296 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1724-6059 |
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| DOI: | 10.1093/joneph/aajaf011 |