The world faces a dramatic man-made ecologic disaster and health care occupies a crucial part in this problem. Compared to other therapeutic areas, nephrology care and especially dialysis creates an excessive burden, via water consumption, greenhouse gas emission, and waste production. In this advocacy publication from the European Kidney Health Alliance (EKHA), we describe the mutual impact of climate change on kidney health and of kidney care on ecology. We propose an array of measures as potential solutions, related to prevention of kidney disease, kidney transplantation and green dialysis. For dialysis, several proactive suggestions are made, especially by lowering water consumption, implementation of energy-neutral policies, waste triage, and recycling of materials. These include original proposals such as dialysate regeneration, dialysate flow reduction, water distillation systems for dialysate production, heat pumps for unit climatization, heat exchangers for dialysate warming, biodegradable and bio-based polymers, alternative power sources, repurposing of plastic waste (e.g. incorporation in concrete), registration systems of ecologic burden and platforms to exchange ecologic best practices. We also discuss how the European Green Deal offers real potential for supporting and galvanizing these urgent environmental changes. Finally, we formulate recommendations to professionals, manufacturers, providers, and policy makers on how this correction could be achieved.