Annual dialysis data report 2023, Japanese Society for Dialysis Therapy (JSDT) Renal Data Registry

Vollständiger Abstract

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Abstract The annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was conducted with 4529 dialysis facilities at the end of 2023, of which 4470 facilities (98.7%) responded to the facility survey and 4284 facilities (94.6%) responded to the patient survey. The increase in the number of patients on dialysis in Japan has slowed in recent years. The number of patients on dialysis at the end of 2023 was 343,508, which less than the previous year. The prevalence of patients on dialysis was 2762.4 per million population. The prevalent patients on dialysis in the patient survey had a mean age of 70.09 years. Among these patients, diabetic nephropathy was the most common primary disease (39.5%), followed by chronic glomerulonephritis (23.4%) and nephrosclerosis (14.0%). The number of incident patients on dialysis during 2023 was 38,764, which decreased by 919 from 2022. Among incident patients on dialysis, the mean age was 71.59 years, and diabetic nephropathy (38.3%) was the most common cause of end-stage kidney disease. The second most common cause was nephrosclerosis (19.3%), which surpassed chronic glomerulonephritis in 2019 and has continued to increase. The crude annual mortality rate was 11.0%, with 38,073 patients dying during 2023; this rate was the same as last year’s. The three major causes of death were infectious disease (22.7%), which surpassed heart failure in 2022, heart failure (20.4%), and malignancy (7.6%). The number of patients treated by hemodiafiltration (HDF) has been rising since 2012, reaching 203,113 by the end of 2023 and accounting for 59.1% of all patients on dialysis. The number of peritoneal dialysis (PD) patients was 10,585 in 2023, which has slightly increased since 2017. Combination or hybrid therapy with hemodialysis (HD) or HDF was given to 21.0% of patients on PD. Home HD therapy was conducted in 799 patients as of the end of 2023; it decreased by 28 from 2022. In 2023, the use of ultrasound in vascular access management and the disinfection status of probe heads were investigated in the facility survey for the first time. In addition, exercise therapy, nutritional guidance, and activities of daily living levels, as well as the occurrence of the following events in 2023 were investigated at the patient survey: malignancies, deep vein thrombosis, pulmonary embolism, vascular access occlusion, and fundal hemorrhage. Hospitalization status and reasons for hospitalization were also surveyed for each patient in 2023. Clinical data about COVID-19 was also investigated in 2023 as 2022. Results obtained for each condition provide a framework to develop more clinically effective practice patterns for these conditions. Trial registration The Japanese Society for Dialysis Therapy (JSDT) Renal Data Registry (JRDR) was approved by the Japanese Society for Dialysis Therapy ethics committee. It was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry on 10 September 2020 and in the UMIN clinical trials registration system (UMIN000018641).