2023 Annual Dialysis Data Report, JSDT Renal Data Registry

<p>The annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was conducted for 4,529 dialysis facilities at the end of 2023, among which 4,470 facilities (98.7％) responded to the facility survey and 4,284 facilities (94.6％) responded to the patient survey. The increase in the number of dialysis patients in Japan has been slowing in recent years. The number of dialysis patients at the end of 2023 was 343,508, which was a decrease from the previous year. The prevalence ratio of dialysis patients was 2,762.4 per million population. The mean age of the prevalent dialysis patients in the patient survey was 70.09 years. Diabetic nephropathy was the most common primary disease among the prevalent dialysis patients (39.5％), followed by chronic glomerulonephritis (23.4％) and nephrosclerosis (14.0％). The number of incident dialysis patients during 2023 was 38,764; it decreased by 919 from 2022. Among incident dialysis patients, the average age was 71.59 years, and diabetic nephropathy (38.3％) was the most common cause of end-stage kidney disease (ESKD). As 38,073 patients died in 2023, the crude annual mortality rate was 11.0％, and it remained the same as last year. The three major causes of death were infectious disease (22.7％), which replaced 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 to reach 203,113 by the end of 2023, which accounted for 59.1％ of all dialysis patients. The number of peritoneal dialysis (PD) patients was 10,585 in 2023, which has slightly increased since 2017. The combination or hybrid therapy with hemodialysis (HD) or HDF was given to 21.0％ of PD patients. Home HD therapy was conducted in 799 patients at 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 at the facility survey for the first time. In addition, exercise therapy, nutritional guidance, and daily activity levels, as well as the occurrence of the following events in 2023: malignant tumors, deep vein thrombosis, pulmonary embolism, vascular access occlusion, and retinal hemorrhage were investigated at the patient survey. Furthermore, a survey was conducted on the hospitalizations of each patient and the reasons in 2023. Clinical data about Coronavirus disease (COVID-19) and the history of past living kidney donation were also investigated in 2023 as 2022. Results obtained on each condition provide a scheme for more clinically effective practice patterns on these conditions to be developed.</p>