Thailand Renal Replacement Therapy Registry 2023: Epidemiology and Trends in Incident Dialysis Patients

This study examines data from the Thailand Renal Replacement Therapy (TRT) Registry, highlighting trends, challenges, and opportunities in managing End-Stage Kidney Disease (ESKD) and delivering renal replacement therapy (RRT) in Thailand. Between 2000 and 2023, the number of new patients initiating hemodialysis rose by 13,045 in 2023, while new peritoneal dialysis cases declined by nearly 50% compared to 2021. Diabetic nephropathy and hypertension remained the leading causes of ESKD, accounting for over 80% of cases. Despite the growing burden of ESKD, significant gaps in care persist, including challenges with vascular access and disparities in dialysis adequacy. Kidney transplantation rates remain low, with only a small percentage of patients on the waiting list. Additionally, the study highlights concerns about malnutrition and low vaccination coverage among dialysis patients. In 2023, the mortality rate among incident dialysis patients was 3.6%, with cardiac disease and infections as the leading causes of death. These findings emphasize the urgent need for targeted interventions in hypertension and diabetes management, infection prevention, and improved access to transplantation and vaccination. This analysis provides critical insights to inform policy development and enhance the quality of care for ESKD patients in Thailand.