Spanish Registry of Renal Patients: 2022 Report and evolutive analysis

Abstract

INTRODUCTION: Chronic kidney disease (CKD) will be the second leading cause of death in Spain by 2100. The Spanish Renal Disease Registry (REER) records the incidence, prevalence and mortality of all patients requiring renal replacement therapy (RRT) in Spain. METHODS: Data are provided by Spanish autonomous regions and cities and the Organización Nacional de Trasplantes. Incidence and prevalence rates of RRT have been calculated (considering the Spanish population according to annual data from the Instituto Nacional de Estadística), as well as mortality of patients on RRT in our country during the period 2013-2022. RESULTS: The incidence rate of RRT increased by 21% from 2013 to 2019, and stabilized thereafter, with a value of 152.2 cases per million population (pmp) in 2022, of which 77.8% were on haemodialysis (HD), 16.7% on peritoneal dialysis (PD) and 5.5% received a preemptive kidney transplant. Diabetes was the leading cause of CKD requiring RRT (21.8%), followed by other causes (21.6%). The incidence rate of RRT was 2-fold higher in men than in women, with large regional differences (1.93-fold for men and 2.55-fold for women in regions with the highest and lowest incidence rates). The prevalence rate of RRT was 1,391.1 pmp in 2022, showing a progressive increase over the last decade, mainly at the expense of an increase in the transplant population (765.0 pmp, 55.0%). In 2022, 3,404 kidney transplants were performed in Spain (71.7 pmp), which situates it as a world leader. The most frequent donor type was the donor after the neurological determination of death (51.5%), followed by the donor after the circulatory determination of death (37%). The overall annual mortality of RRT patients was 8.4% (13.8% for HD, 10.1% for PD and 3.9% for transplantation). CONCLUSIONS: Although it has stabilized somewhat in recent years, the incidence and prevalence of RRT continues to rise in Spain. Additional measures must be adopted to harmonize and optimize kidney health care.