Annual dialysis data report for 2018, JSDT Renal Data Registry: survey methods, facility data, incidence, prevalence, and mortality
Authors: Nitta Kosaku , Goto Shunsuke , Masakane Ikuto , Hanafusa Norio , Taniguchi Masatomo , Hasegawa Takeshi , Nakai Shigeru , Wada Atsushi , Hamano Takayuki , Hoshino Junichi , Joki Nobuhiko , Abe Masanori , Yamamoto Keiichi , Nakamoto Hidetomo ,   on behalf of the Japanese Society for Dialysis Therapy Renal Data Registry Committee, Maeno Kazuyuki , Kawata Tetsuya , Oyama Chikara , Seino Koji , Sato Toshinobu , Sato Shigeru , Ito Minoru , Kazama Junichiro , Ueda Atsushi , Saito Osamu , Ando Tetsuo , Ogawa Tomonari , Kumagai Hiroo , Terawaki Hiroyuki , Ando Ryoichi , Abe Masaki , Kashiwagi Tetsuya , Hamada Chieko , Shibagaki Yugo , Hirawa Nobuhito , Shimada Hisaki , Ishida Yoichi , Yokoyama Hitoshi , Miyazaki Ryoichi , Fukasawa Mizuya , Kamijyo Yuji , Matsuoka Teppei , Kato Akihiko , Mori Noriko , Ito Yasuhiko , Kasuga Hirotake , Koyabu Sukenari , Arimura Tetsuro , Hashimoto Tetsuya , Inaba Masaaki , Hayashi Terumasa , Yamakawa Tomoyuki , Nishi Shinichi , Fujimori Akira , Yoneda Tatsuo , Negi Shigeo , Nakaoka Akihisa , Ito Takafumi , Sugiyama Hitoshi , Masaki Takao , Nitta Yutaka , Okada Kazuyoshi , Yamanaka Masahito , Kan Masaharu , Ota Kazumichi , Tamura Masahito , Mitsuiki Koji , Ikeda Yuji , Nishikido Masaharu , Miyata Akira , Tomo Tadashi , Fujimoto Shoichi , Nosaki Tsuyoshi , Oshiro Yoshinori 
Published: September 2020

Abstract
The annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was sent to 4458 dialysis facilities at the end of 2018; among these facilities, 4402 facilities (98.7%) responded to the facility questionnaire, and 4222 (94.7%) responded to the patient questionnaire. The number of chronic dialysis patients in Japan continues to increase every year; as of the end of 2018, it had reached 339,841 patients, representing 2688 patients per million population. Among the prevalent dialysis patients, the mean age was 68.75 years, and diabetic nephropathy was the most common primary disease among the prevalent dialysis patients (39.0%), followed by chronic glomerulonephritis (26.8%) and nephrosclerosis (10.8%). The number of incident dialysis patients was 40,468, and a reduction by 491 from 2017. The mean age of the incident dialysis patients was 69.99 years old. Diabetic nephropathy was also the most common primary disease (42.3%), representing a 0.2 percent point reduction from 2017. The distribution of diabetic nephropathy appears to have reached a plateau. The number of deceased patients during 2018 was 33,863, and the crude annual death rate was 10.0%. Heart failure was the most common cause of death (23.5%), followed by infection (21.3%) and malignant tumor (8.4%); these causes were similar to those for 2017. The number of patients receiving hemodiafiltration has been increasing since 2012, reaching 125,793 or 37.0% of all dialysis patients at the end of 2018. The number of patients receiving peritoneal dialysis has been gradually increasing since 2017, reaching 9445, and 19.7% of these patients were treated using a combination of peritoneal dialysis and hemodialysis or hemodiafiltration. The proportion of patients receiving combination therapy has remained at around 20% of all peritoneal dialysis patients. The number of patients undergoing home hemodialysis was 720, representing an increase of 36 patients from 2017. The 2018 JRDR survey included several topics such as the present status of the patient kinetics of chronic dialysis patients at the end of 2018, water treatment and hemodiafiltration, peritoneal dialysis, treatments for diabetes, mental and physical conditions, and the present status of viral hepatitis. In this paper, we describe the patient and facility kinetics.

Trial registration
The JRDR was approved by the ethics committee of the JSDT (approval number 1-3) and was registered in the “University hospital Medical Information Network (UMIN) Clinical Trials Registry” under the clinical trial ID of UMIN000018641 on August 8, 2015: (Accessed June 2, 2020)