2024 Annual Report of the Thailand Renal Replacement Therapy (TRT) Registry – Executive Summary
Article Sidebar
Main Article Content
Abstract
The 2024 Thailand Renal Replacement Therapy (TRT) Registry Annual Report examines national trends in incidence, prevalence, practice patterns, and outcomes to inform health policy and system planning. In 2024, the incidence of renal replacement therapy (RRT) reached a historic high of 515 per million population (33,976 new cases), largely reflecting the expansion of hemodialysis (HD) following the implementation of the 2022 “free-choice” dialysis policy. Peritoneal dialysis (PD) initiation declined markedly, while kidney transplantation remained limited. RRT prevalence more than doubled from 2016 to 2024, exceeding 2,600 per million population, with HD accounting for most of the increase. Diabetes (32.7%) and hypertension (32.2%) were the leading causes of end-stage kidney disease. The dialysis population was predominantly older (mean age 62.6 years) and had relatively low educational attainment. Important care gaps were identified, including high catheter use at HD initiation, frequent twice-weekly dialysis, suboptimal anemia control, prevalent mineral and bone disorders, and insufficient preventive care. Between 2017 and 2024, cumulative mortality reached 39.2% (9.5 deaths per 100 patient-years), with higher mortality in PD than HD patients. Cardiovascular disease and infections were the leading causes of death. One-year survival was 95.4%, declining to 61.9% over five years. Despite expanded RRT access under universal coverage, improving long-term outcomes and system sustainability will require strengthened chronic kidney disease prevention, optimized dialysis quality, equitable financing, expanded transplantation, and continued investment in high-quality registry data.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
This article is published under CC BY-NC-ND 4.0 license, which allows for non-commercial reuse of the published paper as long as the published paper is fully attributed. Anyone can share (copy and redistribute) the material in any medium or format without having to ask permission from the author or the Nephrology Society of Thailand.
References
Aiumtrakul N, Kittithaworn A, Supasyndh O, Krittayaphong R, Phrommintikul A, Satirapoj B. Prediction of cardiovascular outcome by estimated glomerular filtration rate among high-risk patients: a Thai nationwide cohort study. Clin Exp Nephrol 2022;26(12):1180–93. doi: 10.1007/s10157-022-02262-5.
Aiumtrakul N, Supasyndh O, Krittayaphong R, Phrommintikul A, Satirapoj B. Cardio-ankle vascular index with renal progression and mortality in high atherosclerosis risk: a prospective cohort study in CORE-Thailand. Clin Exp Nephrol 2022;26(3):247–56. doi: 10.1007/s10157-021-02149-x.
Arriola-Montenegro J, Cheungpasitporn W, Thongprayoon C, Craici IM, Miao J. Public interest in chronic kidney disease and dialysis: a 20-year data analysis. Ren Fail 2025;47(1):2462253. doi: 10.1080/0886022X.2025.2462253.
Collaborators GBDKFwRT. Global, regional, and national prevalence of kidney failure with replacement therapy and associated aetiologies,1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Glob Health 2025;13(8):e1378–e95. doi: 10.1016/S2214-109X(25)00198-6.
Thurlow JS, Joshi M, Yan G, Norris KC, Agodoa LY, Yuan CM, et al. Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy. Am J Nephrol 2021;52(2):98–107. doi: 10.1159/000514550.
Premprasong A, Nata N, Tangwonglert T, Supasyndh O, Satirapoj B. Risk factors associated with mortality among patients on maintenance hemodialysis: The Thailand Renal Replacement Therapy registry. Ther Apher Dial 2024;28(6):839–54. doi: 10.1111/1744-9987.14166.
Agarwal R, Nangaku M, Chen L, Wang AYM, Yanagita M, Bavanandan S, et al. Implementation of Established Global Guidelines in the Management of CKD in Patients with Type 2 Diabetes in Asia. Clin J Am Soc Nephrol 2025. doi: 10.2215/CJN.0000000909.
Makmun A, Satirapoj B, Tuyen DG, Foo MWY, Danguilan R, Gulati S, et al. The burden of chronic kidney disease in Asia region: a review of the evidence, current challenges, and future directions. Kidney Res Clin Pract 2025;44(3):411–33. doi: 10.23876/j.krcp.23.194.
Kanjanabuch T, Takkavatakarn K. Global Dialysis Perspective: Thailand. Kidney360 2020;1(7):671–5. doi: 10.34067/KID.0000762020.
Nyokabi P, Youngkong S, Bagepally BS, Okech T, Chaikledkaew U, McKay GJ, et al. A systematic review and quality assessment of economic evaluations of kidney replacement therapies in end-stage kidney disease. Sci Rep 2024;14(1):23018. doi: 10.1038/s41598-024-73735-8.
Assanatham M, Pattanaprateep O, Chuasuwan A, Vareesangthip K, Supasyndh O, Lumpaopong A, et al. Economic evaluation of peritoneal dialysis and hemodialysis in Thai population with End-stage Kidney Disease. BMC Health Serv Res 2022;22(1):1384. doi: 10.1186/s12913-022-08827-0.
Supaporn T. The Professor Emeritus Sa-nga Nilvarangkun, MD, Endowed Lectureship: National Policy & Sustainability on Thailand Dialysis Program. J Nephrol Soc Thail. 2025;30(4): 241-7.
Morad Z, Choong HL, Tungsanga K, Suhardjono. Funding renal replacement therapy in southeast Asia: building public-private partnerships in Singapore, Malaysia, Thailand, and Indonesia. Am J Kidney Dis 2015;65(5):799–805. doi: 10.1053/j.ajkd.2014.09.031.
Satirapoj B, Tantiyavarong P, Thimachai P, Chuasuwan A, Lumpaopong A, Kanjanabuch T, et al. Thailand Renal Replacement Therapy Registry 2023: Epidemiological Insights Into Dialysis Trends and Challenges. Ther Apher Dial 2025;29(5):721–9. doi: 10.1111/1744-9987.70056.
