Major changes and improvements of dialysis therapy in Korea: review of end-stage renal disease registry

Abstract

The Korean Society of Nephrology (KSN) launched a nationwide end-stage renal disease (ESRD) patient registry in 1985 called the Insan Prof. Byung-Suk Min Memorial ESRD Patient Registry. KSN members voluntarily participate in this registry, which has been collecting data through the Internet since 2000. The KSN ESRD patient registry data were reviewed to elucidate the major changes and improvements in dialysis therapy in Korea. The data review revealed: a rapid increase in the number of patients with ESRD; an increase in the number of patients with diabetic nephropathy; a decrease in the proportion of patients undergoing peritoneal dialysis; an increase in the role of private dialysis clinics; an increase in the number of elderly patients undergoing dialysis and the number of patients undergoing long-term dialysis; a decrease in mean blood pressure and an increase in pulse pressure; improvement in anemia treatment; improvement in dialysis adequacy; and improvement in the survival of patients undergoing dialysis. In conclusion, improvements have been made in blood pressure control, anemia treatment, and dialysis adequacy despite increases in the number of elderly patients, diabetic patients, and patients on long-term dialysis during the last two decades in Korea.

Keywords: Dialysis registry; Kidney failure, chronic; Peritoneal dialysis; Renal dialysis.

Figure 1

Prevalence and incidence of renal replacement therapy in Korea. (A) Number of patients undergoing renal replacement therapy at the end of each year. (B) Changes in the proportion of three major causes of end-stage renal disease. (C) Proportion of renal replacement modalities and incidence in 2013. (D) Percent distribution of patients undergoing hemodialysis (HD) according to dialysis center classification. PD, peritoneal dialysis; KT, kidney transplantation; DM, diabetic nephropathy; HTN, hypertensive nephrosclerosis; CGN, chronic glomerulonephritis.

Figure 2

Major changes and improvements in dialysis therapy in Korea. (A) Age distribution of patients undergoing dialysis according to underlying diseases. (B) Distribution of mean blood pressure (MBP) in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD). (C) Changes in hemoglobin among patients undergoing dialysis (HD vs. PD). (D) Dialysis adequacy parameters (normalized protein catabolic rate [nPCR] and single pool Kt/V [spKt/V]) in patients undergoing HD. DM, diabetes mellitus; HTN, hypertensive nephrosclerosis; GN, glomerulonephritis.