Thailand Renal Replacement Therapy Registry 2023: Epidemiological Insights Into Dialysis Trends and Challenges

ABSTRACT Introduction The Thailand Renal Replacement Therapy (TRT) Registry is a vital database tracking patient demographics, treatment modalities, and outcomes across hemodialysis centers nationwide. Methods This study analyzes TRT Registry data from 2000 to 2023 to identify trends and challenges in managing end‐stage kidney disease (ESKD). Results Among 152 827 patients, 129 113 received hemodialysis, and 23 714 underwent peritoneal dialysis. Diabetic nephropathy and hypertension accounted for over 80% of cases, with IgA nephropathy as the most common biopsy‐confirmed glomerulonephritis. Most patients had a primary school education or lower. The Universal Coverage Scheme (46.2%) was the primary funding source. Thrice‐weekly dialysis was the most common regimen (65.0%), while 34.3% of patients received twice‐weekly dialysis. Key challenges included anemia, malnutrition, vascular access issues, and disparities in dialysis adequacy. Cardiac disease (34.7%), infections (19.7%), and cerebrovascular disease (7.7%) were the leading causes of death. Conclusion Thailand's growing ESKD burden demands improved renal replacement therapy (RRT) strategies. The TRT Registry offers essential insights to guide policy and healthcare improvements.