The annual survey of the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) was conducted for 4,529 dialysis facilities at the end of 2023, among which 4,470 facilities (98.7％) responded to the facility survey and 4,284 facilities (94.6％) responded to the patient survey. The increase in the number of dialysis patients in Japan has been slowing in recent years. The number of dialysis patients at the end of 2023 was 343,508, which was a decrease from the previous year. The prevalence ratio of dialysis patients was 2,762.4 per million population. The mean age of the prevalent dialysis patients in the patient survey was 70.09 years. Diabetic nephropathy was the most common primary disease among the prevalent dialysis patients (39.5％), followed by chronic glomerulonephritis (23.4％) and nephrosclerosis (14.0％). The number of incident dialysis patients during 2023 was 38,764; it decreased by 919 from 2022. Among incident dialysis patients, the average age was 71.59 years, and diabetic nephropathy (38.3％) was the most common cause of end-stage kidney disease (ESKD). As 38,073 patients died in 2023, the crude annual mortality rate was 11.0％, and it remained the same as last year. The three major causes of death were infectious disease (22.7％), which replaced heart failure in 2022, heart failure (20.4％), and malignancy (7.6％). The number of patients treated by hemodiafiltration (HDF) has been rising since 2012 to reach 203,113 by the end of 2023, which accounted for 59.1％ of all dialysis patients. The number of peritoneal dialysis (PD) patients was 10,585 in 2023, which has slightly increased since 2017. The combination or hybrid therapy with hemodialysis (HD) or HDF was given to 21.0％ of PD patients. Home HD therapy was conducted in 799 patients at the end of 2023; it decreased by 28 from 2022. In 2023, the use of ultrasound in vascular access management and the disinfection status of probe heads were investigated at the facility survey for the first time. In addition, exercise therapy, nutritional guidance, and daily activity levels, as well as the occurrence of the following events in 2023: malignant tumors, deep vein thrombosis, pulmonary embolism, vascular access occlusion, and retinal hemorrhage were investigated at the patient survey. Furthermore, a survey was conducted on the hospitalizations of each patient and the reasons in 2023. Clinical data about Coronavirus disease (COVID-19) and the history of past living kidney donation were also investigated in 2023 as 2022. Results obtained on each condition provide a scheme for more clinically effective practice patterns on these conditions to be developed.

We investigated the relationship between the number of remaining teeth and normalized protein catabolic rate (nPCR) in 55 dialysis patients identified through regular dental checkups by dentists. Moreover, we investigated the relationship between the occlusal status of molars and nPCR in 29 hemodialysis patients. The average number of remaining teeth in the patients was 14.7±10.7, being lower than the average number of teeth remaining in the Japanese population, at 21.7. nPCR was 0.80±0.12 g/kg/day for patients with 9 or fewer remaining teeth, being significantly lower than 0.89±0.12 g/kg/day for those with 10 or more teeth. Patients with at least one pair of upper and lower molars that interlocked on the same side were classified into a molar occlusal group, and the rest were placed in a molar non‒occlusal group. nPCR of the molar non‒occlusal group was 0.80±0.10 g/kg/day, being significantly lower than the 0.91±0.13 g/kg/day in the molar occlusal group. Although it is optimal to preserve as many healthy teeth as possible, to improve the nutritional status of dialysis patients, it is also important to preserve the back teeth (molars). The results suggest that a decrease of protein intake in dialysis patients may be preventable even if just one pair of molars that can engage in occlusion remain on the same side.

Objective: To determine the practice level of renal replacement therapy decision support for chronic kidney disease (CKD) nursing. Methods: A web‒based survey was conducted among 2,836 Japanese Academy of Nephrology Nursing members. The survey included items on demographic data, renal replacement therapy decision support, and renal replacement therapy decision‒support practices. Results: Three hundred and eleven respondents were included (response rate: 11.0％). Rates of explaining about the start time, social security, and treatment costs were low in those providing renal replacement therapy decision‒support practice. However, the number of years of renal failure nursing experience, professional certifications, and level of practice were significantly higher with increasing years of experience and number of certifications obtained. Conclusion: Our results suggest that it is crucial to improve the healthcare system so that patients’ priorities regarding renal replacement therapy can be assessed and appropriate interventions can be made in the early stages of CKD. Additionally, there is a need to promote shared decision‒making and associated education to ensure that all nurses involved in renal replacement therapy decision‒making can provide optimal support.