National dialysis registry of the Dominican Republic: first nationwide epidemiological analysis of renal replacement therapy

BACKGROUND: Kidney failure is a growing global health concern, affecting 9-10% of the population and contributing to rising mortality. In the Dominican Republic, a national dialysis registry was created in 2020 to monitor patients receiving kidney replacement therapy (KRT). Yet no comprehensive national epidemiological report has been published to date. METHODS: We conducted a nationwide, cross-sectional study using data from the 2022 Dominican National Dialysis Registry, encompassing all patients, both private and public, on hemodialysis (HD) or peritoneal dialysis (PD) in National Health Service, authorized units. Data were collected via a standardized digital form (August-September 2023) and analyzed using IBM SPSS Statistics v22. RESULTS: A total of 4,690 patients were recorded, median age 56 years (SD ± 15.6), 69% male. HD predominated (78.4%). Hypertension (93.9%) and diabetes mellitus (44.4%) were the most frequent comorbidities, with diabetes more common in PD than HD (52.5% vs. 42.2%). In HD, arteriovenous fistula was the primary access (61.2%); in PD, continuous ambulatory peritoneal dialysis (CAPD) was predominant (80.4%). National prevalence reached 421.8 patients per million population (91.1 ppm PD, 330.7 ppm HD), a 6% increase from 2022. CONCLUSIONS: This first nationwide analysis provides a comprehensive characterization of the epidemiological profile of KRT in the Dominican Republic, revealing the dominance of HD, the high burden of cardiovascular and metabolic comorbidities, and rising prevalence rates. These findings underscore the urgent need to strengthen kidney failure prevention, improve early detection, and enhance the integration of PD within a balanced renal care strategy aligned with regional best practices.