Abstract: SA-PO0342
Nationwide Trends in Chronic Hemodialysis: Factors Influencing Patient Survival and Outcomes in Thailand
Session Information
- Dialysis: Epidemiology and Facility Management
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Satirapoj, Bancha, Phramongkutklao College of Medicine, Bangkok, Thailand
- Tantiyavarong, Pichaya, Thammasat University, Bangkok, Thailand
- Thimachai, Paramat, Phramongkutklao College of Medicine, Bangkok, Thailand
- Chuasuwan, Anan, Bhumibol Adulyadej Hospital, Bangkok, Thailand
- Lumpaopong, Adisorn, Phramongkutklao College of Medicine, Bangkok, Thailand
- Kanjanabuch, Talerngsak, Chulalongkorn University, Bangkok, Thailand
- Ophascharoensuk, Vuddhidej, Chiang Mai University, Chiang Mai, Thailand
Group or Team Name
- The Subcommittee on the Thailand Renal Replacement Therapy (TRT) Registry of the Nephrology Society of Thailand.
Background
End-stage kidney disease (ESKD) presents a substantial health challenge globally, including in Thailand, where chronic hemodialysis patients face considerable mortality risks. The Thailand Renal Replacement Therapy (TRT) Registry provides a comprehensive national dataset including patient demographics, treatment modalities, and clinical outcomes across dialysis centers.
Methods
This retrospective cohort study utilized TRT Registry data from 2018 to 2023 to examine survival trends and mortality-associated factors in 60,053 chronic hemodialysis patients across 1,106 centers, integrated with national mortality records.
Results
Diabetic nephropathy and hypertension accounted for over 80% of ESKD cases. The 1-, 3-, and 5-year survival rates among hemodialysis patients were 95.0%, 84.6%, and 76.6%, respectively. Significant differences in 5-year survival were observed based on the primary cause of ESKD—diabetic nephropathy (71.6%), hypertensive nephropathy (79.7%), tubulointerstitial disease (82.7%), and glomerulonephritis (85.4%) —as well as dialysis frequency—twice weekly (74.4%) versus thrice weekly (77.7%). Leading causes of death included cardiac disease (34.1%), infectious disease (20.8%), and cerebrovascular disease (8.0%). Multivariate analysis identified several significant mortality predictors: advanced age, financial factors (civil servant medical benefit scheme [CSMBS] and self-payment), diabetes as the primary ESKD etiology, permanent catheter use, electrolyte imbalances (hyponatremia, hypokalemia, hypobicarbonatemia, and hypocalcemia, hyperphosphatemia), low intact parathyroid hormone levels, poor nutritional status (low serum albumin and protein catabolic rate), hypocholesterolemia, elevated ferritin levels, and inadequate dialysis clearance (low urea reduction ratio and KT/V).
Conclusion
Mortality rates among chronic hemodialysis patients in Thailand remain significant, driven by advanced age, socioeconomic disparities, suboptimal dialysis access and frequency, malnutrition, anemia, electrolyte imbalances, and inadequate dialysis adequacy. These findings underscore the need for targeted, nationwide interventions to optimize dialysis care and improve long-term outcomes.