How Many Patients Start Dialysis Each Year in the UK?

How Many Patients Start Dialysis Each Year in the UK?

Understanding the scale of kidney failure is vital for healthcare planning and patient awareness. According to the 27th Annual UK Kidney Association (UKKA) Report, the number of people requiring life-saving kidney treatment continues to rise.

Key UK Kidney Failure Statistics at a Glance

• New Patients: 8,556 adults started Kidney Replacement Therapy (KRT) in 2023.

• Incidence Rate: 158 people per million population (pmp) are diagnosed with kidney failure annually.

• Growth: This represents a 2.6% increase in new cases compared to the previous year.

• Primary Cause: Diabetes remains the leading driver of kidney failure (30.6% of cases).

• Gender Split: Men are significantly more affected, making up 63.3% of new patients.

1. Demographics: Who is Starting Dialysis?

The average age for starting dialysis is 63.2 years, but there are stark disparities when looking at ethnic backgrounds and health history.

Age and Ethnicity Trends

Data shows that minority ethnic groups tend to reach kidney failure much earlier in life than White patients:

• White patients: Median age 64.9 years.

• Asian patients: Median age 61.6 years.

• Black patients: Median age 55.5 years.

This nearly 10-year difference for Black patients highlights the aggressive nature of CKD in certain populations and the need for earlier screening.

2. Dialysis Modalities: How is Treatment Starting?

When a patient’s kidney function (eGFR) drops to a critical level—usually around 6.9 mL/min—treatment must begin.

• Haemodialysis (HD): The most common starting point.

• Peritoneal Dialysis (PD): 17.7% of patients choose this home-based needle-free option.

• Pre-emptive Transplant: Only 6.7% of patients are lucky enough to receive a transplant before ever needing dialysis.

The Challenge of “Crash Landing”

Approximately 17.5% of patients “crash land” into dialysis. This means they start treatment urgently without prior planning, often because their kidney function declined faster than expected or was diagnosed late.

3. The Importance of “Definitive Access”

One of the most critical metrics for patient safety is how they are connected to the dialysis machine. Ideally, a patient should have a “definitive access” point ready before their first session.

• Current UK Access Statistics (Access Type at Start of Dialysis):
  • AV Fistula or Graft: 29.7% – The “Gold Standard” for haemodialysis.
  • PD Catheter: 19.6% – Required for peritoneal dialysis.
  • Tunnelled/Temp Line: 50.8% – High risk of infection; used when planning is late.

Note. Only 49.2% of UK patients start with the recommended definitive access, showing a significant need for earlier surgical referrals.

4. Early Outcomes and Risks

The first 90 days of dialysis are the most critical. Sadly, 5.1% of patients die or stop treatment within this window. The leading causes of early mortality are:

1. Infection (22.7%): Often linked to the use of temporary catheters (lines) rather than fistulas.

2. Cardiovascular Disease (20.9%): Reflecting the heavy strain kidney failure puts on the heart.

Summary: The Growing Burden

With over 8,500 new patients every year, kidney failure is a growing public health challenge in the UK. The data underscores two major priorities for the NHS: better management of diabetes to prevent failure and earlier preparation for dialysis access to improve survival rates.

Data Source

UK Kidney Association (UKKA) 27th Annual Report (2023 data). This is currently the most comprehensive and recent dataset available for the United Kingdom.