BACKGROUND: The European Renal Association - European Dialysis and Transplant Association (ERA-EDTA) Registry collects data on kidney replacement therapy (KRT) via national and regional renal registries in Europe and countries bordering the Mediterranean Sea. This article summarizes the 2018 ERA-EDTA Registry Annual Report, and describes the epidemiology of KRT for kidney failure in 34 countries. METHODS: Individual patient data on patients undergoing KRT in 2018 were provided by 34 national or regional renal registries and aggregated data by 17 registries. The incidence and prevalence of KRT, the kidney transplantation activity and the survival probabilities of these patients were calculated. RESULTS: In 2018, the ERA-EDTA Registry covered a general population of 636 million people. Overall, the incidence of KRT for kidney failure was 129 per million population (p.m.p.), 62% of patients were men, 51% were ≥65 years of age and 20% had diabetes mellitus as cause of kidney failure. Treatment modality at the onset of KRT was haemodialysis (HD) for 84%, peritoneal dialysis (PD) for 11% and pre-emptive kidney transplantation for 5% of patients. On 31 December 2018, the prevalence of KRT was 897 p.m.p., with 57% of patients on HD, 5% on PD and 38% living with a kidney transplant. The transplant rate in 2018 was 35 p.m.p.: 68% received a kidney from a deceased donor, 30% from a living donor and for 2% the donor source was unknown. For patients commencing dialysis during 2009-13, the unadjusted 5-year survival probability was 42.6%. For patients receiving a kidney transplant within this period, the unadjusted 5-year survival probability was 86.6% for recipients of deceased donor grafts and 93.9% for recipients of living donor grafts.

Abdominal Center Nephrology University of Helsinki and Helsinki University Hospital Helsinki Finland

Chronic Dialysis Russia and CIS Medical Department Company Baxter AO Moscow Russia

CIBER Epidemiología y Salud Pública Madrid Spain

Clinic of Nephrology Clinical Center University of Sarajevo Sarajevo Bosnia Herzegovina

Clinical Center of Montenegro Clinic for Nephrology Podgorica Montenegro

Complejo Hospitalario de Navarra Pamplona Navarra Spain

Coordinación Autonómica de Trasplantes de Castilla y León Dirección General de Planificación y Asistencia Sanitaria Regional de Salud Valladolid Spain

Cyprus Renal Registry Nicosia Cyprus

Department of Aragon Health General Direction of Health Care Zaragoza Spain

Department of Epidemiology Murcia Renal Registry Murcia Regional Health Authority IMIB Arrixaca Murcia Spain

Department of experimental and clinical pharmacotherapy Slovak Medical University Bratislava Slovakia

Department of Internal Medicine 4 Nephrology and Hypertension Austrian Dialysis and Transplant Registry Medical University Innsbruck Innsbruck Austria

Department of Internal Medicine and Nephrology Carol Davila University of Medicine and Pharmacy Bucharest Romania

Department of Internal Medicine Riga Stradins University Riga Latvia

Department of Internal Medicine Swedish Renal Registry Jonkoping Regional Hospital Jonkoping Sweden

Department of Internal Medicine University of Tartu Tartu University Hospital Tartu Estonia

Department of Medical Informatics ERA EDTA Registry UMC University of Amsterdam Amsterdam Public Health research institute Amsterdam The Netherlands

Department of Medical Informatics SPN ERA EDTA Registry UMC University of Amsterdam Amsterdam Public Health Research Institute Amsterdam The Netherlands

Department of Medicine General University Hospital Prague Strahov Czech Republic

Department of Medicine Holbaek Hospital Holbaek Denmark

Department of Nephrology American Medical Center Nicosia Cyprus

Department of Nephrology Hospital University Virgen del Rocio Seville Spain

Department of Nephrology Istanbul University Cerrahpasa Cerrahpasa Medical Faculty Istanbul Turkey

Department of Nephrology Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania

Department of Nephrology Riga Stradins clinical University Hospital Riga Latvia

Department of Preventive Medicine and Public Health Universitat de Valencia Valencia Spain

Department of Transplantation Oslo University Hospital Rikshospitalet Oslo Norway

Dialysis clinic Alexandrovska University Hospital Sofia Medical University Sofia Bulgaria

Dirección General de Salud Pública Servicio Extremeño de Salud Consejería de Sanidad y Políticas Sociales Junta de Extremadura Mérida Spain

Division of Nephrology Ambroise Paré University Hospital Boulogne Billancourt France

Division of Nephrology Landspitali The National University Hospital of Iceland Reykjavik Iceland

Division of Population Health and Genomics University of Dundee Dundee UK

Dutch Registry RENINE Nefrovsie Utrecht The Netherlands

Faculty of Medicine School of Health Sciences University of Iceland Reykjavik Iceland

Faculty of Medicine University Ss Cyril and Methodius Skopje Skopje N Macedonia

Finnish Registry for Kidney Diseases Helsinki Finland

Health Department Catalan Renal Registry Catalan Transplant Organization Generalitat of Catalonia Barcelona Spain

Health Quality Assessment and Information System Service Dirección General de Programas Asistenciales Servicio Canario de la Salud Canary Islands Spain

Institut National de la Santé et de la Recherche Médicale University of Paris Ouest Versailles St Quentin en Yveline Villejuif France

Institute of Nephrology City Hospital Waid and Triemli Zurich Switzerland

Israel Renal Registry Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel

Latvian Nephrology Association Riga Latvia

Lithuanian Nephrology Dialysis and Transplantation Association Kaunas Lithuania

Minsk Scientific and Practical Center of Surgery Transplantation and Hematology Minsk Belarus

Portuguese Renal Registry Coimbra Portugal

Rare Diseases Joint Research Unit Universitat de Valencia Foundation for the Promotion of Health and Biomedical Research in the Valencian Region FISABIO Valencia Spain

REIN Registry Agence de la Biomédecine Saint Denis La Plaine France

Renal Replacement Registry Russian Dialysis Society Moscow Russia

RERCA Public Health Directorate Asturias Spain

Scottish Renal Registry Meridian Court Information Services Division Scotland Glasgow UK

Service of Nephrology UHC Mother Teresa Tirana Albania

Spanish Consortium for Research on Epidemiology and Public Health Madrid Spain

State Institute of Nephrology National Academy of Medical Sciences of Ukraine Kiev Ukraine

UK Renal Registry Bristol UK

Unidad de Información de Pacientes Renales UNIPAR Basque Country Spain

University Hospital of Nephrology Skopje N Macedonia

Valencia Region Renal Registry Direccio General de Salut Publica i Adiccions Valencia Spain

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The ERA Registry Annual Report 2019: summary and age comparisons

Antibody-mediated rejection of renal allografts: diagnostic pitfalls and challenges