Kidney Replacement Therapy in Latvia: Five-Year Analysis of Demographics, Trends, and Regional Disparities

Objectives
The study aimed to analyze 5 years of data from the Latvian Kidney Patients Database (LKPD) on patients receiving kidney replacement therapy (KRT) in Latvia, highlighting regional differences.

Materials and Methods
LKPD contains data on all kidney transplant recipients and 89% of hemodialysis (HD) and peritoneal dialysis (PD) patients in Latvia over the past 5 years. Microsoft Excel was used to create and analyse the LKPD data.

Results
The total number of KRT patients rose from 1040 in 2019 (585 transplant recipients, 358 HD, 97 PD) to 1129 in 2023 (568 transplant recipients, 457 HD, 104 PD). The mean number of patients starting KRT was 136±32, with the lowest number recorded in 2020 – 105. The median age of new KRT patients decreased from 65 years [1-91] in 2019 to 63 years [22-93] in 2023. A stable male predominance was observed, with 58% of new patients being male. The leading causes of end-stage kidney disease were diabetes mellitus (21%), glomerular disease (18%), pyelonephritis (12%), hypertension (11%), andautosomal dominant polycystic kidney disease (9%). Regional distribution of prevalent KRT patients in 2023 showed a concentration in Riga and its suburbs (822 patients, including 544 transplant recipients), followed by Vidzeme (382 patients), Kurzeme (404 patients, down from 444 in 2021), Zemgale (288 patients), and Latgale (318 patients). The total number of patients increased in all regions except Kurzeme, which experienced a decline. The number of kidney transplant surgeries ranged from 28 in 2021 to 46 in 2023.

Conclusions
The number of KRT patients in Latvia has steadily increased from 2019 to 2023, with notable regional variations and a consistent male predominance, highlighting the need for further research to adjust prevalence and incidence rates to regional population sizes and address healthcare disparities.