调查2010~2020年山西省新进入血液透析患者的发生率、原发病因构成、血管通路及进入透析时各种临床并发症的控制情况等，为血液净化质量控制提供支持。

回顾性分析2010~2020年山西省所有开展血液净化治疗的医疗机构网上直报的血液透析患者资料。各种相关数据的采集通过全国血液净化病例登记系统完成。

2010~2020年山西省新进入血液透析的年度发病率分别为每百万人口46.62例、53.44例、62.61例、62.93例、42.98例、36.63例、45.23例、46.23例、46.3例、64.3例和83.03例，2010至2013年和2017年至2020年为两个快速增长期。2010~2020年男性新进入血液透析的例数及年度发生率均高于女性；2010~2020年山西省终末期肾病患者开始透析的主要年龄段由40~50岁和50~60岁分别向50~60岁和60~70岁转变。血液透析患者前三位的原发病因依次为慢性肾小球肾炎、糖尿病肾病、高血压肾损害，其中慢性肾小球肾炎由2010年的占比60.9%下降至2020年的36.6%，而糖尿病肾病、高血压肾损害分别由2010年的占比23.3%、7.9%上升至2020年的36.3%、13.3%。进入透析时使用自体动静脉内瘘由2010年的占比43.3%上升至2018年的50.8%，临时中心静脉置管由2010年的占比44.1%降至2018年的39.3%。2012~2020年新进入血液透析患者的血红蛋白达标率无明显改善，波动在15.1%到21.9%,而血清白蛋白达标率由51.9%升高到57.2%。收缩血压达标率在39.7%~45.1%之间，舒张血压达标率在70.8%~76%之间。血钙达标率由2012年的39%升至2020年的46.7%，血磷达标率在39.8%~47.3%之间，血清全段甲状旁腺激素达标率不足60%，波动不大。

2010~2020年山西省新进入血液透析年度发生率在波动性增加，2020年最高；山西省进入血液透析患者的年龄由中青年向中老年转变；血液透析病因由原发性肾脏疾病向继发性肾脏疾病转变；首次透析动静脉内瘘使用率呈上升趋势，临时中心静脉置管使用率呈下降趋势；进入透析时并发症的控制达标率有所改善，但仍待提高。

To investigate the epidemiology changes of patients with initial hemodialysis in Shanxi Province from 2010 to 2020, including the incidence, the composition of the primary disease, the vascular access, and the control of various clinical complications before the initial hemodialysis, so as to provide support for the quality control of blood purification.

A retrospective analysis of the data of hemodialysis patients directly reported online from all medical institutions that carry out blood purification treatment in Shanxi Province from 2010 to 2020. The collection of various related data was from the Chinese National Renal Data System (CNRDS).

The annual incidence of new hemodialysis in Shanxi Province from 2010 to 2020 was 46.62, 53.44, 62.61, 62.93, 42.98, 36.63, 45.23, 46.23, 46.3, 64.3, and 83.03 per million population, respectively, with 2010 to 2013 and 2017 to 2020 being two periods of rapid growth. The number of new hemodialysis cases and the annual incidence of initial hemodialysis from 2010 to 2020 in the male patients were higher than those in the female patients. From 2010 to 2020 in end-stage renal disease patients of Shanxi Province, the main age groups of starting dialysis changed from 40-50 year-old and 50-60 year-old to 50-60 year-old and 60-70 year-old, respectively. The top three primary causes of hemodialysis patients were chronic glomerulonephritis, diabetic nephropathy, and hypertensive renal damage, among which chronic glomerulonephritis has dropped from 60.9% in 2010 to 36.6% in 2020, while diabetes nephropathy and hypertensive renal damage increased from 23.3% and 7.9% in 2010 to 36.3% and 13.3% in 2020, respectively. The use of autogenous arteriovenous fistulas for hemodialysis increased from 43.3% in 2010 to 50.8% in 2018, while the use of temporary central venous catheterization dropped from 44.1% in 2010 to 39.3% in 2018. From 2012 to 2020, the control rate of hemoglobin of new hemodialysis patients was not improved significantly, fluctuating from 15.1% to 21.9%, while the serum albumin control rate increased from 51.9% to 57.2%. The systolic blood pressure control rate was between 39.7% and 45.1%, and the diastolic blood pressure control rate was between 70.8% and 76%. The serum calcium control rate rose from 39% in 2012 to 46.7% in 2020, and the serum phosphorus control rate was between 39.8% and 47.3%. The control rate of serum intact parathyroid hormone was less than 60% without apparent fluctuation.

From 2010 to 2020, the annual incidence of hemodialysis in Shanxi Province increased in fluctuation, peaking in 2020. The age of new hemodialysis patients in Shanxi Province changed from the young and middle-aged to the middle and elderly-aged. The cause of hemodialysis changed from primary kidney diseases to secondary kidney diseases. The use rate of arteriovenous fistula of initial hemodialysis patients was on the rise, and the use rate of temporary central venous catheterization was on the decline. The control rate of complications before initial hemodialysis increased a little, but still needed to be improved.