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.