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CKD causes one death every 20 seconds globally and is among the fastest growing causes of death. It is forecast to become the fifth most common global cause of death and the third in western Europe by 2050. It is estimated that 511\u2009549 European Union (EU) inhabitants depend on KRT, with nearly two-thirds (\u2248310\u2009000) treated by dialysis, and the remainder being kidney transplant recipients (\u2248200\u2009000). KRT is provided by every EU country. France (96\u2009317), Germany (77\u2009900), Spain (67\u2009604), and Italy (62\u2009523) account for 60% of people on KRT in the EU. Prevalence per million population ranged from 560 (Luxembourg) to 2022 (Portugal). Germany (55\u2009129) leads in the number of people on dialysis, followed by France (52\u2009817), Italy (44\u2009382), and Spain (29 879). In addition to differences in the relative number of dialysis and transplant patients, there were also EU-wide differences in modality of dialysis. The hemodialysis\/peritoneal dialysis prevalence ratio ranged from 52.0 (Slovakia) to 3.4 (Sweden). The EU should be aware of the burden of KRT when designing regulations, such as the Accelerating Clinical Trials in the EU (ACT EU) and the EU Medical Device Regulation (MDR) or making decisions regarding the prioritization of diseases and the budget for research and healthcare.<\/jats:p>","DOI":"10.1093\/ndt\/gfag017","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T12:42:28Z","timestamp":1770122548000},"page":"1730-1735","source":"Crossref","is-referenced-by-count":4,"title":["Over 500\u2009000 people on kidney replacement therapy in the European Union"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9805-9523","authenticated-orcid":false,"given":"Alberto","family":"Ortiz","sequence":"first","affiliation":[{"name":"Health Research Institute-Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, Universidad Aut\u00f3noma de Madrid (IIS-FJD, UAM) Department of Nephrology and Hypertension, , Madrid ,","place":["Spain"]},{"name":"RICORS2040-renal ; Madrid ,","place":["Spain"]},{"name":"Universidad Aut\u00f3noma de Madrid Departamento de Medicina, Facultad de Medicina, , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7560-2669","authenticated-orcid":false,"given":"Anneke","family":"Kramer","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam ERA Registry, Department of Medical Informatics, , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Public Health Research Institute, Quality of Care , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-1947","authenticated-orcid":false,"given":"Vianda S","family":"Stel","sequence":"additional","affiliation":[{"name":"Amsterdam UMC location University of Amsterdam ERA Registry, Department of Medical Informatics, , Amsterdam ,","place":["The Netherlands"]},{"name":"Amsterdam Public Health Research Institute, Quality of Care , Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"2026082623115712900_bib1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"key":"2026082623115712900_bib2","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1093\/ckj\/sfz007","article-title":"Clarifying the concept of chronic kidney disease for non-nephrologists","volume":"12","author":"Perez-Gomez","year":"2019","journal-title":"Clin Kidney J"},{"key":"2026082623115712900_bib3","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaf151","article-title":"Evolving strategies for early diagnosis, proactive prevention and treatment of CKD","author":"Ortiz","year":"2025","journal-title":"Nephrol Dial Transplant"},{"key":"2026082623115712900_bib4","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1016\/S0140-6736(24)00685-8","article-title":"Burden of disease scenarios for 204 countries and territories, 2022-2050: a forecasting analysis for the global burden of disease study 2021","volume":"403","author":"GBD 2021 Forecasting Collaborators","year":"2024","journal-title":"Lancet"},{"key":"2026082623115712900_bib5","doi-asserted-by":"publisher","first-page":"2461","DOI":"10.1016\/S0140-6736(25)01853-7","article-title":"Global, regional, and national burden of chronic kidney disease in adults, 1990-2023, and its attributable risk factors: a systematic analysis for the Global Burden Of Disease study 2023","volume":"406","author":"GBD 2023 Chronic Kidney Disease Collaborators","year":"2025","journal-title":"Lancet"},{"key":"2026082623115712900_bib6","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1001\/jama.2023.17002","article-title":"Estimated glomerular filtration rate, albuminuria, and adverse outcomes: an individual-participant data meta-analysis","volume":"330","author":"Writing Group for the CKD Prognosis Consortium","year":"2023","journal-title":"JAMA"},{"key":"2026082623115712900_bib7","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.kint.2025.04.005","article-title":"Preventing chronic kidney disease and maintaining kidney health: conclusions from a kidney disease: improving global outcomes (KDIGO) controversies conference","volume":"108","author":"Ortiz","year":"2025","journal-title":"Kidney Int"},{"key":"2026082623115712900_bib8","doi-asserted-by":"publisher","first-page":"1786","DOI":"10.1093\/ndt\/gfaf057","article-title":"ABCDE to identify and prevent chronic kidney disease: a call to action","volume":"40","author":"Ferro","year":"2025","journal-title":"Nephrol Dial Transplant"},{"issue":"1 Suppl 1","key":"2026082623115712900_bib9","doi-asserted-by":"publisher","first-page":"S50","DOI":"10.2337\/dc25-S003","article-title":"3. 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