{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T20:29:45Z","timestamp":1786480185009,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>For 25 years, the Brazilian Society of Nephrology has systematically monitored chronic dialysis care through the Brazilian Dialysis Survey, offering a unique perspective on the evolution of dialysis practices and access to treatment in a large and diverse middle-income country. Analysis of data from 1999 to 2024 reveals that hemodialysis has remained the dominant modality, representing on average 92% of treatments, while peritoneal dialysis (PD) accounted for only 8% and showed a steady decline. Regional differences have been marked: the Northeast consistently reported the lowest rates of PD, while the South maintained above-average use. Funding sources also reflect broader structural dynamics in the health system. The Unified Health System (Sistema \u00danico de Sa\u00fade) has been the backbone of dialysis provision, covering 83% of patients over the period. Yet, the role of private health insurance has expanded, with coverage increasing from 12% in 2006\u20132009 to 20% in 2019\u20132024. Interestingly, regional comparisons show contrasting patterns, with private insurance supporting a disproportionately high share of dialysis in the North compared with the general population, while in the Southeast, the opposite scenario was observed. Taken together, these findings illustrate a landscape shaped by declining use of PD, heavy reliance on public financing, and persistent regional inequities. Beyond documenting numbers, the Brazilian Dialysis Survey highlights the need for policies that promote equity, strengthen the role of PD, and ensure sustainable access to KRTs for all Brazilians.<\/jats:p>","DOI":"10.34067\/kid.0000001135","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T17:00:26Z","timestamp":1768237226000},"page":"658-663","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Brazilian Dialysis Survey from 1999 to 2024"],"prefix":"10.34067","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-0185","authenticated-orcid":false,"given":"Fabiana B.","family":"Nerbass","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3-Rim, Joinville, Brazil"},{"name":"Sociedade Brasileira de Nefrologia, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0081-6897","authenticated-orcid":false,"given":"Helbert N.","family":"Lima","sequence":"additional","affiliation":[{"name":"Sociedade Brasileira de Nefrologia, S\u00e3o Paulo, Brazil"},{"name":"Universidade da Regi\u00e3o de Joinville, Joinville, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8803-1300","authenticated-orcid":false,"given":"Fernanda S.","family":"Gorayeb-Polacchini","sequence":"additional","affiliation":[{"name":"Sociedade Brasileira de Nefrologia, S\u00e3o Paulo, Brazil"},{"name":"Hospital de Base, S\u00e3o Jos\u00e9 do Rio Preto, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1062-0073","authenticated-orcid":false,"given":"Ricardo C.","family":"Sesso","sequence":"additional","affiliation":[{"name":"Sociedade Brasileira de Nefrologia, S\u00e3o Paulo, Brazil"},{"name":"Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6791-3910","authenticated-orcid":false,"given":"Jocemir R.","family":"Lugon","sequence":"additional","affiliation":[{"name":"Sociedade Brasileira de Nefrologia, S\u00e3o Paulo, Brazil"},{"name":"Universidade Federal Fluminense, Niter\u00f3i, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"issue":"suppl 2","key":"B2-20260330","doi-asserted-by":"crossref","first-page":"ii11","DOI":"10.1093\/ndt\/gfae131","article-title":"Global structures, practices, and tools for provision of hemodialysis","volume":"39","author":"Htay","year":"2024","journal-title":"Nephrol Dial Transplant."},{"issue":"1","key":"B3-20260330","first-page":"e20250112","article-title":"Brazilian Dialysis Survey 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international survey study","volume":"77","author":"Cho","year":"2021","journal-title":"Am J Kidney Dis."},{"issue":"18","key":"B12-20260330","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1001\/jama.2024.16338","article-title":"Dialysis for chronic kidney failure","volume":"332","author":"Flythe","year":"2024","journal-title":"JAMA."},{"issue":"2","key":"B13-20260330","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1038\/nrneph.2016.181","article-title":"Changes in the worldwide epidemiology of peritoneal dialysis","volume":"13","author":"Li","year":"2017","journal-title":"Nat Rev Nephrol."},{"issue":"1","key":"B14-20260330","first-page":"e20240081","article-title":"Brazilian Dialysis Survey 2023","volume":"47","author":"Nerbass","year":"2025","journal-title":"J Bras 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