Men account for 65% of the peritoneal dialysis population, while women account for 35%.

The number of men treated with peritoneal dialysis is twice that of women but with a distribution across age groups that differs only slightly (Figure 1).

Among people with diabetes, the use of intraperitoneal insulin is minimal (Table I) and affects only 0.6% of patients.

Kidney diseases are dominated by vascular and diabetic nephropathies, which accounted for 22.9% and 20.8% of patients, respectively, in 2025 (Table II).

France benefits from the assistance of independent registered nurses (IDE) who work in patients’ homes, performing bag changes for CAPD or setting up machines for APD for patients who cannot perform these tasks on their own (Table III). In metropolitan France, assistance from nurses accounted for 30.5% of patients in 2025, while assistance from family members was less common (5%).

During 2025, three regions saw slight increases in the numbers of patients (Brittany, Hauts-de-France, and Nouvelle-Aquitaine), but the total number of patients on peritoneal dialysis decreased by nearly 100 patients (Table IV).

As of December 31, 2025, patients were being treated with CAPD (56.1%), 962 patients were being treated with APD (43.2%), and 14 (0.6%) were receiving a combination of APD and CAPD.

Patients treated with the assistance of a nurse are almost always on CAPD (82.8%), while independent patients are predominantly on APD (55%). The choice of PD modality based on patient independence is summarized in Table V and Figure 2.

The PD regimens used are not fixed for any given patient. To track these changes over time, we selected new patients enrolled between January 1, 2023, and December 31, 2024, and followed up on them through December 31, 2025. The permanent discontinuation of treatment during the follow-up period was counted as a concurrent event.

Between the initial treatment and the 90-day mark, 18.1% of patients changed treatment modalities, while 16.6% of patients changed them between the 90th day and the end of the observation period. These changes are illustrated in Figure 3.

Causes of permanent discontinuation of treatment in 2025 among patients treated with PD

The treatment modalities and causes of permanent discontinuation of treatment in 2025 were calculated for all patients regardless of age and comorbidities. The most common modality is transfer to in-center hemodialysis followed by death (Figure 4). Peritonitis accounts for 3.4% of deaths; however, it is the second leading cause of transfer to hemodialysis, preceded by transfer due to dialysis dose that the physician deems insufficient (32.3%) (Figure 6). The main causes of death are illustrated in Figure 5.

The latest International Society for Peritoneal Dialysis (ISPD) guidelines recommend reporting the annual rate of hemodialysis use [2]: this rate is calculated by counting all episodes of one or more periods of in-center hemodialysis plus any permanent transfers to hemodialysis; a transfer is considered permanent if it lasts more than 90 days.

During the year 2025,

- Number of patients treated: 3,410

- Cumulative duration: 2,309.06 patient-years

- Number of temporary HD treatments: 156

- Number of permanent transfers to HD: 499

- Total number of HD treatments: 655

HD transfer rate: 28.37 per 100 patient-years or 0.28 HD periods per patient-year.

To better analyze the causes of hemodialysis use, we felt it was clearer to distinguish between the causes of temporary hemodialysis periods and the causes corresponding to permanent transfers—that is, those lasting more than 90 days. The causes of temporary transfers to hemodialysis (thus, excluding permanent transfers from Figure 6) are reported in Table VI.

To ensure there was a sufficiently large population and adequate follow-up, new patients enrolled from January 1, 2023, through December 31, 2024, were selected and followed up on until July 31, 2026. The various incidence rates over 42 months are shown in Figure 7.

All patients use glucose-based dialysis solutions as a baseline, supplemented in three-quarters of cases by one or more icodextrin exchanges; we know that a number of patients sometimes use only two bags of icodextrin during CAPD, but the database-recording methods do not allow us to count them with sufficient reliability to report them. However, it appears that this approach is used more frequently among patients with diabetes (Table VII). More than one-quarter of patients with diabetes use both icodextrin and amino acids (26%), likely to reduce glucose intake [5].

Patients’ transplant statuses as of August 1, 2026, are summarized in Table VIII. The statuses as of December 31, 2025, were no longer available at the time of writing this report.

During 2025, 81.2% of French patients did not experience peritonitis.

Peritonitis rates are summarized in Table IX. A Poisson test comparing CAPD and APD shows a higher incidence of peritonitis in the APD group (p = 0.012, CI: 1.04–1.137); however, these rates are not adjusted for age, diabetes status, and level of independence, which vary significantly (see Table V and Figure 2 above).

Analysis using a Kaplan-Meier curve shows a median peritonitis-free survival of 32 months (Figure 8).

Taking into account the competing risks the permanent discontinuation of dialysis from all causes posed, the cumulative incidence of first-time peritonitis is 32% at two years (Figure 9).

The distribution of pathogens identified in cases of peritonitis is summarized in Figure 10 and Table X below.

Men account for 60% of the peritoneal dialysis population, while women account for 40% of the population; the distribution by age group is similar to that observed in France (Figure 1b).

As in metropolitan France, the use of intraperitoneal insulin remains rare among diabetic patients (Table Ib); vascular and diabetic nephropathies together account for more than 40% of nephropathies, with diabetes accounting for 20% (Table IIb)

Twelve percent of patients receive care from their families (Table IIIb); this percentage is double that observed in France, where the use of private nurses has historically been the most widespread.

Due to the smaller numbers of centers and patients included in the RDPLF in Belgium, it is not possible to reliably analyze trends in the number of patients by region; nevertheless, across all participating centers, the trend is, as in France, downward (Table IVb).

The distribution of PD techniques based on the level of patient autonomy differs significantly from that observed in France. APD is more widely used. Patients treated with the assistance of a nurse are almost always more likely to be on APD, whereas, in France, the vast majority are on CAPD. Furthermore, reliance on assistance from a family member is more common in Belgium than in France (see Table Vb and Figure 2b).

As in France, the PD modalities used are not fixed for a given patient. To track these changes over time, we selected new patients enrolled between January 1, 2023, and December 31, 2024, and followed up on them through December 31, 2025. Permanent discharges during the follow-up period were counted as competing events.

Between the initial treatment and the 90-day follow-up, 18.4% of patients changed treatment modalities, and 13.4% changed them between the 90th day and the end of the observation period. These changes are illustrated in Figure 3b.

The patterns and causes of permanent discontinuation of treatment in 2025 were calculated for all patients regardless of age and comorbidities. The most common pattern is transfer to in-center hemodialysis followed by death (Figure 4b). Peritonitis accounts for 1.9% of deaths (lower than the percentage in France); however, it is the leading cause of transfer to hemodialysis (Figure 6b). The main causes of death are illustrated in Figure 5b.

To follow the ISPD recommendations [2], as was done for France above, we report the annual rate of hemodialysis use for Belgium [2]: We calculate this rate by counting all episodes of one or more periods of hemodialysis in a center plus any permanent transfers to hemodialysis; a transfer is considered permanent if it lasts longer than 90 days.

The causes of temporary transfers to HD (thus, excluding the permanent transfers shown in Figure 6b) are reported in Table VIb.

During the year 2025,

Number of patients treated: 510

Cumulative duration: 350.5 patient-years

Number of temporary HD transfers: 19

Number of permanent transfers to HD: 57

Total number of HD treatments: 76

HD utilization rate: 21.68 per 100 patient-years (including 57 permanent transfers to HD)

To ensure there was a population with sufficient follow-up, new patients enrolled from January 1, 2023, through December 31, 2024, were selected and followed up on through July 31, 2026. The various incidence rates over 42 months are shown in Figure 7b.

All patients primarily use glucose-based dialysis solutions, often supplemented by one or more icodextrin exchanges; we know that a few Belgian patients sometimes use only two bags of icodextrin during CAPD, but the database-recording methods do not allow for these cases to be counted with sufficient reliability to report them. As in France, there is a higher rate of icodextrin use among diabetic patients but to a lesser extent (66.7% of diabetic patients in Belgium compared to 80.1% in France). The combination of icodextrin and amino acids (Table VIIb) is significantly less common than in France.

In this case, the main difference from France appears to be that half as many patients refuse to be placed on a transplant waiting list (Table VIIIb).

In 2025, 79.2% of Belgian patients did not experience peritonitis.

As shown above for France, the infection rate—although low in both cases—is higher for APD than it is for CAPD. Analysis using a Kaplan-Meier curve reveals a median peritonitis-free survival of 32 months (Figure 8b), identical to that observed in France.

The cumulative incidence of a first episode of peritonitis is similar to that in France, around 32% at 24 months ( Figure 9b).

The distribution of pathogens identified in cases of peritonitis is summarized in Figure 10b and Table Xb below. The small number of cases does not allow for a comparison, over this period, with the figures presented above for France.