The 2020 Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) annual survey, conducted among 4493 dialysis facilities in Japan, reported an increase in the number of chronic dialysis patients to 347,671, with a prevalence rate of 2754 patients per million population. Diabetic nephropathy was the most common primary disease, followed by chronic glomerulonephritis and nephrosclerosis. The average age of patients was 69.40 years, with an increase in the proportion of older patients. In 2020, there were 40,744 new dialysis patients, a slight decrease from 2019. The crude mortality rate was 9.9%, with heart failure, infection, and malignancy as the leading causes of death. Hemodiafiltration (HDF) and peritoneal dialysis (PD) are gaining popularity, with 163,825 and 10,338 patients, respectively, in 2020. The survey also included new items on COVID-19 and kidney donation history, providing insights into the impact of these factors on dialysis patients. The results highlight the need for continued quality management of dialysis fluid and the importance of addressing the unique challenges faced by dialysis patients.The 2020 Japanese Society for Dialysis Therapy Renal Data Registry (JRDR) annual survey, conducted among 4493 dialysis facilities in Japan, reported an increase in the number of chronic dialysis patients to 347,671, with a prevalence rate of 2754 patients per million population. Diabetic nephropathy was the most common primary disease, followed by chronic glomerulonephritis and nephrosclerosis. The average age of patients was 69.40 years, with an increase in the proportion of older patients. In 2020, there were 40,744 new dialysis patients, a slight decrease from 2019. The crude mortality rate was 9.9%, with heart failure, infection, and malignancy as the leading causes of death. Hemodiafiltration (HDF) and peritoneal dialysis (PD) are gaining popularity, with 163,825 and 10,338 patients, respectively, in 2020. The survey also included new items on COVID-19 and kidney donation history, providing insights into the impact of these factors on dialysis patients. The results highlight the need for continued quality management of dialysis fluid and the importance of addressing the unique challenges faced by dialysis patients.