Objective: Turkish Society of Nephrology registry collects data on hemodialysis, peritoneal dialysis, and transplantation annually. Registry reports are printed every year as a booklet, and this is the 32nd year of registry reports. The registry is in close collaboration with international registries. Methods: In this paper, we summarized data from the 2021 registry report and provided yearly trends for managing end stage kidney disease. Results: The number of patients on kidney replacement therapy increases; at the end of 2021, 84 128 patients were on kidney replacement therapy. The prevalence and incidence of end-stage kidney disease were 993.5 and 149.5 per million population, respectively. Diabetes was the most common cause of end-stage kidney disease. Hemodialysis (71.4%) was the most common type of treatment modality, followed by transplantation (24.6%) and peritoneal dialysis (4.0%). Conclusion: End-stage kidney disease is a critical and growing health problem for our country. The kidney registry of the Turkish Society of Nephrology is one of the leading tools for providing current and sound data on this public health problem.