This study examines the actual trends in the various treatment modalities for kidney failure, in light of the 2002 decrees and the quantitative objectives of the Regional Health Organization Plans that modified the organization of dialysis. It describes the evolution of treatment modalities and the characteristics of patients undergoing treatment as of December 31 of each year for the period 2005–2008 in one of the 12 regions contributing to the Rein registry, using comprehensive data. It also provides an overview of patient flows between treatment modalities by detailing the status as of December 31, 2005, and the outcomes as of December 31, 2007, for patients undergoing treatment as of December 31, 2006. The number of patients treated for end-stage renal disease increased annually by 4.7% during the study period, with a persistent rise in the number of patients undergoing hemodialysis in centers, a stagnation in the number of patients on peritoneal dialysis, and a decrease in the number of patients undergoing dialysis outside of centers. At the same time, there has been a gradual increase in the workload of medical dialysis units, driven by the redistribution of less severe patients from in-center hemodialysis and the most severe patients from out-of-center dialysis. The expansion of kidney transplantation also positively limits the growth of out-of-center dialysis and peritoneal dialysis. The characteristics of patients in the various treatment modalities suggest a broad alignment with their chosen treatment modality. This study suggests that the assessments to be drawn from the Chronic Kidney Disease components of the Regional Health Organization Plans (SROS) will highlight discrepancies between the expected quantitative targets and those observed by 2011. Healthcare planning must take into account the condition of patients, the reality of possible transitions from one treatment modality to another, and the prospects for kidney transplantation. (R.A.)