The analysis of data from the Ministry of Health’s Integrated Chronic Kidney Disease Management Platform (PI -GID), reveals the existence of a striking regional difference in the incidence in dialysis. This difference is characterized by high levels of incidence in all regions, except the Alentejo, and extremely high levels in the Lisbon and Tagus Valley region. In this region, the incidence values are two to three times higher than in the others. The difference between regions is the result of a different number of patients starting hemodialysis, since the incidence in peritoneal dialysis is low and similar in all of them. It is difficult to find justification for such a discrepancy since the prevalence of factors usually responsible for the higher or lower level of incidence in dialysis does not differ significantly between them. A probable explanation may lie in the difference found in the concentration of public hemodialysis centers, a fact that may determine a difference in the criteria used for the entry of patients undergoing substitutive treatment of renal function. In fact, we found a close correlation between the number of public hemodialysis centers per million inhabitants and the level of incidence in dialysis. A more comprehensive analysis of the data from the Ministry of Health’s Integrated Chronic Kidney Disease Management Platform (PI -GID), if allowed, would be of enormous interest, not only to explain this discrepancy in the incidence of dialysis between regions, but because it could probably allow an explanation for Portugal having (one of) the highest levels of dialysis incidence in Europe