Nephrol Dial Transplant (2000) 15: 156-160
© 2000 European Renal Association-European Dialysis and Transplant Association
Dialysis and Transplantation News
Changing pattern of end-stage renal disease in central and eastern Europe
sk, Poland,21 CEE Advisory Board in CRF: Vladimir Teplan (Prague, Czech Republic), Zvonimir Puretic (Zagreb, Croatia), Valery Pilotovich (Minsk, Byelorussia), Natalia Tomilina and Irina Tareyeva (Moscow, Russia), Istvan Kiss (Budapest, Hungary), Alexandrou Ciocalteu (Bucarest, Romania), Ljubica Djukanovic (Belgrade, Yugoslavia), Miroslav Mydlik (Kosice, Slovakia), Stefan Krivoshiev (Sofia, Bulgaria), Rado Kveder (Ljubliana, Slovenija), Momir Polenakovic (Skopje, Macedonia), Merike Luman (Talinn, Estonia), Rafail Rozental (Riga, Latvija), Maria Stanaityte (Vilnius, Lithuania) 2 Scientific Advisory Board of the ERA–EDTA Registry: J. Douglas Briggs, Dimitri Tsakiris, Benedicte Stengel, Izhar Khan, Elizabeth H. Jones, Otto Mehls, Joao Pinto dos Santos
Correspondence and offprint requests to:
Prof. Boleslaw Rutkowski, Department of Nephrology, Medical University, Debinki 7, 80-211 Gdask, Poland.
Abstract
Background. The epidemiology of end-stage renal disease (ESRD) is changing all over the world. Particularly dramatic changes of the epidemiology of ESRD have occurred in central and eastern Europe (CEE). The aim of the present study was (i) to document the further expansion of renal replacement therapy (RRT) noted in recent years in CEE and (ii) to analyse in some detail treatment modalities and underlying renal conditions.
Methods. Three independent surveys were performed in 1995, 1997 and 1998. Fifteen CEE countries participated. The data were mainly obtained from national registries which are based on centre and patient questionnaires.
Results. The data collected from 15 CEE countries document further expansion of RRT in this region. The report includes data on the availability of RRT in Byelorussia, Estonia, and Russia which have become available for the first time. The epidemiology of dialysed patients has changed remarkably. In the majority of countries the number of diabetic patients has increased, most dramatically so in the Czech Republic (31% of all dialysed patients), in the majority of the other countries 10–14%. The number of ESRD patients with the diagnosis of hypertensive nephropathy has also increased and this was accompanied by an increase in proportion of elderly (>65 years) patients, i.e. 46% in the Czech Republic and 12–25% in most other countries.
Conclusion. Dramatic changes of the availability of RRT treatment have occurred in central and eastern Europe. The proportion of diabetic nephropathy and elderly patients has risen. Large differences in RRT exist between individual CEE countries and this appears mainly dependent on the level of economic development.
Keywords: ESRD epidemiology; diabetic nephropathy; central and eastern Europe; renal replacement therapy
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