FURTHER ADVANCES OF CHRONIC RENAL REPLACEMENT THERAPY IN EASTERN GERMANY, 1994 VERSUS 1989

Unlike the other former Soviet-block countries, Eastern Germany/the '' GDR'', had the opportunity to the re-unification with a highly develop ed western country, the Federal Republic of (West) Germany in 1990. In order to record the following rapid improvements in renal replacement therapy, we performed our own survey in Eastern Germany - excluding E astern Berlin - by questionaire, comparing the years 1989/December, an d 1994/December, 112 of the 113 dialysis facilities for adult regular dialysis patients replied to our questionnaire (99%). From 1989 to 199 4, the number of dialysis centers increased from 53 to 113 (-->213%), reaching 7.9 centres p. m. p. Of these facilities, 29% were hospital c enters, 48% were private dialysis units, and 23% were run by non-profi t dialysis organizations. The number of dialysis stations increased fr om 602 to 1,719 (-->286%), i. e. 120 stations p. m. p. The number of p atients in regular dialysis treatment rose from 2,127 to 5,335 (-->251 %), that means a prevalence of 373 patients p. m. p. In 1989, 67 new p atients (p. m. p.) had been accepted for maintenance treatment (incide nce), in contrast to 130 new patients p. m. p. in 1994 (-->194%), now under the conditions of unlimited accessibility to dialysis treatment. Questions referring to this point - the incidence of new patients - w ere only asked in Thuringen (2.5 mio. inhabitants), Alternative treatm ent modalities became feasible under the new conditions in Eastern Ger many. In contrast to 99% hemodialysis patients in December 1989, at th e end of 1994 92.8% of the patients were treated by hemodialysis, 2.0% by hemofiltration, and 5.2% by peritoneal dialysis, predominantly CAP D. The proportion of dialysis patients positive for hepatitis-B-antige n decreased from 21% in 1989 to 3.9% at the end of 1994. At the same t ime, a prevalence of 9.5% patients positive for hepatitis-C-antibodies was stated, At the end of 1989, in the former GDR (excluding Eastern Berlin) 773 patients, and at the end of 1994, 1,533 patients were aliv e with functioning renal grafts (-->198%). Summarizing the number of p atients on regular dialysis treatment and those having functioning gra fts, to renal replacement therapy, there was an increase from 2,900 pa tients (193 p. m. p.) at the end of 1989, to 6,868 patients (480 p. m. p.) at the end of 1994 (-->237%). The annual renal transplantation ra te of East German patients (including Eastern Berlin) rose only slight ly from 254 in 1989, to 279 in 1994 (-->110%). The number of patients on waiting lists for renal transplantation (including Eastern Berlin) enlarged from 620 patients (42 p.m.p.) at the end of 1989, to 1,094 pa tients (71 p. m. p.) at the end of 1994 (-->176%).