NEPHROLOGY AND RENAL REPLACEMENT THERAPY IN ROMANIA

Background, In the context of the transformation of the Health Systems of Central and Eastern European countries, the role of professional a ssociations is increasing, especially as regards data collection, anal ysis, and implementation of programmes for development of nephrology a nd renal replacement therapy (RRT). Methods. The Romanian Renal Regist ry sent questionnaires to the heads of Haemodialysis and Nephrology Ce ntres. The need for renal replacement therapy was deduced from the ann ual incidence (127 patients p.m.p.) of chronic renal failure. Results. Although the rates of increase in the numbers of Nephrology Departmen ts (+82%), HD Centres (+142%), and total number of patients alive on R RT (+196%) from 1991 to 1995 were higher than the European mean, only 27-30% of the incident patients (459 of 1000-1200 patients) could be p rovided with RRT. Sixty-two percent of the need for RRT in the age gro up 25-44 years was mel, while only 20% of children (age <15 years) and people over 55 years requiring RRT received this treatment. Primary r enal diseases in patients on RRT were glomerulanephritis (49%) or inte rstitial nephropathies (23%); diabetic nephropathies, nephroangioscIer osis and systemic diseases were rare (4, 2, and 1% respectively). Most of the CRF patients (88%) were treated by HD, Renal transplantation a nd peritoneal dialysis were seldom performed (8 and 4%). The cost of H D treatment in Romania (87 USD) is low, even though dialyser reuse is not common practice. Conclusions. The increase in renal replacement th erapy in Romania was mainly due to the expansion of the number of haem odialysis centres. Although a significant progress was realized, only one-third of the patients needing RRT could be treated in Romania In 1 995.