EVOLUTION OF RENAL REPLACEMENT THERAPY IN CENTRAL AND EASTERN-EUROPE 7 YEARS AFTER POLITICAL AND ECONOMICAL LIBERATION

Purpose of the study. The conditions of renal replacement therapy (RRT ) were very poor in the countries located in Central and Eastern Europ e (CEE) when they were members of the so-called 'socialist bloc'. The aim of the present analysis was to document the impact of the socioeco nomic changes on dialysis therapy in the CEE countries. Design. This w as a special survey with the participation of 12 CEE countries, with d ata obtained through national registries (with the exception of Russia ).Results. During the period 1990-1996 the number of haemodialysis uni ts increased by 56% and the number of centres performing peritoneal di alysis by 296%. The number of patients increased respectively by 78% ( haemodialysis) and 306% (peritoneal dialysis). The percentage of patie nts with diabetic nephropathy and elderly patients rose dramatically d uring this period. One of the main reasons of such expansion was the r apid development of peritoneal dialysis programmes in the majority of the CEE countries. The introduction of modern haemodialysis machines a nd a wider choice of different dialysers and concentrates permitted in dividualization of dialysis procedures. These points and the wider use of erythropoietin had a positive influence on quality of life and tre atment outcome. There was also a notable increase in the number of tra nsplant centres, but less so of the number of transplanted patients. C onclusion. Renal replacement therapy experienced a major expansion in the CEE countries. Despite the progress achieved, the level of RRT is not yet completely satisfactory in most CEE countries.