RENAL REPLACEMENT THERAPY IN AN ERA OF SOCIOECONOMIC CHANGES - REPORTFROM THE POLISH REGISTRY

During the era of so-called 'real' socialism, renal replacement therap y was in a very poor condition in Poland. Here we present data on the influence that the socioeconomic changes in Poland had on the status o f dialysis therapy. All data are based on analysis of annual questionn aires from all dialysis and renal transplant units. During the period 1989-1995, the number of dialysis units increased by 39%, the number o f stations by 68%, and the number of patients by 136%. Not only quanti tative but also qualitative changes occurred in the introduction of ne w, modern machines, individualization of dialysis treatment, the start of a peritoneal dialysis programme, and an increasing number of patie nts on erythropoietin therapy. Also, broader criteria for the admissio n of patients with secondary nephropathies (especially diabetes) and a ged people were adopted. The gross mortality rate (9.5-10.5%) during t he period of observation was satisfactory and comparable with that of western European countries. Progress was the result of the implementat ion of the programme of the National Committee for the Promotion of Ne phrology, approved by the Ministry of Health and the Parliamentary Hea lth Commission, and supported by the central funding system. Further c onsequent development of all alternative renal replacement therapy met hods (among them especially renal transplantation) is necessary to ach ieve an acceptance rate comparable with developed countries by the beg inning of the next century.