Epidemiology of end‐stage renal disease and hemodialysis treatment in Serbia at the turn of the millennium

Abstract

The study presents the epidemiological features of patients treated with renal replacement therapy (RRT) in Serbia from 1997 to 2009 and compares the results of hemodialysis treatment in 1999 and 2009. Epidemiological data were obtained from the National Registry of RRT patients and data on hemodialysis treatment from special surveys conducted in 1999 and 2009. Within the period 1997-2009 the incidence of patients on RRT increased from 108 to 179 per million population (pmp), prevalence rose from 435 to 699 pmp, while mortality rate fell from 20.7% to 16.7%. The frequency of patients with glomerulonephritis decreased, while that of patients with diabetes and hypertensive nephropathy increased. In late 2009 there were 5208 patients receiving RRT in Serbia. Within the examined period new hemodialysis and reverse osmosis equipment were purchased, high-flux dialyzers with synthetic membranes were increasingly used and the number of patients receiving hemodiafiltration increased to 17.6%. Kt/V greater than 1.2 was recorded in 16% of the patients in 1999 but 52% in 2009. Options for correction of anemia and mineral disorders have also improved. The percentage of patients with HbsAg (13.8% vs. 4.8%) as well as anti-hepatitis C virus antibodies positive patients (23.2% vs. 12.7%) was significantly lower in 2009 than in 1999. Both the incidence and prevalence of RRT patients in Serbia are rising continuously, while the mortality rate is falling. More favorable conditions for dialysis treatment have brought about significant improvement in the results over the last 10 years.

Comprehensive geriatric assessment: comparison of elderly hemodialysis patients and primary care patients

“…A high prevalence of overweight in the HD population has already been reported. [26][27][28] The general prevalence of overweight patients found here is consistent with data that overweight occurred in 60.7% of the adult population in Bosnia and Herzegovina 29 and 54% in Serbia. 30 Although, reverse epidemiology regarding BMI and survival was reported for HD patients, 31 indicating increased mortality in those with low BMI and no increased mortality in overweight and obese HD patients, more recently obesity has been registered as an independent risk factor for cardiovascular morbidity and mortality in HD patients as for the general population.…”

Autoimmune manifestation of hepatitis C virus infection as a risk for late virological relapse after pegylated interferon and ribavirin therapy

“…Owing to the stricter blood bank screening rules, widespread use of erythropoiesis-stimulating agents instead of blood transfusions and stronger adherence to infection control practices in dialysis units, there was a reduction in the prevalence of the HCV infection in the HD patient group 22 . The percentage of the anti HCV positive patients dropped from 23.2% in 1999 to 12.7% in 2009 in Serbia 22 . In this particular HD Center our patient was the only anti-HCV positive and during 10 years of follow-up, there was no new HCV infection among the patients on HD.…”

“…1. Unfortunately, serum samples of the patients before treatment PegIFN were not available and we could not exclude the re-HCV infection by the molecular analysis of HCV sequences [21][22][23] .…”

Glutathione transferase gene polymorphism in end stage renal disease

“…Data are showing that incidence of ESRD is progressively growing worldwide in the last twenty years, with more than two million affected individuals and over half million in the Europe. According to national dialysis register, there are almost 6000 people in Serbia treated with some type of renal replacement therapy (2). Incidence of ESRD in Serbia was also growing in the last decade, rising from 107 to 189 patients per million individuals.…”