Availability of renal replacement therapy in Central and Eastern Europe

During the past 15 years, deep political and economic changes have occurred in Central and Eastern Europe (CEE). New, independent countries have appeared on the map because of the partition of the former Soviet Union and the former Yugoslavia and Czechoslovakia. One significant area of change in the CEE region has been intensive reform of the healthcare systems in each country. In particular, renal replacement therapy (RRT) in most of these countries was underdeveloped during the so-called "real" socialism era. But enormous effort on the part of the nephrology communities, supported by the economic help of local, regional, and central authorities, has resulted in gradual progress in this matter. Both main RRT modalities (dialysis and renal transplantation) have evolved simultaneously in most of these countries but not always equally. In most CEE countries, RRT is available for all patients with end-stage renal disease. Still, an unsatisfactory level of RRT availability, despite the efforts of the nephrology community, continues to be a concern in Belorussia and Russia, where additional support from the healthcare system is required. The lowest rates of RRT are found in Albania, Moldova, and Ukraine, but reliable data from these countries are lacking.