Nephrology and renal replacement therapy in Romania

Area of Science:

• Nephrology
• Public Health
• Health Systems Research

Background:

• The transformation of health systems in Central and Eastern European countries has increased the role of professional associations in nephrology and renal replacement therapy (RRT).
• Data collection, analysis, and program implementation are key areas where these associations contribute to the development of nephrology services.

Purpose of the Study:

• To assess the development and current status of renal replacement therapy (RRT) in Romania between 1991 and 1995.
• To evaluate the capacity and accessibility of RRT services in Romania during the specified period.

Main Methods:

• The Romanian Renal Registry distributed questionnaires to heads of Haemodialysis and Nephrology Centres.
• The incidence of chronic renal failure (127 patients per million population) was used to estimate the need for RRT.

Main Results:

• Between 1991 and 1995, Romania saw significant increases in Nephrology Departments (+82%), Haemodialysis (HD) Centres (+142%), and patients on RRT (+196%), exceeding European averages.
• Despite this growth, only 27-30% of patients needing RRT received treatment, with significant disparities based on age (62% for 25-44 years, 20% for children and >55 years).
• Glomerulonephritis (49%) and interstitial nephropathies (23%) were the primary causes of renal disease; HD was the predominant treatment (88%), with renal transplantation (8%) and peritoneal dialysis (4%) being less common. The cost of HD was low ($87 USD).

Conclusions:

• The expansion of haemodialysis centres primarily drove the increase in RRT in Romania.
• Although substantial progress was made, Romania could only provide RRT to approximately one-third of the patients requiring it in 1995.