Renal replacement therapy in the Russian Federation: A 20-year follow-up

Abstract

ABSTRACT Background: Chronic kidney disease (CKD) is a serious medical as well as socioeconomic problem in the Russian Federation. Competent primary and secondary prevention of CKD, along with the availability of suitable renal replacement therapy (RRT), are the key factors for reducing mortality, incidences of complications, rate of disease progression, and cost of treatment in the human population. Problem: Since 1998, particularly during 2010–2015, there is an increase in the provision of the RRT in the Russian Federation. At present, the available therapy is unable to meet the real need, which is related both to the high prevalence of patients with CKD in the population and the current slow rate of RRT development. Insufficient secondary prevention, shortage of qualified personnel, and delayed primary diagnosis lead to a high prevalence rate of end-stage CKD and thus giant treatment costs of the condition. Purpose: This study aimed to analyze the RRT structure by studying the key parameters that describe the national situation of RRT during the last two decades: 1998–2018 in the Russian Federation. Conclusion: The Russian system of RRT has been constantly developing since 1998, and inequality in access to the RRT system is gradually decreasing among different regions. Some parameters still need improvements, such as availability of hemodialysis and peritoneal dialysis, cost of consumables, complications related to drug therapy for end-stage CKD patients, and an better assessment of the real statistics of CKD patients at pre-dialysis and dialysis stages in the Russian Federation.