#3859 THE TREND OF RENAL REPLACEMENT THERAPY IN N. MACEDONIA FROM 2015 TO 2020: DATA FROM THE ERA-EDTA ANNUAL REGISTRY

Abstract Background and Aims Kidney Failure (KF) is treated with three modalities of renal replacement therapy (RRT): kidney transplantation (Tx), hemodialysis (HD), and peritoneal dialysis (PD). Our study aimed to present the trend of RRT in N. Macedonia from 2015 to 2020. Method The epidemiological retrospective study analyzed the patients with kidney failure by gender, age, etiology of kidney disease, and modality of RRT. The data were processed from the annual reports of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA). The study patients were divided into group 1 (prevalent) with patients on the RRT at the current year, group 2 (incidence at Day 1) with patients on the RRT with a duration of at least 1 day, and group 3 (incidence at Day 91) with patients on the RRT with a duration beyond 91 days. Results A total of 10395 patients were analyzed with a mean age of 59.2 ± 9.5 years (median 60.4 years), of which 60.2% were male. From 2015 to 2019, there was an increasing trend in all groups, and most patients were reported in 2019. In group 1, 1598 patients were registered in 2015, and 1762 patients were registered in 2020, which is an increasing trend of 10.3%. The number of patients in group 2 was increasing every following year, with the highest growth in 2019 up to 12.1%, compared to 2018. The number of patients in group 3 also showed significant growth from 253 patients in 2015 to 324 patients in 2019, but there was a decrease of 16.4% in 2020 (271 patients). Deviations are observed in 2020, with a decrease in the number of patients in group 1 and group 3, as well as a slowdown in the growth dynamics of patients in group 2, which might be associated with the start of the SARS-CoV-2 pandemic. According to the modality, most of the patients (84.7%) were on HD in 2015 and 85.9% in 2020. The most frequent age group of patients was from 45 to 64 years, from 36.3% to 49.4%. There was an increasing trend of patients from older age groups (over 64 years) and male patients. The increasing number of patients from the age group 75+ years was also noted in all groups. Etiology of kidney disease: hypertension (25.8%) and diabetes mellitus (17.4%) were the leading causes of KF in patients requiring RRT. Conclusion The study showed a constantly increasing trend of patients with KF requiring RRT. The largest number of patients were men, aged from 45 to 64 years. Hypertension and diabetes mellitus were the leading causes of KF, and most of the patients were treated with HD.