THE RENAL REGISTER FOR BOSNIA AND HERZEGOVINA The Society for Nephrology, Dialysis, and transplantation in Bosnia and Herzegovina has formed the Renal Register and started gathering the data in 1999. We sent surveys to 18 centers for dialysis. Six of them replayed during the first year. By 2001, we gathered data from all of the twenty centers in Bosnia and Herzegovina Following the European renal register standards, for the year 2002, we created individual surveys for each patient. Using this data, we formed data basis which included the surveys from 1531 patient who were treated in the centers at this time. Since 2002, the renal register in Bosnia and Herzegovina is added to the European renal register. The president of the Committee for the Renal Register for Bosnia and Herzegovina is M.D. Ph.D. Halima Resić. The Center for Hemodialysis at the Clinical Center of the University of Sarajevo. Introduction The Society for nephrology, dialysis and transplantation in Bosnia and Herzegovina (UNDT BiH) was founded in 1997. Humanitarian organization Medicine du Monde provided crucial organizational and financial aid. During the warfare in Bosnia and Herzegovina (1992-1995), the necessary function of the centers for dialysis was helped with donations made by European Union. Transportation and distribution of the donated materials were provided by the humanitarian organization Medicine du Monde (1). Since 1997, treatments for the patients with chronic renal failure have been sponsored by the government. The reasons for such are tough economical situation, as well as the specific political organization of the country. In the process of dealing with these problems, activities of UNDT BiH are very important. We are striving to standardize equal treatments for renal patients, to educate nephrology professionals, to increase number of patients treated with peritoneal dialysis, and to enhance the program of kidney transplantation.Since 2002, due to the survey results, our country has been involved in the activities of the Central and Eastern European (CEE) Advisory Board in Chronic Renal Failure (CRF). Methods The surveys prepared by the Committee for the standardization and the renal register UNDT BiH were delivered to the staff of the centers for dialysis. We asked for a report on the function of the centers on the December 31st of 1999, 2000, and 2001. The survey (Appendix V) includes groups of questions about the center itself (size, equipment, staff, water treatment), about the distribution of patients according to sex, age, primal renal disease, length and model of the treatment, mortality, and about the number of kidney transplantations. We used 90-days-rule, which means that only the patients treated for longer than 90 days were considered to be patients with chronic renal failure(2). The statistical analysis of the data was limited because the demographic data was not always accessible. Analysis of the collected data The population of Bosnia and Herzegovina has been roughly estimated to 3,500,000. The last national census of population dates from 1991. Due to the warfare, the number and the structure of the population has been drastically changed. In Bosnia and Herzegovina, the prevalence of renal replacement patients (RRT) is around 450 pmp. However there are large variations among the regions of the country. The population of the northern-east Bosnia is estimated to 300,000. This is the region of the endemic nephropathy, and it has the prevalence of 1.030 pmp (“per million populations”) of renal replacement patients. Thus, the concentration of the centers for dialysis is the highest in this area. Herzegovina, on the other hand, has 5 times smaller prevalence of renal replacement patients, about 203 pmp. The previous image illustrates locations and sizes of the centers for dialysis in Bosnia and Herzegovina. The stuff of the centers number 280 nurses and 52 doctors. It means 14 treatments per one nurse and 73 treatments per one doctor per week. Two centers work in 4-shift schedule, while other centers wokr in 2 or 3-shift schedule. With exception of one small center, the centers for dialysis have satisfactory water treatments (reverse osmosis). None of the centers uses reprocessing (reusing) of dialyzators. There are 279 devices for dialysis in function. A few private centers with excellent working environment operate in Banja Luka and Bijeljina. The Fond for Medical Insurance of RS pays for treatments in these centers.
The Renal Register UNDT