Trend of Kidney Replacement Therapy in North Macedonia from the Years 2015 Through 2020.

Introduction: Kidney replacement therapy (KRT) by dialysis or kidney transplantation represents the main treatment modalities for patients with kidney failure. Here we evaluate the trends in taking care of such patients in North Macedonia from 2015 through 2020.

Methods: The patients were analyzed according to age, sex, primary disease, and treatment modality. They were further subdivided into 3 groups: Group 1, prevalent patients; Group 2, incident patients with analysis starting at day 1 of KRT; and Group 3, incident patients with analysis starting at day 91 of KRT.

Results: The study included 10,395 person-years, mean age 59.2 ± 9.5 years, male sex 60.2%, hemodialysis therapy 84.7% in 2015 and 85.9% in 2020. Hypertension and diabetes mellitus were the leading causes of kidney disease. Group 1 showed an increase in KRT care of 10.3% (from 799 part per million population [pmp] in 2015 to 881 pmp in 2020). In Group 2 the number of patients was increasing with each successive year, the highest growth being observed in 2019. The patients of Group 3 showed a significant growth during this time period, from 126.5 ppm in 2015 to 162 pmp in 2019, but a subsequent decrease of 16.4% in 2020 (135.5 pmp), probably explained by the SARS-CoV-2 pandemic.

Conclusion: In the analyzed period, an increase in the number of patients with kidney failure in need of KRT is observed. We believe that this trend will continue in the following years, which should be taken into account when planning health policies in our country in the future.