Further advances of chronic renal replacement therapy in eastern Germany, 1994 versus 1989.

Unlike the other former Soviet-block countries, Eastern Germany/the GDR, had the opportunity to the re-unification with a highly developed western country, the Federal Republic of (West) Germany in 1990. In order to record the following rapid improvements in renal replacement therapy, we performed our own survey in Eastern Germany - excluding Eastern Berlin - by questionaire, comparing the years 1989/December, and 1994/December. 112 of the 113 dialysis facilities for adult regular dialysis patients replied to our questionnaire (99%). From 1989 to 1994, the number of dialysis centers increased from 53 to 113 (→213%), reaching 7.9 centres p. m. p. Of these facilities, 29% were hospital centers, 48% were private dialysis units, and 23% were run by non-profit dialysis organizations. The number of dialysis stations increased from 602 to 1,719 (→286%), i. e. 120 stations p. m. p. The number of patients in regular dialysis treatment rose from 2,127 to 5,335 [→251%), that means a prevalence of 373 patients p. m. p. In 1989, 67 new patients (p. m. p.) had been accepted for maintenance treatment (incidence), in contrast to 130 new patients p.m.p. in 1994 (<194%), now under the conditions of unlimited accessibility to dialysis treatment. Questions referring to this point - the incidence of new patients - were only asked in Thuringen (2.5 mio. inhabitants). Alternative treatment modalities became feasible under the new conditions in Eastern Germany. In contrast to 99% hemodialysis patients in December 1989, at the end of 1994 92.8% of the patients were treated by hemodialysis, 2.0% by hemofiltration, and 5.2% by peritoneal dialysis, predominantly CAPD. The proportion of dialysis patients positive for hepatitis-B-antigen decreased from 21% in 1989 to 3.9% at the end of 1994. At the same time, a prevalence of 9.5% patients positive for hepatitis-C-antibodies was stated. At the end of 1989, in the former GDR (excluding Eastern Berlin) 773 patients, and at the end of 1994, 1,533 patients were alive with functioning renal grafts (→198%). Summarizing the number of patients on regular dialysis treatment and those having functioning grafts, to renal replacement therapy, there was an increase from 2,900 patients (193 p. m. p.) at the end of 1989, to 6,868 patients (480 p. m. p.) at the end of 1994 (→237%). The annual renal transplantation rate of East German patients (including Eastern Berlin) rose only slightly from 254 in 1989, to 279 in 1994 (→110%). The number of patients on waiting lists for renal transplantation (including Eastern Berlin) enlarged from 620 patients (42 p.m.p.) at the end of 1989, to 1,094 patients (71 p. m. p.) at the end of 1994 (→176%).