ISSN 2217-9828

Serbian Society f Nephrology

, 2011


, 2011

, 2013.


, 9

300

Roche d.o.o.,

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, 2011........................................7
...............................................................................................................................9
1. ......... 11
2.
2011. ......................................................................................12
3.
...............................................................................................13
4.
2011. .....................................15
5.
2011. ..................................................... ................... 20
6.
31. 2011..................................................................................26
7. 2011. ...........................................................33
8. ,

1997. 2011. .................................................................................... 35

2011. ....................................................39
1.
( )..................................................................................43
2. Ke 2011.
( )......................44
3. 2011. .........48
....................................................................................................................53


Serbian Society f Nephrology

, 2011
ANNUAL REPORT ON DIALYSIS
AND KIDNEY TRANSPLANTATION IN
SERBIA, 2011

, 2013.

 :
.


.

.


2011.

.

2011. .
,
ERA-EDTA.
- ,
.
, ,
( ) . ,
,
.

,
.
.
,
,
.

,

.
, 10. 2013.

 , 2011

1.

.
1.
31.12. 2011.
Table 1. Number of dialysis and kidney transplantation centers in Serbia,
December 31st 2011

Treatment methods used

Number of centers

& y
Hemodialysis & Peritoneal dialysis

29

Hemodialysis

29

Kidney transplantation

2011. 57 . -
2009. ,
. ,
.
2011. :
Medicon
.
29 a, .

: , ,
,
.

11

 , 2011

2.

2011.

2011. 100%.
,
,
.

. , ERA-EDTA
15
.
,
.
%

100
80
60
40
20
0
1997

1998

1999

2000

2001

2002

2003

2004 2005-8 2009

2010

2011

: ( ),
( ), 2005-2008 ( )
*Method of data collection: aggregated data based on centre questionnaire (gray column), individual patient data (black
column), aggregated data collected retrospectively for the period 2005-2008 (white column)

1.

Figure 1. Response rate on the questionnaires sent to the centers for dialysis and kidney
transplantation

12

 , 2011

1997.
2004.
.

1997.
2004.

,

2005.

,
2005.

.
.

3.

3.

5 311. 2 19
5 311. 2
(33%) 50 , 150 6
19 (33%) 50 ,
(11%) .
150 6 (11%) .

25
20

22
19

15

10

10
5

150-200

>200

0
<50

50-100

100-150

2.

2.

Figure
2. 2.
Distribution
of centers
according
to number
of patients
on maintenance
hemodilysis
Figure
Distribution
of centers
according
to number
of patients
on maintenance
and peritonal dialysis
hemodilysis and peritonal dialysis

2
2 .
. 2011.


2011.

2011.

2011.

13

 , 2011

2.
2011. 2011.
Table 2. Number of patients on maintenance hemodialysis (HD) and peritoneal dialysis (PD) on
December 31st 2011, number of patients started hemodialysis and peritoneal dialysis in 2011
(HD)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
59

A

,
,
,
,
,
,
,
, Medicon
,
,
, FMC,
, FMC, .
, FMC,

,
,
, FMC

,
, FMC

Ho , Medicon

14

31.12.2011.
14
51
33
95
8
245
80
130
88
38
66
46
86
81
64
24
96
117
47
55
7
68
101
76
13
29
138
87
119
11
96
79
24
5
191
22
91
121
92
116
52
124
26
50
8
11
85
50
86
164
62
157
84
76
104
6
15

2011.
New in
2011
1
12
2
11
2
46
24
3
13
11
5
7
2
33
4
5
18
26
8
12
0
12
21
13
0
10
17
12
17
4
27
13
6
1
49
0
19
33
9
21
13
22
12
12
3
2
17
4
9
40
9
35
14
26
16
4
4

(PD)
31.12. 2011.

2011.
New in 2011

0
0
0
18
6
66
13
74
0
0
0
0
0
0
0
1
16
0
0
1
0
7
1
3
0
2
41
2
2
3
27
0
1
0
47
0
2
17
0
0
9
0
0
2
0
0
0
4
0
0
13
2
10
1
4
0
0

0
0
0
1
3
15
3
18
0
0
0
0
0
0
0
0
4
0
0
0
0
3
1
0
0
1
11
0
0
0
6
0
0
0
6
0
0
7
0
0
2
0
0
2
0
0
0
1
0
0
4
0
4
0
4
0
0

 , 2011

2011. ,
Medicon
.
2011. 2010.

(78,1%

, 7,8% ).


ERA-EDTA.
(3,7%), (11,3%) [1].

10-20% , 20% ,
10-20% 20% .
29 ,
14 , .
, ,
8
58 , 1%
.
(CAPD),
(APD).

4.

2011.

2011.
ERA-EDTA .
, ,
.

15

 , 2011

, (,
),

.
ERA-EDTA
.
ERA-EDTA 91. .

(,
pre-emptive kidney transplantation).
91.

.

.
3
2011. : 2011.

, 31. 2011. ,
2011.
2011. .
3.
2011.
Table 3. Main epidemiological data of patients on renal replacement therapy in
Serbia in 2011

1.
Number of new patients,
at day 1

31. 12. 2011.
Number of patients
Dec 31st 2011

2011. .
Number of patients
died 2011

O
( )
General population
(in thousands)

1043

5275

774

7259

4
2011.
16

 , 2011

91. , 5
31. 2011.
.
4. 2011.
91.
Table 4. Data on patients who started renal replacement therapy in Serbia in 2011 and were on
the therapy at day 91

Hemodialysis

Peritoneal
dialysis

idny
transplantation

Total

(%)
91. .
Number (%) of new patients,
at day 91

847
(88,2)

100
(10,4)

13
(1,4)

960
(100)

91.
Number of patients
per milion population
at day 91

116,7

13,8

1,8

132,3

3 4

2011. 1043, 90
960 . 83 2011.
, 90 (8%)
. ERA-EDTA
91.
2% 17% ( , ) [1].

2011. 91. (960), 847 (88,2%)
, 100 (10,4%) ,

13 (1,4%) ( 4).
2011. 5275 : 4119 (78 %), 414 (8%), 738 (14 %) ( 5). 4
.

17

 , 2011

5.
31. 2011.
Table 5. Data on renal replacement therapy patients in Serbia on December 31st 2011

(%)
31.12. 2011.
Number (%) of patients
Dec 31st 2011


31.12. 2011.
Number of patients
per milion population
Dec 31st 2011

Hemodialysis

Peritoneal
dialysis

idny
transplantation

4119
(78)

414
(8)

738
(14)

5275
(100)

568

57

102

727

Total

2011.
: 2010. 5546, 2011. 5275,

. ,
2011. .
. ,
2011. , , .
2011.
2010. ( 468 414),
2010. 2009. ( 504 468).
/
.
, , ,
.
2010. 31. 997
, 2011. 738.

18

 , 2011

.
, .
.
2011. 772 , 90 2010.
.
741 688, 106 79,
2010.
10 5.


,

. , ,
.
3
1997. 2011. .

.
100%
90%
80%
70%

60%
50%

40%
30%

20%
10%
0%
1997 1998 1999 2000 2001 2002 2003 2004

2008 2009 2010 2011

- (hemodialysis); - (peritoneal dialysis); -

(kidney transplantation)

- (hemodialysis); - (peritoneal dialysis); -

(kidney transplantation)

3.
3.
1997 2011.

1997
2011.

Figure
3. Distribution
of patients
according
to the
method
of renal replacement therapy in our
Figure 3.
Distribution
patients
to the method of renal replacement therapy
country
duringofthe
period according
1997 2011

in our country during the period 1997 2011

19
ERA-EDTA 2010. 2011. ,

 , 2011

ERA-EDTA 2010.
2011. ,
,
.
, 40%
, [1,2].

5.

2011.

2011. e 1043
.


(60,5 vs. 58,8 ).
, 2011. ,

6.
6.
2010.
Table 6. Data on patients started renal replacement therapy in 2010

All patients

Number

Incidence
Mean ge
,
New patients at
day 1

Incidence pmp at
day 1
, 91.
New patients at
day 91

143,7

91.
Incidence pmp at
day 91

132,3

20

1043

960

60,514,5

Males

Number

Incidence
Mean ge
637

60,514,3

180,4

59,514,5

592

167,7

Females

Number

Incidence
Mean ge
406

60,514,9

108,9

60,014,3

368

98,7

59,815,0

2011

,
(1043

,

188,6

).

(1043

1420
),

(143,7

(
3).

. 188,6

91.
).

91.
(

2011.

4). 2011.
,
,

,.
.

pmp

1420 ), (143,7 .

200
180
160
140
120
100
80
60
40
20
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
1.

91.

4. 4.

91.

91.

Figure
4. Incidence
rate of renal
replacement
therapy
patients per million population (pmp)
at day 1 and
91 of renal replacement therapy patients per million population
Figure 4. Incidence
rate

(pmp) at day 1 and 91

4 2005. 2010.
91.

4
62

2005. ,
2010.

43

91. 2435%.

2011.
91.

83
,

43 62

8,0%.
91. 2435%. 2011.
91. .

83 ,
8,0%.

-

,

91.
. ,
.
-

21

 ,
. ,

,
2011

pmp

.

,

91.

91.

ERA-EDTA [1,2].
ERA-EDTA [1,2].
500
450
400
350
300
250
200
150
100
50
0
0-19

20-44

45-64

65-74

75+

5.

5.

91.
91.


Figure 5. Distribution of patients on renal replacement therapy at day 91 according to age
Figureand
5. gender
Distribution of patients on renal replacement therapy at day 91 according to
age and gender

91.

91.

.

.

6574 , 75
6574 ,
( 426 146
75 ( 426
).
146 ).

22

 , 2011

7.
2011.
91.
( )
Table 7. Causes of end-stage renal disease in all patients started renal replacement therapy in
2011 and those on treatment at day 91 presented as incidence rate (pmp) and percent

Diagnosis

1.
at day 1

91.
at day 91

I/pmp

I/mp

Glomerulonephritis

13,5

9,4

13,2

10,0

Pyelonephritis

16,3

11,3

13,9

10,5

Balkan nephropathy

3,2

2,2

Polycystic kidney disease

8,8

6,1

8,5

6,5

31,3

21,8

30,0

22,7

36,2

25,2

34,4

26,0

Renovascular disease

0,4

0,3

0,4

0,3

Miscellaneous

20,6

14,3

19,8

15,0

Unknown

13,4

9,3

11,8

9,0

Diabetes

Hypertension

2011. (Ta 7),

.
2011.
.
2011.
,

ERA-EDTA. ( )
39,4% [1]. ERA-EDTA , 23

 , 2011

,
[1-3].

.
, ,
.

90

81

80
70
60
50
40
30
20
10

0.4

0
HDcentar

HD-kua

6.8
HDF

10
0.4
APD

CAPD

1.1

0.2

Tx-ivi
dav.

Tx-kad.

6. 6.

91.
91. (
91. )

91. )
Figure 6. Methods
of renal replacement therapy used in new patients at day 91 (presented as
percentages
number
of patients regisetred
day 91)
Figure 6. Methods ofoftotal
renal
replacement
therapy atused
in new patients at day 91

(presented as percentages of total number of patients regisetred at day 91)

6
91. .

6
2009.

2011.
,

91.

.

4%.
2009. 2011. ,
,

4%.

1,3% ,

2,1% (, ) 15,9% ().

1,3% ,

2,1% (, )
24
15,9% ().

 , 2011

100
90
80
70
60
50
40
30
20
10
0
0-19

20-44

45-64

65-74

75+

- (hemodialysis); - (peritoneal dialysis);

- (hemodialysis); - (peritoneal dialysis); - (kidney transplantation)

(kidney transplantation)

7.
91.

7.

Figure
7.
Distribution
of
patients
on
established
renal
replacement
therapy
methods at day 91
91.
according to age
Figure 7. Distribution of patients on established renal replacement therapy methods at

day 91 according to age

c
2011.

( 7).

2011.

(
7). X

. 9 ,

, .
.
,
9 , ,
2044 .

. ,
2544 .

25

 , 2011

6.

31. 2011.

31. 2011.
.
8.
31. 2011.
Table 8. Data on patients on renal replacement therapy in Serbia on December 31. 2011

All patients

Males

Females

Number
(Prevalence, pmp)

Age, years

Number
(Prevalence,
pmp)

Age, years

Number
(Prevalence,
pmp)

Age, years

5275
(726,7)

57,014,3

3143
(887,6)

57,014,2

2141
(574,3)

57,114,5

2011. 727 ( 8).
ERA-EDTA
2011. 802 ()
1271 (, ) [1], 2010. 1752 [4]. A
ERA-EDTA 2011. 705
624 [1].

1997,
,
2010. . 1997. 435
305
2010. ( 9).
2011. , .

26

 , 2010.
. 1997. 435
305 2010.

, 2011

( 9). 2011.
, .

8 2011.
8 2011.
(59,5%) (40,5%),
(59,5%) (40,5%),


2011. .
2011. .
ERA-EDTA [1]. ERA-EDTA [1].
2011. 57
2011. 57 , 5,5
, 5,5 1999. [5].
1999. [5]. ERA-EDTA
ERA-EDTA 2011.
2011. 55 ()
55 () 65,1 (,
65,1 (, ) [1].
) [1].
2500

pmp

2000
1500
1000
500
0

0-19

20-44

45-64

65-74

75+

8.
31.
8.
Figure 8. Distribution of patients on renal replacement therapy in Serbia on December 31st
31.
according to age and gender
Figure 8. Distribution of patients on renal replacement therapy in Serbia on December
31st according to age and gender

31. 2011.
.
8 .
6574 , 918
75 .
19 , ,
.

27

28

2009

2010

2011

100

100

100

73,9

71,7

71,7

71,7

83,0

60,2

90,4

96,2

92,3

92

93,9

92,6

RR

7,3

7,5

7,5

7,6

7,4

7,4

7,4

8,5

8,5

8,5

8,5

8,5

8,5

8,5

10,6

POP

1043

1420

1332

1349

1208

1093

1150

635

573

1112

977

985

958

1042

1149

Ni

144

189

179

178

175

158

167

95

117

137

115

116

113

123

108

Ni/P

774

862

871

636

635

662

563

783

736

689

677

680

953

No

106

115

116

97

92

96

82

96

87

81

80

80

90

No/P

5275

5546

5208

4493

3990

3689

3530

2700

2398

3997

4224

3961

3604

3785

4615

Ns

727

740

699

686

578

535

512

402

491

492

497

466

424

445

435

Ns/P

41,0

74,4

61,5

93,8

77,4

58,2

79,3

40,7

28,3

34,8

33

42,6

18,5

(Ni-No)/P

RR =
POP =
Ni =
Ni/P =
No =
No/P =
Ns = 31.
Ns/P =
(Ni-No)/P =
Ki =
Ko= No/Ns ()
K linear = Ki Ko

2007

2008

2005

2006

2004

2002

2003

2000

2001

1999

1998

1997

19,8

25,6

25,6

30,1

31,2

30,5

33,5

23,6

23,8

27,8

23,1

24,9

26,5

27,5

24,4

Ki

14,7

15,5

16,7

14,6

16,4

18,5

16,3

19,6

17,4

17,4

18.8

17,9

20,7

Ko

9
1997-2011.
Table 9. Epidemiological data on end-stage renal disease patients in our country from 1997-2011

5,1

10,1

8,9

15,5

14,8

12,0

17,2

8,2

5,7

7,5

7.7

9,6

4,2

K linear

, 2011

 , 2011

10.
31. 2011. e
able 10. Frequency of end-stage renal disease causes in patients on renal replacement therapy
on December 31st 2011

Diagnosis

Prevalence, pmp

Glomerulonephritis

153,6

21,1

Pyelonephritis

85,0

11,7

Balkan nephropathy

34,5

4,7

Polycystic kidney disease

51,7

7,1

Diabetes

95,1

13,1

Hypertension

170,3

23,4

Renovascular disease

7,9

1,1

Miscellaneous

86,0

11,8

Unknown

42,7

5,9

10
31. 2011. e.

.
.
,
[4],

[1].

.
2009.
137,7
, 32,6 2011.
. .
29

 , 2011

,

( 10, 9).
,
.
.
10 ,
ERA-EDTA
. , .
: 37,9 2009. , 31,6 2010. 34,5
2011. .

30
25
20
15
10
5
0

2000

2011

(Glomerulonephritis); (Pyelonephritis);


 (Pyelonephritis); 
(Glomerulonephritis);
(Balkan nephropathy);

(Polycystic
kidney disease); (Polycystic kidney disease);

(Balkan
nephropathy);


mellitus);

(Hypertension)

(Diabeltes
(Diabeltes
mellitus);

(Hypertension)

9.

9.

2000. 2011.

.
2000

2011

(
31.
( 31. )
)
Figure 9. Frequency of end-stage renal disease causes in patients on renal replacement therapy
in 2000 and 2011 (on December 31)

Figure 9. Frequency of end-stage renal disease causes in patients on renal replacement

therapy in 2000 and 2011 (on December 31)

30

31.

2000 2011 .

 , 2011

9 31. 2000. 2011. .

.
, . ,

. ,
,

. , ,

[6,7].
[6,7].
63.1
60
50

40
30
20

14.3
7.6

10

0.6

0
HD-centar

HD-kua

9.5

0.3
HDF

APD

CAPD

Tx-ivi
davalac

4.5
Tx-kadaver.
Davalac

10.

10.

31.

2011.

31. 2011.
Figure 10. Percent of established renal replacement therapy methods in prevalent patients on
Figure 10. Percent of established renal replacement therapy methods in prevalent
December 31st 2011.
patients on December 31st 2011.

2011.
o
2011.

(333063,1%),

(333063,1%),

754 (14,3%) (
10).
754 (14,3%)

10).

413 (7,9%)
(



413 (7,9%)
(3997,6%).

2011.(3997,6%).
14%

2011. 14%
, 31
.

 , 2011

,
. 40%
,
(61.8%) (71,9%).
6,6% 34,4%,
[1,8].

100
80

60
40
20
0
0-19

20-44

45-64

65-74

75+

- (hemodialysis);
(hemodialysis); -
dialysis);
-
-
(peritoneal
(peritoneal
dialysis); -
-
(kidney transplantation)
(kidney transplantation)

11.
91.
11.
Figure 11. Distribution of patients on established renal replacement therapy methods at day 91
91.
according to age
Figure 11. Distribution of patients on established renal replacement therapy methods at

day 91
according to age

c

2011.
c
( 11).
2011.
X
( 11).

X
,

. , , . 9 ,

2044
, . ,
.

2544 .

32

 , 2011

7.

2011.

2011. o 113 ,
44 (38,9%) , 69 (61,13%)
. 2011.

. 13,4 ( ) 2010. 15,6 2011.. ,
2011.
(69 44) ( 11).
11. Te 2011.
Table 11. Kidney transplantations performed in 2011

Total

Living

Related

Unrelated

Type unknown

Deceased

(%)
Number (%)

113

28 (24,8%)

3 (2,7%)

13 (11,5%)

69 (61,1%)

Number pmp

15,6

3,9

0,4

1,8

9,5

11 13
.
13 , 2011. , 20 ERA-EDTA
. ,
(21), (22)
.
ERA-EDTA,
20, . ,
,
.

33

 , 2011

12. , 31. 2011.

Table 12. Number, percentage and prevalence of patients with functional kidney graft on
December 31st 2011

Donor

(%)
Number (%)

Prevalence, pmp

Total

Living

Deceased

Type unknown

501 (67,9%)

237 (32,1%)

0 (0%)

738 (100%)

71,7

31,6

103,3

31. 2011. 738

501 (67.9%)
, 237 (32.1%) ( 12).
1200
1000

800
600
400
200
0
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

12.
12
1997. 2011.
1997. 2011.

Figure
12. tal
number of patients with transplanted kidney in period 1997- 2011 and number
Figureof12.
tal number
of patients
with transplanted
kidney in period 1997- 2011 and
patients
transplanted
in presented
years

number of patients transplanted in presented years

2011. 259 2010. (738 2011.

997) ( 12). ,
259 2010. (738 997) ( 12).

,
. ,
.

34

, 2011.
.
,

 , 2011

2011. . , .

8.

,


8. ,

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2011.

1997. 2011.

13


1997.
2011. 13
.

1997. 2011.
1997. 2005. 108 167
. 1997.
, 2010. .
2005. 108 167 ,

2010. .
[9-11].

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700
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K

13. K

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2004.

1997. 2004. 2005.

2005.
2011.
2011.

Figure 13.Figure
Changes
in incidence
and prevalence
of renal
replacement
therapy
patients
in in
our
13. Changes
in incidence
and prevalence
of renal
replacement
therapy
patients
country from 1997 to 2011
our country from 1997 to 2011

35

 , 2011

2011.

2011.

ERA
, EDTA ( 14). 2011.
ERAEDTA ( 14).

2011.
.

2010.

( 13)

2010.
(
13)

1000





( 14).
1000 ( 14).
125
130

, ERA

149
189

960
939

, ERA
727
737

,
0

200

400

600
2010

800

1000

1200

2011

14.

14.

(
)
)
ERAEDTA (ERA) () 2010.

ERAEDTA (ERA) () 2010. 2011.

2011.
Figure
14. Comparison of incidence and prevalence (per million population) of renal replacement
therapy
patients in countries
registered
in Section
A of ERA-EDTA
(ERA) of renal
Figure
14. Comparison
of incidence
and
prevalence
(per millionregistry
population)
and Serbia () in 2010 and 2011

replacement therapy patients in countries registered in Section A of ERA-EDTA registry

(ERA)
and15
Serbia
() in 2010
and 2011

,
15
31.
,

20,7%

1997.
2011. .

31.

1997.
2011.

1997.

17,4 19,6%

. ,
, 16,3%.
14,6 18,5%, .
36

. 20,7% 1997.
17,4 19,6% .
, , 16,3%.

14,6
18,5%,

2011

,

25

20.7
20

17.9

18.8

19.6
17.4 17.4

18.5
16.3

16.4

15.5

14.7

15

16.8
14.6

10
5
0
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

15.
(%)
(%)

15.

1997.
2011.

o
1997. o2011.

FigureFigure
15. Mortality
(%)(%)
of patients
on on
renal
replacement
15. Mortality
of patients
renal
replacementtherapy
therapyfrom
from 1997
1997 to
to 2011
2011

.

,
2011.

.
2011.

,

.
,

.
,

.
.
25
20

19.8
16.6

14.7

15
10
5

1.0
0

16. 2011.

16. 2011.

31.

2011
2011

31.

Figure 16. Mortality

calculated
as percent
of patientsas
died
in 2011 of
from
the total died
number
renal from the total
Figure 16.
Mortality
calculated
percent
patients
inof2011
replacement
on Decembar
31 2011
in relation
of established31
therapy
number
of therapy
renal ptients
replacement
therapy
ptients
on Decembar
2011 in relation of

established therapy

37

16 ,

 , 2011

16
, 31. 2011.
.
2010. ,
, 2011. .

14.5

10.1

3.6

9.1

6.2

17.4

37.8

10

15

20

25

30

35

40

- (cardiovascular diseases); -
- (cardiovascular diseases); -
(cerebrovascular diseases); - (gastrointestinal diseases)
(cerebrovascular diseases); - (gastrointestinal diseases)

17.
17.
2011.
2011.
of death of renal replacement therapy ptients in 2011
Figure
17. Causes
Figure
17. Causes of death of renal replacement therapy ptients in 2011

17
17

2011. .

2011.
.

6,7%
.

, 6,7%

.

.
2011.
414

113
,

2011.
414
34

34
113 ,

.
,


.

2011. ,

38

 , 2011

.
. 2011.
2001. [12]
, 2001.
18.
[12] 18.
30
25
20

HBV 2001
HBV 2011

15

HCV 2001
HCV 2011

10
5
0
HD

PD

Tx

- (hemodialysis); - (peritoneal dialysis);

- (kidney transplantation)

18.

18.

2011.

Table
18. Percentage
of hepatitis B and hepatitis C positive patients treated with renal
2011.
replacement therapy in Serbia in 2011
Figure 18. Percentage of hepatitis B and hepatitis C positive patients treated with renal
replacement
therapy in
Serbia in 2011
18

18

2001. 2011. .
.


,
2001. 2011. .
anti-HCV .

,
anti-HCV .

39

 , 2011

1.

ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2011. Academic

Medical Center, Department of Medical Informatics, Amsterdam, The
Netherlands, 2013.
2. ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2010. Academic
Medical Center, Department of Medical Informatics, Amsterdam, The
Netherlands, 2012.
3. ERA-EDTA Registry: ERA-EDTA Registry Annual Report 2008. Academic Medical
Center, Department of Medical Informatics, Amsterdam, The Netherlands, 2010
4. U.S. Renal Data System, USRDS 2012 Annual Data Report: Atlas of Chronic
Kidney Disease and End-Stage Renal Disease in the United States, National
Institutes of Health, National Institute of Diabetes and Digestive and Kidney
Diseases, Bethesda, MD, 2012.
5. Djukanovi L, Aksi-Milievi B, Anti M, et al. Epidemiology of end-stage renal
disease and hemodialysis treatment in Serbia at the turn of the millennium.
Hemodial Int 2012;16:517525
6. Schlessinger SD, Tankersley MR, Curtis JJ. Clinical documentation of end-stage
renal disease due to hypertension. Am J Kidney Dis 1994;23:655660.
7. Zucchelli P, Zuccala A. Can we accurately diagnose nephrosclerosis? Nephrol
Dial Transplant 1995;10 [Suppl 6]:25.
8. ERA-EDTA Registry: ERA-EDTA Registry 2003 Annual Report. Academic
Medical Center, Amsterdam, The Netherlands, May 2005.
9. Kramer , Stel V, Zoccali C, et al. An update on renal replacement therapy in
Europe: ERAEDTA Registry data from 1997 to 2006. Nephrol Dial Transplant
2009;24:35573566.
10. Collins AJ, Foley RN, Chavers B, Gilbertson D, Herzog C, Johansen K, et al.
United States Renal Data System 2011 Annual Data Report: Atlas of chronic
kidney disease & end-stage renal disease in the United States. Am J Kidney Dis.
2012;59(1 Suppl 1):A7, e1420.
11. Stewart JH, McCredie MR, Williams SM. Geographic, ethnic, age related and
temporal variation in the incidence of end-stage renal disease in Europe, Canada
and the Asia-Pacific region, 19982002. Nephrol Dial Transplant 2006;21:2178
2183.
12. Djukanovi Lj, Radovi M. Godinji izvetaj o leenju dijalizama i transplantacijom bubrega u Jugoslaviji, 2001. Beograd: KC Srbije; 2003.

40


Serbian Society f Nephrology

, 2011
ANNUAL REPORT ON VASCULAR ACCESS
FOR HEMODIALYSIS IN
SERBIA, 2011

, 2013.

 e

.

 , 2011

1.

( )

57 , 2011. 53 . , ,
94,7% e
83,6%.
4171 3249 (92,7%) ,
(91,9%).
(3,2% 3,8%)
(4,1% 4,3%) . ( 1).
1.
31. 2011.
Table 1. Prevalence of certain types of vascular access in patients treated with hemodalysis in
Serbia on 31st December 2011

Vascular Access

Arteriovenous fistula

Vascular Graft
/Arm

(%)
Number (%)
3868 (92.7%)

87 (2,1%)

/Leg

45 (1,1%)

/Overall

132 (3,2%)

()
Vascular Catheters (VC)
-/ VC-J

67 (1,6%)

-/VC-SC

91 (2,2%)

-/VC-F

13 (0,3%)

/Overall

171 (4,1%)

Vascular Access, Overall

4171 (100%)

-= , -K =
-=
VC-J= vascular catheter, jugular, VC-SC= vascular catheter, subclavian,
VC-F=vascular catheter, femoral

43

 , 2011

The Dialysis Outcomes and Practice Patterns Study - DOPPS III
, - 50% , 70% 47%
[1].
91% .
(,Fistula first)
32% 2003.
60,6% 2012. [2].

2.

KE
2011.
( )

, . ,
, o ( ) ,
.

1.

1.

Figure
1. Dialysis centers
that create
the greatest
number
vascular
access
with a number of

of

Figurereferral
1. Dialysis
centers centers that create the greatest number of vascular access with a

number of referral centers

2011.

2011.

,
,


,

, , ,
44 .

( 2).

 , 2011

.

( 2).
( , , ),
, .

, ,
,

.
2.
2011.
Table 2. Number of particular vascular access created in referent centers in 2011

Overall

AVF

AVG
arm

AVG
leg

-
VC-J

-
VC-SC

-
VC-F

Preemptive
AVF

267

165

35

29

21

259

250

172

145

113

109

106

104

76

71

64

64

62

61

59

55

44

42

44

40

40

39

32

23

32

31

31

23

29

29

20

19

18

18

Center

2
22

28
24
7
14

11
24

1
3
1
2

1
1

22

13

1
1

6
8

11
3

4
2

45

 , 2011

17

16

16

15

13

15

15

13

13

12

12

10

10

1574
(100)

1378
(87,6)

,
(%)
Overall,
No(%)

13

1
8

67
(4,3)

16
(1,0)

65
(4,1)

26
(1,6)

22
(1,4)

203
(14,7)

-= , -K =
-=
VC-J= vascular catheter, jugular, CV-SC= vascular catheter, subclavian,
VC-F=vascular catheter, femoral
#
*

,

(87,6%)
(5,3%) (7,1%) ( 2).
, .
,
-Vascular
Access Society [3] .
, 83 (5,3%),
(4,3%), (3,3%). O
u 2011. 14,7% je , (7,3%).
, .

46

(3,3%). O u 2011. 14,7% je

, (7,3%).
,
, 2011

(arteriovenous
fistula),
=

(arteriovenous
fistula), =

(vascular
catheter,
jugular)r,
=

(vascular
catheter, subclavian),
(vascular
catheter,
jugular)r,
=

(vascular
catheter,
subclavian),

(vascular
catheter, catheter,
femoral) femoral)

(vascular

2.

2011.

2.

2011.
Figure
2. The number and type of vascular access created in Serbia in 2011

Figure 2. The number and type of vascular access created in Serbia in 2011

2

.
.

3, 313,
(59%) (59%)

31

,
. .
, 29
29

( ).
( ).

. 7 ,
. 7 , 14% 10
14%

10 .

.
,

,
,

.

,
.

47

 ,
.
, 2011

7 (14%)

29 (56%)

15 (30%)

<10

>10

3. 3.(%)

(%)

Figure
3. Number
(%) ofcenters
dialysis
that create
pre-emptive
arteriovenous
Figure
3. Number
(%) of dialysis
that centers
create pre-emptive
arteriovenous
fistula

3.

fistula

3.

2011.

2011.

2011.2011.

(1021),(1021),

(65%)
663

663
(65%) ( 4).
( 4).

358 (36% )
358 (36% )
663 (64% )
663 (64% )

= ca ,
with vascular catheter
= ,
without vascular catheter

4.

sa
=(%)
ca
,
with
vascular
catheter

2011.

be = , without vascular catheter ()

sa = ca , with vascular catheter
Figure 4. Number (%) of incident patients who started hemodialysis with/without vascular
be = , without vascular catheter
catheter
() in 2011
4. (%)

2011.
,



4. (%)

()

2011. ,
48
Figure
() 4. Number (%) of incident patients who started hemodialysis with/without
vascular
in incident
2011 patients who started hemodialysis with/without
Figure 4.catheter
Number()
(%) of

 , 2011

32
( 32 ).
8 , 4 .

,
.

5.
5.
(%)
(%)

5.
(%)

Figure 5.Figure
Number
of centers
that
set temporary
vascular catheters
hemodialysis
5. (%)
Number
(%) of
centers
that set temporary
vascularforcatheters
for hemodialysis
Figure 5. Number (%) of centers that set temporary vascular catheters for hemodialysis

5. (%)

re 5. Number (%) of centers that set temporary vascular catheters for hemodialysis

(vascular
catheter,
jugular),
=jugular),

(vascular
catheter,
(vascular
catheter,
subclavian),
=

(vascular catheter,

(vascular
catheter,
subclavian),
=
=

(vascular
catheter,
jugular),
=
femora)l
=

(vascular
catheter,
femora)l (vascular catheter,

(vascular
catheter,
subclavian),
=

femora)l

6.

6.

6.

Figure 6. Localization of temporary

vascular catheters for hemodialysis

Figure 6. Localization of temporary vascular catheters for hemodialysis

Figure 6. Localization of temporary vascular catheters for hemodialysis

49

 , 2011

,
2011. 2011.

(97%

).

(97% ).

(66%

60%),

(66% 60%),
(59% 73%),
(59% 73%),
( 6).
( 6).
,
,


.
.

= (vascular catheter, jugular),

= (vascular catheter, subclavian),
=

(vascular
catheter,
femoral)

=

(vascular
catheter,
jugular),
=

(vascular catheter, subclavian), = (vascular catheter,

7.femora)l
(%)

7. (%)
of(%)

Figure 7.
Number
temporary
vascular
catheters
thatare
used as
permanent
vascular

hemodialysis

access for
Figure 7. Number (%) of temporary vascular catheters that are used as permanent
vascular access for hemodialysis

- Vascular Access Society ( 10.4) [3], - Vascular Access Society

(
10.4)
[3],

( 152 ).

(
152
).
(60%), (31%)

(9%), 7. ,
,
.

50

 , 2011

1.

2.

3.

Ethier J, Mendelssohn DC, Elder SJ, Hasegawa T, Akizawa T, Akiba T, Canaud BJ,
Pisoni RL. Vascular access use and outcomes: an international perspective from
the Dialysis Outcomes and Practice Patterns Study. Nephrol Dial Transplant.
2008; 23(10): 3219-3226.
http://www.fistulafirst.org, About Fistula First, Fistula First Catheter Last (FF/
CL) Data, July 2003 April 2012 Graphs, Graphs of Prevalent AV Fistula Use
Rates, By Network. Accessed on September 9, 2013.
http://www.vascularaccesssociety.com Vascular Access Society, Home Page,
Guidelines, 10. Central venous access, Guidelines 10.3. Accessed on September
10, 2013.

51

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:
: 3
:24000
: 024 555 222
: 024 555 267
E-mail: belavuk@gmail.com; dijaliza@bolnicasombor.org.rs
:
:
:
:
: 78
:35230
: 035 470 773
: 035 474 306
E-mail: bolnicacuprija@nadlanu.com
:
:
:
:
: 17 :31000
: 031 562 254, 031 561 255/333
:
E-mail: jadrankamilinkovic@gmail.com
:
:
:
: .
: 70/6
:32000
: 032 355 014
: 032 307 043
E-mail: dijalza.cacak@gmail.com
65

:
:
:
: .
: 24
:15000
: 015 363 557
: 015 343 622
-mail: drn.zora@gmail.com

66