State of renal replacement therapy for chronic kidney disease in Moscow in 2015-2020

Objective. provision of the information on the six-year period of the organization of the replacement therapy service for end-stage renal disease in a large metropolis. demonstration of the impact of the covid-19 novel coronavirus pandemic on the state of various types of renal replacement therapy in urban healthcare. Materials and methods. The data from the Moscow nephrological Registty were used in this work. The registry was formed in 2014 and includes data on patients with chronic kidney disease, which are accumulated on the basis of weekly, monthly and annual reports from the heads of departments/centers of nephrology, hemodialysis, and peritoneal dialysis. results. over a 5-year period, before the pandemic of the novel coronavirus infection covid-19, renal replacement therapy developed dynamically: the number of hemodialysis units/centers increased and thus the number of dialysis places increased; the average annual increase in the proportion of patients receiving hemodialysis treatment was 7%; by the beginning of 2020, the number of treated patients on hemodialysis increased by 21%, on peritoneal dialysis - by 53.6%, and the number of patients with a functioning graft increased by 85%. During 2020, as a result of a pandemic of a new coronavirus infection covid-19, the mortality rate of patients increased from an average over a 5-year period of 7.9% to 17.з% in patients on hemodialysis and from 5.2% to 17.2% in patients on peritoneal dialysis. Conclusion. The formation of an urban system for organizing renal replacement therapy requires an integrated approach, including information support (patient registry maintenance), regulatory and methodological support, the development of a network of medical organizations, including on the basis of public-private partnerships (PPP), improving the transportation of patients for hemodialysis procedures. The organized and consistent development of ppp in Moscow has made it possible to significantly increase the provision of renal replacement therapy for patients on programmed hemodialysis. peritoneal dialysis provided exclusively in the medical organizations of the Moscow healthcare department, remains at a stable, insufficiently high level in the shared distribution of renal replacement therapy types. one of the important criteria for the quality of the dialysis therapy method in the urban program is the preparation of patients for kidney transplantation, the development of which remains the main priority for the development of the renal replacement therapy system in Moscow

dialysis, transplantation, chronic kidney disease registry