Hypertension and nephrology

[Dialysis treatment in Hungary: 2010–2015]


OCTOBER 20, 2016

Hypertension and nephrology - 2016;20(05)

[The authors show the data of Hungarian dialysis statistics from 2010 to 2015. The questionnaire - based data collection was made by Dialysis Registry Committee of the Hungarian Society of Nephrology. The number of all patients entered in the dialysis program increased by 8.4% over six years (an average of 1.4/ per year) and the number of new ones increased by 10.5% (1.75% per year). Between 2003 and 2009 the mean annual increasing of new patients was 7.5%! The incidence of new dialyzed patients was 440/1 million population in 2010 and 486/1 million) in 2015. The population point prevalence at the end of the year was 621/1 million in 2010 and 643/1 million in 2015. The penetrance of peritoneal dialysis was 13.5% in 2010, and 13.6% in 2015. The proportion of incident patients with diabetic or hypertensive nephropathies (conditions which lead to end stage renal disease) was about the same in 2010 (27 and 21%) than in 2016 (27 and 22%). The mean age of incident patients entered into dialysis program decreased from 66.9 years (2010) to 62.8 years (2015), surprisingly. The rate of patients on waiting list for renal transplantation was 10.7% in 2009 and increased to 15,8% in 2015. There is also a significant increase in the number of the annual renal transplantations (268 in 2010 and 356 in 2015). The mortality rate of chronically dialyzed patients shows little decrease (14.4-13.1%).]


  1. B. Braun Avitum Hungary Zrt. 6. sz. Dialízisközpont, Szombathely
  2. Markusovszky Egyetemi Oktatókórház, Nephrologia Részleg, Szombathely



Further articles in this publication

Hypertension and nephrology

[Letter to the Reader]

A szerkesztôség

Hypertension and nephrology

[Hemodynamic approach of the treatment of hypertension. The possible role of impedance cardiography in the tailored antihypertensive therapy]


[It is important to achieve the blood pressure targets in the course of antihipertensive therapy. It will be beneficial to increase the proportion of patients on blood pressure target to avoid adverse cardiovascular consequences. In hypertension the main definition the elevation of blood pressure alone, but in hypertension are several abnormalities of cardiac output, systemic vascular resistance, stroke volume and arterial compliance too. Impedance cardiography is a simple highly accurate non-invasive device to assess hemodynamic parameters in hypertension. Hemodynamic assessment may help in the treatment of hypertension. Various authors report the improving rate of blood control rate using impedance cardiography which may decrease the risk of target organ damage.]

Hypertension and nephrology

[A new perspective on the extrarenal regulation of sodium and water balance]

AGÓCS Róbert István, SUGÁR Dániel, SULYOK Endre, SZABÓ J. Attila

[The regulation of the homeostasis of sodium and water is one of the oldest fields in medical research. Our article exhibits a new aspect of sodium balance: the concept of the regulated sodium storage taking place in the interstitium of the skin. We summarize the history of the research carried out in this area, beginning with the discovery of osmotically inactive sodium reservoirs to the localization of these buffers and the elucidation of the role of a regulating cutaneous cascade, which has an effect on blood pressure. Glycosaminoglycan (GAG) macromolecules present in the skin interstitium, come into reversible contact with the excess of dietary sodium intake. Thus in addition to the known role of the kidney, the above system may contribute to the regulation of sodium- and water balance and thereby to the regulation of blood pressure.]

Hypertension and nephrology

[Quality of Life: How Health is Considered. A European Comparison ]


Hypertension and nephrology

[Changes to the Prevalence, Diagnosis, Treatment and Effective Control Frequency of Hypertension in Turkey between 2003 and 2012: Studies PatenT and PatenT2]


All articles in the issue

Related contents

Clinical Neuroscience

[Epidemiology, cost and economic impact of cerebral palsy in Hungary]

FEJES Melinda, VARGA Beatrix, HOLLÓDY Katalin

[Objective - The purpose of our communication was to determine the total cost of cerebral paretic patients in Hungary between 0 and 18 years and to assess their impact on the national budget. Methods - Based on the data of Borsod county we calculated the CP characteristics. The cost of CP was determined by routine care of individuals. Lost Parental Income and Tax were calculated on the basis of average earnings. The ratio of GDP, Health and Social Budget and Health Budget to CP is based on CP annual average cost and frequency. We have developed a repeatable computational model. Results - Of the risk groups, premature birth (30.97%), low birth weight (29.64%), perinatal asphyxia (19.47%) were the most common. Source is unknown of 37.61% of the cases. CP prevalence was 2.1‰. The two-sided (59.7%) and the one-sided (19.0%) spastic pareses dominated. The most serious form is the two-sided spastic paresis (42.5% GMFCS 3-5 degrees). Epilepsy was 22.0%, incontinence was 27%, mental involvement was 46%. Care for one child up to 18 years of age costs an average of 73 million HUF (€ 251,724). The lost family income was 27.36 million HUF (€ 94,345), and lost tax and health care contributions were 14.46 million HUF (€ 49,862). Additionally, 0.525% of the GDP, 0.88% of the full health and social budget and 1.83% of direct medical costs were spent for CP families. Conclusion - The cost of CP disease is significant. Costs can be reduced by improving primary prevention. From the perspective of the family and government, it is better to care for families so they can take care of their disabled children.]

Hypertension and nephrology

[Hungarian dialysis statistics: changing trends in the renal epidemiology]


[In the last 30-35 years, dialysis care in Hungary has been a major development: both the incidence and prevalence of patients have increased year by year. Over the last decade, growth has slowed and is becoming more and more stabilized (similar trends can be seen in dialysis statistics in developed countries). Behind the dialysis indication the acute kidney injury (AKI) is more common than the end-stage renal disease (ESRD). The latter incidence has been stable for last 6 years (200-230 patient/million population). The annual average growth rate of prevalent dialysis patients was only 0.9%/year in the last 6 years. Among prevalent dialysis patients, the proportion of diabetic patients has remained unchanged for 10 years (26-27%), but those have increased who had hypertension nephropahty. The average age of incident and prevalent dialyzed patients has decreased gradually over the past 8 years (between 2009 and 2017 incident rate was from 67.1 to 63.0 years, prevalent rate was from 65.6 to 61.8 years). Unfortunately, just over half of the patients who dialyzed due to chronic kidney disease (CKD) have reached dialysis day 91. This is due to the high proportion of patient who was in urgent need of dialysis. In chronic hemodialysis (HD) program, the proportion of patients treated with arterovenous fistulas (AVF) decreases, while the rate of central venous catheter (CVC) users increases. The Hungarian peritoneal dialysis program in Europe is very good. The number of prevalent patients receiving renal replaement therapy (RRT) in Hungary in 2017 was 1005 for 1 million inhabitants.]

Clinical Neuroscience


GULÁCSI László, MÁJER István, KÁRPÁTI Krisztián, BRODSZKY Valentin, BONCZ Imre, NAGY Attila, BERECZKI Dániel

[The aim of our research was to assess the incidence and the 12- and 24-month mortality of hospitalized stroke in Hungary. We analyzed the rate of mortality after stroke and compared it to the standard mortality rate of the population. To assess the incidence we extracted the data of “new” stroke patients (ICD- 10 diagnoses: I60-64) hospitalized in May 2003 from the database of the National Health Insurance Fund Administration. We regarded those as “new” patients who had not been treated with these primary or secondary diagnoses in the previous 24 months. Data were collected by sex and age (age groups: 25-44, 45-64, 65 and over). We analyzed the patients' survival on the basis of their April 2004 and April 2005 data. The incidence of the “new” hospitalized stroke patients was higher in men than in women; the incidence in the age group of 65 and over was 2112/100.000 in males and 1582/100.000 in females, the corresponding values in the 45-64 age group were 623 vs. 366 per 100.000, respectively. In 2003 more than 42 thousand “new” stroke patients were hospitalized in Hungary of whom over 10 thousand died in the first year, followed by a further 2 thousand in the second year. Women’s survival is more favourable than men's: in the first year it is 71.47% vs. 69.24% (65+ group), and 88.18% vs. 83.16% (45-64 group); in the second year the corresponding values are 66.95% vs. 61.62% (65+), and 85.45% vs. 80.90% (45-64), respectively. The risk of death in the first year after stroke, compared to the standard population, is 5.17- fold in women and 4.70-fold in men in the total sample, and 10-15-fold in the 45-64 group. There are large differences by gender, particularly in men of the working age groups (25-44, 45-64), whose mortality is twice as high as that of women of the same age.]

Hypertension and nephrology

[Elderly patients with end-stage renal disease, its epidemiology and questions regarding it in Hungary]

SZEGEDI János, KISS István

[The number of elderly people and the kidney disease’s importance connected to it has increased worldwide, therefore the chronic kidney disease became an endemic. Parallel to the dwindling of population the people in it age. Because of the men’s higher mortality rate the proportion of women in the elderly is greater. Prognosis indicates that by 2060 every third citizen will be aged 65 or more. Between 1990 and 2015 the life expectancy at birth increased by 6.95 years in the case of men (in 1990 it was 61.13, and in 2015 it was 72.08) and by 4.9 years in the case of women (in 1990 it was 73.7, and in 2015 it was 78.6) in Hungary. Chronic kidney disease concerns 10 to 14 % of the population and 1% of all of them suffers from end stage kidney failure. In the end of 2015 3.52 million patients received kidney replacement therapy around the globe (2.42 million received hemodialysis, 329000 received peritoneal dialysis and 704 000 lived with transplanted kidneys). Of all the risk factors of chronic kidney disease age, hypertension, diabetes mellitus and obesity stand out as the most important ones. The kidneys’ anatomy and function change in elderly age, making it possible for the kidney disease to manifest in greater numbers. The elderly dialysis patients’ number increases worldwide which is connected to their higher life expectancy and better life prospects which on the other hand ultimately means that more and more patient lives to suffer from kidney disease. It cannot be disregarded either that the increasing number of elderly patients suffering from hypertension or diabetes means that because these are causes of kidney disease, the latter’s numbers are also increasing. International data indicates that in the case of incident ESRD patients their number was between 68-2784 and the older than 75 years was 142-1660 per million population. In Hungary there was 778/pmp and 677/pmp, respectively. In 2015 the ratio of incident dialysis patients the ones aged above 65 was 58,9% in the case of incident patients and 50,3% in the case of prevalent patients. The ratio of the ones aged above 75 was 28,2% in the case of incident patients and 22,6% in the case of prevalent patients. The number of elderly dialysis patients differs by region too. Dialysis treatment started in elderly age requires special knowledge and teamwork, similarly to the question of refusing the treatment. The latter team work, adequate experts (doctors and nurses) and the related professions’ representatives build the foundations of a proper clinical practice.]

Lege Artis Medicinae



[Type 1 diabetes is generally believed to be be the result of an immune destruction of pancreatic ßcells in genetically susceptible individuals exposed to environmental risk factors. To study the epidemiology of childhood-onset type 1 diabetes mellitus in Europe, the EURODIAB collaborative group established in 1988 prospective geographicallydefined registers of new cases diagnosed under 15 years of age. The 10-year-old study shows a greater than 10-fold range in incidence rate of childhood diabetes in Europe. The standardised average annual incidence rate during the period 1989-1998 ranged from 3,6 cases per 100 000 per year in Macedonia to 43,9 cases per 100 000 per year in Finland. Combined data from all centres indicates that the annual rate of increase in incidence was 3,2% but in some central and eastern European countries it was higher. The age-group-specific rates of increase were 5% for children aged 0-4 years, 3,7% for 5-9 years, and 2,1% for 10-14 years, which shows that the highest rates of increase occurred in the youngest age group. The Hungarian Childhood Diabetes Registry has collected the data of all newly diagnosed children with type 1 diabetes aged 0-14 years since 1st January 1978. The standardised incidence rate during the period 1978-2002 was 8,6 cases per 100000 per year, the lowest in the youngest (0-4 yr), highest in the10-14-year-old-children. There was a linear increasing trend in incidence with the average rate of annual increase of 5,1%. Comparing our incidence rate with other European countries Hungary belongs to the medium-risk countries with similar age- and sex-specific incidence rates. The results of the EURODIAB study confirm a very wide range of incidence rates of childhood type 1 diabetes within Europe and show that the increase in incidence varies from country to country. Such variation seems to be unlikely to be explained by genetic differences, since Europeans (except some small populations) are more homogeneous compared with other populations of other continents. The rapid increase in incidence may be explained by changes in environmental factors.]