Development of renal replacement therapy in Poland.

Different methods of renal replacement therapy (RRT) were introduced in Poland quite early: peritoneal dialysis (1953), hemodialysis (1958), renal transplantation (1966). Unfortunately due to the lack of resources in the health care budget, caused by an inefficient economic system, the further development of this therapy was very slow and not compatible with patients needs. The situation changed in the 1980s and 1990s when a National Board of Specialists in Nephrology chaired by A. Manitius and later by B. Rutkowski created a special Program for the Improvement and Development of Dialysis. Long-term efforts and pressure by a united nephrological community led to the establishment of a special fund in the central budget of the Ministry of Health. Final success was related to the political and economical changes in our country and region. Nowadays all three main RRT methods are available to all patients with end-stage renal disease and the actual incidence rate of ESRD is comparable with those of developed European countries. The Polish model of RRT development was also a good example for other Central and Eastern European countries and developing regions.