Analysis of the state of nephrology and hemodialysis services and the prevalence of diabetic nephropathy in the republic of Uzbekistan for 2019-2024

The aim of the study is to analyze the state of nephrology and hemodialysis services in the Republic of Uzbekistan for 2019-2024 and the prevalence of diabetic nephropathy stages I-III in the Republic of Uzbekistan. Material and research methods: The study included 22,319 people with type 2 diabetes mellitus (DM2) from 13 regions of the Republic of Uzbekistan and the city of Tashkent, who were divided into 3 groups: The first group included representatives of the active working population who were examined at local regional endocrinology dispensaries: 6,433 people - 4,228 men (65.7%) and 2,205 women (34.3%) aged 44-55 years (average age 44.1±11.2 years) without concomitant diseases. The second group - patients who were examined at local regional endocrinology dispensaries: 7320 people - 4075 men (55.7%) and 3245 women (44.3%) aged 56-65 years (mean age 59.5±13.9 years) with concomitant diseases. The third group - patients who were examined at local regional endocrinology dispensaries: 8566 people - 4390 men (51.3%), 4176 women (27.9%) aged over 66-78 years (mean age 66.3±16.7 years) with micro and macroangiopathies. Patients were subjected to studies performed in the regions based on regional endocrinological dispensaries or hemodialysis: general clinical, biochemical (blood glucose, urea, creatinine, calcium, parathormone, electrolytes, lipids, etc.) Instrumental research methods (ECG, X -ray of the chest, Doppler of vessels of the legs et al). Research results: It was established that the largest number of patients with stage 1-3 DN in 2019 was in Tashkent - 3,533 patients and in the Samarkand region - 2,175 patients, the number of which in 2023 increased to 5,469 and 3,012 patients, respectively. In total, for the period from 2016 to 2023, the number of patients with DN increased from 14,148 to 24,964, that is, by 10,816 people. If in 2016 the number of deaths from chronic renal failure with type 2 diabetes in the Republic of Uzbekistan was 703 cases, then in 2023 it reached 1,330 people, that is, it increased 2 times. Moreover, in the Fergana region the number of deaths in 2016 was the highest – 123 cases, and in 2023, this number also remained the highest in this region – 289 patients (21.7%). In 2019, the total number of patients with chronic kidney disease was 125,274. Conclusions: 1. Our republic has a shortage of specialists to ensure employment of nephrologists in medical organizations providing inpatient nephrological care. For example: out of 219.5 allocated staff positions, 108 are filled and 111.5 are vacant, which is 50% in total. 2. The reporting system does not contain sufficient information on the actual number of patients with chronic kidney disease and their risk groups. For example: Patients at risk of developing chronic kidney disease are seen by other specialists in 30–40% of cases. 3. The prevalence of diabetic nephropathy stages 1–3 in dynamics from 2019 to 2024 has significantly increased over the current period.