Even in as small a country as R. Macedonia with limited resources allocated for science, there are many journals trying to establish good editorial practices and policies in publishing the scientific work achieved. Among the currently existing medical journals Macedonian Medical Review (MMR), ISSN 0025-1097, deserves to be elaborated as the oldest journal with continuous publication since its first appearance as the journal of the Macedonian Medical Association (MMA). Since its first issue, published in 1946, there has been an opus of some 4500 peer-reviewed published papers in more than 210 issues and some 80 supplements from various congresses and meetings. In this regard, great respect should be paid not only to the editorial boards, but also to the collaborators who have contributed to its successful continuity in all previous years.
In line with the needs for further development of the journal and possibilities for access to world databases, the Editorial Board of MMR has made every effort to improve and modernize its work as well as the technical quality of the journal. Hence, MMA has signed a contract with De Gruyter Open as leading publisher of Open Access academic content for further improvement and promotion of the journal and facilitation of the Medline application, so we do hope for the further success of the journal.
BANTAO Journal is published on behalf of the Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO), ISSN 1312-2517. The first issue was published in 2003, ten years after BANTAO was born. Its appearance was an extremely important event in the existence of BANTAO. The first official editor of the journal was Dimitar Nenov, Varna (2003-2005), followed by Ali Basci (Izmir, Turkey) and Goce Spasovski (Skopje, Macedonia) as editor-in-chief since 2009. Over the years, the Journal has been included in the EBSCO, DOAJ and SCOPUS/SCIMAGO databases.
The journal is published biannually. Until now, 345 papers have been published in the past 11 years, in 21 regular issues and 3 supplements. It may be said that the journal is the “glue” between the nephrologists from the Balkan cities, reflecting the high quality research and scientific potential of Balkan nephrologists. The entire process of submitting and reviewing the manuscripts is electronically done and after their acceptance they are freely available (open access journal) on the website of the association and the journal: www.bantao.org.
In this regard, the current President of BANTAO has already signed a contract with De Gruyter Open as leading publisher of Open Access academic content for further improvement and promotion of the journal and Medline application for the further success of the journal.
The International Nephrology Days in honor of the 75th anniversary of Academician Momir Polenakovic and 50 years of his scientific work were held in the Macedonian Academy of Sciences and Arts (MASA) on 26 and 27 September 2014. Organizers of the meeting were the Macedonian Academy of Sciences and Arts and the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO). The days were programmed with the VII Macedonian-Croatian Nephrology Meeting and the Continuing Medical Education (CME) Course on "Renal Replacement Therapy - when & how - update on the outcome and cost-efficacy" organized by the MSNDTAO in cooperation with the European Renal Association (ERA-EDTA). Prominent academicians, researchers and nephrologists from Europe and neighboring countries contributed with their lectures and discussion at this scientific event. On September 26, 2014 the opening talk was given by Acad. V. Kambovski, President of the MASA, about the Life and Work of Academician Momir Polenakovic. In honor of his anniversary and valuable scientific opus, during the meeting Acad. Momir Polenakovic was awarded with Certificate of the European Renal Association (ERA-EDTA) for his significant role in the development of nephrology in the Balkan region and couple of other diplomas and acknowledgement. Prof. Polenakovic is founder of the MSNDTAO and his lifetime honorary president.
Kidney transplantation is the best treatment option in comparison to dialysis, although patients are obliged to receive life-long medical treatment with immunosuppressive drugs (ISDs) for prevention of the graft rejection. Such immunosuppressive treatment may be costly and associated with multiple adverse effects. Since costs are viewed as one of the major constraints for the increasing number of transplantation, the use of generic ISDs may decrease the overall cost of transplantation and raise the possibility for its further development.
An ideal ISD should have the security margin between toxic and therapeutic dose, and prevent development of acute or chronic rejection of the transplanted kidney. This is particularly important for drugs with a "narrow therapeutical index" (NTI), where small differences in dose or concentration lead to dose and concentration-dependent, serious therapeutic failures and/or adverse drug reactions. The NTI generic drug is approved if within 90%-112% of the area under the curve of the original product the pharmacokinetics fulfills the strict criteria of pharmaceutical equivalence and bioequivalence. Every generic has to be proven to be bioequivalent to the innovator product, and not to other generic products because of the possible generic "drift". Thus, the generic ISDs may be economically attractive, but theoretically, they may pose a risk to transplant patients. Such risks may be reduced if a long-term clinical studies showing cost-effectiveness of generic ISDs in de novo and prevalent transplant patients for every new generic ISD are performed.
In conclusion, the increased number of solid organ transplantation goes in line with the increased health care expenditure for ISDs. The generic immunosuppressants could be a possible solution if safely substituted for innovator products or other generic drug of choice. The substantial cost reduction needs to be redirected into organ donation initiatives so that more patients can benefit from the further increase in transplantation.
In the period from 26th until 29th of September 2019, the 15th BANTAO Congress (Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs) in conjunction with the 6th Congress of the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) was held in Skopje, Republic of North Macedonia, hosted by the Macedonian Academy of Sciences and Arts (MASA). MSNDTAO was created in 1992 and the First Congress of the MSNDTAO was held on 9th October 1993 in Ohrid when, also, the Balkan Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO) was established, as the only professional association of this kind in the Balkans and Southern Europe. Since then, MSNDTAO has been very active in education and collaboration with BANTAO, the European Renal Association (ERA-EDTA) and the International Society of Nephrology (ISN). The 15th BANTAO and the 6th MSNDTAO Congress were highly professional events in honor of the 80th anniversary of Academician Momir Polenakovic from the Republic of North Macedonia, one of the founders of BANTAO and MSNDTAO, who was unselfishly dedicated to the education and guidance for many generations of young doctors in this region. This year’s Congress was endorsed by the ERA-EDTA, and supported by the ISN. On the first day of the Congress, a European Renal Best Practice (ERBP) session was held, in which the Chair of the ERBP Working Group, Prof. Dr. Jonathan Fox gave a comprehensive insight of the purpose and aims of ERBP, the methods used for their achievement, and an overview of the recently produced and guidelines in development. The second day was organized in four sessions: Clinical nephrology and renal registries; CKD Diagnosis, comorbidities and treatment; Kidney transplantation and Acute and chronic renal failure management. On the third congress day, the ISN CME Course with ERA-EDTA endorsement was held. The course was entitled “Possibility of diagnosis and treatment of the CKD progression and complications/Possibility of diagnosis and treatment of the CKD progression – current perspective” and was chaired by Prof. Dr. Caskey Fergus and Prof. Dr. Serhan Tuglular. On the last Congress day, before the official closure and the best wishes from the President of the Congress, Prof. Dr. Goce Spasovski, a session about CKD and the renal replacement therapy complications was held. This event was of an exceptional importance for the region, considering the charred international achievements and the most up-to-date methods used in the Nephrology field, bringing out continuous quality improvement in the treatment of patients with renal diseases.
Acad. Momir Polenakovic has devoted his life and work in the diagnosis and treatment of kidney patients, as well as in research of kidney disease. The great experience he has acquired in the work with kidney patients, and after the visit to the most renowned nephrology centers in Europe and the world, he has transferred it to his colleagues through the work in the medical and nephrology associations. The work of the associations was in fact a successful education of young doctors and specialists. Among his most distinguished positions, we can mention: President of the Macedonian Medical Association, founder and President of the MSNDTAO, President of the Yugoslav Society of Nephrology, founder and President of BANTAO, as well as member of the Boards of ESAO and ERA-EDTA. He has received a lot of recognitions for his work achievements.
A Workshop and Regular Meeting of the Marie Curie Training and Research Programs iMODECKD (Identification of the Molecular Determinants of established Chronic Kidney Disease) and BCMolMed (Molecular Medicine for Bladder Cancer) was held from 20-22 March at the Macedonian Academy of Science and Arts (MASA). The meeting was hosted by the participating center University of Skopje (SKO) - Goce Spasovski and MASA - Momir Polenakovic (R. Macedonia). The representative from MASA proteomic research center - Katerina Davalieva (R. Macedonia) had presentation on proteomic research in prostate cancer (PCa). 40 researchers from 13 different countries participated at the meeting. The Workshop was devoted on "Chronic Kidney Disease: Clinical Management issues", and consisted of 15 oral presentations given by nephrologists and experts in the field of CKD. Raymond Vanholder (Belgium) - past president of ERA-EDTA had a keynote lecture on "CKD: Questions that need to be answered and are not (or at least not entirely)". The workshop continued in four sessions with lectures from Alberto Ortiz (Spain), Olivera Stojceva-Taneva (R. Macedonia), Dimitrios Goumenos (Greece), Joachim Beige (Germany), Marian Klinger (Poland), Goce Spasovski (R. Macedonia), Joachim Jankowski (Germany), Adalbert Schiller (Romania), Robert Johnson (USA), Franco Ferrario (Italy), Ivan Rychlik (Czech Republic), Fulvio Magni (Italy) and Giovambattista Capasso (Italy), all covering a training theme. Within the meeting there were two lectures on complimentary skills for ethics in science and career advancement from two principal investigators - Goce Spasovski (R. Macedonia) and Joost Schanstra (France). During the Regular Meeting, 13 PhD students i.e. Early Stage Researchers and one Experienced Researcher from both Programs presented their work and progress within iMODE-CKD and BCMolMed projects. This meeting was a great opportunity to exchange experience and ideas in the field of systems biology approaches and translational medicine and planning future collaboration.
Introduction. Patients on hemodialysis (HD) are proven to have impaired Health Related Quality of Life (HRQoL) compared to the general population. Recovery from the hemodialysis session is a permanent problem among majority of patients receiving HD treatment. A partial explanation may be the osmotic imbalance between different compartments of the body due to the fluid and electrolyte movement across the cell membrane which is a part of the HD process itself. The aim of our study was to see whether the length of recovery time (RT) is associated with different clinically relevant variables and dialysis treatment features in our HD population.
Methods. We performed a cross-sectional study on patients receiving trice weekly HD in a single hemodialysis center. The recovery time was defined by posing a single question "How long does it take you to recover after a hemodialysis session?" and was calculated in hours (up to 2, 2-6, 6-12, and 12-24 hours) / minutes. Various demographic and clinical characteristics were analyzed for association with the RT.
Results. The mean RT was 364.62±339.24 minutes. From all of the analyzed variables a significant statistical correlation was obtained with the level of albumin, urea, interdialytic weight gain (IDWG), protein catabolic rate (PCR), body mass index (BMI) and the level of hemoglobin (p<0.05 for all parameters). The longest mean RT had patients with hypertension and glomerulonephritis as a primary cause of ESRD and the shortest, patients with an adult dominant polycystic kidney disease. With the multiple regression analysis a significant correlation was obtained only for the level of hemoglobin (Hb) with a coefficient for partial regression analysis - 0.2635. The t-test showed that the influence of the level of hemoglobin on recovery time in patients was statistically significant (p = 0.039).
Conclusions. RT in our study was associated with IDWG, albumin, urea, BMI, and PCR, while the level of hemoglobin was also shown to have a significant impact on the RT and on patients’ overall health status. Hence, we could conclude that maintaining Hb levels in dialysis patients within reference values among the other benefits, may improve the recovery time and HRQoL of our patients.