Against the « Quiet Killer »: For the early detection of chronic kidney disease there will be money

The National Health Insurance Fund will take on the early detection of chronic kidney disease (HCC). The amendments proposed in November by the Ministry of Health have been promulgated in the State Gazette.

This will already cover research to determine albumin-credinine ratio in urine and calculated glomerular filtration (EGFR) in ML/Min/1.73m² (The volume of fluids filtered from the kidney glomerular capillaries – white aut.)S With amendments to Ordinance 9, they are included in the package of health activities guaranteed by the budget of the cashier.

The NHIF confirmed to Dnevnik that the negotiation of volumes and prices in the negotiation process on the conclusion of an annex to the National Framework Agreement for Medical Activities 2023-2025 will be guaranteed in the budget of the cashier for 2025.

Risk groups are patients with diabetes mellitus, high blood pressure, kidney diseases that damage the part of the kidney that filters the blood (glomeruli), systemic vasculitis (connective tissue diseases – white aut.), Those with kidney disease or renal polycystic. The other group, which is speeding very quickly, is patients with overweight or metabolic syndrome.

The chronic kidney disease, also called the « quiet killer », is characterized by five degrees. In the initial first stage of the disease, there is a very mild impairment of renal function, which is asymptomatic. Normal glomerular filtration (The volume of fluids filtered by the kidney glomerular capillaries – white aut.) is over 90 ml per minute.

At an early stage, patients may even be at a stage of hyperfiltration, ie. More than 125-130 calculated filtration, the Chief of the Internal Medicine Clinic at the University Hospital « St. Anna » told Dnevnik Prof. Dr. Boris Bogov. However, this should be monitored with special care, since after hyperfiltration, the subsequent stages of the CKC occur.

In the fifth degree of the disease (chronic renal failure), the glomerular filtration is below 15 ml per minute, ie. The kidneys have stopped functioning or functioning very little. And the patient should switch to hemodialysis and look for ways to transplant.

Another necessary measure that experts insist for the purpose of early detection of chronic kidney disease (HCC) is to update the existing International Statistical Classification of Diseases and Problems (ICD-10), which is used in Bulgaria.

This will be done by incorporating MKB codes (Medicines that are covered by the Health Insurance Fund have the corresponding codes – note aut.) For the HCC. « Because it is encoded only as CKD in Bulgaria, that is, the cashier takes over treatment only in the last, fifth, stage – renal failure, » explained Prof. Dr. Boris Bogov before Dnevnik. A new code classification of chronic kidney disease should be introduced, he said. « Five codes corresponding to the five stages of the HCC. »

Each code « will speak » at which stage the patient is. Accordingly, this will imply the appointment of different therapy, « says Dr. Bogov.

Read more in an interview with Prof. Dr. Boris Bogov tomorrow.