УПРАВИТЕЛЕН СЪВЕТ
НА БЪЛГАРСКО ДРУЖЕСТВО ПО НЕФРОЛОГИЯ,

избран на Общо събрание на дружеството на 15.10.2016


Проф. Емил Паскалев
Председател на БДН
началник клиника по нефрология и трансплантация, УМБАЛ "Александровска", София
Тел.: 02 923 05 39
emilpaskalev@abv.bg
Проф. Борис Богов
зам. председател,
началник клиника по нефрология, УМБАЛ "Александровска"
тел.: 02 923 02 63
bbogov@gmail.com
Проф. Боряна Делийска

началник Клиника по нефрология,
УМБАЛ "Царица Йоанна - ИСУЛ"

delijska10@yahoo.com
Проф. Даниела Монова

началник Първа Клиника по вътрешни болести,
Медицински институт на МВР
Проф. Валентина Маджова

УМБАЛ"Св. Марина", Варна
v_madjov@abv.bg

Tел./Факс. 0035952300262

GSM 0888627871

Проф. Райна Робева

ВМА,
гл. редактор на сп. "Нефрология, диализа и трансплантация",
тел.: 0887 538 579
rrobeva@yahoo.com
Доц. Емил Кумчев

Клиника по нефрология,
УМБАЛ"Каспела", Пловдив
Доц. Светла Стайкова

Клиника по диализа,
УМБАЛ"Св. Марина" Варна
Д-р Димитър Русинов

Клиника по нефрология и диализа, 
СМБАЛ по детски болести
Recently, the diagnostics and treatment of kidney diseases in Bulgaria have become one of the basic problems discussed at various forums in which different non-governmental and governmental organizations took part. In 2001 a National programme for nephrology and dialysis treatment was developed. All of the changes that the National health care system has made during the most recent years have been aimed at the gradual introduction of a new funding system to treat kidney diseases. This system has to be committed with the medical and economic results from the treatment, as well as with the cost of the dialysis treatment and medical services, i.e. payment to be made on the basis of the quality and quantity of work. Parallel to the ongoing Health Care reform in the country, best practice guidelines have been worked out dealing with diagnostic and therapeutic behaviour of the GPs and the specialists in nephrology. The main job of the nephrologist in the country is the early diagnosis and treatment of kidney diseases; the prevention or retardation of chronic renal failure, ensuring, to all people in need, a normal life with the help of extrarenal methods for blood purification or the possibility of kidney transplantation.

Organizational issues
There are five medical universities in Bulgaria (in the towns of Sofia, Plovdiv, Varna, Pleven and Stara Zagora) with 9 nephrological clinics and over 70 haemodialysis centres. The first Nephrological clinic in Bulgaria has been established in 1966 by Prof Georgi Magdrakov. Step-by-step specialized nephrological units have been established in a greater part of the regional hospitals. In about 65% of the hospitals in the country patients with nephrological symptoms are being treated in the units of internal medicine. Over 900 physicians / nephrologists, surgeons, anaesthesiologists, psychiatrists, psychotherapeutists/ are engaged in the nephrological care network. The specialists in nephrology are nearly 300. Over 120 nurses work in the nephrological clinics/units and over 500 in  dialysis centers. 
The number of the beds in the country for nephrologic patients is over 600, i.e. over 0,8 per 10 000 people. The number of patients with chronic renal  disease  are more than 50 000.


Dialysis units
Prof Anton Chervenyakov was the first to introduce the idea of implementing treatment with haemodialysis in Bulgaria. In 1958 two "artificial kidneys", trade mark "Nephra II" have been imported in Bulgaria. Dr M. Karapandov has elaborated the first trials for haemodialysis with patients with ARI. The first successful haemodialysis procedures have been performed in January 1962 at the Dialysis clinic in Sofia, headed by Assoc. Prof Patev. At present there are 70 and more dialysis centers /clinics/ in the country, spread on a regular territorial base, so that the patients in need have to travel no more than 50 km. Now the dialysis centres are part of the hospital care system, although the Bulgarian legislation allows the establishment of a dialysis centre as a part of the extra-hospital (out-patients') health care system. Some of the dialysis centers are specialized, for example for the treatment of patients with acute renal failure, for patients with diabetes or infectious diseases.
The dialysis centers with 6 to 12 positions are predominant. In 20 of the dialysis centers there are above 15 dialysis positions. The number of the patients on haemodialysis is 3500. About 15% of these patients have acute renal failure, the remaining 85% have chronic renal failure. The number of patients on CAPD is 120. Qualified medical staff /physicians, nurses and medical technicians/ work in the nephrological clinics and dialysis centers. The dialysis centers are funded mainly by the Ministry of Health budget, the hospitals' budget and directly by the municipalities.
The first kidney transplantations in Bulgaria have been performed in the Institute for Emergency "Pirogov" in Sofia by Prof N. Minkov /1968/ and in The Urology Department of the Medical Academy /1969/ by Prof Lambrev, Prof Atanasov and Prof Kumanov. Since then the procedure of kidney transplantation has passed through a complicated and very difficult way, full of legislative obstacles, extreme pressure, sleepless nights, great emotions and deep disappointments.
In 2002, 37 patients have undergone renal transplantation. The number of the followed-up renal transplanted patients in 2002 is 256, in 2015 - 530 patients.


Bulgarian Society of Nephrology
Bulgarian Scientific Society of Nephrology (BSN) has been founded as an independent scientific organization in 1972. The first chairman was Prof. G. Majdrakov, later on he was succeeded by Assoc. Prof. Andreev, Acad. Puhlev, Prof. Astrug, Prof. Stefanov, Prof. Tishkov, Prof. Kiriakov, Prof. P. Simeonov, Prof. B. Kiperova and 2012 - prof. E. Paskalev.

National meetings
All National and regional nephrology meetings are organized on the initiative of the Bulgarian Scientific Society of Nephrology, Dialysis and Transplantation (BSN). The Union of the Scientific Medical Societies in Bulgaria submits every meeting to a preliminary accreditation. An evaluation on a scale of credits is made according to the reputation of the institution, the quality and qualification of the invited speakers, the scientific level and the practical significance of the topics foreseen, as well as the logistic conditions. The number of credits should approximately correspond to that used by the European Accreditation Council for Continuing Medical Education (CME) at the Union of the European Medical Specialists (UEMS). All participants in the events receive certificates of attendance.
Periodically the following meetings are being organized:
• National Congress of Nephrology takes place every forth year. Nephrologists and lecturers from the Balkan countries, Europe and the USA are invited to participate and present lectures. Educational courses are organized during the congresses as a part of the ongoing Medical education.
• Every sixth year BSN is the host of the consecutive congress of BANTAO (Balkan Cities Association of Nephrology, Transplantation and Artificial Organs).
• Four conferences of the BSN (regional and national) on scientific and clinical problems take place every year.
• 2-3 workshops and consensus conferences on problems concerning the best clinical practice in nephrology are held every year. As a result, there are elaborated documents concerning the nephrology care in Bulgaria. They are presented to the respective authorities at the Ministry of Health and the National Health Insurance Fund. Recently best clinical practice guidelines have been elaborated for the management of the entire spectrum of chronic renal insufficiency: anaemia, hypertension and LVH, renal bone disease, malnutrition, adequate dialysis, vascular access.
• A Nephrology School of Continuing Medical Education is organized every autumn in Varna, named "Hot points in Nephrology". Bulgarian and foreign lecturers present actualities in clinical nephrology, dialysis and renal transplantation. Nephrologists from all over the country participate in the event. The "Kidney" Foundation and some pharmaceutical companies sponsor the event.
• The medical nurses, working in the dialysis centers have organized their independent scientific society. Courses for postgraduate training of the dialysis nurses have been annually organized with the help of the BSN.

Official publications
"Nephrology Dialysis and Transplantation" is the official journal of the BSN. It has four issues every year.
The "Kidney" Foundation journal is named Actual Nephrology.