MANAGEMENT BOARD
ON
BULGARIAN SOCIETY OF NEPHROLOGY
Elected to the General Assembly of the BSN on 09/28/2019.
Prof. Emil Paskalev
Chairman of the BSN
Head of the Clinic of Nephrology and Transplantation,
MBAL "Lozenetz", Sofia
Tel.: 02 960 73 94 nephcl@abv.bg emilpaskalev@abv.bg
Vice-Chairman of the Board
Assoc. Prof. Alexander Osichenko, MD
Head of the dialysis clinic,
Hospital Tokuda, Ajibadem City Clinic, Sofia
tel: 0884933100, 02 4034300
alosichenko@abv.bg
Prof. Daniela Monova
Head of the First Internal Medicine Clinic,
MINISTRY OF INTERNAL AFFAIRS Medical Institute
Prof. Raina Robeva
THE MILITARY MEDICAL ACADEMY,
Ch. editor of the journal "Nephrology, dialysis and transplantation",
tel .: 0887 538 579
rrobeva@yahoo.com
Prof. Dimitrichka Bliznakova, MD
Director of the Medical College - Varna
Associate Professor Velislava Dimitrova 
Head of Department of Internal Medicine, Pharmacology and Clinical Pharmacology, Pediatrics, Epidemiology, Infectious and Skin Diseases,
Sofia University “Kliment Ohridski”, MF
Prof. Svetla Stajkova, MD, PhD
Head of the Clinic of Nephrology and Dialysis at University Hospital “St. Marina EAD - Varna
Dr. Dimitar Georgiev Nikolov
 
Head of the Clinic of Nephrology, St. George Hospital, Plovdiv
Dr. Dimitar Rusinov
Clinic of Nephrology and Dialysis,
SMBAL on childhood diseases
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 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 62 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 10 positions are predominant. In 20 of the dialysis centers there are above 10 dialysis positions. The number of the patients on haemodialysis is 2680. About 20% of these patients have acute renal failure, the remaining 80% 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, 2015 - 530.


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 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.
The National Kidney Association journal is named "Nephrology".