NIK: billions for dialysis and kidney transplants, but prevention is lame

The efforts of the Minister of Health and the National Health Fund to increase the availability of early diagnosis of chronic kidney disease were insufficient and ineffective, the Supreme Audit Office (NIK) emphasized in a statement published on Thursday entitled "Billions on dialysis and kidney transplants, but prevention is lame."

The Supreme Audit Office noted that 19% of eligible individuals benefited from the "Prevention 40 PLUS" pilot program, which cost PLN 395 million. Meanwhile, over PLN 6 billion was allocated for the diagnosis and treatment of patients with chronic kidney disease (CKD) during the period under review, 92% of which were dialysis and transplant costs, the report emphasized.

According to the Supreme Audit Office (NIK), however, high expenditures did not translate into improved quality of care for patients with kidney disease. The NIK emphasized that waiting times for appointments at nephrology clinics nearly doubled between 2022 and 2024. Furthermore, access to nephrology treatment was uneven across the country, and the specialist workforce was increasingly aging. Staff shortages and low interest in the nephrology specialty among junior doctors were significant problems.

Between 2021 and 2023, the number of patients diagnosed with kidney failure increased by almost 15% (from 105,600 to 121,000). At the same time, the number of patients receiving specialist outpatient care in nephrology clinics and hospital nephrology departments increased by approximately 21%.

The increase in the number of patients was one of the reasons for the almost doubling of waiting times for appointments at nephrology clinics (including pediatric ones) between 2022 and 2024. For example, for urgent cases, it increased from 27 to 55 days in adult clinics and from 40 to 70 days in pediatric clinics, noted the Supreme Audit Office.

NIK noted that, according to the forecasts contained in the Health Needs Map, the number of deaths caused by chronic kidney disease in Poland between 2022 and 2024 was not expected to exceed 15,000. Meanwhile, in just two years (2022-2023), as many as 154,500 people died from kidney disease. "However, despite the alarming data, kidney disease was not included in the Health Needs Map among the health problems that burden society the most," NIK emphasized.

The Ministry of Health emphasized that it recognizes the need to increase access to healthcare services for chronic kidney disease. The Ministry of Health noted that outpatient specialist care (AOC) clinics, which see few first-time patients, will be encouraged to increase this percentage. The Ministry noted that the preventive program "My Health - Adult Health Checkup" is intended to enable early detection of health problems and disease risk factors, which will also increase access to early diagnosis of chronic kidney disease and, consequently, care for patients with this condition.

The Ministry of Health noted that between 2019 and 2023, the number of physicians specializing in nephrology in Poland increased from 1,310 to 1,399, an increase of 89 people (approximately 6.8%). This increase translated into an improvement in the number of nephrologists per 100,000 inhabitants – from 3.4 in 2019 to 3.7 in 2023.

The Supreme Audit Office (NIK) report emphasizes that chronic kidney disease (CKD) is the second most common chronic disease in Poland, after hypertension. It is easy to diagnose and relatively simple to treat. However, the asymptomatic nature of the disease in its early stages is a problem. The NIK report emphasized the importance of regular preventive screenings to enable early diagnosis and the implementation of appropriate treatment, which can significantly slow the progression of the disease. Untreated CKD ultimately leads to complete kidney failure and the resulting complications or premature death.

It is estimated that only 5% of patients with CKD are diagnosed. Experts estimate that approximately 80,000 people in Poland die prematurely each year due to undetected CKD, shortening the average life expectancy in Poland by over two years. According to estimates from the Health Needs Map (HND), the number of people affected by CKD will exceed 4.5 million in 2023 and is expected to reach 5.2 million in 2034, according to the Supreme Audit Office (NIK). (PAP)

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