In a position delivered within the scope of the public discussion of the National Health Plan 2021-2030, which ended last week, the SPN recognizes the importance of other chronic diseases identified in the PNS, such as cancer and diabetes, but considers that the dimension of chronic kidney disease (CKD) justifies its inclusion in the priority areas of intervention.
“It is not understandable to us that this issue does not deserve further attention in this healthcare pillar in Portugal, as it has been happening in other countries,” sees the SPN, proposing the inclusion of a PNS subclass in the PNS. Diabetes and/or cardiovascular disease strategy including kidney disease.
“Our proposal is to include chronic kidney disease in the area of early identification, referral criteria for nephrology counselling, measures of renal protection and prognosis-modifying therapy, in a sub-chapter of the diabetes and/or cardiovascular disease strategy,” he said.
SPN is also ready to collaborate and participate in the global PNS strategy.
In the document, which Lusa has access to, SPN said that in Portugal, although data on the prevalence of CKD in stages 1 through 5 (before dialysis is needed) may be scant, “there is sufficient evidence to form a cause for concern.”
He cites, for example, a study developed in 2020 that found that about 20% of the Portuguese population had some degree of CKD and another degree, which included residents of 11 countries and which indicates a 10% prevalence of CKD.
Already on dialysis, SPN itself says it has a general record where both the incidence and prevalence of stage 5 chronic kidney disease requiring renal function replacement therapy (TSFR) are “extremely high”.
“In 2020, more than 2,000 new patients started some TSFR and it spread to the country in 2011 [por milhão de habitantes] Of the TSFR patients, that is, more than 20,000 patients are either on dialysis or have already been transplanted,” the SPN insists, noting that according to the European Renal Association registry, this prevalence is one of the highest across Europe..
He says it is estimated that the prevalence of CKD should increase and that by 2040 “it will be the fifth leading cause of life years lost to disease”.
“As if this effect, on an individual and social level, was not painful enough, it is also very disturbing on a financial and economic level,” he recalls, adding: “Although only 0.1-0.2% of the general population is affected. Some TSFR types, this group consumes at least 2% and up to 5-6% of the healthcare budget.”
“It is estimated, moreover, that each patient costs the state about 80,000 euros per year,” he adds.
SPN also cites studies indicating that chronic kidney disease in Portugal “incurs more costs than heart failure, acute myocardial infarction, or peripheral arterial disease.”
He remembers that although kidney disease can be a “silent disease” with few or no symptoms until later stages, it can be prevented — its progression — “by addressing lifestyle factors, such as improving nutrition, increasing physical activity, and quitting Smoking or even with medications that have been shown to have a strong effect on disease progression and mortality.”
The National Health Plan 2021-2030, under the Directorate General of Health, defines the strategic path of intervention within the health system, compiling the measures considered most relevant for obtaining further health gains by the Portuguese population. It also serves as a reference for policies and procedures in the health sector.
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