Pakistan Kidney centre, Abbottabad Pakistan.

IntroductionBy Dr. Khalil Ur Rehman

FCPS (Internal Medicine),MRCP, FCPS ( Nephrology)

OUR INTRODUCTION

• Pakistan Welfare Society (PWS) established in Jeddah KSA, 2006

• Registered in 2007 in Islamabad– As non profitable & Charitable NGO– Registration No:- 1837/2020 dated 10/04/2007

PWS activities in KSA

• Fortnightly Free medical Camp under the supervision of Pakistan Consulate, Jeddah since 2006.

• Health awareness seminar on various topics.• Educational Activities & others• ( read more )

Activities in Pakistan.

• Relieve activities– Earth quake.– Flood.– Eid gift distribution and qurbani meat.– ( read more )

– Now

Pakistan Kidney Centre (PKC)

KIDNEY FAILURE.

• What's Kidney failure ?– Acute• Mostly reversible

– Chronic –silent epidemic• Irreversible• Causes

– DM= 40%– HTN, Kidney stone, GN, Drugs, infections, Malignancy

CONSEQUENCE OF CHRONIC KIDNEY FAILURE (CKD)

Progression toward end stage renal disease

Stage (I II III IV V)

Deterioration of General health

Requiring Dialysis/ Kidney Transplant

Available Not Available

DEATH within hours to days

NEAR NORMAL LIFE with reduced survival

ESRD

RENAL DATA

• Number of patient with CKD in Pakistan = not established

• Number of patients on haemodialysis worldwide=20 million ( 2010)

• Number of patients with CKD world wide =50 million

KIDNEY FUNCTION• Body Fluid maintenance• Body Electrolytes maintenance • Removal of toxins ( filter)• Provide support for Haemoglobin and Vitamin D• Normally 2 kidneys. • Single kidney– Congenital .– Transplant.

PKC IN ABBOTTABAD

• Why ?– Poverty in Pakistan from North to South– Lack of awareness of common disease affecting

kidneys due illiteracy.– Poor screening at Primary Health Care level (BHU). – Only 8 dialysis machines available in Public sector

in Hazara Division (Ayub Medical Complex, Abbottabad)

– No evaluation for Kidney Transplant– Estimated population of catchment area is 10

million

COST OF HAEMODIALYSIS.

• In Public sector– Haemodialysis per session Rs 2,000- 3,000

• In Private sector– Haemodialysis per session: Rs 5,000- 6,000

• Ideally 3 session per week.

LOCATION OF DIALYSIS CENTER

• Ideally near to a tertiary care health facility– Cardiac issues– ICU Care– Surgery procedures• Access issues• Transplant

• Our PKC is close to Ayub Medical Complex

SERVICES OF PKC

• Out reach programme – Screening at door step for DM, HTN, CKD– Through periodic medical team visits at BHU levels– Referral/acceptance for treatment at PKC for

those with CKD.

Mobile clinic for screening

Rs= 50,00,000

TREATMENT AT PKC

• Adult patients with Kidney disease– Out patient’s clinic (OPD)– GP’s & specialist (Urologist & Nephrologists)– Dialysis treatment• 10 machines• 2 shifts 8.00 PM to 4.00 PM• If required and feasible a third shift from 5.00 to 8.00 PM

SURGICAL TREATMENT AND PROCEDURES

• Treatment for Kidney stones including lithotripsy

• Access creation for dialysis patients• Kidney biopsy• Diagnostic facilities– X rays, ECG, ultrasound, laboratory , Blood bank.

• Liaison with other hospital AMC, SIUT, PIKD at SHIFA hospital Islamabad & others

Eligibility for treatment.

• Outreach screening free for every body.• Centre based treatment will be free for

deserving patients.• To off set the running cost, treatment will be

available on payment.

STAFFING• Permanent staff

– Physicians• 2-3 GP• 1 urologist and 1 nephrologist• Part time Radiologist, Pathologist, Anaesthetist.

– Para-medical staff• 5-7 nurses• Technician for X ray, Lab & OT, pharmacist

– Administrative staff• 7-8 in number

• Visiting- honorary – Nephrologist – Surgeons– Instructors

Site

Site

Site

PKC Site

• Acquired 11,084 sq. feet ( 2. 7 kanal)• Purchased and donated to PWS trust worth of

6. 5 million Rupees.• Covered area– Basement= 7,000 sq. feet (option )– Ground floor= 10,000 sq. feet– First floor = 7,000 sq. feet

DESIGN- BASEMENT

DESIGN- GROUND FLOOR

GF

GF

GF

OPD

Women waiting

GF

GF

GF

GF

GF

DESIGN- FIRST FLOOR

FF

FF

FF

CEO/ Conference room

FF

ULTRASOUND AND LITHOTRIPSY ROOM

FF

FF

EQUIPMENT & FINISHING COST• 1 mobile field hospital= 50,00,000.(5 Million)• 2 Ambulance= 20,00,000 (2 Million)• X ray plant=10,00,000 (1 Million)• Laboratory=75,00,000 (7.5 Million)• Ultrasound =50,00,000 (5 Million)• Lithotripsy=1,50,00,000 (15 Million)• Haemodialysis machines=10,00,000 per machine (1

Million)• Over head miscellaneous= 5,00,000 (0.5 Million)• Pharmacy= 30,00,000 ( 3 Million)• Total: 4,90,00,000 (49 Million)

RUNNING COST FOR FIRST MONTHGeneral Staff 100 Thousand

Nurses & Technician 150 Thousand

GP 50 Thousand

Specialist 200 ThousandDialysis (5 machine, 10 patients @ 3000 per dialysis) 1.8 Million

Overhead 300 Thousand

Lab, X Ray, Ultrasound 100 Thousand

Other Medical expenses 200 Thousand

TOTAL 2.9 Million

CONSTRUCTION COST

• Basement parking Rs= 14,000,000 (14 million)• Ground Floor Rs=18,500,000 (18.5 million)• First Floor Rs=10.43 Million• Total 42.93 million

TARGET DATES

• Foundation stone : - November 2012• Completion of structure 1 year• Functioning start : March 23, 2014

BOARD OF MANAGEMENT• Dr. Khalil ur Rehman• Dr. Farooq Ahmed Farooqi• Dr. Ayaz Khan• Engr. Khalid Zia• Engr. Mohammad Mansha• Mr. Sharif Zaman• Prof. Dr. Muzamil Hussain• Justice retd Sardar Raza ( expected)• Mr. Ghazi Khan• Mr. Saleem Advocate• Mr. Anas Khalil

FUTURE PLANS

• Expansion of PKC– ICU, Kidney transplant– Chain of Kidneys centres in other areas of

Pakistan.