Pakistan Kidney centre, Abbottabad Pakistan.

Introduction By 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) Available Deterioration of General health ESRD Requiring Dialysis/ Kidney Transplant Not Available

DEATH within hours to days NEAR NORMAL LIFE with reduced survival

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

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

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 MONTH

General Staff Nurses & Technician GP Specialist Dialysis (5 machine, 10 patients @ 3000 per dialysis) Overhead Lab, X Ray, Ultrasound Other Medical expenses TOTAL 100 Thousand 150 Thousand 50 Thousand 200 Thousand 1.8 Million 300 Thousand 100 Thousand 200 Thousand 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.