Download - The National Kidney and Transplant Institute
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The National Kidney and Transplant Institute (NKTI)is a
government-owned and controlled corporate tertiary specialty
center attached to the Department of Health. Its mandate is to
specialize in the prevention, diagnosis, rehabilitation and
treatment of kidney and allied diseases through dialysis andtransplantation. It focuses on service, training and research in the
eld of renal diseases and organ transplantation
Contact Us
National Kidney & Transplant Institute!ast "venue, Diliman#uezon $ity %%&%
'hilippines
Phone:()*+ (+ %-&*&&, %-&/&&Fax: ()*+ (+ -0)& 1 ()*+ (+ -&*00Email ddress:pro2nkti.gov.ph
3verview4
3ur goal is to provide world class health care to all patients andtheir families and to pursue e5cellence in developing and
establishing the highest level of training and research for
physicians and paramedical personnel.
The Institute employs one of the region6s most e5perienced
surgical transplant team and is home to the nation6s top
transplant program. 7e have a hundred board-certied specialists
and sub-specialists combining skills and talents for theadvancement of medical practice.
The Institute has a long and distinguished history of service and
medical e5cellence. It operates the busiest transplantation
program in the country including kidney, liver, pancreas, stem
mailto:[email protected]:[email protected] -
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cell, 8 bone marrow.
In addition to its transplant specialties, the Institute is respected
as top facility in the other areas including dialysis and vascular
surgery.
#uality patient care 8 dedication to patient satisfaction are the
cornerstones of 9ational :idney 8 Transplant Institute. 3ur ;uality
is measured in high patient satisfaction scores, continuous clinical
performance activities, 8 e5cellent medical outcomes.
!out NKTI
The 9ational :idney and Transplant Institute is a tertiary medical
specialty center with a signicant history relevant to the medical
profession in the 'hilippines. It is the center for referral of kidney
patients from various regional hospitals in the nation and is
recognized as the lead agency in voluntary blood services. In its
-year e5istence and operations, the Institute6s medical
achievements and milestones are comparable to any specialty
hospital in the world.
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visitors the ease of commute and travel and also ensuring
tran;uility amidst the bustle of the city. This area is very
accessible to all types of land transportation. ( @aps and
Directions +
The Institute itself is -storey structure with three buildings (@ain,
"nne5 and Dialysis $enter+ connected to each other. The @ain
Auilding houses most of the $ost $enters and where the
"dministrative oBces can be found. The "nne5 Auilding encloses
the recently opened @arcos 7ing and the >adiology Dept (@>I
and $T =can centers+, $enter for =pecial =ervices and also the !>
Dept. In the Dialysis $enter, you can nd the 3ut-'atient Dep6t.,
Hemodialysis and $"'D centers, H3'! oBce, @edical >ecordsoBce and the clinics (third Coor+ of all our @edical =pecialists.
Commitment to $ealthcare Excellence
In its more than two decades of operations, 9:TI has always
aimed for e5cellence relevant to general patient care but most
importantly to the prevention or treatment of renal disease and
the various achievements can readily attest to this not only in the
'hilippines but in "sia as well 4 double transplant - kidney 8
pancreas (rst in "sia, @arch %+ :idney - Eiver transplant
(rst in "sia, =eptember %&+ Aone @arrow Transplant (rst in
the 'hilippines, "ugust %&+ I=3-$ertication (rst Fovernment
Hospital in the 'hilippines, enal Disease $ontrol 'rogram (>!D$3'+ and
Total #uality @anagement (T#@+
Corporate %ision In'rastructure and Euipment
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"ligned to 9:TI6s commitment to healthcare e5cellence is its
continuing e5pansion and growth, infrastructure- and patient
service-wise. "s it e5pands, 9:TI has been successful in getting
more trust and condence of both the local and internationalpatients.
The Institute6s infrastructure e5pansions in the recent years have
made good impression to visitors as 9:TI aims to convey its
global status. "fter e5pansion constructions of the Dialysis $enter,
3ut-'atient =ervices and !mergency >oom, 9:TI plans to
construct a ve-storey dormitoryJ building for its employees,
build a separate *-storey, %&&-bed, building for charity patientsand establish a satellite dialysis and transplant units in the
'hilippines.
"mong the recent maKor e;uipment ac;uisitions include the
@ammogram, esonance Imaging (@>I+. "s part of
9:TI6s long-range Ausiness 'lan (&&0 L &%&+, future ac;uisitions
include the !lectron @icroscope, 'ositron !mission Tomography
('!T+, MT= Mrology Imaging =ystem and ascular Imaging =ystem,and Eaparoscopic Instruments for the Institute6s 3perating >oom.
Emerency *oom Tel+ No+ ()*+ (+ %-&*&&, %-&/&& local
%/*&1%/*%
%I#I,N
To be a globally recognized premier center of advancements in
transplantation, renal and other end-organ diseases providing
cost-eGective and multidisciplinary care for all.
-I##I,N
7e are a healthcare team that inspires hope provides responsive
care for all patients with renal and end-organ diseases by creating
strong partnerships with key stakeholders, providing e5ceptional
solutions and employing eBcient systems.
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C,*E %"UE#
isionary Eeadership
=ervice with Integrity
'assion for !5cellence
Milestones
The National Kidney and Transplant Institute is a tertiary medical specialty center
formerly known as the National Kidney Foundation of the Philippines (NKFP)
created on January 16 1!"1 #y $irtue of Presidential %ecree 1"&' sined #y then
President Ferdinand * +arcos* It was created with a three,fold mission of -er$ice
Trainin and .esearch primarily for the #enefit of the Filipino people afflicted with
kidney and allied diseases and in pursuance of the policy of the -tate to secure thewell,#ein of the people #y pro$idin them with the speciali/ed health and medical
ser$ices*
The Institute is situated in a 0""!! suare meter parcel of land located alon ast
2$enue 3ue/on 4ity near the 3ue/on 4ity 5all and is accessi#le to all types of
land transportation* NKTI is a three,story edifice which can accommodate '0
patient #eds* Presently the Institute has an actual #ed capacity of '78 patient #eds*
There are other o$ernment hospitals in the neih#orhood namely the 9un 4enter
of the Philippines ast 2$enue +edical 4enter the Philippine 5eart 4enter thePhilippine 4hildren +edical 4enter and ast 2$enue +edical 4enter* ach
hospital has its own field of speciali/ation and NKTI is presently the only
o$ernment hospital speciali/ed in renal diseases and oran transplantation* It is
the center for referral of kidney patients from $arious reional hospitals nationwide
and is reconi/ed as the lead aency in $oluntary #lood ser$ices*
History of the Institute
The National Kidney and Transplant Institute:s forerunner was the National
Kidney Foundation of the Philippines (NKFP) which was formally crated in
January 16 1!"1 #y $irtue of -ection I of Presidential %ecree 1"&'* It #ecame
operational at the ;in 2& and 27 of the 9un 4enter of the Philippines*
The cornerstone of the NKFP #uildin in 3ue/on 4ity was laid #y NKFP
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4hairman then First 9ady +adame Imelda .omualde/ +arcos assisted #y the
mem#ers of the
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li$in related donors*
2 chane in the leadership of o$ernment meant a chane in the manaement of
the Institute* The 4ory 2uino administration and part of Fidel .amos term as
President saw %r* Filoteo 2* 2lano as its %irector until he resined in 1!!"*
The Institute has since then underwent a series of chanes with the eneri/ed
leadership of the present @ecuti$e %irector %r* nriue T* =na one of the
pioneers of transplantation in the Philippines
The #ed,capacity of the hospital #efore ?nits 0 6 and 8 were affected #y the +ay
1!!" 9un 4enter #urnin was '&1* 2n 94P,NKTI connectin passae turned
office that 5*=*P** occupied was totally ra/ed down durin the fire* ?nit 8 which
had the #ulk of the charity #eds and part of the .adioloy %epartment were also
hea$ily damaed*
New units with 8& pri$ate rooms at the third floor and =ut,Patient -er$ices were
#uilt to accommodate the e$er increasin num#er of Filipinos sufferin from
kidney diseases and other ailments* ?nits at the second floor are #ein spruced up
in conformity with the total face lift that the Institute is underoin* The NKTI has
e@panded into a '78 #ed,capacity hospital that pro$ides the #est facilities for
uality tertiary medical ser$ices*
The end,section of the &!,#ed ward which the P2>4=. constructed for ser$ice
patients (?nit ',%) was reno$ated to i$e room to the 0,#ed Intermediate 4are
?nit (I+4?)*
The 4enter for -pecial -er$ices composed of the ?roloy ?nit ndoscopy ?nit
4hemotherapyCTransfusionCPain +anaement ?nit and Peritoneal %ialysis
2m#ulatory ?nit has replaced what used to #e ?nit 8 at the second floor of the
anne@ #uildin*
The new merency room comple@ was specially redesined to suit its purpose
with its 8 #ed o#ser$ation and ! #ed treatment rooms* The Pharmacy and5ousekeepin sections were also constructed to pa$e way for #etter and faster
ser$ices*
2nne@ II a three,storey #uildin which is separate from the main #uildin was
also constructed* New %octor:s clinics were #uilt to accommodate more out,
patient consultations* The Institute has also e@panded and moderni/ed its %ialysis
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4enter* ;ith &1 state,of,the,art hemodialysis machines the center is capa#le of
doin '7 dialysis procedures per month* It is also capa#le of doin any type of
dialysis treatment custom,fit to the $aried clinical conditions that may #e
encountered in clinical practice*
NKTI is a leader in pro$idin continuin education for youn doctors throuh
InternshipC.esidencyCFellowship prorams in the different fields of +edicine* This
proram is in partnership with the Philippine 5eart 4enter (P54) 9un 4enter of
the Philippines (94P) and ast 2$enue +edical 4enter (2+4)*
To continually de$elop and uprade the le$el of skills of the nurses and other
paramedical staff the Institute de$eloped and esta#lished the Institute of 2d$anced
Nursin and 2llied 5ealth Professions* It is en$isioned to pro$ide and euip our
nursin and paramedical staff the necessary trainin e@posure and skills #ased on
lo#ally accepted standards*
2s it was in the earlier days of the NKFP today the National Kidney and
Transplant Institute is still an institution that e$ery Filipino must #e proud of* 2s
the first o$ernment hospital to #e I-=,!1D' certified it pro$ides top uality
care at par with any treatment found anywhere in the world* Its euipment
manpower and ser$ices are of the hihest standard* It #oasts of the most modern
dianostic techniues in kidney and other related diseases all modes of dialysis
and surical procedures most nota#ly oran transplantation*
These days kidney transplantation is a reular acti$ity of the hospital* NKTI holds
the record of the most num#er of kidney transplants performed in the country since
1!"&* =ther oran transplants ha$e also #een done at the Institute namely li$er
pancreas #one marrow and islet cell* %ou#le transplants like li$er and kidney
pancreas and kidney are transplant operations which were performed at NKTI lon
#efore any other transplant centers in 2sia would do it*
Historical Milestone
February
22, 2013
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February
18, 2013
NKTI &thFoundin 2nni$ersary
4ele#ration of 0 Kidney Transplant and countin
(Transplant ;eek)
January
23, 20139aunchin of the %ystonia and +uscle -pasm 4enter >C+>
October
5, 20129aunchin of I44 5and#ook
February
29, 2012
NKTIs '!th Foundin 2nni$ersary
.e,namin of the %ianostic 4enter 2uditorium to "Dr.
Enrique T. Ona Auditorium"
-oft,openin of the NKTI 5ymn
Sete!be
r ", 2011T?E Performs .ecertification 2udit at NKTI
July 21
an# 2$,
2011
T?E Performs .ecertification 2udit at NKTI
July 20,
2011
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June 25,
2011&rd Philhealth -a#ado
June 1",
2011
Eideo conference with +assachusetts >eneral 5ospital as hosted
#y 2dult Nephroloy %epartment
February
28, 2011+edical -ocial -er$ice %i$ision '"th Foundin 2nni$ersary
February
23, 2011
NKTI '"th Foundin 2nni$ersary
First Filipino,-panish 4onress of -e@ual .eproducti$e
+edicine and Fertility
October
11%12,2010
%epartment of Pediatric Nephroloy 'nd Post >raduate 4ourse
2raduate 4ourse in 5emodialysis 4ustomi/in
%ialysis in 2cute Kidney InAuryG
October$, 2010 9aunchin of the 5and#ook for Kidney Transplant .ecipient andKidney %onorG
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October
2, 2010
NKTI Participated in Phil5ealth -a#adoH +aseuro
+aparehistroG Nationwide .eistration
Sete!be
r 21, 2010&rd Peace Pole Plantin 2nni$ersary*
June 2$,
2010
NKTI,P?2 'nd .afael
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r 30, 2009
Sete!be
r 8, 2009NKTI %ianostic 4enter Toppin,=ff 4eremony*
June 1& %
18, 2009
NKTIP?2 First .afael
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(o)e!be
r 20, 2008NKTI recei$ed I-= !1D' .e,certification*
June 1$,
2008Formal openin of mployees 9oune*
May 21,
2008
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200& of 2ccess 4omplications*
March 8,
200&First ;orld Kidney %ay 4ele#ration of NKTI*
February
19, 200&
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June 18,
2005
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*u+ust
11, 200"
* +artine/
%irector of .enal Transplant Proram Kaiser Permanente +edical
>roup -an Francisco 4alifornia and %r* Peter N*
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r 2003 %
February
200"
=rani/ational Ealues alinment*
*u+ust
18, 2003=penin of the New @panded %ialysis 4enter*
June 19,
2003
First %irector:s 4up >olf Tournament held in ;ack ;ack >olf
and 4ountry 4lu#*
June 25,
2003
'th ear 2nni$ersary 4ele#ration
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October
", 2002
.ecei$ed Fi$e -tar 2ward for uality L,.ay ser$ice i$en #y the
%epartment of 5ealth throuh its
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July 2&,
2001
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4hemotherapyCTransfusion and Pain +anaement ?nit)*
June 9,
2000
NKTI Transplant Team performed the first kidney transplant at
2-2 2wardee for successfully orani/in the
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at Ilocos .eion +edicalC.esearch 4enter*
NKTI assist the first kidney transplant in %a$ao 4ity*
June
22,1998
NKTI earned ' -tarsG in the -tar 2wards for 3uality 2ssurance
in 5ospitalG sponsored #y the %epartment of 5ealth*
May
1,1998
+s* Nelia 4* 2$illa Nurse 4oordinator recei$ed the 1!!8,1!!"
Presidential -cholarship 2ward durin the ' th 2nnual
4on$ention of the 2ssociation of %onor .ecruitment Professionalsat %allas Te@as ?-2*
'ece!ber
"%&, 199&
The 0 th 4onress of the 2sian -ociety of Transplantation was
held in +anila with NKTI as a maAor participant and host*
(o)e!be
r 2" % 2$,
199$
NKTI was a maAor participant in the medical co$erae of thedeleates 1!!6 to the 2P4 -ummit %r* Filoteo 2* 2lano
@ecuti$e %irector of NKTI was assined to #e the personal
physician for President
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May 25,
1995
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Philippines (NKFP) to the National Kidney Institute*
July 11,
198"
-tart of the construction of the +ain
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1$, 1981 Kidney Foundation of the Philippines (NKFP)
Hosital an# Me#ical ea#ershi
Jose 'ante -. 'ator, M. '., F-/
@ecuti$e %irector
!"1,& loc 11 1' 116
enai#a . *ntonio, M.'., F--S, F-S(
%eputy @ecuti$e %irector for +edical -er$ices
!"1,& loc 10
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Joselito . ha)e4, M.'., F--, F--, F*-, S
%epartment +anaer for 4linical -er$ices
!"1,& loc 77'8
o!ina *. 'an+uilan, M.'., F--, F-S(
%eputy %irector for +edical ducation
!"1,& loc 77'6 77'"
/lesil#a *. 6utierre4
%eputy @ecuti$e %irector for 2dministrati$e -er$ices
!"1,& loc 111
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(erissa M. 6erial, (, MH*, -h', S, F-H*
%eputy %irector for Nursin -er$ices
!"1,& loc &1' &1&
I. Me#ical Ser)ices
'r. Joseh Michael *. Jaro
4hairman Internal +edicine
&118
'r. o!ina *. 'an+uilan
4hairperson %epartment 2dult
Nephroloy&11"
'r. Ofelia . 'e eon
4hairperson %epartment of Pediatric
Nephroloy
'18'
'r. 7alerie *nn . esoro4hairperson 5ematoloy and -tem
4ell
10!
'r. *n+elo O. Martine4
4hief Nuclear +edicine
171 17'
'r. uis 7. i!chiu, Jr.
4hief merency .oom ?nit17&17&1
'r. orna . Si!an+an
4hairperson =ut,Patient -er$ices
11''11'&
'r. Joseh Michael *. Jaro
4hief 4ardio$ascular +edicine
'7&6 '7&'
'r. Joselito -. hico
4hief Pulmonary +edicine -ection
'1'6 '1'8
'r. osalia . ele+4hief Neurophysioloy -ection
'1'7 '1'0
'r. Maria oena . Ja)ier
4hief Physical +edicine and
.eha#ilitation -ection
'1'&
'r. o!ina *. 'an+uilan
5ead %ialysis 4enter&11"
'r. atherine S. eh
4hairman %epartment of >eneral -urery
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'181
'r. !!anuel 7. enon
5ead %epartment of ?roloy
'1&8
'r. *rnol# S. y
4hairman %epartment of 2nesthesia
'1&6
'r. /enito 7. -uru++anan, Jr.
4hairman %epartment of =ran Transplantation
'18
'r. eo arlo 7. /aloloy
4hief Eascular -urery -ection
'100 '106
'r. *rnorl# Joseh M. Ferna#e4
4hairman %epartment of 9a#oratory +edicine
101
'r. Florecita . -a#ua
4hief Immunoloy %i$ision
100
o!eo /. 'y, .M..
4hief +edical Technoloist
%epartment of 9a#oratory +edicine
101
'r. Fer#inan# . Morabe%ept* +anaer %ianostic 4enter
'7! '71
'r. osanna . Fra+ante
4hief 4T -canCTranin =fficer
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'7! '71
'r. 6erar#o M. Sil)a
@ecuti$e =fficerC 4hief ?ltrasonoraphy
'7! '71
'r. Fer#inan# . Morabe
4hief %ianostic and Inter$entional
'7! '71
II. Finance an# *#!inistrati)e Ser)ices 'eart!ent
Ms. Maribel . strella
=I4 Finance and 2dministrati$e -er$ices %epartment
1!
Ms. 7ictoria 7. lias
=I4 2ccountin %i$ision
11&" 11&8
Ms. eticia . 'obla#o
4hief 5uman .esource +anaement
%i$ision
&1'
Ms. Josefina . Sa!an+
4hief
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1106 1108
Ms. Marichu . scober
4hief Purchasin %i$ision
1"1 1"7
Mr. Johnny 7ictor . aoan+
5ead eneral -er$ices %i$ision
1!6 1!8
Ms. *rlene Maria . -ilasilas>Ms. Josehine . 7illalon
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111
Ms. Merce#ita 7. Jocson
%eputy 3uality +anaement .epresentati$e
&76!
Ms. a=uel 6. Ma+talas, -*
5ead Internal 2udit -er$ices
1&1
Ms. Sarah . ui4
%4=,I-= %ocument 4ontrol =fficer
110" 110!
7. (ursin+ Ser)ices 'eart!ent
Ms. (erissa M. 6erial, (, MH*, F-H*
%eputy %irector of Nursin -er$ices
&1' &1&
Ms. 6lecita S. rni
4hief 4linical B Pu#lic Nursin %i$ision
&1"
Ms. Helen . Malata
4hief 4ritical %i$ision
&1!
7I. enal 'isease ontrol -ro+ra! ?'O-@
'r. Susan Jor+e
Proram +anaer
&11' &111
7II. Hu!an Or+an -reser)ation ffort ?HO-@
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'r. #uar#o . i)era
5ead
77
otal Auality Mana+e!ent ?AM@
For se$eral years now National Kidney and Transplant Institute has taken a
trail#la/in and mountin role in renal healthcare and oran transplantation in the
Philippines and the rest of 2sia with this the Institute has constantly walked the
path of ser$ice uality*
The Institute:s Total 3uality +anaement ad$ocacy was formally launched on
+arch '" '1 a definin milestone in our deli$ery of uality healthcare* 2s
supported #y the Institute:s 3uality Policy and 3uality =#Aecti$es we maintain
ser$ice uality in all areas of the hospital* 3uality +anaement is seen in all
aspects of our daily operationsD from the +edical Para,+edical Patient -afety
Infection 4ontrol and to the Nursin -er$ices uality permeates all acti$ities*
Incorporatin the fi$e pillars of Total 3uality +anaement 0- -uestion-cheme 3uality 4ircles I-= , to our Institute has allowed us to #e more
responsi$e to the needs of our patients and their families $isitors and e@press
enuine concern for their utmost comfort welfare and self,esteem*
NKTI acuired its I-= !1 D ' 4ertification (4omprehensi$e -pecialty
5ealthcare -er$ices) in 2pril '0 '' and was a#le to sustain its I-=
certification* The Institute was a#le to acuire its re,certification on 2uust 1
'! and has #een upraded to !1 D '"H and up until now we remain the only
Tertiary >o$ernment 5ospital in the Philippines to attain the I-= lo#al seal of
uality standard* 2nd Aust recently NKTI achie$ed the 4ertificate of @cellenceG
from the Philhealth Inc* aain as a testament to NKTI:s dedication to pro$idin
uality healthcare to its patients*
2s a result we ha$e em#raced and actuali/ed the concept of 4ontinual 3uality
Impro$ement in our ser$icesH and we acknowlede that it is throuh a competent
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workforce with selfless teamwork dedication and sense of accounta#ility that
uality impro$ement and ser$ices uality can #e achie$ed*
2t NKTI we make sure that your e@pectations from us are met and our
commitment to 3uality also uarantees that we will e@ceed your e@pectations*
Auality -olicy
To fulfill the Eision,+ission of National Kidney and Transplant Institute we shall
pro$ide the most appropriate comprehensi$e effecti$e health care ser$ices toe@ceed our customers: e@pectations*
=ur success will #e achie$ed throuh full participation of our employees at all
le$els of the orani/ation uided #y our 3uality =#Aecti$es*
National Kidney and Transplant Institute shall commit to ensure compliance to all
reulatory statutory en$ironmental and health C safety reuirements of the
o$ernment and other reconi/ed world orani/ations like the ;5= etc*
The 3uality Policy shall #e communicated to and made understood #y all
employees throuh orientations meetins circulars posters and other related
means*
This 3uality Policy shall #e re$iewed annually or as necessary #y manaement to
adapt to current de$elopments C reuirements throuh continual impro$ement*
Auality ObBecti)es
The o#Aecti$es of the 3uality 2ssurance Proram of National Kidney and
Transplant Institute is the preser$ation and enhancement of the hih uality
patient,centered care #y ensurin that D
5?+2N .-=?.4- ha$e optimum skills and competencies*
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T45N=9=> and F24I9ITI- are state,of,the,art and properly
maintained*
-.EI4- are deli$ered in the safest and most efficient manner*
--T+- are effecti$e well,defined and continually impro$ed to meet
customer reuirements*
2FF=.%2+NT D
4ustomer,FirstG 2ttitude
4ommitment and participation #y e$eryone
4ompetence %e$elopment
Pre$ention
4ontinuous Impro$ement
Fast .esponse
+anaement #y Fact
'OH /oar# of rustees
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Janette
9oreto,
>arin +%
4hairman
+em#ersDTeofilo -*Pilando Jr*
=ffice of the
President
Nemesto T*
>ako +%
?-4 %=5
+ario 9*
.elampaos
?-4 %=s and
>o$ernment 2encies forein institutions and from
any local and National >o$ernment* Please prepare a
communication (written or email) addressed to our
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1" C 117
!ail *##ressC pronkti*o$*ph
enal Health -lus
Kidney diseases especially nd -tae .enal %isease (-.%) are already the 8 th
leadin cause of death amon the Filipinos* =ne Filipino de$elops chronic renal
failure e$ery hour or a#out 1' Filipinos per million population per year* +ore
than 0 Filipino patients are presently underoin dialysis and appro@imately
1*1 million people worldwide are on renal replacement therapy* .elia#le estimates
re$eal that the num#er of these patients will dou#le in '1*
In the past chronic lomerulonephritis was the most common cause of chronic
renal failure* Today dia#etes mellitus and hypertension ha$e taken center stae in
the causation of -.% which toether account for almost 6M of dialysis patients*
The cost of medical treatment for kidney disease is really e@or#itant #eyond the
reach of ordinary patients* .enal transplantation is limited due to the e@pense and
the shortae of donors* The #est that can #e done at present is to focus efforts on
the pre$ention of proression of renal diseases* -trict #lood pressure and lycemic
control and adoption of healthy lifestyleG play a maAor role in reducin if nottotally controllin the epidemic of renal failure and this could #e achie$ed throuh
proper education*
This .enal 5ealth Plus pro$ides educational information related to the pre$ention
dianosis and treatment of kidney diseases*
he Hu!an Di#neys
Kidneys are important parts of the urinary system* They are found at each
side of the spine #elow the ri# cae of the human #ody* ach kidney is as
#i as a fist weihs O pound and looks like a kidney #ean*
mailto:[email protected]://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus#bttmailto:[email protected]://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus#btt -
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The kidneys perform $ital life,maintainin functions as monitors and
reulators of #ody fluid* They e@crete fluids when the #ody has an e@cess of
them and retain the su#stances necessary for the #ody:s continuin function*
They produce and release a $ariety of chemicals to keep the #ody healthy
and filter the entire #lood supply e$ery ' minutes e@cretin waste materialsthrouh the urine*
The kidneys also produce erythropoietin a hormone that controls the
production of red #lood cells #y the #one marrow*
They also are in$ol$ed in the reulation of #lood pressure* This pro#a#ly
happens throuh the reulation of #lood $olume and the amount of sodium
in the #ody as well as the production of su#stances such as the aniotensin*
6eneral Eays of -rotectin+ your Di#neys
@ercise reularly
at healthy diet
+aintain ideal #ody weiht
2$oid smokin
2$oid takin medications or her#al supplements without ad$ice of physician
4onsult doctor riht away if with symptoms
%rink lots of water and a$oid e@cessi$e salt
5a$e annual physical check,up especially if with or with family history of
hypertension dia#etes or renal failure
If hypertensi$e and dia#etic
o Take medications reularly
o -ee the doctor reularly
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o Know #lood suar and #lood pressure oals and make sure tarets are
met
o +ake sure the doctor checks the kidneys reularly
'ia+nostic Ser)ice
%ianosis of kidney ailments and kidney related health diseases is pi$otal in
pro$idin effecti$e therapeutic plan* The National and Kidney and Transplant
Institute offers a wide rane of the latest and state of the art dianostic tools to
uickly and accurately dianose kidney diseases*
Please click on the %i$isionC%epartment #elow to know more a#out their
respecti$e ser$icesD
aboratory Me#icine
a#iolo+y
(uclear Me#icine
rolo+y
F*A
AuestionC
;hat are the sins and symptoms of kidney disorder
*nserC
The main symptom of kidney disorder is fluid retention or edema* Patients may
ha$e puffiness around the eyes swellin in the feet and les and water in the lunsleadin to difficulty of #reathin
2ny chane in urination may also indicate kidney pro#lem* This may consist of
pain or unusual sensation durin $oidin increased or decreased freuency of
urination difficulty in initiatin urination freuent urination at niht chane in
color of urine #lood in the urine or #u##ly appearance of the urine*
http://www.nktilab.com/http://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus?id=567http://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus?id=620http://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus?id=783http://www.nktilab.com/http://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus?id=567http://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus?id=620http://www.nkti.gov.ph/patients-and-visitors/kidney-health-plus?id=783 -
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Kidney failure results in the retention of $arious #ody wastes which cause
anore@ia $omitin difficulty in sleepin and enerali/ed #ody weakness* This is
often e$aluated #y measurin serum creatinine and #lood urea nitroen*
The presence of protein and red #lood cells in the urine is also an indication of
kidney disorder* In lomerulonephritis proteinuria and hematuria are commonly
seen #ecause the lomeruli ha$e #ecome inflamed* Proteinuria is also the earliest
manifestation of dia#etic nephropathy* Pallor and weakness are also amon the
indications of kidney failure due to anemia secondary to low erythropoietin
production #y the failin kidneys*
5ypertension is also a maAor conseuence of kidney disorder* Initial e$aluation of
all newly dianosed hypertensi$e patients should include serum creatinine and
electrolyte le$els (sodium and potassium) particularly amon youn hypertensi$esu#roup*
.epeated urinary tract infections #ack pain or pain in the lower a#domen may
indicate the presence of kidney stones and may also cause #lood in the urine*
AuestionC
;hat diseases commonly affect the kidneys
*nserCInfection is the most common disorder of the kidneys and the urinary tract*
?ncomplicated urinary tract infections are $ery easy to treat
-tones are solid residues in the urinary tract that may cause o#struction to the flow
of urine which in turn may lead to infection of the kidneys and su#seuent
scarrin*
>lomerulonephritis is inflammation of the lomeruli the small $essels in the
nephron* If not treated patients may suffer slow proressi$e damae to the kidneys
and de$elop renal failure*
5ypertension occurs with many cases of kidney diseases* Proloned hypertension
damaes the small arteries in the kidneys* This may start a $icious cycleD damaed
kidneys cause more serious hypertension which in turn #rins more damae to the
kidneys*
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%ia#etes may also damae the kidneys* It is the leadin cause of chronic renal
failure in many countries*
2#normalities in the urinary tract that are conenital or in#orn may conseuently
lead to poor function o#struction or infection of the kidneys*
-ome drus her#al medicine sol$ents and insectides can also harm the kidneys*
AuestionC
;hat are the warnin sins of kidney disease
*nserC
Puffiness of the eye area
Proressi$e swellin of parts of the #ody usually at the ankles
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There is no pro$en way to pre$ent ?TI #ut the followin suestions may#e
helpfulD
%rink plenty of liuids a#out 6," lassesCday to flush #acteria out of the
urinary system
-chedule freuent #athroom #reaks
;omen should drink water #efore and after se@ so they will urinate a ood
$olume with a steady stream afterward* This will help eliminate any #acteria
that may ha$e entered the urinary #ladder*
2fter defecatin women should not wipe in the direction of the $aina to
a$oid spreadin #acteria from the astrointestinal tract
AuestionC
5ow should patients with hypertension #e treated
*nserC
Treatment of hypertension can #e achie$ed throuh non,pharmacoloic and
pharmacoloic means* It consists of the followin
9ifestyle modification
;eiht loss
@ercise
9ow salt low fat diet
-top smokin
9ess alcohol consumption
4ope with stress
.eular intake of antihypertensi$e medications
AuestionC
5ow are kidney stones pre$ented from de$elopin
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*nserC
The simplest and most important lifestyle chane to pre$ent all kinds of kidney
stones from de$elopin is to drink more liuids* ;ater is the #est* It is
recommended that water intake should #e at least ' liters per day* There are many
proponents of $arious curesG #y drinkin other liuids such as #uko Auice pito,
pito tea sam#on tea and many other teas #ut scientific studies ha$e not pro$en
their efficacy and safety*
heraeutic Otions
Treatment of kidney diseases may in$ol$e the followinD medical therapy such as
medicines and dietary chanes dialysis and transplantation
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wastes from the #lood* 5emodialysis is usually performed ' to & times a
week* ach treatment last for 7 hours*
Peritoneal dialysis is another procedure that remo$es e@tra water and wastes
from the #ody* This type of dialysis uses the linin of the a#domen to filter
the #lood* This linin is called the peritoneal mem#rane and acts as the
artificial kidney* 2 mi@ture of minerals and suar dissol$ed in water called
dialysis solution tra$els throuh a soft tu#e into the a#domen* The suar
called de@trose draws wastes chemical and e@tra water from the tiny #lood
$essels in the peritoneal mem#rane into the dialysis solution* 2fter se$eral
hours the used solution is drained from the a#domen throuh the tu#e
takin the wastes from the #lood with it* Then the patient fills his a#domen
with fresh dialysis solution and the cycle is repeated usually & to 7 times a
day* ach cycle is called an e@chane*
Kidney transplantation surically places a healthy kidney from another
person into the #ody of the patient with end stae renal disease* The donated
kidney does the work that the ' failed kidneys used to do* It is enerally not
necessary to remo$e the diseased kidneys* 2 donated kidney may come from
an anonymous donor who has recently died or from a li$in person usually
relati$e* The kidney that the patient recei$es must #e a ood match for his
#ody* The more the new kidney is like his own the less likely will his
immune system reAect it* The patient will #e made to take special drus
called immunosuppressi$es to help trick his immune system so it would notreAect the transplanted kidney*
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(DI%He!o#ialysis
*bout s
NKTI,5emodialysis 4NT. is a Pu#lic,Pri$ate Partnership (PPP) and a special
proAect in$ol$in enaement of a pri$ate sector throuh a lease contract to
pro$ide top of the line and state of the art 5% euipment for the manaement and
treatment of -.% and other .enal , related diseases* The partnership stratey
allows and resulted in the pro$ision of the hihest uality hemodialysis facility and
allows the most efficient and safe treatment for all Filipinos needin treatment at a
reasona#le cost*
NKTI,5emodialysis 4enter has #een in all the headlinesG locally and
internationally as T5 successful model of the fusion of modern technoloy
usin the pri$ate sector 2N% health* The success of NKTI,5% 4enter as the first
PPP model in healthcare is now reconi/ed lo#ally and continues to #e the
countryQs model for other o$ernment and pri$ate dialysis facilities as well as
2siaQs model and pride of the %epartment of 5ealth*
Ser)ices
The 5emodialysis ?nit which is located at the 2nne@ II #uildin opens from
6D&am to 7Dam of the ne@t day to accommodate out patients needin
5emodialysis treatment* The treatment procedure is 7 hours there#y 7 #atches of
patients are #ein ser$ed till 7Dam* .eular schedule is #ein pro$ided upon
presentation of reuirements* For patients without a reular schedule takin the
chance to #e accommodated durin day is included in the waitin list Aust in case areular patient does no arri$e*
The 5emodialysis ?nit which is located at the main #uildin is desined for
patients needin emerency dialysis* The unit then is open '7 hours a day to ser$e
patients comin from the merency .oom Intensi$e 4are ?nit .eco$ery .oom
and from different wards* 4ontinuous .enal .eplacement Therapy (4..T) is also
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#ein done to critically ill patients in the Intensi$e 4are ?nit and is #ein done
continuously dependin on the doctor:s prescription and patient reco$ery*
Our
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reat!ent Sche#uleC +onday to -aturdayD
1stsessionD 6D&am to 1D&am
'ndsessionD 1'nn to 7Dpm
&rdsessionD 0D&pm to !D&pm
7thsessionD 11Dpm to &Dam
He!o#ialysis e=uire!ents for (e -atients, ransient an# ransferrin+
-atients fro! other H' enterC
1* 5emodialysis =rder from your attendin physician
'* In,house Nephroloist
&* 5epatitis < and 4 -creenin (5#s2C2nti 5
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and e@cess fluid that accumulates in the #ody when patients: kidneys are no loner
a#le to function adeuately*
Peritoneal dialysis can #e performed when there is an acute deterioration in kidney
function such as with se$ere #lood loss or se$ere dehydration due to $omitin and
diarrhea* It can also #e used for entle fluid remo$al in patients with non,primary
kidney disease such as patients with conesti$e heart failure or cirrhosis of the
li$er* In these cases dialysis may #e necessary only for a short period i$in the
patient:s kidneys time to reco$er from the sudden and se$ere situation that caused
it to fail temporarily*
It can also #e used to permanently replace a patient:s kidney function in patients
with lonstandin kidney disease* These include lonstandin hypertension and
dia#etes mellitus which are common causes of kidney failure in Filipinos* It can
also #e used in place of the kidneys for patients with primary kidney disease suchas chronic lomerulonephritis when kidneys are no loner a#le to perform their
function sufficiently well*
+aAority of the patients are on 4ontinuous 2m#ulatory Peritoneal %ialysis
(42P%) since this is the more physioloic type of dialysis and pro$ides the #est
clearance*
=ne of the prorams of the unit is the 42P% Trainin for 42P% patients* This
trainin prorams is de$ised for patients dianosed to ha$e nd -tae .enal
%isease (-.%) who are a#out to undero Peritoneal %ialysis* This reuiresadmission for a period of & days where a series of lectures and return
demonstration of the desired 42P% system is performed* Ser)ices
Insertion the *cute or -er!anent -' atheter
5ihly trained sureons place the P% catheter into the a#dominal ca$ity of the
patient* The acute P% catheter is used for patients who need P% treatment only for
a short period* It is a stiff catheter* The permanent P% catheter is a soft plia#le tu#e
that is used for the lifetime of the patient*
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This is a chronic type of P% therapy where patients are trained to perform the
dialysis themsel$es in the comfort of their homes* It is a continuous type of
treatment #ecause there is always P% fluid inside the peritoneal ca$ity where
dialysis is continuously occurrin* It is am#ulatory #ecause while the P% fluid is
inside the #ody the patient is free to do his daily acti$ities* The patient can o to
work or Aust stay at home and do their usual acti$ities*
Inter!ittent -' ?I-'@
This can #e performed for #oth acute and chronic kidney failure* P% e@chanes are
performed e$ery & minutes in order to uickly remo$e the poisons and e@cess
fluid that ha$e accumulated in the #ody #ecause the kidneys were not performin
adeuately* It can #e done #y the P% nurses e$ery & minutes or the patient can #e
hooked to a special P% machine called the cycler* The P% solutions are connected
to the cycler and a special tu#in from the cycler is connected to the patients P%catheter* The machine is turned on and the cycler #eins the dialysis therapy* IP%
is usually performed from se$eral hours to se$eral days dependin on the needs of
the patient*
ontinuous ycler%*ssiste# -' ?-'@
P% therapy can also use a com#ination of the cycler machines and manual P%
e@chanes* This is called 44P%* It is continuous #ecause there is always P%
solution inside the peritoneal ca$ity* The cycler is used to do se$eral short
e@chanes durin the niht while the patient is asleep and 1 to ' manuale@chanes are performed #y the patient durin the day* -pecial P% trainors train
the patient their relati$es or carei$ers to perform this type of therapy* ;hen the
P% therapy is performed only at niht and the patient does not ha$e any P%
solution inside the #ody durin the daytime it is called N=4T?.N29
INT.+ITTNT P% (NIP%)* our physician will decide which type of therapy
you need* 2ll of these types of P% therapy are a$aila#le at the NKTI* The ?nit has
a medical and nursin staff especially trained to perform P% and has a specific
proram for trainin patients in usin P%* The ?nit also has speciali/ed P%
technicians and clinical nursin assistants who assist in the performance of P%
throuhout all areas of the hospital*
Facilities
-' M*I(
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9ocated at the #ack of ;in '% and '4
1,#eds for in,patients
-pecial area for 42P%
*-' enter
9ocated at 'nd Floor of the %ialysis
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Hea#C .omina 2* %anuilan +% FP4P FP-N
(urse Suer)isorC .ita S*
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F*AGs
AuestionC
;hat is Peritoneal %ialysis
*nserC
Peritoneal dialysis is a form of therapy that replaces a patient:s kidney function* Ituses the patient:s own peritoneal mem#rane to act as the artificial kidney* 2 special
type of fluid called peritoneal dialysis fluid enters the patient:s a#dominal ca$ity
throuh a surically placed P% catheter* It stays inside the a#dominal ca$ity where
it lies in contact with the peritoneal mem#rane* %urin this time poisons to@ins
and e@cess fluid which are found in a#undance in the #lood of a patient with
kidney failure will transfer from his #lood to the P% fluid* 2fter 6 to " hours the
P% fluid will #e drained $ia the P% catheter containin many poisons to@ins and
e@cess fluid* This is how the #lood is cleaned of all the to@ic su#stances that
accumulated #ecause the kidneys were no loner functionin adeuately* 2fter
drainin the fluid fresh solution will #e infused into the a#dominal ca$ity aainthrouh the P% catheter* This cycle is repeated from & to 7 times each day
e$eryday*
AuestionC
;hat are the ad$antaes of doin P% Is it riht for me
*nserC
The maAor ad$antae of doin P% is that the patient andCor carei$ers are trained to
perform P% at home* There is no need to o to a hemodialysis center in a hospital
or clinic for 7 hours ' to & times a week* %ialysis usin P% can #e performed in
the comfort of one:s #edroom or in the office* 2ll the patient needs is a clean room
with adeuate $entilation* The patient is therefore more mo#ile with freedom to
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tra$el* If one is plannin to o to a different city for a $acation there is no need to
make reser$ations at an 5% center* The patient Aust #rins his reuired num#er of
P% dialysis fluid #as and off they o to their city of choice*
P% is especially appropriate for children who may not ha$e suita#le $eins lare
enouh for the 5% needles* They can row up in the warm en$ironment of home
without the memory of doin therapy in the hospital*
lderly patients or patients with sinificant heart disease may feel #etter on P%
therapy #ecause it is a entler form of dialysis which is performed daily e$ery day*
They will not #e su#Aected to the se$ere drops in #lood pressure associated with
5% treatment when #lood e@its from the arm e$en thouh it is returned to the
patient*
P% is appropriate for any patient as lon as their peritoneum is workin properly*Patients who ha$e had pre$ious a#dominal sureries like surery for a ruptured
appendi@ or an operation to remo$e a all #ladder or a pre$ious child#irth #y
ceasarian section may not #e suita#le #ecause the peritoneal mem#rane may ha$e
de$eloped adhesions (or scar tissue) as a result of the operation* =nce the
peritoneal mem#rane is replaced #y scar tissue it can no loner function
adeuately as an artificial kidney* %iscuss this concern with your physicianR our
doctor will help you make the #est decision on your choice of dialysis therapy*
P% can #e performed #y anyone from an adolescent to an elderly patient* The
steps are easy to perform and the P% tu#ins and #as $ery simple to use*.emem#er they were made especially to #e used #y ordinary men women and
children* ;e ha$e an e@pert trainin team who will teach the patient relati$es and
carei$ers all the steps in performin peritoneal dialysis*
AuestionC
;hat is the Peritoneal +em#rane
*nserC
This is the linin of the a#dominal orans such as the stomach and intestines li$er
and spleen and linin the #ody wall* It acts as the artificial kidney durin peritoneal
dialysis* It allows the passae of to@ins such as e@cess urea creatinine and
potassium which accumulate in patients with kidney failure* It also allows e@cess
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water to #e remo$ed from the #ody in patients who ha$e le edema and fluid in
the luns* This can happen in patients with kidney failure who can no loner
urinate sufficiently*
AuestionC
;hat is a P% 4atheter
*nserC
The P% catheter is a plia#le tu#in a#out 1' inches lon which is surically placed
inside the a#domen* In patients with kidney failure it is placed only once and lasts
the lifetime of the patient* It is the permanent access where the P% fluid will enter
and e@it from the patient:s a#domen in order for peritoneal dialysis to #e
performed* 2#out 0 inches of tu#in may #e seen e@itin from the a#domen*
AuestionC
;hat is P% Fluid or P% -olution
*nserC
P% fluid is a special type of fluid similar to the de@trose fluid i$en intra$enously*
It contains electrolytes which are usually lackin in a patient with kidney failure
such as calcium and has de@trose which acts to remo$e fluid from the #ody*
AuestionC
;hat is a P% @chane
*nserC
2 P% e@chane is the process of infusin P% solution into the peritoneal ca$ity $ia
the P% catheter and then drainin it after se$eral hours* Fresh P% solution is
infused into the peritoneal ca$ity of the patient #y connectin the dialysis fluid
tu#in to the patients P% catheter* The P% solution stays inside the peritoneal
ca$ity where it lies in contact with the peritoneal mem#rane which now acts as the
artificial kidney* To@ins and poisons from the #lood enter into the P% solution as
well as the #ody:s e@cess fluid* 2fter a#out 6 to " hours the P% solution containin
the to@ins is drained from the peritoneal ca$ity into the empty drain #a and fresh
P% solution is infused aain* The used tu#ins and spent dialysis fluid (fluid
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containin all the to@ins) is then disconnected from the patient and discarded* This
is performed & to 7 times a day e$eryday* =ne e@chane takes a#out ' minutesH
1 minutes to infuse fluid and 1 minutes to drain it*