the national kidney and transplant institute

7/26/2019 The National Kidney and Transplant Institute

1/55

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]


2/55

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.


3/55

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


4/55

"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.


5/55

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


6/55

4hairman then First 9ady +adame Imelda .omualde/ +arcos assisted #y the

mem#ers of the


7/55

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


8/55

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


9/55

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


10/55

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


11/55

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


12/55

r 30, 2009

Sete!be

r 8, 2009NKTI %ianostic 4enter Toppin,=ff 4eremony*

June 1& %

18, 2009

NKTIP?2 First .afael


13/55

(o)e!be

r 20, 2008NKTI recei$ed I-= !1D' .e,certification*

June 1$,

2008Formal openin of mployees 9oune*

May 21,

2008


14/55

200& of 2ccess 4omplications*

March 8,

200&First ;orld Kidney %ay 4ele#ration of NKTI*

February

19, 200&


15/55

June 18,

2005


16/55

*u+ust

11, 200"

* +artine/

%irector of .enal Transplant Proram Kaiser Permanente +edical

>roup -an Francisco 4alifornia and %r* Peter N*


17/55

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


18/55

October

", 2002

.ecei$ed Fi$e -tar 2ward for uality L,.ay ser$ice i$en #y the

%epartment of 5ealth throuh its


19/55


20/55

July 2&,

2001


21/55

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


22/55

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


23/55

May 25,

1995


24/55


25/55

Philippines (NKFP) to the National Kidney Institute*

July 11,

198"

-tart of the construction of the +ain


26/55

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


27/55

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


28/55

(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


29/55

'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


30/55

'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


31/55

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


32/55

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-@


33/55

'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


34/55

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*


35/55

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


36/55

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


37/55

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


38/55

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


39/55

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


40/55

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*


41/55

%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


42/55

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


43/55

*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


44/55

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*


45/55

(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


46/55

#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


47/55

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


48/55

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*


49/55

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(


50/55

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


51/55

Hea#C .omina 2* %anuilan +% FP4P FP-N

(urse Suer)isorC .ita S*


52/55

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


53/55

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


54/55

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


55/55

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*

the national kidney and transplant institute

Documents