1. Pakistan Kidney centre, Abbottabad Pakistan. Introduction By Dr. Khalil Ur Rehman FCPS (Internal Medicine), MRCP, FCPS ( Nephrology)

2. 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

3. 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 )read more

4. Activities in Pakistan. Relieve activities – Earth quake. – Flood. – Eid gift distribution and qurbani meat. – ( read more )read more – Now Pakistan Kidney Centre (PKC)

5. KIDNEY FAILURE. What's Kidney failure ? – Acute Mostly reversible – Chronic –silent epidemic Irreversible Causes – DM= 40% – HTN, Kidney stone, GN, Drugs, infections, Malignancy

6. CONSEQUENCE OF CHRONIC KIDNEY FAILURE (CKD) Progression toward end stage renal disease Stage (I    II   III    IV  V) Deterioration of General health Requiring Dialysis/ Kidney Transplant Available Not Available DEATH within hours to days NEAR NORMAL LIFE with reduced survival ESRD

7. 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

8. 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.

9. 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

10. 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.

11. 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

12. 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.

13. Mobile clinic for screening Rs= 50,00,000

14. 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

15. 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

16. 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.

17. 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

18. Site

21. 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

22. DESIGN- BASEMENT

23. DESIGN- GROUND FLOOR

24. GF

26. OPD Women waiting

27. GF

32. DESIGN- FIRST FLOOR

33. FF

35. CEO/ Conference room

36. FF ULTRASOUND AND LITHOTRIPSY ROOM

37. FF

39. 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)

40. RUNNING COST FOR FIRST MONTH General Staff100 Thousand Nurses & Technician150 Thousand GP50 Thousand Specialist200 Thousand Dialysis (5 machine, 10 patients @ 3000 per dialysis)1.8 Million Overhead300 Thousand Lab, X Ray, Ultrasound100 Thousand Other Medical expenses200 Thousand TOTAL2.9 Million

41. 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

42. TARGET DATES Foundation stone : - November 2012 Completion of structure 1 year Functioning start : March 23, 2014

43. 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

44. FUTURE PLANS Expansion of PKC – ICU, Kidney transplant – Chain of Kidneys centres in other areas of Pakistan.