The National Kidney And Transplant Institute 622b4

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 and transplantation. It focuses on service, training and research in the field of renal diseases and organ transplantation Us National Kidney & Transplant Institute East Avenue, Diliman Quezon City 1101 Philippines Phone: (63) (2) 981-0300, 981-0400 Fax: (63) (2) 922-5608 / (63) (2) 928-0355 Email Address: [email protected]

Overview: Our goal is to provide world class health care to all patients and their families and to pursue excellence in developing and establishing the highest level of training and research for physicians and paramedical personnel. The Institute employs one of the region’s most experienced surgical transplant team and is home to the nation’s top transplant program. We have a hundred board-certified specialists and sub-specialists combining skills and talents for the advancement of medical practice. The Institute has a long and distinguished history of service and medical excellence. It operates the busiest transplantation program in the country including kidney, liver, pancreas, stem

cell, & bone marrow. In addition to its transplant specialties, the Institute is respected as top facility in the other areas including dialysis and vascular surgery. Quality patient care & dedication to patient satisfaction are the cornerstones of National Kidney & Transplant Institute. Our quality is measured in high patient satisfaction scores, continuous clinical performance activities, & excellent medical outcomes. About NKTI The National Kidney and Transplant Institute is a tertiary medical specialty center with a significant history relevant to the medical profession in the Philippines. 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 22-year existence and operations, the Institute’s medical achievements and milestones are comparable to any specialty hospital in the world. Formerly known as the National Kidney Foundation of the Philippines (NKFP) , the Institute has a three-fold mission : Service, Training and Research primarily for the benefit of the Filipino people afflicted with kidney and allied diseases and to secure the well-being of the people by providing them with the specialized health and medical services. Location and Structure National Kidney and Transplant Institute sits in the center of a 58,899 square-meter lot, along East Avenue in Quezon City, bordered by greenery screening the main building structures from the surrounding bustling avenues. This gives the patients and

visitors the ease of commute and travel and also ensuring tranquility amidst the bustle of the city. This area is very accessible to all types of land transportation. ( Maps and Directions ) The Institute itself is 2-storey structure with three buildings (Main, Annex and Dialysis Center) connected to each other. The Main Building houses most of the Cost Centers and where the istrative offices can be found. The Annex Building encloses the recently opened Marcos Wing and the Radiology Dept (MRI and CT Scan centers), Center for Special Services and also the ER Dept. In the Dialysis Center, you can find the Out-Patient Dep’t., Hemodialysis and CAPD centers, HOPE office, Medical Records office and the clinics (third floor) of all our Medical Specialists.

Commitment to Healthcare Excellence In its more than two decades of operations, NKTI has always aimed for excellence 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 Philippines but in Asia as well : double transplant - kidney & pancreas (first in Asia, March 1988); Kidney - Liver transplant (first in Asia, September 1990); Bone Marrow Transplant (first in the Philippines, August 1990); ISO-Certification (first Government Hospital in the Philippines, February 2003). To sustain such commitment, the Institute has continuously maintain various healthcare-related programs of the Institute such the Human Organ Preservation Effort (HOPE), Voluntary Blood Donation Program (VBDP), Renal Disease Control Program (REDCOP) and Total Quality Management (TQM) Corporate Vision – Infrastructure and Equipment

Aligned to NKTI’s commitment to healthcare excellence is its continuing expansion and growth, infrastructure- and patient service-wise. As it expands, NKTI has been successful in getting more trust and confidence of both the local and international patients. The Institute’s infrastructure expansions in the recent years have made good impression to visitors as NKTI aims to convey its global status. After expansion constructions of the Dialysis Center, Out-Patient Services and Emergency Room, NKTI plans to construct a five-storey “dormitory” building for its employees, build a separate 3-storey, 100-bed, building for charity patients and establish a satellite dialysis and transplant units in the Philippines. Among the recent major equipment acquisitions include the Mammogram, FISH, Magnetic Resonance Imaging (MRI). As part of NKTI’s long-range Business Plan (2005 – 2010), future acquisitions include the Electron Microscope, Positron Emission Tomography (PET), UTS Urology Imaging System and Vascular Imaging System, and Laparoscopic Instruments for the Institute’s Operating Room. Emergency Room Tel. No. (63) (2) 981-0300, 981-0400 local 1430/1431 VISION To be a globally recognized premier center of advancements in transplantation, renal and other end-organ diseases providing cost-effective and multidisciplinary care for all. MISSION We 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 exceptional solutions and employing efficient systems.

CORE VALUES Visionary Leadership Service with Integrity ion for Excellence 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, 1981 by virtue of Presidential Decree 1832 signed by then President Ferdinand E. Marcos. It was created with a three-fold mission of Service, Training and Research primarily for the benefit of the Filipino people afflicted with kidney and allied diseases and in pursuance of the policy of the State to secure the well-being of the people by providing them with the specialized health and medical services. The Institute is situated in a 58,899 square meter parcel of land located along East Avenue, Quezon City, near the Quezon City Hall and is accessible to all types of land transportation. NKTI is a three-story edifice which can accommodate 250 patient beds. Presently, the Institute has an actual bed capacity of 247 patient beds. There are other government hospitals in the neighborhood namely the Lung Center of the Philippines, East Avenue Medical Center, the Philippine Heart Center, the Philippine Children Medical Center and East Avenue Medical Center. Each hospital has its own field of specialization and NKTI is presently the only government hospital specialized in renal diseases and organ transplantation. It is the center for referral of kidney patients from various regional hospitals nationwide and is recognized as the lead agency in voluntary blood services.

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, 1981 by virtue of Section I of Presidential Decree 1832. It became operational at the Wing A3 and A4 of the Lung Center of the Philippines. The cornerstone of the NKFP building in Quezon City was laid by NKFP

Chairman, then First Lady Madame Imelda Romualdez Marcos, assisted by the of the Board of Trustees and world renowned Transplant Surgeons, Anesthesiologists, Nephrologists and Immunologists on February 23, 1983. On this same date, the first kidney transplant at NKFP was performed by Dr. G. Baird Helfirch of Georgetown University in Washington D.C., USA, Dr. Edgar Milford of Harvard’s Brigham and Women’s Hospital in Boston and Dr. Barry D. Kahan of the University of Texas Medical School and Organ Transplantation Center. NKFP was constructed in a unique hospital configuration geared for transplant operations. The Operating room air conditioning system has laminar flow with a high efficiency particulate (HEPA) filter. The laboratory equipment was state-ofthe-art with capabilities seen only in the most advanced clinical laboratories in the world. Soon, under the directorship of Dr. Claver P. Ramos, NKFP embarked on an ambitious kidney transplant project which was made available to all patients from all over the country regardless of social status. Cyclosporine A, a revolutionary anti-rejection drug was immediately made available through Sandoz Philippines (now Novartis Healthcare). This drug was not yet in the U.S. market at that time and the Philippines was among the first countries in the world to approve its use for transplantation. The hospital churned out transplant research works one after the other that saw publications in the most prestigious transplant journals and presentations in the world transplant congresses. The first living related kidney transplant was performed at the NKFP operating room on August 5, 1983. The need for cadaver organs for transplantation was immediately recognized and a directive to start an organ retrieval program was issued. Through the initiatives of then NKFP Director Dr. Claver P. Ramos, Assistant Director Dr. Potenciano Baccay and Transplant Surgeon Dr. Enrique T. Ona, cadaver organ harvest and cadaver kidney transplant had a headstart on December 5 & 6, 1983 respectively. Dr. Antonio R. Paraiso, a Nephrologist was given the task of heading the cadaver program called Cadaver Organ Retrieval Effort (CORE) which was renamed as Human Organ Preservation Effort (HOPE) in 1990. These Transplant Coordinators braved weather and circumstance to promote the program and achieve its goal of providing transplantable organs to end-stage renal disease patients who do not have

living related donors. A change in the leadership of government meant a change in the management of the Institute. The Cory Aquino istration and part of Fidel Ramos term as President saw Dr. Filoteo A. Alano as its Director until he resigned in 1998. The Institute has since then underwent a series of changes with the energized leadership of the present Executive Director, Dr. Enrique T. Ona, one of the pioneers of transplantation in the Philippines The bed-capacity of the hospital before Units 5, 6 and 7 were affected by the May 1998 Lung Center burning was 231. An L-NKTI connecting age turned office that H.O.P.E. occupied was totally razed down during the fire. Unit 7, which had the bulk of the charity beds, and part of the Radiology Department were also heavily damaged. New units with 73 private rooms at the third floor and Out-Patient Services were built to accommodate the ever increasing number of Filipinos suffering from kidney diseases and other ailments. Units at the second floor are being spruced up in conformity with the total face lift that the Institute is undergoing. The NKTI has expanded into a 247 bed-capacity hospital that provides the best facilities for quality tertiary medical services. The end-section of the 39-bed ward which the PAGCOR constructed for service patients (Unit 2-D) was renovated to give room to the 5-bed Intermediate Care Unit (IMCU). The Center for Special Services, composed of the Urology Unit, Endoscopy Unit, Chemotherapy/Transfusion/Pain Management Unit and Peritoneal Dialysis Ambulatory Unit has replaced what used to be Unit 7 at the second floor of the annex building. The new Emergency room complex was specially redesigned to suit its purpose with its 7 bed observation and 9 bed treatment rooms. The Pharmacy and Housekeeping sections were also constructed to pave way for better and faster services. Annex II, a three-storey building which is separate from the main building, was also constructed. New Doctor’s clinics were built to accommodate more outpatient consultations. The Institute has also expanded and modernized its Dialysis

Center. With 31 state-of-the-art hemodialysis machines, the center is capable of doing 2,400 dialysis procedures per month. It is also capable of doing any type of dialysis treatment, custom-fit to the varied clinical conditions that may be encountered in clinical practice. NKTI is a leader in providing continuing education for young doctors through Internship/Residency/Fellowship programs in the different fields of Medicine. This program is in partnership with the Philippine Heart Center (PHC), Lung Center of the Philippines (L), and East Avenue Medical Center (EAMC). To continually develop and upgrade the level of skills of the nurses and other paramedical staff, the Institute developed and established the Institute of Advanced Nursing and Allied Health Professions. It is envisioned to provide and equip our nursing and paramedical staff the necessary training, exposure and skills based on globally accepted standards. As it was in the earlier days of the NKFP, today, the National Kidney and Transplant Institute is still an institution that every Filipino must be proud of. As the first government hospital to be ISO-9001:2000 certified, it provides top quality care, at par with any treatment found anywhere in the world. Its equipment, manpower and services are of the highest standard. It boasts of the most modern diagnostic techniques in kidney and other related diseases, all modes of dialysis, and surgical procedures, most notably, organ transplantation. These days, kidney transplantation is a regular activity of the hospital. NKTI holds the record of the most number of kidney transplants performed in the country since 1983. Other organ transplants have also been done at the Institute, namely, liver, pancreas, bone marrow and islet cell. Double transplants like liver and kidney, pancreas and kidney are transplant operations which were performed at NKTI long before any other transplant centers in Asia would do it.

Historical Milestone

February 22, 2013

Blessing of NEW OPD Waiting Area and Main NKTI Signage

February 18, 2013

 NKTI 30th Founding Anniversary  Celebration of 5000 Kidney Transplant and counting (Transplant Week)

January 23, 2013

Launching of the Dystonia and Muscle Spasm Center EEG/EMG

October 5, 2012

Launching of ICC Handbook

 NKTI,s 29th Founding Anniversary February 29, 2012

 Re-naming of the Diagnostic Center Auditorium to "Dr. Enrique T. Ona Auditorium"  Soft-opening of the NKTI Hymn

Septembe r 4, 2011

TUV Performs Recertification Audit at NKTI

July 21 and 26, 2011

TUV Performs Recertification Audit at NKTI

July 20, 2011

Blessing of the New Diagnostic Center

June 25, 2011

3rd Philhealth Sabado

June 14, 2011

Video conference with Massachusetts General Hospital as hosted by Adult Nephrology Department

February 28, 2011

Medical Social Service Division 28th Founding Anniversary

February 23, 2011

 NKTI 28th Founding Anniversary  First Filipino-Spanish Congress of Sexual Reproductive Medicine and Fertility

October 11-12, 2010

Department of Pediatric Nephrology 2nd Post Graduate Course “ABCD’s of kids’ CKD”

October 7-9, 2010

17th Post Graduate Course in Hemodialysis “Customizing Dialysis in Acute Kidney Injury”

October 6, 2010

Launching of the “Handbook for Kidney Transplant Recipient and Kidney Donor”

October 2, 2010

NKTI Participated in “PhilHealth Sabado; Magseguro, Magparehistro” Nationwide Registration

Septembe r 21, 2010

3rd Peace Pole Planting Anniversary.

June 26, 2010

NKTI-PUA 2nd Rafael Buenaventura Memorial Lecture “Lasers in Urology”

June 2010

NKTI Executive Director, Dr. Enrique T. Ona appointed as Secretary of Health.

May 1, 2010

The NKTI was recently awarded the title of "Center of Excellence" by the PhilHealth.

March 24, 2010

NKTI Hosted the 1st Outside Washington DC International Conference on Public - Private Sector Partnership Study Visit

March 10, 2010

Blessing and Inauguration of Center for Urology and Men’s Health.

December 14, 2009

NKTI Medical Lab received ISO 15189:2007 Accreditation.

Septembe

2nd NKTI-Stanford Teleconference “ Pediatric Urology”.

r 30, 2009

Septembe r 8, 2009

NKTI Diagnostic Center Topping-Off Ceremony.

June 17 18, 2009

NKTI–PUA First Rafael Buenaventura Memorial Lecture in Urology.

May 27, 2009

The 1st NKTI – Stanford Teleconference “ Urologic Oncology”

March 27, 2009

December 5, 2008

NKTI received ISO Certification 9001:2008 version

Launching of the First NKTI Total Laboratory Automation (TLA).

Cornerstone Laying Ceremony of NKTI Diagnostic Center 1st NKTI Director’s Annual Lecture

December 3, 2008

Blessing and Inauguration of Dr. Filoteo A. Alano Auditorium.

Novembe r 26, 2008

NKTI received Center of Wellness Award given by the Philippine Hospital Association.

Novembe r 20, 2008

NKTI received ISO 9001:2000 Re-certification.

June 16, 2008

Formal opening of Employees Lounge.

May 21, 2008

Blessing and Inauguration of Employees Lounge.

February 22, 2008

Cornerstone Laying-Anniversary of the Institute (Celebrating 25th Year).

January 25, 2008

Unveiling of the DNA Fusion Metal Sculpture.

December 6, 2007

Soft Blessing of the newly renovated PIO, itting, Billing and Atrium.

Septembe r 21, 2007

Peace Pole Planting.

June 4, 2007

Blessing of the Libra 120 Energy Filtering Transmission Electron Microscope (F10).

March 10,

First Post Graduate Course on Vascular Access and Management

2007

of Access Complications.

March 8, 2007

First World Kidney Day Celebration of NKTI.

February 19, 2007

Blessing of Ward 2C.

October 4, 2006

Blessing of the New Laboratory Reception Hall and Ward 3D.

June 1, 2006

Blessing of Chronic Kidney Disease Clinic.

March, 2006

Blessing of Molecular and Cellular Therapeutics.

February 23, 2006

Blessing of the New Cafeteria and Launching of the NKTI Coffee Table Book.

June 22, 2005

Blessing and Opening of Vascular Laboratory, Wound and Ostomy Care Clinic.

June 18, 2005

Blessing and Opening of the Prostate Health Clinic (Out-Patient Services).

June 7, 2005

Establishment of the Kidney Donor Care Unit.

June 1, 2005

Launching of the new NKTI website.

April 29, 2005

First Post-graduate course on Molecular Diagnostics in Oncology.

February 23, 2005

Blessing and Opening of Ward 2 E (Annex 1 Building) and Launching of the Philippine Transplant Data Base 22nd year Anniversary

Novembe r 17, 2004

Renal Disease Control Program (REDCOP) received the 13 th Gawad Oscar M. Florendo Award for Outstanding Public Information Tool, Print Category at AFPCOC, Tejeros Hall Camp Aguinaldo, Quezon City.

Septembe r 10, 2004

NKTI Bags 3 rd Prize Winner in the 2004 Search for the Most Outstanding Quality Improvement Study Contest conducted by the Philippine Society for Quality in Health Care (PSQua).

August 11, 2004

Blessing of the new Open Magnetic Resonance Imaging (MRI), Fluorescence In Situ Hybridization (FISH) and Nutrition and Dietetics Division (NDD).

June 28, 2004

Blessing of new Ecumenical Chapel, Doctors’ Lounge, Urology and Surgery Office, Extra Corporeal Shock Wave Lithotripsy (ESWL), Medical Conference Room and Medical Library.

June 4, 2004

Launching of NKTI Documentary Film, Renal Cook Book and Training Module on the Prevention of Kidney Disease.

February 25, 2004

First live operative demonstration of full laparoscopic donor nephrectomy in the country done by Dr. Howard Man Ho Lau, Consultant Urologist and Transplant Surgeon, West Mead Hospital, Sydney Australia.

February 24, 2004

First live operative demonstration of hand-assisted laparoscopic donor nephrectomy in NKTI done by Dr. Arturo G. Martinez, Director of Renal Transplant Program, Kaiser Permanente Medical Group, San Francisco California and Dr. Peter N. Bretan, Jr., Clinical Associate Professor, Department of Urology, University of California, San Francisco.

February 23-26, 2004

First Post-graduate Course and Workshop on Basic Urologic Laparoscopy in the country.

Novembe

NKTI Employees undergone Seminar/Workshop on Personal and

r 2003 February 2004

Organizational Values alignment.

August 18, 2003

Opening of the New Expanded Dialysis Center.

June 19, 2003

First Director’s Cup Golf Tournament held in Wack Wack Golf and Country Club.

20th Year Anniversary Celebration June 25, 2003

Blessing of the newly renovated Auditorium II, New Physical Medicine and Rehabilitation, New Chapel, and New Expanded Dialysis Center

May 7, 2003

Soft Opening/Blessing of Doctors’ Clinics, Medical Records (Annex II Building), Housekeeping and Pharmacy.

December 18, 2002

Blessing of Ablatherm & Mammography machine.

December 12, 2002

Blessing of Miggy’s Corner (Children’s Playground) located in front of Annex Building II. Sponsored by Canadian-based life insurance company Manulife Philippines and the brainchild of Ms. Cathy Babao-Guballa, founder of Migi’s Corner Foundation.

October 4, 2002

Received Five Star Award for quality X-Ray service given by the Department of Health through its Bureau of Health Devices and Technology. Awarding ceremony was held at San Lazaro Hospital, Amphi Theater.

August 5, 2002

Blessing/Opening of the newly renovated Emergency Room Department, Medical Social Service, Unit 2A and Interns/Nurses Dormitory.

July 29, 2002

Blood Bank received the Sandugo Masigasig, Sandugo Mabuhay, and Sandugo Mapag-impok awards during the DOH-National Voluntary Blood Services program held at Heritage Hotel. Ms. Nelia Avila, Blood Bank Coordinator was also given an award for her outstanding work.

June 5, 2002

NKTI formally received the ISO 9001:2000 certificate from TUV Product Service.

March 18, 2002

Blessing and opening of the new Peritoneal Dialysis Ambulatory Care Unit, Center for Special Services, Annex Bldg.

February 23, 2002

NKTI celebrates the 1 st Transplant Day Anniversary and 2000 th kidney transplant count since 1983.

February 22, 2002

Blessing of the new Millenium VG Gamma Camera of the Nuclear Medicine Section.

December 19, 2001

Blessing of Residents’ Quarters, Intermediate Care Unit, New Elevator, etc.

December 12, 2001

NKTI received the GAWAD OSCAR M. FLORENDO award for Outstanding Public Information Program for its entry “Renal Disease Control Program – Organ Donation Information Campaign.

December 5 -7, 2001

First National Convention on Disaster Management by the Health Sector “Strengthened Health Sector in Emergencies and Disasters” was held at NKTI.

Novembe r 28, 2001

Received the“Star Awards” (4 stars) / certificate of recognition for very satisfactory performance in the implementation of Quality Assurance-Quality Control program in the Radiology Department given at the Manila Midtown Hotel by DOH Radiation Health Services.

Novembe r 16 17,2001

First Post-graduate Course in Transplantation “The Alphabet of Transplantation”.

August 10, 2001

NKTI Transplant Team performed the first Kidney Transplant at Davao Medical Center in Davao City.

August 9, 2001

Blessing of the newly renovated Batong-Bulilit Learning & Recreation Center funded-sponsored by the Manila Jaycees.

July 27, 2001

Blood Bank received the Mabuhay award plaque and certificates of Masigasig and Mapag-impok awards during the DOH National Voluntary Blood Services Program Awarding Ceremony held at the World trade Center, Roxas Blvd.

June 29, 2001

The First Peripheral Blood Stem Cell Transplant in the country.

June 28, 2001

Soft launching of Renal Cookbook “Secrets Revealed for Healthy Cooking” by Nutrition and Dietetics Division.

June 4, 2001

Official launching of ISO 9001:2000 Certification Project.

April 23, 2001

The new Out-Patient Services Building and the additional 73-bed Patient Areas at the 3 rd floor were formally inaugurated by her Excellency President Gloria Macapagal-Arroyo.

March 28, 2001

Official launching of the Total Management Program.

March 16, 2001

NKTI Transplant Team performed the 2 nd Kidney Transplant at Bicol Medical Center in Naga City.

December 7, 2000

Inauguration of the newly established NKTI Center for Special Services (Urology Unit, Endoscopy Unit,

Chemotherapy/Transfusion and Pain Management Unit).

June 9, 2000

NKTI Transplant Team performed the first kidney transplant at Bicol Medical Center in Naga City.

June 6, 2000

Official launch of the NKTI Website.

February 8, 2000

Unveiling of the Institute’s Vision/Mission Statement.

Septembe r 30,1999

The Division of Pediatrics of NKTI was chosen 1999 Civil Service Commission PAGASA Awardee for successfully organizing the Batong-Bulilit School.

The DOH-NVBSP gave two recognition awards to NKTI: July 1999

1. Masigasig Award – for having the highest number of mass blood donation 2. Mabuhay Award – for having the highest number of walk-in donors

June 22,1999

 NKTI Radiology Department garnered the top award in the nationwide DOH Radiation Health Services “Star Awards” (4 stars).  NKTI Transplant Team performed the first kidney transplant

at Ilocos Region Medical/Research Center.  NKTI assist the first kidney transplant in Davao City.

June 22,1998

NKTI earned “2 Stars” in the “Star Awards for Quality Assurance in Hospital” sponsored by the Department of Health.

May 1,1998

Ms. Nelia C. Avilla, Nurse Coordinator, received the 1997-1998 Presidential Scholarship Award during the 20 th Annual Convention of the Association of Donor Recruitment Professionals at Dallas, Texas, USA.

December 4-7, 1997

The 5 th Congress of the Asian Society of Transplantation was held in Manila with NKTI as a major participant and host.

Novembe r 24 - 26, 1996

NKTI was a major participant in the medical coverage of the delegates 1996 to the APEC Summit, Dr. Filoteo A. Alano , Executive Director of NKTI, was assigned to be the personal physician for President Bill Clinton of the United States of America.

April 12, 1996

Together with a team of surgeons from Taiwan, the first pediatric living-related liver transplant was performed.

December 5, 1995

Awarded Outstanding Hospital in Sanitation and Waste Management, also Best Food Sanitatio.

May 25, 1995

By virtue of Republic Act No. 8020, the National Kidney Institute (NKI) was renamed to be the National Kidney and Transplant Institute and designated as the lead center for organ transplantation.

May 16, 1995

Establishment of NKI as “Healthy Hospital” (DOH Hospitals as Centers for Wellness Program).

December 14,1994

Establishment of NKI as the DOH Hospital Network Depot for the STOP D.E.A.T.H. Program.

October 24,1994

Achieved the 1000 th kidney transplant at NKI.

February 18, 1994

Designated implementing agency of the DOH National Voluntary Blood Donation program for year 1994.

July 29, 1993

Memorandum of Agreement signed by the Philippine Charity Sweepstakes, DOH, and NKI to set-up regional dialysis centers nationwide.

May 31, 1993

Pres. Fidel V. Ramos signed the following Presidential Decrees: 184: Declaring the month of June of every year as National Kidney Month 185: Declaring the last week of June of every year as Organ and

Blood Donation Awareness Week

1992 1993

First Hospital to achieve 100% voluntary blood donation.

June 22, 1992

Visit of President-Elect Fidel V. Ramos.

January 7, 1992

Republic Act 7170, otherwise known as the “Organ Donation Act of 1991” was signed into law by Pres. Corazon C. Aquino.

Septembe r 18, 1990

The first Combined Kidney & Liver transplant in Asia was performed at NKI.

August 6, 1990

First Bone-Marrow transplant in the Philippines was performed at NK.

August 6, 1988

The first Liver Transplant in the Philippines was performed at the NK.

March 3, 1988

The first double transplant (kidney & pancreas) in Asia was performed at NKI.

Novembe r 12, 1986

Through Memorandum Order No. 48, the name of the institution was changed from the National Kidney Foundation of the

Philippines (NKFP) to the National Kidney Institute.

July 11, 1984

Start of the construction of the Main Building which was completed in 1985, increasing the bed capacity of the hospital to 127 beds.

August 5, 1983

The first living-related donor transplant was performed at the NKFP operating room.

July 31, 1983

The construction of the Annex Building of the NKFP was completed.

April 26, 1983

Start of the NKFP Annex building construction.

February 23, 1983

Mrs. Imelda Romualdez Marcos, assisted by the of the Board of trustees and world renowned transplant surgeons and nephrologists, laid down the cornerstones of the NKFP The First Living Related Donor transplant was performed at the Lung Center operating room

January 6, 1983

The NKFP became operational at wings A3 and A4 of the Lung Center of the Philippines

January

Section 1 Presidential Decree 1832 formally creates the National

16, 1981

Kidney Foundation of the Philippines (NKFP)

Hospital and Medical Leadership

Jose Dante P. Dator, M. D., FPBU Executive Director 981-0300 loc 1001, 1002, 1160

Zenaida L. Antonio, M.D., FPPS, FPSN Deputy Executive Director for Medical Services 981-0300 loc 1005

Joselito R. Chavez, M.D., FP, FPC, FAC, CESE Department Manager for Clinical Services 981-0300 loc 4427

Romina A. Danguilan, M.D., FP, FPSN Deputy Director for Medical Education 981-0300 loc 4426, 4428

Blesilda A. Gutierrez Deputy Executive Director for istrative Services 981-0300 loc 1011

Nerissa M. Gerial, RN, MHA, PhD, CESE, FPCHA Deputy Director for Nursing Services 981-0300 loc 3102, 3103 I. Medical Services Dr. Joseph Michael A. Jaro Chairman, Internal Medicine 3117

Dr. Lorna L. Simangan Chairperson, Out-Patient Services 1122,1123

Dr. Romina A. Danguilan Chairperson, Department Adult Nephrology 3118

Dr. Joseph Michael A. Jaro Chief, Cardiovascular Medicine 2436, 2432

Dr. Ofelia R. De Leon Chairperson, Department of Pediatric Nephrology 2172 Dr. Valerie Ann T. Tesoro Chairperson, Hematology and Stem Cell 1059

Dr. Joselito P. Chico Chief, Pulmonary Medicine Section 2126, 2127

Dr. Rosalia E. Teleg Chief, Neurophysiology Section 2124, 2125

Dr. Angelo O. Martinez Chief, Nuclear Medicine 1401, 1402

Dr. Maria Rowena L. Javier Chief, Physical Medicine and Rehabilitation Section 2123

Dr. Luis V. Limchiu, Jr. Chief, Emergency Room Unit 1430,1431

Dr. Romina A. Danguilan Head, Dialysis Center 3118

Dr. Catherine SC. Teh Chairman, Department of General Surgery

2171 Dr. Emmanuel V. Lenon Head, Department of Urology 2137 Dr. Arnold S. Uy Chairman, Department of Anesthesia 2136 Dr. Benito VC. Purugganan, Jr. Chairman, Department of Organ Transplantation 2170 Dr. Leo Carlo V. Baloloy Chief, Vascular Surgery Section 2155, 2156

Dr. Arnorld Joseph M. Fernadez Chairman, Department of Laboratory Medicine 1051 Dr. Florecita R. Padua Chief, Immunology Division 1055 Romeo B. Dy, R.M.T. Chief Medical Technologist Department of Laboratory Medicine 1051 Dr. Ferdinand L. Morabe Dept. Manager, Diagnostic Center 2409, 2410 Dr. Rosanna E. Fragante Chief, CT Scan/Traning Officer

2409, 2410 Dr. Gerardo M. Silva Executive Officer/ Chief, Ultrasonography 2409, 2410 Dr. Ferdinand L. Morabe Chief, Diagnostic and Interventional 2409, 2410

II. Finance and istrative Services Department Ms. Maribel U. Estrella OIC, Finance and istrative Services Department 1009 Ms. Victoria V. Elias OIC, ing Division 1138, 1137

Ms. Ma. Lourdes V. Tengson Head, Material Management and Inventory Division 1081, 1084

Ms. Leticia R. Doblado Chief, Human Resource Management Ms. Cristina DL. Barcena Division Chief, Patient Business Services Division 3120 1016, 1007 Ms. Josefina C. Sampang Chief, Budget Division 1038, 1039 Dr. Pepito E. Dela Peña Head, Public Information Office 1008, 1014 Dr. Romina A. Danguilan Chairman, Bids and Awards Committee (BAC)

Dr. Genlinus D. Yusi Chief Information Officer Information Resource Management Division 3450, 3483 Rev. Fr. Tex Rico V. Buntol, MI Chaplaincy and Pastoral Care 2117

1156, 1157 Ms. Marichu C. Escober Chief, Purchasing Division 1081, 1084

Mr. Johnny Victor C. Laoang Head, Business Records Unit 1162

III. Ancillary Services Department Mr. Jaime G. Velasquez Department Manager 1140 Ms. Salvacion G. Munda OIC, Pharmacy Division 1074, 1075 Ms. Socorro T. Balderamos Chief, Nutrition and Dietetics Division 1071, 1072 Ms. Leonides L. Basada Chief, Medical Social Services Division 1078, 1080 Ms. Josephine U. Hubilla OIC, Medical Records and Library Division 2129, 2130 Engr. Elecio L. Tribunalo Chief, General Services Division 1096, 1097 Ms. Arlene Maria L. Pilaspilas/Ms. Josephine E. Villalon Building / Housekeeping and Linen Section 1092, 1093, 1094, 1139 IV. Management Services Office Dr. Zenaida L. Antonio, FPPS,FPSN Total Quality Management Representative

1011 Ms. Mercedita V. Jocson Deputy Quality Management Representative 3469 Ms. Raquel G. Magtalas, A Head, Internal Audit Services 1031 Ms. Sarah L. Ruiz DCO-ISO, Document Control Officer 1158, 1159 V. Nursing Services Department Ms. Nerissa M. Gerial, RN, MHA, FPCHA Deputy Director of Nursing Services 3102, 3103 Ms. Glecita S. Erni Chief, Clinical & Public Nursing Division 3108 Ms. Helen R. Malata Chief, Critical Division 3109 VI. Renal Disease Control Program (REDCOP) Dr. Susan Jorge Program Manager 3112, 3111

VII. Human Organ Preservation Effort (HOPE)

Dr. Eduardo L. Rivera Head 4400

Total Quality Management (TQM) For several years now, National Kidney and Transplant Institute has taken a trailblazing and mounting role in renal healthcare and organ transplantation in the Philippines and the rest of Asia with this, the Institute has constantly walked the path of service quality. The Institute’s Total Quality Management advocacy was formally launched on March 28, 2001, a defining milestone in our delivery of quality healthcare. As ed by the Institute’s Quality Policy and Quality Objectives, we maintain service quality in all areas of the hospital. Quality Management is seen in all aspects of our daily operations: from the Medical, Para-Medical, Patient Safety, Infection Control and to the Nursing Services, quality permeates all activities. Incorporating the five pillars of Total Quality Management – 5S, Suggestion Scheme, Quality Circles, ISO - to our Institute has allowed us to be more responsive to the needs of our patients and their families, visitors, and express genuine concern for their utmost comfort, welfare and self-esteem. NKTI acquired its ISO 9001 : 2000 Certification (Comprehensive Specialty Healthcare Services) in April 25, 2002, and was able to sustain its ISO certification. The Institute was able to acquire its re-certification on August 10, 2009 and has been upgraded to 9001 : 2008; and up until now, we remain the only Tertiary Government Hospital in the Philippines to attain the ISO global seal of quality standard. And just recently, NKTI achieved the “Certificate of Excellence” from the Philhealth Inc., again as a testament to NKTI’s dedication to providing quality healthcare to its patients. As a result, we have embraced and actualized the concept of Continual Quality Improvement in our services; and we acknowledge that it is through a competent

workforce with selfless teamwork, dedication, and sense of ability that quality improvement and services quality can be achieved. At NKTI, we make sure that your expectations from us are met and our commitment to Quality also guarantees that we will exceed your expectations.

Quality Policy To fulfill the Vision-Mission of National Kidney and Transplant Institute, we shall provide the most appropriate, comprehensive, effective health care services to exceed our customers’ expectations. Our success will be achieved through full participation of our employees at all levels of the organization guided by our Quality Objectives. National Kidney and Transplant Institute shall commit to ensure compliance to all regulatory, statutory, environmental, and health / safety requirements of the government and other recognized world organizations like the WHO, etc. The Quality Policy shall be communicated to and made understood by all employees through orientations, meetings, circulars, posters and other related means. This Quality Policy shall be reviewed annually or as necessary by management to adapt to current developments / requirements through continual improvement.

Quality Objectives The objectives of the Quality Assurance Program of National Kidney and Transplant Institute is the preservation and enhancement of the high quality patient-centered care by ensuring that :  HUMAN RESOURCES have optimum skills and competencies.

 TECHNOLOGY and FACILITIES are state-of-the-art and properly maintained.  SERVICES are delivered in the safest and most efficient manner.  SYSTEMS are effective, well-defined and continually improved to meet customer requirements.  AFFORDABILITY shall not compromise the cost of QUALITY.  REQUIREMENTS OF INTERESTED PARTIES shall be observed with maximum compliance at all times. Above-mentioned Quality Objectives are inspired by the following CORE VALUES of TOTAL QUALITY MANAGEMENT :  “Customer-First” Attitude  Commitment and participation by everyone  Competence Development  Prevention  Continuous Improvement  Fast Response  Management by Fact

DOH Board of Trustees

Janette LoretoGarin, MD Chairman Teofilo S. Pilando, Jr. Office of the President

:

Nemesto T. Gako, MD USEC, DOH Mario L. Relampagos USEC, DBM Atty. Ron Salo Corporate Secretary

How You Can Help

The Institute receives donation (Cash, Equipment or Medical Supplies) from any local NGOs and Government Agencies, foreign institutions and from any local and National Government. Please prepare a communication (written or email) addressed to our Executive Director to serve as a Letter of Intent for your donation and do make sure that your numbers are included for our reply and confirmation of acceptance. Direct Line :

981-0300 / 981-0400 local

1008 / 1014 Email Address:

[email protected]

Renal Health Plus Kidney diseases, especially End Stage Renal Disease (ESRD), are already the 7 th leading cause of death among the Filipinos. One Filipino develops chronic renal failure every hour or about 120 Filipinos per million population per year. More than 5,000 Filipino patients are presently undergoing dialysis and approximately 1.1 million people worldwide are on renal replacement therapy. Reliable estimates reveal that the number of these patients will double in 2010. In the past, chronic glomerulonephritis was the most common cause of chronic renal failure. Today, diabetes mellitus and hypertension have taken center stage in the causation of ESRD which together for almost 60% of dialysis patients. The cost of medical treatment for kidney disease is really exorbitant, beyond the reach of ordinary patients. Renal transplantation is limited due to the expense and the shortage of donors. The best that can be done at present is to focus efforts on the prevention of progression of renal diseases. Strict blood pressure and glycemic control and adoption of “ healthy lifestyle” play a major role in reducing if not totally controlling the epidemic of renal failure and this could be achieved through proper education. This Renal Health Plus provides educational information related to the prevention, diagnosis and treatment of kidney diseases.

The Human Kidneys  Kidneys are important parts of the urinary system. They are found at each side of the spine, below the rib cage of the human body. Each kidney is as big as a fist, weighs ¼ pound and looks like a kidney bean.

 The kidneys perform vital life-maintaining functions as monitors and regulators of body fluid. They excrete fluids when the body has an excess of them and retain the substances necessary for the body’s continuing function. They produce and release a variety of chemicals to keep the body healthy and filter the entire blood supply every 2 minutes, excreting waste materials through the urine.  The kidneys also produce erythropoietin, a hormone that controls the production of red blood cells by the bone marrow.  They also are involved in the regulation of blood pressure. This probably happens through the regulation of blood volume and the amount of sodium in the body as well as the production of substances such as the angiotensin.

General Ways of Protecting your Kidneys  Exercise regularly  Eat healthy diet  Maintain ideal body weight  Avoid smoking  Avoid taking medications or herbal supplements without advice of physician  Consult doctor right away if with symptoms  Drink lots of water and avoid excessive salt  Have annual physical check-up especially if with or with family history of hypertension, diabetes or renal failure  If hypertensive and diabetic, o Take medications regularly o See the doctor regularly

o Know blood sugar and blood pressure goals and make sure targets are met o Make sure the doctor checks the kidneys regularly

Diagnostic Service Diagnosis of kidney ailments and kidney related health diseases is pivotal in providing effective therapeutic plan. The National and Kidney and Transplant Institute offers a wide range of the latest and state of the art diagnostic tools to quickly and accurately diagnose kidney diseases. Please click on the Division/Department below to know more about their respective services:  Laboratory Medicine  Radiology  Nuclear Medicine  Urology

FAQ Question: What are the signs and symptoms of kidney disorder? Answer: The main symptom of kidney disorder is fluid retention or edema. Patients may have puffiness around the eyes, swelling in the feet and legs and water in the lungs leading to difficulty of breathing Any change in urination may also indicate kidney problem. This may consist of pain or unusual sensation during voiding, increased or decreased frequency of urination, difficulty in initiating urination, frequent urination at night, change in color of urine, blood in the urine or bubbly appearance of the urine.

Kidney failure results in the retention of various body wastes which cause anorexia, vomiting, difficulty in sleeping and generalized body weakness. This is often evaluated by measuring serum creatinine and blood urea nitrogen. The presence of protein and red blood cells in the urine is also an indication of kidney disorder. In glomerulonephritis, proteinuria and hematuria are commonly seen because the glomeruli have become inflamed. Proteinuria is also the earliest manifestation of diabetic nephropathy. Pallor and weakness are also among the indications of kidney failure due to anemia secondary to low erythropoietin production by the failing kidneys. Hypertension is also a major consequence of kidney disorder. Initial evaluation of all newly diagnosed hypertensive patients should include serum creatinine and electrolyte levels (sodium and potassium) particularly among young hypertensive subgroup. Repeated urinary tract infections, back pain or pain in the lower abdomen may indicate the presence of kidney stones and may also cause blood in the urine. Question: What diseases commonly affect the kidneys? Answer: Infection is the most common disorder of the kidneys and the urinary tract. Uncomplicated urinary tract infections are very easy to treat Stones are solid residues in the urinary tract that may cause obstruction to the flow of urine which in turn may lead to infection of the kidneys and subsequent scarring. Glomerulonephritis is inflammation of the glomeruli, the small vessels in the nephron. If not treated, patients may suffer slow progressive damage to the kidneys and develop renal failure. Hypertension occurs with many cases of kidney diseases. Prolonged hypertension damages the small arteries in the kidneys. This may start a vicious cycle: damaged kidneys cause more serious hypertension which in turn brings more damage to the kidneys.

Diabetes may also damage the kidneys. It is the leading cause of chronic renal failure in many countries. Abnormalities in the urinary tract that are congenital or inborn may consequently lead to poor function, obstruction or infection of the kidneys. Some drugs, herbal medicine, solvents and insectides can also harm the kidneys. Question: What are the warning signs of kidney disease? Answer: Puffiness of the eye area Progressive swelling of parts of the body usually at the ankles Back pain on the lower part just below the ribcage Changes in urination (increased or decreased frequency of urination, frequent urination at night, pain or unusually sensation during voiding, hesitancy or difficulty in initiating urination, change in color of the urine, blood in the urine) New onset of high blood pressure Question: What are the symptoms of Urinary Tract Infection (UTI)? Answer: Not everyone with UTI has symptoms, but most people get at least some. These may include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone and some men experience fullness in the rectum. It is common for a person with UTI to complain that despite the urge to urinate, only a small amount of urine is ed. The urine itself may look milky or cloudy, even reddish if blood is present. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea or vomiting. Question: How can UTI be prevented? Answer:

There is no proven way to prevent UTI, but the following suggestions maybe helpful:  Drink plenty of liquids about 6-8 glasses/day to flush bacteria out of the urinary system,  Schedule frequent bathroom breaks  Women should drink water before and after sex so they will urinate a good volume with a steady stream afterward. This will help eliminate any bacteria that may have entered the urinary bladder.  After defecating, women should not wipe in the direction of the vagina to avoid spreading bacteria from the gastrointestinal tract Question: How should patients with hypertension be treated? Answer: Treatment of hypertension can be achieved through non-pharmacologic and pharmacologic means. It consists of the following  Lifestyle modification  Weight loss  Exercise  Low salt, low fat diet  Stop smoking  Less alcohol consumption  Cope with stress  Regular intake of antihypertensive medications Question: How are kidney stones prevented from developing?

Answer: The simplest and most important lifestyle change to prevent all kinds of kidney stones from developing is to drink more liquids. Water is the best. It is recommended that water intake should be at least 2 liters per day. There are many proponents of various “cures” by drinking other liquids such as buko juice, pitopito tea, sambong tea and many other teas but scientific studies have not proven their efficacy and safety. Therapeutic Options Treatment of kidney diseases may involve the following: medical therapy such as medicines and dietary changes, dialysis and transplantation  Because kidney failure is already irreversible at later stages, treatment focuses on controlling the symptoms, minimizing complications and slowing the progression of the disease.  Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension, diabetes, congestive heart failure, UTI, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated appropriately.  Medications such as iron supplements and erythropoietin injections may be needed to control anemia. Blood transfusion may be given but they are less preferred.  Fluid intake may be restricted, often to an amount equal to the volume of urine produced. Dietary protein restriction may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus and other electrolytes may be restricted.  Dialysis and kidney transplantation may be required eventually when end stage renal disease ensues or when 85-90 percent of kidney function is lost.  Hemodialysis uses a special filter called a dialyzer that functions as an artificial kidney to clean the blood. During treatment, blood travels through the tubes into the dialyzer which filters out wastes and extra water. Then the cleaned blood flows through another set of tubes back into the body. The dialyzer is connected to the machine that monitors blood flow and removes

wastes from the blood. Hemodialysis is usually performed 2 to 3 times a week. Each treatment last for 4 hours.  Peritoneal dialysis is another procedure that removes extra water and wastes from the body. This type of dialysis uses the lining of the abdomen to filter the blood. This lining is called the peritoneal membrane and acts as the artificial kidney. A mixture of minerals and sugar dissolved in water called dialysis solution travels through a soft tube into the abdomen. The sugar, called dextrose, draws wastes, chemical and extra water from the tiny blood vessels in the peritoneal membrane into the dialysis solution. After several hours, the used solution is drained from the abdomen through the tube, taking the wastes from the blood with it. Then the patient fills his abdomen with fresh dialysis solution and the cycle is repeated usually 3 to 4 times a day. Each cycle is called an exchange.  Kidney transplantation surgically places a healthy kidney from another person into the body of the patient with end stage renal disease. The donated kidney does the work that the 2 failed kidneys used to do. It is generally not necessary to remove the diseased kidneys. A donated kidney may come from an anonymous donor who has recently died or from a living person usually relative. The kidney that the patient receives must be a good match for his body. The more the new kidney is like his own, the less likely will his immune system reject it. The patient will be made to take special drugs called immunosuppressives to help trick his immune system so it would not reject the transplanted kidney.

NKTI-Hemodialysis NKTI-Hemodialysis CENTER is a Public-Private Partnership (PPP) and a special project involving engagement of a private sector through a lease contract to provide top of the line and state of the art HD equipment for the management and treatment of ESRD and other Renal - related diseases. The partnership strategy allows and resulted in the provision of the highest quality hemodialysis facility and allows the most efficient and safe treatment for all Filipinos needing treatment at a reasonable cost. NKTI-Hemodialysis Center has been in all the “headlines” locally and internationally, as THE successful model of the fusion of modern technology using the private sector AND health. The success of NKTI-HD Center as the first PPP model in healthcare is now recognized globally, and continues to be the country's model for other government and private dialysis facilities, as well as Asia's model and pride of the Department of Health.

Services The Hemodialysis Unit which is located at the Annex II building opens from 6:30am to 4:00am of the next day to accommodate out patients needing Hemodialysis treatment. The treatment procedure is 4 hours thereby 4 batches of patients are being served till 4:00am. Regular schedule is being provided upon presentation of requirements. For patients without a regular schedule taking the chance to be accommodated during day is included in the waiting list just in case a regular patient does no arrive. The Hemodialysis Unit which is located at the main building is designed for patients needing emergency dialysis. The unit then is open 24 hours a day to serve patients coming from the Emergency Room, Intensive Care Unit, Recovery Room and from different wards. Continuous Renal Replacement Therapy (CRRT) is also

being done to critically ill patients in the Intensive Care Unit and is being done continuously depending on the doctor’s prescription and patient recovery.

Our Expert Team Head: Supervisor: Head Nurse:

Romina A. Danguilan, MD Delia Santelices-Lagura, RN Ma. Elizabeth I. Espiritu, RN

Us

Mailing Address:

Email Address:

Numbers:

Business Days & Hours:

Dialysis Center (Hemodialysis) Annex II Building 2nd Floor National Kidney and Transplant Institute East Avenue, Quezon City 1100 [email protected] For inquiry please call (63) (2) 981-0300, 9810400 local 2103 / 2104 - Information at Out Patient Area local 2105/2106- In-patient area Fax No.: (63) (2) 981-0300, 981-0400 local 2102 Annex II Building-Out patient Monday to Saturday 6:30am to 4:00am of the next day Main Building-24 hrs., Monday to Sunday

Treatment Schedule: Monday to Saturday: 1st session: 6:30am to 10:30am 2nd session: 12nn to 4:00pm 3rd session: 5:30pm to 9:30pm 4th session: 11:00pm to 3:00am Hemodialysis Requirements for New Patients, Transient and Transferring Patients from other HD Center: 1. Hemodialysis Order from your attending physician 2. In-house Nephrologist 3. Hepatitis B and C Screening (HbsAg/Anti HBs/ Anti-HCV/ Anti-HBc total ) within the last 3 months 4. Latest laboratory result (CBC, Blood chemistries, etc) 5. Clinical Abstract/ or Medical record (from other Hemodialysis center if transferring) 6. Hemodialysis Treatment Sheet (last 3 treatment from other Hemodialysis center)

Peritoneal Dialysis The Peritoneal Dialysis (PD) Unit of the National Kidney & Transplant Institute(NKTI) is the largest in the Philippines. It is the leading facility in providing peritoneal dialysis therapy and is fully equipped to treat all kinds of patients who may need PD therapy. The PD Unit is one of the critical areas of the Institute, handling patients on various types of peritoneal dialysis. Peritoneal dialysis is another form of dialysis where the patient’s own peritoneal membrane (or lining of the abdominal organs and body surfaces within the abdominal cavity) acts as the artificial kidney. There is no blood removed or returned to the patient. Dialysis using the peritoneal membrane is also a means to remove toxins, poisons

and excess fluid that accumulates in the body when patients’ kidneys are no longer able to function adequately. Peritoneal dialysis can be performed when there is an acute deterioration in kidney function, such as with severe blood loss or severe dehydration due to vomiting and diarrhea. It can also be used for gentle fluid removal in patients with non-primary kidney disease, such as patients with congestive heart failure or cirrhosis of the liver. In these cases, dialysis may be necessary only for a short period, giving the patient’s kidneys time to recover from the sudden and severe situation that caused it to fail temporarily. It can also be used to permanently replace a patient’s kidney function in patients with longstanding kidney disease. These include longstanding hypertension and diabetes mellitus which are common causes of kidney failure in Filipinos. It can also be used in place of the kidneys for patients with primary kidney disease such as chronic glomerulonephritis when kidneys are no longer able to perform their function sufficiently well. Majority of the patients are on Continuous Ambulatory Peritoneal Dialysis (CAPD) since this is the more physiologic type of dialysis and provides the best clearance. One of the programs of the unit is the CAPD Training for CAPD patients. This training programs is devised for patients diagnosed to have End Stage Renal Disease (ESRD) who are about to undergo Peritoneal Dialysis. This requires ission for a period of 3 days where a series of lectures and return demonstration of the desired CAPD system is performed. Services Insertion the Acute or Permanent PD Catheter Highly trained surgeons place the PD catheter into the abdominal cavity of the patient. The acute PD catheter is used for patients who need PD treatment only for a short period. It is a stiff catheter. The permanent PD catheter is a soft pliable tube that is used for the lifetime of the patient. Both catheters provide access for the infusion and drainage of the special PD fluid or solution. Placement of the PD catheter is only a 30-minute procedure performed under local anesthesia in the strictly sterile environment of the operating room. As soon as the catheter is placed it can be used immediately to perform PD.

This is a chronic type of PD therapy where patients are trained to perform the dialysis themselves in the comfort of their homes. It is a continuous type of treatment because there is always PD fluid inside the peritoneal cavity where dialysis is continuously occurring. It is ambulatory because while the PD fluid is inside the body, the patient is free to do his daily activities. The patient can go to work or just stay at home and do their usual activities. Intermittent PD (IPD) This can be performed for both acute and chronic kidney failure. PD exchanges are performed every 30 minutes in order to quickly remove the poisons and excess fluid that have accumulated in the body because the kidneys were not performing adequately. It can be done by the PD nurses every 30 minutes or the patient can be hooked to a special PD machine called the cycler. The PD solutions are connected to the cycler, and a special tubing from the cycler is connected to the patient?s PD catheter. The machine is turned on and the cycler begins the dialysis therapy. IPD is usually performed from several hours to several days, depending on the needs of the patient. Continuous Cycler-Assisted PD (CD) PD therapy can also use a combination of the cycler machines and manual PD exchanges. This is called CD. It is continuous because there is always PD solution inside the peritoneal cavity. The cycler is used to do several short exchanges during the night while the patient is asleep, and 1 to 2 manual exchanges are performed by the patient during the day. Special PD trainors train the patient, their relatives or caregivers to perform this type of therapy. When the PD therapy is performed only at night and the patient does not have any PD solution inside the body during the daytime, it is called NOCTURNAL INTERMITTENT PD (NIPD). Your physician will decide which type of therapy you need. All of these types of PD therapy are available at the NKTI. The Unit has a medical and nursing staff especially trained to perform PD and has a specific program for training patients in using PD. The Unit also has specialized PD technicians and clinical nursing assistants who assist in the performance of PD throughout all areas of the hospital.

Facilities PD MAIN

 Located at the back of Wing 2D and 2C  10-beds for in-patients  Special area for CAPD CAPD Center  Located at 2nd Floor of the Dialysis Building CAPD Out-Patient Clinic  Conducts out-patient clinic visits  Performs patient-related PD activities such as exit site dressing, change of PD transfer set, prescription of dialysis needs. Cycler Assited IPD  4-bed capacity for out-patient cycler-assisted PD therapy Although there are 2 main areas for PD, patients may be itted anywhere in the hospital for their PD therapy. The PD Unit staff supervises all the PD therapy being perfomed throughout all the areas of the hospital. Patient's Benefits  Senior citizen discounts, direct government employee discounts  HMO  PCSO, PAGCOR and PNP assistance  Discounts for patients qualified for social service assistance  Philhealth – SOON !

Our Expert Team

Head:

Romina A. Danguilan, MD, FP, FPSN

Nurse Supervisor:

Rita Z. Blanco, RN, MAN

CAPD Coordinator:

Liezel P. Evangelista, RN

Us Mailing Address:

Peritoneal Dialysis Unit 2nd Floor, Main Building National Kidney and Transplant Institute East Avenue, Quezon City 1100 Philippines

Email Address: Numbers:

[email protected] CAPD Loc. 2109 PD Main Loc. 2069

Business Days & Hours: CAPD Monday-Friday, 8am-5pm PD Main - Monday to Sunday, 24 Hours

FAQ's Question: What is Peritoneal Dialysis? Answer: Peritoneal dialysis is a form of therapy that replaces a patient’s kidney function. It uses the patient’s own peritoneal membrane to act as the artificial kidney. A special type of fluid called peritoneal dialysis fluid enters the patient’s abdominal cavity through a surgically placed PD catheter. It stays inside the abdominal cavity where it lies in with the peritoneal membrane. During this time, poisons, toxins, and excess fluid which are found in abundance in the blood of a patient with kidney failure will transfer from his blood to the PD fluid. After 6 to 8 hours, the PD fluid will be drained via the PD catheter, containing many poisons, toxins, and excess fluid. This is how the blood is cleaned of all the toxic substances that accumulated because the kidneys were no longer functioning adequately. After draining the fluid, fresh solution will be infused into the abdominal cavity again through the PD catheter. This cycle is repeated from 3 to 4 times each day everyday.

Question: What are the advantages of doing PD? Is it right for me? Answer: The major advantage of doing PD is that the patient and/or caregivers are trained to perform PD at home. There is no need to go to a hemodialysis center in a hospital or clinic for 4 hours, 2 to 3 times a week. Dialysis using PD can be performed in the comfort of one’s bedroom, or in the office. All the patient needs is a clean room with adequate ventilation. The patient is therefore more mobile with freedom to

travel. If one is planning to go to a different city for a vacation, there is no need to make reservations at an HD center. The patient just brings his required number of PD dialysis fluid bags and off they go to their city of choice. PD is especially appropriate for children who may not have suitable veins large enough for the HD needles. They can grow up in the warm environment of home, without the memory of doing therapy in the hospital. Elderly patients, or patients with significant heart disease may feel better on PD therapy because it is a gentler form of dialysis which is performed daily, every day. They will not be subjected to the severe drops in blood pressure associated with HD treatment when blood exits from the arm even though it is returned to the patient. PD is appropriate for any patient as long as their peritoneum is working properly. Patients who have had previous abdominal surgeries like surgery for a ruptured appendix or an operation to remove a gall bladder, or a previous childbirth by ceasarian section may not be suitable because the peritoneal membrane may have developed adhesions (or scar tissue) as a result of the operation. Once the peritoneal membrane is replaced by scar tissue, it can no longer function adequately as an artificial kidney. Discuss this concern with your physician! Your doctor will help you make the best decision on your choice of dialysis therapy. PD can be performed by anyone, from an adolescent to an elderly patient. The steps are easy to perform and the PD tubings and bags very simple to use. , they were made especially to be used by ordinary men, women and children. We have an expert training team who will teach the patient, relatives and caregivers all the steps in performing peritoneal dialysis.

Question: What is the Peritoneal Membrane? Answer: This is the lining of the abdominal organs such as the stomach and intestines, liver and spleen and lining the body wall. It acts as the artificial kidney during peritoneal dialysis. It allows the age of toxins such as excess urea, creatinine, and potassium which accumulate in patients with kidney failure. It also allows excess

water to be removed from the body in patients who have leg edema, and fluid in the lungs. This can happen in patients with kidney failure who can no longer urinate sufficiently. Question: What is a PD Catheter? Answer: The PD catheter is a pliable tubing about 12 inches long which is surgically placed inside the abdomen. In patients with kidney failure it is placed only once and lasts the lifetime of the patient. It is the permanent access where the PD fluid will enter and exit from the patient’s abdomen in order for peritoneal dialysis to be performed. About 5 inches of tubing may be seen exiting from the abdomen. Question: What is PD Fluid or PD Solution? Answer: PD fluid is a special type of fluid, similar to the dextrose fluid given intravenously. It contains electrolytes which are usually lacking in a patient with kidney failure, such as calcium, and has dextrose which acts to remove fluid from the body. Question: What is a PD Exchange? Answer: A PD exchange is the process of infusing PD solution into the peritoneal cavity via the PD catheter and then draining it after several hours. Fresh PD solution is infused into the peritoneal cavity of the patient by connecting the dialysis fluid tubing to the patients PD catheter. The PD solution stays inside the peritoneal cavity where it lies in with the peritoneal membrane which now acts as the artificial kidney. Toxins and poisons from the blood enter into the PD solution, as well as the body’s excess fluid. After about 6 to 8 hours, the PD solution containing the toxins is drained from the peritoneal cavity into the empty drain bag, and fresh PD solution is infused again. The used tubings and spent dialysis fluid (fluid

containing all the toxins) is then disconnected from the patient and discarded. This is performed 3 to 4 times a day, everyday. One exchange takes about 20 minutes; 10 minutes to infuse fluid and 10 minutes to drain it.