END STAGE RENAL DISEASE The BVI Experience

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Presentation transcript:

END STAGE RENAL DISEASE The BVI Experience Dr Jomo James Consultant Internist

The Peebles Hospital Dialysis Unit Located on Tortola. Located on the ground floor of the annex building. Started operation 2000. Currently has 12 functioning machine. Dialyze patients 3 times a week.

Vision-Provide comprehensive nephrology nursing care to all patients without discrimination using an interdisciplinary approach.

The Staff 12 Staff assigned to dialysis Nurse manager-1 Technician-1 Registered nurses-8 Secrectary-1 Orderlies-1

Monday/Wednesday/Fridays-3 shifts Tuesday/Thursday/-4 shifts

Nephrologist [through the years] 2000-2003: Dr Hunt 2003-2009: Dr Nelson 2009-2013: Dr Ojo 2013-present: Dr Gorrachateugui Dr Joel Stevens vascular surgeon.

The Patients Male 38 Female 16 Total 54

Patients by Gender and Age Male Female 20-29 1 30-39 3 40-49 5 4 50-59 12 6 60-69 15 70-79 2 80-89

Etiology Diagnosis Diabetes 7 Hypertension 14 Diabetes and Hypertension 29 Sickle cell Nephropathy 2 Chronic glomurelonephritis CGN 1 Polycystic kidney disease

Venous Assess Type Types Number of Patients Fistula 11 AV Graft 23 PermCath 9 Temporary Catheter

Transplant Number of Patients Age Diagnosis Year of transplant Age at Transplant 1 61 Hypertension 2003 49 2 54 Polycystic kidney disease 2004 43 3 79 NSAID nephropathy 2009 73 4 21 2011 17 5 2012 51 6 39 ? 2013 37 7 74 72 8 48 CGN 2015

Dialysis to Date 158 Patients to date 79 have died 8 transplant with one subsequently returning to dialysis. 7 Patients for acute renal failure returned to normal function. 10 migration 1 absconded

Number Of New Dialysis Patients per Year Peebles Hospital Dialysis Unit

Rate of Dialysis Country Rate of dialysis per 100,000 population Japan 247 US 138 Germany 104 Brazil 55 China 21 BVI 143

Cost Per Patient Per session US$ 1200 Per Week US $3600 Per year US$ 187 200 Total ?????US$8million

Chronic Kidney Disease It is said that for every dialysis they are 30 patients in the community with CKD. CKD list from referrals, admission and clinics.

Much more needs to done. The work continues.