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

2. 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.

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

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

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

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

7. The Patients
Male 38
Female 16
Total 54

8. 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

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

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

11. 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

12. 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

13. Number Of New Dialysis Patients per Year Peebles Hospital Dialysis Unit

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

15. Cost Per Patient Per session US$ 1200 Per Week US $3600
Per year US$
Total ?????US$8million

16. 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.

18. Much more needs to done.
The work continues.