A new clinical standard has just been set for people seeking dialysis treatment in the country.
Fresenius Medical Care, the world’s leading provider of dialysis products, is now the Philippines’ first—and only—non-hospital-based dialysis clinic to achieve international accreditation through the Australian Council on Healthcare Standards International (ACHSI).
ACHSI is Australia’s leading health-care assessment and accreditation provider. It is an independent, nonprofit organization dedicated to improving quality in health care. An ACHSI accreditation means a health-services provider has a demonstrated record of commitment to quality, and is driven by a continuous patient-care improvement program.
Four clinics in Metro Manila received the ACHSI accreditation: Fresenius Kidney Care Alabang, Fresenius Kidney Care Shaw, Fresenius Kidney Care Fairview and Fresenius Kidney Care North Edsa. An ACHSI accreditation needs to be maintained every three years, to be earned once again after another round of annual assessments.
So, an ACHSI seal is an assurance to patients, and the medical community, that Fresenius Medical Care continually holds its management, clinical operation, and infrastructure on par with international standards.
Chronic kidney disease is on the rise in the country, said Dr. Lynn Gomez, nephrology chief at Asian Hospital Medical Center, and consultant, nephrologist and medical director at Fresenius Kidney Care Alabang.
Premature deaths
Gomez said some 2.6 million patients worldwide undergo dialysis or transplantation, but 2.3 million succumb to premature deaths due to lack of access to dialysis and transplantation.
The 2017 Philippine Renal Disease Registry annual report shows that 21,535 Filipino patients underwent dialysis due to kidney failure in 2016. That’s a massive jump from a mere 9,716 cases recorded in 2010—increasing at the rate of 8-18 percent per year.
That data, Gomez said, does not include patients who are unable to get treatment due to prohibitive costs or due to inaccessibility to clinics. The cost of one dialysis session ranges from P2,800 to P4,000 per session. Gomez said most patients require at least two sessions per week, for life.
According to the National Kidney Institute, one Filipino suffers chronic kidney failure every hour. Kidney disease was the sixth leading cause of death in the Philippines in 2013. Gomez said poorly controlled diabetes and hypertension are among the leading causes of chronic kidney failure.
Start screening
“There is a huge gap between the need for renal replacement therapy and the availability of renal replacement therapy… In Asia, the gap is up to 66 percent,” Gomez said. “We should at least start screening people who are at risk of developing diabetes and/or hypertension.”
The most dreaded complication, Gomez said, is cardiovascular abnormalities.
“Those who go through dialysis without any heart attack or stroke, I commend them because their hearts are strong,” she said.
Chronic kidney disease is a condition characterized by the gradual loss of kidney function over time. The kidneys serve as the body’s filter machine, removing waste products and toxins from the blood through the urine.
But in patients with chronic kidney failure, the kidneys are unable to clean the blood properly. Waste products and fluid begin to accumulate in the body, requiring them to undergo dialysis to clean their systems.
For some patients, damage to the kidneys is extensive enough to lead to kidney failure, or end-stage renal disease. Unfortunately, when the kidneys fail, patients will now require regular, weekly dialysis, or a kidney transplant to live.
Increased risk
“The incidence of the disease is higher than the prevalence. That means patients are not living long,” Gomez said.
There is an increased risk of developing chronic kidney disease in people with diabetes, hypertension, heart disease and family history. The disease progresses slowly, so symptoms may not appear until the damage has become pervasive.
Kidneys have begun to fail when there’s itching, muscle cramps, nausea and vomiting, swelling in the feet and ankles, or too much or not enough urine.
Gomez also warned those who take nonsteroidal antiinflammatory drugs (NSAIDs) without restrictions. Ibuprofen and other NSAIDs block prostaglandins, natural body chemicals that dilate blood vessels to the kidneys. Blocking prostaglandins may lead to decreased blood flow to the kidneys. That means there’s a lack of oxygen to keep the kidneys alive, causing acute kidney injury.
“Providing high-quality medical services has always been a priority for Fresenius Medical Care. Seeking the ACHSI accreditation demonstrates our commitment to transparency and proving high-quality care to patients in the Philippines. This will enable us to address the health-care needs arising from the increasing number of Filipinos with chronic kidney failure, as shown in the PRDR data,” said Mabel Callera, GM for provider’s business, Fresenius Medical Care Phils.
Fresenius Medical Care is the world’s leading provider of products and services for people with chronic kidney failure, providing care to more than 336,000 patients for more than two decades through more than 3,900 dialysis clinics around the world.
ACHSI is the largest, oldest, and most respected health-care quality improvement organization in Australia. Founded in 1974, it has provided products and services in education, consulting, performance outcomes, and quality programs to support global health-care organizations to improve the safety, quality, and outcomes for patients.