Al-Khezam dialysis and nephrology center

Alkhezam dialysis and nephrology center is considered to be one of the most important dialysis centers in Kuwait, and the largest in term of number of patients,  it is located at Al-Adan hospital and covers the Ahmedi Health Area.

 

The center has all dialysis modalities (Hemodialysis and Peritoneal dialysis) and includes out patient services that deal with acute and chronic kidney diseases. Chronic kidney disease specialized clinic and renal Transplant Workup clinic.

 

The center also covers consultations from different departments from the Adan hospital including;  Intensive care unit, Aldabos Cardiac center and other medical and surgical wards.

        1. To provide all the medical care for all kidney disease patients related to Al-Ahmadi medical area.
        2. To perform all the dialysis types with all modalities and it contains:
          • Conventional hemodialysis sessions (3 sessions/week).
          • Peritoneal dialysis with its different types (APD, CAPD).
          • Continuous slow therapy venovenous hemofilteration or hemodiafilteration in all wards of Al-Adan hospital , ICU, and CCU under supervision by center’s doctors and nursing staff.
          • Plasma pharesis sessions in the hospital wards by center’s doctors and nurses.
        3. Preparation of patients with chronic kidney disease for transplantation with cooperation with doctors in Hamed Elessa hospital ( organ transplantation center).
        4. Insertion of central venous lines (dialysis catheters) guided with ultrasound in a minor operation theater in the center.
        5. Performing Ultrasound Guided renal biopsies.
        6. The unit is involved in the medical education for medical students, internal medicine board and nephrology fellowship program.
        7. Conducting medical researches.
        8. Continuous medical educations with weekly ground rounds and morning meetings

 

The center consists of 3 floors ( Ground, first , and second).

1-Ground floor it contains:

        • The center’s head office .
        • Meeting room.
        • Lectures room.
        • 6 doctor offices.
        • Outpt clinics and it contains 4 separate rooms as outpt clinic for following up chronic kidney disease pts and also acute kidney disease pts.
        • Pharmacy : that includes medicines for pts with chronic kidney disease on hemo or peritoneal dialysis also medicines for pt who are following up in nephrology OPD .
        • Head nurse office.
        • Medical engineering office.
        • PD storage room.

 

2-first floor it contains:

        • Male hemodialysis unit it consists of :
            • Isolation rooms 1, and 2 ( one machine in each room).
            • Hepatitis B virus room (3 machines).
            • Hepatitis C virus room (5 machines).
            • 2 big rooms for negative cases (21 machines).
        • Male peritoneal dialysis unit .
        • Minor operation theater for central venous dialysis catheters insertion guided by ultrasound.
        • Store room.
        • Dialysis water system unit.

 

3-second floor it contains:

        • Female hemodialysis unit it consists of :
            • Isolation rooms 1, and 2 (one machine in each room).
            • Hepatitis B virus room (3 machines).
            • Hepatitis C virus room (4 machines).
            • 2 big rooms for negative cases (21 machines).
        • Female peritoneal dialysis unit.
        • Maintenance room.
        • Dialysis water system unit.

 

Team from doctors ( consultant, specialists, senior GP {A}, senior GP {B}, registrars) are responsible for daily follow-up all the patients that have renal disease or have any disease that caused deterioration of  kidney functions either in acute form or chronic form , this follow-up is carried out  daily by center’s doctors in all the hospital wards , ICU ,and  CCU. Another similar team is doing daily follow-up in the center for end stage renal patients who are already  on hemodialysis or peritoneal dialysis in the center.

 

Morning meeting ( Signing in ):

There is daily signing in morning meeting in which all doctors discussing the issues about the patients whom already seen in the last days and following up the result of the decision that were already taken by them, and also discussing the newly patients added to the nephrology patients’s list before  seeing them  in the daily round  (these cases who  entered the hospital in the previous day or nephrology team had been consulted to see them during the previous day in the evening or night shift).

 

Daily round (follow-up):

Every day in the morning after finishing the morning signing in meeting the doctors will go to do the daily round to see all the nephrology patients that are already admitted in different wards of Adan hospital including ICU and CCU. Other nephrology team will do the round in the center for pt on dialysis either ( hemo or peritoneal ).

 

Singing out meeting :

After doing the wards round there is short meeting as signing out in which doctors have to inform the doctors who will be on duty about their patients and about what will be done for them during the day and what they should follow . Also there is a special weekend signing out meeting on every Thursday afternoon in which all doctors have to give a summary about their cases and about treatment that they will receive during the weekend.

 

As this is the largest dialysis and nephrology center in Kuwait so we have to think about the future vision , many ideas are on their way to be accomplished some of them are  :

        • Minimize the rate of ESRD with expansion of Advanced CKD clinic and improving the measures that affect the incidence of CKD, including DM and HTN at the Ahmedi health area..
        • To create the quality care system that supervises the work offered by the team and ensure it was conducted according as its planed
        • To maintain up-to-date technology and to keep high standards in term of dialysis technology and modalities.
        • Introduce up-to-date computer networking technologies in the wards, pharmacy and OPD.
        • To introduce in-patient dialysis ward to decrease the load on the center and help admitted patients receiving their dialysis at most convenient way.
        • To introduce nocturnal home (Independent) dialysis.
        • To train all nephrologist on how to use portable ultrasound to guide insertion of temporarily hemo-dialysis catheters.
        • To train all senior nephrologist on performing ultrasound guided renal biopsies.

As Al-Khezam center considered to be  the largest center in Kuwait in numbers of chronic kidney disease patients who are being on dialysis .

It conducts service of conventional hemodialysis 3 times/week for about 375 patients (197 male pts, and 178 female pts). Hemodialysis services offered over 4 shifts a day between 6am till 2 am the next day. About 5000 hemodialysis sessions are being given every month (60000 hemodialysis sessions /year).

 
Machines of hemodialysis and peritoneal dialysis in the center:

Machines in the center can be divided as:

    •  80 machines for hemodialysis ( 41 in male side and 39 in the female side). 31 Active machines in each ward and the remaining  is for backup,
    • 28 machines for peritoneal dialysis (18 in male side and 10 in female side) as machines to be used in training the newly diagnosed patients and their relatives to the peritoneal dialysis.

The OPD is located at the ground level, it consists of 4 rooms. The clinic working hours from 8am-1pm Sunday to Thursday.

 

Outpatients clinics services:

Evaluation clinics:

To ensure minimal waiting time this clinic is responsible for all new cases refered from other OPD in the hospital. A full workup and investigations will be arranged. Once workup and diagnosis established patients will be refered to the Follow-up clinic.

 

Follow-up clinics:

Clinics offer services for patients suffer from kidney diseases that include chronic and acute disorders including; Diabetic nephropathy, Hypertension, Glomerulonephritis , Fluid and electrolytes and acid base disorders.

 

Advanced CKD clinic :

This specialsed clinic deals with patients suffering from advanced renal disease (CKD stages 4 and 5), offers the patients and relatives all the information about the dialysis modalities and to refer the patient to vascular surgery OPD clinic for creation of permanent vascular access for dialysis like arterio-venous fistula (AVF). As well its covers other aspects like patients psychosocial and nutritional health