About Us
End-stage renal disease (ESRD) is a chronic disease which requires patients to receive on-going treatment for kidney failure. Haemodialysis (HD) and peritoneal dialysis (PD) are the most common treatment methods for patients suffering from ESRD to replace the work of the failed kidneys.



Established in 1983, the Renal Dialysis Centre at the Hong Kong Sanatorium & Hospital has been providing comprehensive and high quality dialysis therapy and support services to ESRD patients. The Centre accepts referrals by doctors including overseas patients (download form) during their stay in Hong Kong.

Managed by a well-coordinated health care team of Nephrologists and certified Renal Nurses, the Centre adheres to the highest standard of sanitary conditions and quality assurance protocols. The Centre is committed to acquiring the latest equipment and new pharmaceutical products to achieve the best possible treatment outcome for patients and improving their quality of life.

About Haemodialysis
Haemodialysis is a method of treatment for ESRD patients. It allows the blood of a patient to flow from the body via a vascular access into a machine with a special filter. The special filter called a haemodialyzer functions as an artificial kidney to remove body wastes and excess body fluids. The clean blood is then returned to the body via the vascular access.

To control blood pressure and maintain a proper balance of electrolytes in the body, the patient is required to follow a rigid schedule to undergo dialysis two or three times a week. Each visit takes four hours or more. During dialysis, the patient can perform activities such as reading, sleeping and watching TV.

About Peritoneal Dialysis
Peritoneal dialysis or PD is a method of treatment for ESRD patients. It eliminates body wastes and removes excess body fluids by introducing dialysis solution into the peritoneal (abdominal) cavity via a plastic tube (catheter). By means of osmosis, the high concentration of sugar in the dialysis solution draws wastes and extra water from the tiny blood vessels in the peritoneal membrane into the peritoneal cavity. The catheter then drains the fluid from the cavity, taking the waste products from the body.

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Haemodialysis Therapy
Advantages of Haemodialysis
At the Centre, patients are attended by trained professionals at all times. Nephrologists order a prescription for haemodialysis and certified Renal Nurses monitor the patient closely throughout the haemodialysis procedure. Staffed with caring personnel, the Centre also provides a safe and comfortable environment for patients receiving haemodialysis, which adheres to the highest sanitary conditions and quality assurance protocols.

Prepare for Haemodialysis
A vascular access is prepared on the body by an operation procedure using local anaesthesia. There are three kinds of vascular access: arteriovenous fistula, Gortex graft or venous catheter. Generally, it takes several weeks or months for a permanent vascular access (except venous catheter) to develop before it is ready to perform dialysis. The Centre provides comprehensive training to teach patients on how haemodialysis works and how to protect the vascular access and prevent complications.

Equipment
4008S Dialysis System (Fresenius Medical Care, Germany)
Features:
• One touch hot disinfection and decalcification programme
• Blood volume monitor to minimize excessive blood volume reduction
• Automatic self-testing of all vital functions and circuits before restarting for the second dialysis

4008H Dialysis System (Fresenius Medical Care, Germany)
Features:
• One touch hot disinfection and decalcification programme;
• Blood volume monitor to minimize excessive blood volume reduction;
• Automatic self-testing of all vital functions and circuits before restarting for the second dialysis.
• Blood temperature monitoring to ensure temperature balance

Aquaboss Reverse Osmosis Water Treatment System
Features:
• Twin-passing Reverse Osmosis (RO) System to provide ultrapure and safe water for dialysis
• Reliable backup system to continue treatment in case of breakdown without immediate shutdown
• Autosanitation by eliminating dead space and impulse back-washing
• Fluid circuit is constructed in stainless steel which provides high durability and
  reduces risk of microbiological contamination and corrosion
• Auto-detector of water leakage

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Insertion and Management of Vascular Access
At the Centre, the Nephrologist prepares the appropriate vascular access depending on patient's conditions and progress.

There are three kinds of vascular access: arteriovenous fistula, Gortex graft or venous catheter. Renal Nurses provides instructions on how to take care of the access between treatments.


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Tests for Haemodialysis
To assess the haemodialysis dose and adequacy to see if the treatments are removing enough wastes, tests using one of the following formulas will be performed once a month:
• URR, which stands for urea reduction ratio, is one measure of how effectively and
  adequately a dialysis treatment removed waste products from the body. It represents
  the reduction in urea as a result of dialysis.
• Kt/V is another measure of dialysis adequacy. K stands for the dialyzer clearance,
  expressed in milliliters per minute (mL/min), t stands for time and V represents the
  volume of distribution of urea.


Online Haemodiafiltration
Online Haemodiafiltration is a special mode of ESRD treatment, combining advantages of haemodialysis and haemofiltration, i.e. high elimination rates for small and large molecular weight substances via diffusive and convective mechanisms, respectively.


Plasmapheresis
Plasmapheresis is a process to remove disease-causing protein molecules (e.g. antibodies) in the blood. During plasmapheresis, the fluid part of the blood, called plasma, is separated from blood cells by passing it through a filter (plasmafiltre). The plasma removed is then replaced with plasma free of disease-causing protein or albumin.


Renal Nursing Care and Clinical Support
All nursing staff at the Centre are trained and certified as Renal Nurses to take care of ESRD patients. Advice on diet, access care and prevention of complications are provided. Follow-up nursing care is available to patients who encounter problems between treatments or require nursing support.

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Peritoneal Dialysis Therapy
Advantages of Peritoneal Dialysis (PD)
PD is a daily continuous treatment that maintains the body at a relatively stable and equilibrium state. Diet and fluid restriction in PD patients is therefore less than in haemodialysis (HD) patients. Besides, as patients can perform the procedures at home, they are not required to visit the hospital on a weekly basis, with minimal disturbance to their daily life.

How to prepare for Peritoneal Dialysis?
A catheter is introduced into the peritoneal cavity by a simple operation procedure using local anaesthesia. Patients are required to be admitted to the Hospital for receiving PD intermittently for about two weeks to allow the wound to heal. In preparing patients to perform PD at home, the Centre provides a 5-day comprehensive training on an inpatient or outpatient basis on the procedures of PD solution exchange, catheter and exit site care and how to handle problems relating to dialysis and its complications.

Therapy Modes of Peritoneal Dialysis
There are several therapy modes of PD depending on the lifestyle and health needs of patients. The two most common modes are:
Automated Peritoneal Dialysis (APD)
   Solution exchanges can be automatically done, usually at night, by using a PD machine according to a preset programme.
Continuous Ambulatory Peritoneal Dialysis (CAPD)
   A continuous 24-hour method, which requires patients to perform solution exchanges 3 to 4 times a day.

Equipment
   HomeChoice PRO Automated Peritoneal Dialysis System (Baxter Healthcare)
   Features:
   • Compact, portable and easy to use
   • All functions are easily accessible for patients to operate the machine without
     difficulty thereby reducing therapy burden
   • An advanced Drain Logic system for continuous monitoring of fluid infusions
     and draining to maximize dwell times and avoid overfill
   • A self-check system to minimize night time disruption

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Intermittent Peritoneal Dialysis Therapy
PD is mainly a home therapy. Patients may receive PD intermittently at the Centre in the following conditions:

• After the insertion of Tenchkoff catheter, patients receive Intermittent Peritoneal
   Dialysis Therapy two or three times a week for about two weeks to allow the wound to heal.
• As doctors prescribed.


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Insertion and Management of Tenckhoff Catheter
The Centre performs insertion of Tenckhoff catheter as day case for all patients receiving PD. Renal Nurses will instruct patients how to take care of the catheter to avoid infection or peritonitis.

For HA Hospitals Patients
Since October 2004, the Centre has reached an agreement with the Hospital Authority to perform insertion of Tenckhoff catheter for patients from HA hospitals at an agreed charge. For enquiries, please call our Centre during service hours.

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Tests for Peritoneal Dialysis
To assess the PD dose and adequacy to see if the treatments are removing enough wastes, the following regular tests will be performed, which are particularly important during the first few weeks:

Peritoneal Equilibration Test or PET is used to test the peritoneal membrane viability as the peritoneal transport rate varies from person to person. PET measures how much sugar has been absorbed from a bag of infused dialysis solution and how much urea and creatinine have entered into the solution during a 4-hour exchange.

Clearance tests including a urea clearance test (Kt/V) and a creatinine clearance test are used to test for PD adequacy. An increase in frequency of dialysis exchange or a change in dwell time may be needed to ensure that the blood is cleaned efficiently.

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Renal Nursing Care and Clinical Support
Follow-up nursing care is available for patients who may encounter problems in dialysis at home or require nursing support. Advice on diet, access care and prevention of complications are provided.
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Download
Download pamphlet

Contact Us
Address: 16/F, Li Shu Pui Block
Tel: 2835 8926
Fax: 2892 7524
Emai: rdc@hksh.com

Service Hours
Monday to Saturday: 7:00 am – 8:00 pm
Opened on Public Holidays
Closed on Sundays

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2 Village Road, Happy Valley, Hong Kong   Tel : 2572 0211   Fax:2835 8008

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