Possibility of Donating Dialysis Units/Systems to Qualified Government Hospitals

Borgjie B. Distura

Kidney disease, which includes Nephritis1, Nephrotic Syndrome2 and Nephrosis3, is

one of the leading causes of death in the Philippines. Based on the Department of Health
(DOH) data, kidney disease is included in the top 10 leading causes of mortality and it shows
no sign of declining in the near future with an average of almost 13,000 deaths annually.
(Table 1 and 2) According to Philippine Charity Sweepstakes Office (PCSO) Charity
Assistance Department (CAD), citing Philippine Renal Disease Registry (PRDR) annual
report, the number of Filipinos who underwent dialysis treatment in 2016 was 21,535 and
increasing at the rate of 8% to 18% per year.

Table 1: Mortality due to Nephritis,

Nephrotic Syndrome and Nephrosis
CY 2006-2010
     
Year Number Rank
2010 14,048 9
2009 13,799 9
2008 12,538 10
2007 12,231 10
2006 11,981 10
Average 12,919 9.6

Table 2: Mortality Due to Nephritis, Nephrotic

syndrome and Nephrosis
CY 2006-2010
16,000
14,048 13,799
14,000 12,538 12,231 11,981
12,000
10,000
2010 2009 2008 2007 2006 XSource: DOH
Statistics4

The Institute for Health Metrics and Evaluation (IHME), an independent population
health research center at University of Washington that provides rigorous and comparable
measurement of the world's health problems, even regarded kidney disease as the 4 th leading

1
Inflammation of the kidney, which causes impaired kidney function. (www.medicinenet.com)

2
Nephrotic syndrome may occur when the filtering units of the kidney are damaged. This damage allows protein
normally kept in the plasma to leak into the urine in large amounts, which reduces the amount of protein in your blood. Since
the protein in the blood helps keep fluid in the bloodstream, some of this fluid leaks out of the bloodstream into your tissues,
causing swelling, called edema. (www.kidney.org)

3
Any degenerative disease of the kidney tubules, the tiny canals that make up much of the substance of the kidney.
(www.medicinenet.com)

4
(Available at https://www.doh.gov.ph/Statistics/Leading-Causes-of-Mortality)

Page 1 of 4
 cause of mortality in the country. According to data, there is an increase of almost 57% from
2007 to 2017 when it comes to chronic kidney disease as cause of death among Filipinos.

Table 3: TOP 10 CAUSES OF DEATHS IN THE PHILIPPINES

Institute for Health Metrics and Evaluation
CYs 2007 and 2017
% Change
2007 RANKING 2017 RANKING
2007-2017
1 Ischemic heart disease 1 Ischemic heart disease 38.00%
2 Stroke 2 Stroke 27.80%
3 Lower respiratory infect 3 Lower respiratory infect 24.10%
CHRONIC KIDNEY
Neonatal disorders 56.40%
4 4 DISEASE
5 Tuberculosis 5 Tuberculosis -2.80%
CHRONIC KIDNEY
Diabetes 47.20%
6 DISEASE 6
7 Diabetes 7 Neonatal disorders -23.50%
8 COPD 8 Hypertensive heart disease 77.60%
9 Interpersonal violence 9 COPD 34.70%
10 Hypertensive heart disease 10 Interpersonal violence 8.70%

Source: www.healthdata.org/philippines

In the first semester of 2018, a family of five needed no less than PhP 10,481 on
average, to meet both basic food and non-food needs of a family of five in a month according
to Philippine Statistics Authority (PSA). This amount is the poverty threshold.5

According to PSA, there are more than 22 million Filipinos or 21% of the total
population who live below the poverty threshold in the first semester of 2018. (Table 5) And
so, a family of 5 earning less than 10,000 pesos every month does not have the capacity to set
aside a monthly kidney treatment which is more than their monthly income resulting to a high
incidence of not-attended-to-deaths due to kidney disease.

The cost of dialysis session ranges from P2,800 to P4,000 6 requiring two (2) sessions
per week for life.

According to DOH data, there are more than half or at 58% of the total deaths caused
by kidney disease are caused by not-attended-to-death. (Table 4) The reason for this not-
attended-to-deaths is evident, the financial incapacity of kidney disease patients and their
family to sustain long-term medication or treatment.

5
Poverty threshold is the minimum income required to meet the basic food and non-food needs such as clothing,
fuel, light and water, housing, rental of occupied dwelling units, transportation and communication, health and education
expenses, non-durable furnishing, household operations and personal care and effects. (PSA, https://psa.gov.ph/poverty-press-
releases/nid/138411)
6
Kidney Disease is on the Rise – but there’s a new standard in dialysis treatment, Anne A. Jambora, PDI, May 28,
2019

Page 2 of 4
 Table 4: % of Not-Attended Death
(Nephritis, Nephrotic Syndrome and Nephrosis)
CY 2013

Attended Not Attended

Total Deaths Number % Number %
14,954 6,288 42 8,60 57.5
2
Source: Philippine Health Statistics 2013, Epidemiology Bureau, DOH

Table 5: Poverty Incidence Among

Population
First Semester of 2015 and 2018

First Semester Poverty Incidence

2018 21
2015 27.6
Source: Philippine Statistics Authority

Recognizing the plight of kidney patients, the PCSO provides medical-financial

assistance to patients undergoing either hemodialysis and peritoneal dialysis. According to
CAD data from 2014 to 2018, there is an average of more than PhP250 million worth of
assistance given to an average of 8,000 patients undergoing either hemo or peritoneal
dialysis. (Table 6)

Table 6: PCSO Data on Dialysis Patients

(Peritoneal/Hemodialysis)
CY 2014-2018
     
IMAP Approved
YEAR No. of Cases Amount (in
Millions
2018 13,271 298
2017 5,080 181
2016 4,964 206
2015 6,857 192
2014 10,084 418
AVERAGE 8,051.20 259
Source: Memorandum No. 2019-073, Charity Assistance Department

Page 3 of 4
 This amount can be donated to capable and qualified regional hospitals to put up a 5-
bed Dialysis Treatment Facility. Table 7 provides for the estimated cost.
XTable 7: Dialysis Cost (Approximate) for 5-Bed Dialysis Treatment Units*

Brand New
with BP Brand New
Refurbished
monitor (China)
    (Fresenius)
4008K
385,000/pc x
Model
5 =1,925,000
(USA) 1,300,000/pc x 442800/pc x
1 Dialysis Machine
2006- 5 = 6,500,000 5 = 2,214,000
450,000/pc x
Model
5 = 2,250,000
(Germany)
Water Treatment Set
2 (includes R.O. brine
tank- 6,000 gal/day 430,000
Reprocessing Machine
3
(semi-automated) 200,000
Mixer (for bicarb and
4 acid solution) stainless
steel 55,000
5 Dialysis Chair (Reclining) 19,000 each x 5 = 95,000
6 Weighing Scale (Digital) 65,000
2,770,000 (USA)
TOTAL 7,345,000 3,059,000
  3,095,000 (Germany)
* This does not include construction cost such as laying out of pipes for R.O. which may vary
depending on the size of the facility. Other necessary emergency equipments are not
included.

Some Criteria to be considered:

 2 Regional Hospitals
 5 units of dialysis
 Regions whose poverty incidence is more than the national average based on the 2018
poverty incidence
 Regions with High incidence of CKD/ESRD

Page 4 of 4