0 st July 2005

Volume 2, Issue 2

The Philippine Society of Nephrology is a component society of the Philippine College of Physicians

Tenckhoff Arise!

PSN working on the inclusion of chronic peritoneal dialysis therapy under Philhealth coverage for "dialysis"

Over the last several years, there are more patients diagnosed with end stage renal disease who are put on hemodialysis than peritoneal dialysis, partly due to the Philhealth coverage for hemodialysis, translating to much needed financial assistance for renal replacement therapy. Not wanting to leave PD patients in the dark, the Philippine Society of Nephrology heeded the persistent clamor among PD patients and their respective caregivers to assist them in seeking financial subsidy from the government. PSN is proposing to expand the coverage ofPhilhealth to include chronic PD therapy.

The proposal states that "PD provides an alternative therapy for patients who may not be suitable for HD for various medical reasons or who prefer an independent form of therapy that leaves them with sufficient time to continue being part of the workforce of the country. Both HD and PD are complementary types of renal replacement therapy. The patient should have access to both types of therapy since his condition may make him more suitable for preferring one treatment over another, in varying periods of his life. Thus his Philhealth benefit should cover both types of dialysis. "

An analysis was performed comparing cost of PD and HD at the National Kidney and Transplant Institute. It was able to show that the Philhealth benefit for dialysis would result in a lower patient co-payment if the patient were placed on PD, which would therefore allow the patients to afford dialysis for a longer period of time. Cost savings of up to P2,318.40 to P2,929.00 for start-up and Pl0,625.00 to Pl3,273.00 per month for maintenance dialysis was seen to favor PD over HD.

The process of coverage of chronic PD by Philhealth requires the coordination of several agencies. Working closely with the PSN are Dr. Giovanni Roan and Dr. Adeline Amano­Mesina of the Standards Development Division of the PHIC. Guidelines will be established for the accreditation of peritoneal dialysis centers nationwide. These PD centers will be the conduit for patient claims and reimbursements. The Philippine Renal Disease Registry (PRDR) will also play a vital role as it will verify that patients are indeed on maintenance peritoneal dialysis.

Everyone is hopeful that these policies are implemented soon, so that finally, all our patients on renal replacement therapy will receive the benefits they deserve.

WHAT'S INSIDE

25th PSN Annual Convention

Opening Ceremonies_ .... p.2

Fellowship Night .... .. .... p.3

Paparazzi -----·- --- ·-- ·----- p.4

The Nephrologist As An Artist.. ..... ... ...... p.S

Achievements .. ... . ..... .. p.6 PMA'sMost Outstanding Physician Awardee

Winning Research Papers ... .... .. . p.6

WCN scholars .. .... .. ...... p.6

7th PSN Midyear Convention nA Midyear to Remember" Shangri-La Mactan, Cebu • October 2-4, 2005 • Fellowship Night Theme: Hats and Flowers

PSN's 25th Annual Convention Kicks Off With Formal Opening Ceremonies

The opening ceremonies held last April 13, 2005 at the Isla Ballroom of EDSA Shangi-la Hotel formally commenced the 25th Annual Convention. Innovations were introduced to make the event more solemn than in the past years. The most obvious change was that all the participants in the academic procession were dressed in togas. The induction of the new members and the giving of special awards, traditionally held during the fellowship night, were made part of the opening ceremonies. Gone are the days when the inductees and awardees were forced to show up in their funny-looking or revealing stage costumes and make-up. Dr. Alberto T.

Chua, PSN President, delivered the welcome remarks. Emphasizing the convention's theme, he highlighted how systemic illnesses affect kidney function. Dr. Lynn Almazan-Gomez, Vice-President of the PSN and concurrent over-all chair of the convention, gave the convention overview and thanked the International Society ofNephrology for their tremendous support. Twenty two associate members, fourteen diplomates and seven fellows then took center stage during the induction. Interestingly, three out of the seven new fellows are from Bacolod City, and the rest are from Metro-Manila, mostly from St. Luke's Medical Center. Dr. Josefino Ramos was also inducted as the new board member of the PSN and concurrent President of the PSN Mindanao Chapter. The officers of the newly formed Central and Eastern Visayas Chapter, led by Dr. Vivina Chiu, were also inducted.

Dr. Oscar Naidas Dr. Libertad Rosales

PSN likewise honored the outstanding contributions of its members and institutional partners. The Renal Disease Control Program (REDCOP) received the Presidential Service Award for its groundbreaking efforts in creating the Philippine Renal Registry and in formulating the "Training Module on the Prevention of Kidney Disease." Dr. Remedios De Belen-Uriarte, the National Program Manager ofREDCOP, accepted the award. The Special Award for Research went to Dr. Oscar D. Naidas for having published a total of 40 researches, both locally and internationally. He thanked his mentors for inspiring him to be constantly inquisitive and making him the doctor that he is now. Dr. Libertad Nazareno-Rosales was the recipient of the Special Award for Medical Education. She was cited not only for her outstanding contributions in teaching medical students and doctors-in-training, but also for inspiring them to be the best physicians they could be. In her acceptance speech, she poignantly recounted her dream to become a high school teacher. Instead, she ended up studying

Dr. Imw G11eco medicine. However, she never forgot her desire to teach and so she did just that. The last but not the least special honoree was Dr. Irmingarda P. Gueco, recipient of the A-One Award. Dr. Gueco veered away from the usual thanks in her acceptance speech and instead touched on pressing ethical issues in nephrology. She voiced her concern over the growing commercialization of kidney transplants. She emphasized that the practice of nephrology is not only an art and a science, but also a responsibility. She stressed that medical prudence should always be above monetary gain. The night ended with the much awaited keynote address from Dr. Eduardo Go tam co Tan, past president of the PSN. He gave a detailed and comprehensive account on how a group of foreign-trained physicians first struggled to bring home the technology they had learned and to apply this knowledge to the Philippine setting. Through their persistence, the practice of nephrology became at par with international standards. Dr. Tan recounted that in 1961 , peritoneal dialysis was the only mode of renal replacement therapy in the country. At that time, nephrologists had to prepare their own dialysis solutions! In 1963, Dr. Antonio

Dr. Ed 11ardo Gotamco Tmz Talusan and Dr. Alberto Daysog were able to set up the first hemodialysis unit at the Philippine General Hospital. By 1970, the first successful renal transplant was performed in the Philippines.

The number of Filipino kidney specialists were growing in number by 1971. The doctors realized that it was time for them to organize and become a formal society. Thus, the Philippine Society of Nephrology was born. When PSN first started, they had 18 members and eventually, half of the membership became its first officers. Today, the PSN has grown to be a formidable organization, with a total membership of more than 300 specialists. The value of Dr. Tan's speech was aptly stated by Dr. Libertad Rosales when she introduced him. "Knowing the past, we will appreciate the present. Knowing the present, we can forge the future."

New PSN Fellows New PSN Diplomates

* * * * * STAR 80 * * * * * The fellowship night officially ended the four-day PSN annual convention with a big bang! The theme was "The SO's;' a decade known for its colorful and outlandish fashion and its melodic pop hits. The Socials Committee and the medical representatives of the sponsoring pharmaceutical companies aptly set the tone of the night with a medley showcase of Top 40 hits (Buttercup, Rico Mambo, Street Beat, Mickey, Just Got Lucky). Growing up in the SO's, it certainly brought back fond memories of soirees, "baston" pants, the punk look, the EDSA revolution and the coming-of-age movie "Bagets." Before my mind started to wander, St. Luke's opened the competition by giving a performance of a lifetime, with their interpretation of the hits of Madonna. They paid great attention to her famous choreography and flamboyant costumes, and made a huge comeback from their less fabulous performance last year. (Highlights: Dr. Zel Catungal in her fuschia Material Girl bustier gown, Dr. Dinna Cruz in a virginal wedding gown and the bold transition of their male consultants from wearing tux to black skimpy shorts). Defending champion NKTI then rose to the challenge of recreating the famous dance moves of Michael Jackson. Wearing his famous "bitin" black leather pants and white socks, they did the strut and the moonwalk, and held their (oops, censored). (Highlights: Dr. Delia Bayog in black leather mini skirt and fishnet stockings, scary consultants in graveyard fashion, and the candle-bearing little boy, Isaiah, who also happens to be the Broadcasts' editor's son). UP-PGH was all fired up with the Latin spirit with their Gloria Estefan presentation. The Miami Sound Machine, with instruments and all, gave musical accompaniment to Drs. Coralie Dimacali and Elizabeth Montemayor, whose make-up and costumes were so great it took time before the audience figured out who were on stage! (Highlights: The Fantastic Vegas Showgirl and animal costumes). UST presented an innovative concept of re-introducing Cyndi Lauper, with their search for the SO's icon on video finally ending with their own Cyndi, none other than this year's special awardee for Medical Education, Dr. Libertad Rosales. According to the judges, their group had the most dynamic dancers in the whole competition. (Highlights: The colorful wigs, the daring lifts ala Loveliness, and definitely, the tattoo on Dr. Rosales' back) . The judges were so pleased with the performances they all volunteered to come back as judges for next year's competition. St. Luke's emerged as the new champion, followed by NKTI, UP-PGH and UST. Upon review of the judges' scores, it was a very close fight, with a mere 1.2% difference between the first and second placers. If critically appraised in evidence-based medicine, the conclusion would be that it is statistically insignificant (but clinically relevant! - Ed.) Can't wait for next year!

Dr. Benjie Balmores accepts the award f or the winning St. Luke's group

In this series, we will be featuring the different facets, talents and creative interests of our members. Our first subject is the renowned Dr. Alberto Daysog, ]r. This piece was written by Mr. Gino Dormiendo and published in the Philippine Daily Inquirer on December 27, 2000.

Alberto Daysog, Jr. has two great loves to which he pours all his time and energy: his medical practice and the art of ceramic painting. The first has been his lifelong profession since he graduated from the University of Sto. Tomas College of Medicine in the mid-1950's. The second is a creative activity that he has pursued with equally consuming passion.

A renowned nephrologist, medical educator and researcher, the 66-year old Daysog shuttles among three hospitals: the UST, where he is a respected professor of medicine, the San Juan de Dios Hospital and the Ospital ng Maynila. His work in medical research has yielded over 23 original scientific articles and studies, and a good number of them have won citations and awards, including the Secretary Paulino Garcia Award named after the famous pioneering doctor­

researcher who devoted much of his time in government serviCe.

Dr. Daysog accidentally rediscovered the artist in him sometime in 1990 after he was invited to participate in the exhibit of Thomasian doctors who are artists in their own right, which coincided with the inauguration of the UST Central Library building. While he formerly dabbled in oil painting, he decided to switch to ceramics by stroke of serendipity and has since been hooked on the medium.

It was, however, in 1961, when he was initiated into the ceramic art. That time, he had just come home from his residency at the Texas Medical Center in Houston, USA. He was already then painting pottery and bisque vases as a hobby but later abandoned it because he thought "it could no longer sustain my interest and besides, I was too preoccupied with my medical practice." Thus, when the offer from fellow Thomasian artists came, he decided to try once again his hand in ceramic painting.

Since then, Dr. Daysog, who trained in chemistry during his undergraduate years at the Pontifical University, has come up with a highly innovative and remarkably inventive approach to

ceramic art by using white translucent underglaze tiles and plates. Eschewing the conventional ceramic technique of using five or six layers of glazes on bisque (fired clay) or greenware objects (unfired clay, which is not commercially available), he has made the work faster, simpler and more economical.

The result after countless experimentations, is a kind of glaze that proudly sports the desired color and gloss, not to mention the lasting imprint on the glazed object. Dr. Daysog explains the process: ''After the bisque tiles are acquired, they are cleaned and screened for cracks. They are then laid down flat on a table. The sketch is placed by pencil, then two or three more coats of underglaze colors are painted. After the

underglaze painting is completed, two or three more coats of clear glossy overglaze are painted over to produce the desired sheen. The painting is then placed in the kiln and fired for six to seven hours. After this, the kiln can be opened only after 24 hours. In cases of breakage or defects, you must repeat the entire process."

He had the foresight to invest in an oven kiln when he was starting in the 90's and since then has experimented on ways to simplify the process or invent new ways of painting on ceramics. Like his works, he is fired up by the untold possibilities that result from the firing.

His first solo show- a sellout- was in 1994 at the lobby of the Ospital ng Maynila. The exhibit was offered as a benefit for the AIDS ward project at the city government's hospital. In 1997, in another exhibit held at the Sto. Tomas University Hospital, proceeds of the show went to the hospital's indigent patients. Another show at the San Juan de Dios Hospital the following year was for the benefit of the indigent patients and the street children who incidentally dropped by to see his show.

Dr. Daysog works in a realistic mode that is reminiscent of fine old paintings, truly remarkable for someone who merely picked up the hobby and put a sense of wonder. Dr. Daysog has pursued an artistic activity that has virtually given him a new lease on life. A doctor blessed with a philanthropic heart, he has breathed new hope to the less fortunate in life, so they, in turn, may have the chance to lead longer, healthier and happier lives.

Grants to the WCN 2005 Nephrology Training Course Awarded

Four nephrology fellows-in-training were the recipients of travel grants and free registration to the Pre-Congress and Main Congress of the World Congress of Nephrology in Singapore beginning June 24, 2005. Nominated by their respective institutions and screened by the PSN and WCN, the candidates also attended the Pre­Congress Nephrology Training Course Scholarship Programme from June 15-June23.

The Hongkong West Cluster and Queen Mary Hospital hosted the clinical training of Dr. Alejandro Sese, Jr. of Veterans Memorial Medical Center. Dr. Edison Guerrero ofUSTwent to the Sir Charles Gairdner Hospital in Perth, Australia. The National University Hospital in Singapore was the Renal Unit Host of Dr. AlmaAlmera­Borja ofNKTI and Dr. Eric Emmanuel Aragon of UP-PGH.

Alma Almera- Edison SA Alejandro S. Eric Emmanuel Borja, MD Guerrero, MD Sese, MD Aragon, MD

Winning Research Papers

From among numerous research papers submitted to the Research Committee during the last Annual PSN Convention, the following were recognized as the most outstanding:

1st place: "A STUDY ON THE PRE- KIDNEY TRANSPLANT EVALUATION PROCESS AMONG INDIGENT CANDIDATES"­Rosalie Imelda Orejudos, Edwin Tan and Benita Padilla, National Kidney and Transplant Institute 2nd place: "EFFECTS OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS ON RENAL FUNDCTION IN AUTOMOSAL DOMINANT POLYCYSTIC KIDNEY DISEASE- A META ANALYSIS" -Alfredo P. Obieta, Dinah D. Parasilan, Vivianne L. Untalan and Elizabeth Montemayor, University of the Philippines­Philippine General Hospital 3rdplace: "INCIDENCE OF NEW-ONSET DIABETES MELLITUS AMONG FILIPINO RENAL ALLOGRAFT PATIENTS" -Alvin W. Young, Romina Danguilan, and Ma. Teresa Plata-Que, National Kidney and Transplant Institute

ACHIEVEMENTS

~ PMA MOST OUTSTANDING PHYSICIAN

Dr. Carmelo A. Alfiler was conferred the Award for the Most Outstanding Physician of the Philippine Society of Nephrology by the Philippine Medical Association on May 21,2005 at the Convention Plaza Hotel in Bacolod City.

Dr. Alfiler, a pediatric nephrologist and former PSN president, is a graduate of the UP-PGH where he currently holds the position of Medical Director.

T

~ NEWPCMCADMINISTRATOR

Another eminent pediatric nephrologist, Dr. Zenaida Antonio, has been appointed as Officer-In-Charge of the Philippine Children's Medical Center.

DIDYOUKNOW ABOUT ...

• The physician who, while acquainting himself with a new elderly patient, asked, "How long have you been bedridden?" After a look of complete confusion she answered ... "Why, not for about twenty years- when my husband was alive."

• The surgeon who asked a woman in his care, "So, how's breakfast this morning?" "It's very good, except for the Kentucky Jelly. I can't seem to get used to the taste," the patient replied. He then asked to see the jelly and the woman produced a foil packet labeled "KY Jelly."

• The cardiologist who had to be a bearer of bad news? He told a wife that her husband had died of a massive myocardial infarct. Not more than five minutes later, she was heard reporting to the rest of the family that the husband had died of a "massive internal fart."

The BroadCasters GLENDA ELEANOR P. PAMUGAS, MD

REY JAIME M. TAN, MD RONALD S. PEREZ, MD

VIMAR A. LUZ, MD BENITA S. PADILLA, MD MELVIN MARCIAL, MD

(For comments and suggestions, e-mail us at psn@skyinet.net)

"i:

NEWS! NEWS! NEWS! ..-::.

Epoetin Beta- Recormon®: Now reimbursable thru PhilHealth (Reference: Phi/Health Circular No. 08 s-2005).

I Epoetin BetaJ Recormon®

Energy to make a difference

J Mycophenolate MofetiiJ

CeiiCept® Please review Product Information before prescribing.

Full details on drug available upon request.

BroadCasts

•