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Sister Renal Center Trio Partnership Graduates: How Did They Improve Kidney Care in Egypt?

Emerging Center: Menoufia Nephrology Department, Menoufia University, Egypt. Liaison Officer, Mahmoud Emara

Supporting Center: Nephrology Department, Damanhour Medical National Institute, Egypt. Liaison Officer, Dr. Zaghloul Gouda

Mentoring Institution: Sheffield Kidney Institute, United Kingdom. Liaison Officer, Professor Ahmed Halawa

Dr. Zaghloul Gouda (Damanhour) and Prof. Mahmoud Emara (Menoufia) during the Damanhour Interventional Nephrology Workshop supported by the ISN SRC program.

Three medical institutions have completed a trio partnership through the ISN Sister Centers Renal Program, increasing capacity and skills to provide improved kidney care in the region. The Damanhour Medical National Institute graduated in 2015 as an emerging center in an SRC partnership with the

Sheffield Kidney Institute and transmitted their knowledge and skills to the Menoufia Nephrology Department in this trio partnership.

Through the collaboration, the Menoufia Nephrology Department (MND) achieved one of its foremost goals – upgrading its clinical services to include a referral center for a parathyroidectomy program to treat end-stage kidney disease patients with secondary hyperparathyroidism. This advance was implemented with help from professor Ahmed Halwa from the mentor center when he visited MND.

Another significant accomplishment was the initiation of an outpatient department for the early detection and prevention of NCDs in collaboration with the Egypt Information, Prevention, and Treatment of Chronic Kidney Disease (EGIPT-CKD) Program, supported by the ISN Clinical Research Program.

Menoufia University supplied hemodialysis (HD) machines to provide continuous renal replacement therapy CRRT and hemodiafiltration to specialized populations. The Damanhour Medical National Institute helped set up a computerized system in the hemodialysis (HD) unit alongside free access to the supporting center’s ”NCDs Made Easy Program.” The institute also supplied textbooks and educational material to facilitate the clinical training of nurses and nephrologists at Menoufia.

In 2017, Professor Ahmed Zahran from the Menoufia medical team was supported through an ISN fellowship grant, training for six months in the trio’s mentor center, the Sheffield Kidney Institute in the United Kingdom. Dr. Ahmed Saber and Dr. Ahmed Kamal from MND visited Damanhour Medical National Institute to train in point-of-care ultrasound (POCUS) in nephrology. They also received instruction on interventional nephrology (IN), including renal biopsy, vascath insertion, and assessment of IVC diameter.

Dr. Gouda, the liaison officer from the supporting center at Damanhour, also visited the center in Menoufia several times to provide training in IN and HD vascular access insertion.

Alongside the team at Manoufia, Dr. Gouda produced a research paper, “Studying Alternative Approaches for Placement of Cuffed Hemodialysis Catheters in Hemodialysis Patients with Bilateral Internal Jugular Vein Occlusion,” which was published in the Journal of Vascular Access.

The medical team also carried out research on AKI under the supervision of Dr. Walid Hemida, a nephrology consultant at Damanhour Medical National Institute. Together, they developed a risk stratification score for the development of AKI in hospitalized patients, which was published in a highly indexed journal. Staff at the emerging center received training in continuous ambulatory peritoneal dialysis (CAPD) from Dr. Nivin Saber, a nephrology specialist at Damanhour Medical National Institute, introducing the practice as an important renal replacement therapy modality.

Subsequently, three workshops on implementing interventional nephrology were held to benefit satellite centers in Shebin Elkom city, supported by the ISN and the Menoufia faculty of medicine.

This sustained program of continuing medical education meetings and workshops reinforced good nephrology practice in the surrounding community, improving overall kidney health awareness and quality of care in the region.

With these significant improvements, the center in Menoufia Nephrology Department hopes to be included in a future SRC partnership as a supporting center.

Mahmoud Emara, liaison officer at Manoufia University, thanked Professor Ahmad Halawah and Dr. Zaghloul Gouda for their support in the trio partnership, as well as the ISN SRC Committee and members, commenting:

“I would like to express my great thanks to the ISN SRC program. It was a very effective and impressive partnership with the ISN and the TRIO SRCs. The ISN’s support was essential to providing educational activities. The program structure and processing were excellent.”

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