Interview with Mr. Noel Onukogu, Ag. Head, Laboratory Services, Avon Dialysis Centre
Q: When was Avon Dialysis Centre established and for what cause?
Re: Avon Dialysis Centre was established in August of 2018 to provide qualitative care to patients with renal issues. It was born to address the growing needs in renal care. Back then, patients who were diagnosed at our hospital were referred to other centres for dialysis. Many patients came back with reports of poor service, high cost and limited accessibility to renal care. To fill this gap, we decided to bring the Avon culture and expertise into renal care; providing affordable, accessible, and state of the art care to patients with renal issues.
Q: Do tell us some more about Avon Dialysis Centre. What do you do here?
Re: At Avon, we carry out general and renal screening, diagnosis, and management not just for dialysis patients but walk-in patients as well. The nature of our care is holistic. Many patients under dialysis tend to have other underlying conditions, as other organs might have been affected by kidney failure. We diagnose and treat patients with a wide scope, which borders not only on the kidneys but on the heart and other organs, using a wide array of parameters. We test for HIV, Hepatitis, and a host of other conditions. This holistic check-up provides information on the patient’s general well-being as it relates to renal functions. We also care for dialysis patients with underlying issues, such as diabetes and high blood pressure.
Q: Do patients come in not knowing their renal status?
Re: Yes. We have some walk-in patients who have relatives with renal issues and want to find out their own status. When we have newly diagnosed patients, we begin to manage them immediately, to prevent their condition from getting to the stage of dialysis.
Q: What analyzers have proven instrumental for the diagnosis of renal issues at your lab?
Re: Our Cobas C111 Analyzer is as old as the centre itself (laughs). It even arrived before the centre was opened. Its functionality spans far beyond dialysis and renal functions. It guides us in liver function tests, glucose and diabetes analysis and management, cardiac-related tests, and a wide range of parameters. It is a core when it comes to diagnostics, not just for dialysis and renal functions but for almost all Chemistry Analysis. So, we use the Cobas C111 Analyzer for full check-ups as well as organ function tests.
Q: What kinds of Kidney Function Tests do you run on your Cobas system?
Re: When you narrow it down to kidney function tests, primarily, we run Urea and Creatinine. We also run electrolyte tests, using the Roche AVL 9180. We carry out pre-diagnosis to know whether dialysis is needed, the level of dialysis required, and the need for other forms of treatment apart from dialysis. Dialysis is simply the removal of urea and creatinine that the kidney can no longer expel on its own.
At the end of dialysis, we do a post-diagnosis to discover the effect of the dialysis, the current level of urea and creatinine, and when the patient should come for the next dialysis. Everything we need for a holistic and qualitative check-up, we currently have in our laboratory.
Q: How would you describe the impact of accurate diagnosis on patients with kidney diseases?
It saves the lives of some patients. You know, some people walk in here and we are surprised after running their tests that they could even walk in. In such cases, the visit to our Dialysis Centre is their saving grace. The results of our analysis inform decision making and patient management. Once we know the values, we can guide the patients on their diets, next dialysis, and any secondary issues they may be having because of their renal failure, such as low haemoglobin levels, high blood pressure, hepatitis etc.
Q: What would you say distinguishes the Cobas in kidney function testing?
Re: The major distinguishing factors of the Cobas c111 analyser are its speed, the number of samples that can be run at a time. Its precision, accuracy, and management are also noteworthy. The Cobas c111 is an auto-manager. It queries problematic samples,electrical current fluctuations and a host of other errors as they occur. It also has alerts that serve as auto-guides during sample analysis. You can barely make a mistake with the Cobas c111 analyser because it will notify you of any errors. That is the beautiful thing about the system.
Q: Do you get any support from ISN and in what ways?
Re: Yes. We get a lot of support. I will commend your engineers for that. Whenever we have issues, we reach out and they come right away. They see the analyser as their own. We are currently working on our maintenance contract so that the ISN engineers can identify issues as they arise, inform us and resolve the issues immediately.
So, you would say you receive excellent field support?
Re: Yes. Excellent field support.
Q: What role would you say preventive maintenance plays to ensure proper diagnosis?
Preventive maintenance is very important because it helps you see the unseen. Fluctuation in analysis is a very serious matter. If there is an issue with your analyser which has been left undetected, wrong diagnosis is inevitable. This could lead to ghastly results and great costs to the patients and practitioners. That is why we go for preventive maintenance – to detect the worst-case scenario and prevent it before it occurs. Preventive maintenance should be a constant feature in every lab.
However, it does not take away the importance of quality assurance. We do both internal and external quality assurance.
Q: The kidney patients you dialyse, do you also manage them?
Re: Yes, we have a nephrologist in the house who cares for and manages our patients.
Q: How would you describe your experience with ISN?
Re: I would describe my experience with ISN as “A beautiful experience”.