RenaCare Dialysis Clinic — Services & Clinical Model
Core clinical services across in-centre haemodialysis, peritoneal dialysis and acute renal replacement therapy, ancillary services, clinical protocols and the quality and governance framework.
Section 5 · Business Plan
Services & Clinical Model
Core clinical services across in-centre haemodialysis, peritoneal dialysis and acute renal replacement therapy, ancillary services, clinical protocols and the quality and governance framework.
5.1 Core Clinical Services
Renacare will deliver a comprehensive specialist renal service
offering built around three pillars: maintenance haemodialysis,
peritoneal dialysis support, and ancillary nephrology services. The
service model has been designed to deliver international-standard
outcomes while remaining operationally lean and financially
sustainable.
5.1.1 In-centre haemodialysis (HD)
Maintenance haemodialysis is Renacare’s core service and the
principal driver of revenue. Patients attend the clinic three times per
week for a four-hour treatment during which excess fluid, urea and other
waste products are removed from the blood using a dialyser membrane. The
clinic will operate three 5-hour shifts per day (06:00, 11:30 and
17:00), six days per week. At full utilisation, each of the 20 stations
can deliver approximately 936 sessions per year (3 shifts × 312 days),
for a clinic-wide capacity of 18,720 sessions annually.
5.1.2 Peritoneal dialysis (PD) programme
Peritoneal dialysis is a home-based alternative to in-centre HD that
offers significant quality-of-life advantages for appropriate patients.
Renacare will establish a dedicated PD training suite where new patients
are initiated, catheters are managed, and ongoing support (including
monthly nursing reviews, catheter exit-site care, and peritonitis
management) is provided. The PD programme targets approximately 15% of
total patient volume by Year 3, consistent with international best
practice and with the Company’s PD-first messaging for younger, employed
patients.
5.1.3 Acute & continuous renal replacement therapy
Through partnerships with hospitals in the catchment area, Renacare
will deliver 24-hour acute haemodialysis and continuous renal
replacement therapy (CRRT) services to patients who cannot travel to the
clinic. A dedicated on-call clinical technologist and registered nurse
team will respond to hospital requests within 90 minutes of
dispatch.
5.2 Ancillary Services
The clinic will offer the following ancillary services that
complement the core dialysis offering and strengthen the
comprehensive-care value proposition for patients and referrers:
- Nephrology consultation rooms for use by visiting nephrologists,
charged on a sessional basis. - Dietician and nutrition counselling integrated into the routine
treatment schedule, with particular focus on phosphate, potassium and
fluid management. - Social work support, including assistance with medical-aid
authorisations, disability grant applications, and psychosocial
adjustment to chronic illness. - Vascular access clinic, coordinating fistula creation, fistula
surveillance, and catheter management with vascular surgery
partners. - On-site pharmacy coordination for EPO, iron supplementation,
phosphate binders and related medications. - Patient and family education programme, including pre-dialysis
education, modality selection counselling, and transplant readiness
assessment.
5.3 Clinical Protocols & Quality Framework
Renacare’s clinical protocols are derived from the Kidney Disease:
Improving Global Outcomes (KDIGO) international clinical practice
guidelines and from the Association for the Advancement of Medical
Instrumentation (AAMI) standards for dialysis water quality and
equipment validation. Every clinical intervention will be logged in the
electronic medical record. Key clinical performance indicators will be
calculated monthly and benchmarked quarterly against SARR data and
international norms.
| Clinical KPI | Target (2030 benchmark) | International Comparator |
|---|---|---|
| Single-pool Kt/V per session | ≥ 1.4 | ERA-EDTA median 1.4 |
| Access-related bacteraemia rate | < 0.5 per 1,000 patient-days | UK RR < 0.5 |
| Fistula use rate (prevalent patients) | ≥ 65% | ERA-EDTA 65 – 75% |
| Annual mortality | ≤ 12% | SARR SA ~14% |
| Unplanned hospitalisation days | < 5 per patient-year | DOPPS 5 – 7 |
| Patient satisfaction score | ≥ 4.6 / 5.0 | Internal measure |
5.4 Clinical Governance
Clinical governance is the responsibility of the Medical Director,
supported by the Head of Nursing & Clinical Operations, and overseen
by the Clinical Advisory Panel. Monthly morbidity and mortality meetings
will review all adverse events, mortality cases and near-misses. An
annual clinical audit will be commissioned from an external independent
nephrologist. Compliance with water-quality testing,
infection-prevention and control, and serological screening will be
documented continuously and audited quarterly.
Confidential — this business plan is provided to prospective investors and lenders for evaluation purposes only and may not be reproduced or distributed without the written consent of RenaCare Dialysis Clinic (Pty) Ltd.