10% of Indians suffer from Chronic Kidney Disease (CKD). Every year India adds another 2 lakh new cases of CKD. Where the global demand for dialysis is at 8%, the demand for dialysis in India is at 31%. About 50% of the patients needing dialysis reside in rural India where the facilities are marginal. They often have to travel over 100 kilometers to reach the dialysis centre. A 2018 estimate puts the number of patients on chronic dialysis in India at about 175,000, giving a prevalence of 129 per million population. Another estimate says that about two-thirds of all patients with kidney failure died without receiving dialysis in 2010.

Shashank Moddhia is equipped with over 15 years of multinational experience in the domain of medical devices and healthcare. He has previously worked with Baxter, Philips Healthcare, GE Healthcare and more. He has completed his Master’s in Science and Biomedical Engineering from the University of Texas at Arlington. To tackle the problem of affordability and accessibility that CKD patients have to deal with in rural India, he left his job in the USA to start the Renal Project in 2019.

About Renal Project

Moddhia begins, “When we started the Renal Project we only had one thing on our mind that more than the affordability in India the problem was of availability and awareness. If I have to swell on the feet, have breathlessness, or headache then there is no one to tell me that maybe my kidneys are failing. The awareness of conducting basic blood tests of urea and creatinine levels is missing.”

“One side of the story is awareness. Once the condition reaches the advanced level (there are 5 levels), it becomes too late to act on it or marginally reverse it. This happens when it reaches stage 4 or stage 5 which is also known as End-stage renal disorder. At this stage, they will require a therapy called dialysis or they have to go for a kidney transplant. The latter is quite rare and of concern even in the developed countries.”

“Less than 5% get a kidney transplant and for the rest, dialysis is a lifeline. Once kidney failure is detected the burning question is where can I get dialysis. As dialysis is a repetitive thing they have to travel 100 kilometers every 2 to 3 days. In this scenario, we researched the landscape of India and found out that they are in tier 1 cities.”

“Imagine a small town on the outskirts of Nashik that have to cater to a few people who really need dialysis. This is where the need for 15-bed dialysis is not present. So by catering to the smaller patient groups in deeper India, one can cater to 200 to 300 dialysis patients by just 10 to 15 centres. By doing this one can prevent deaths and make people live longer. This can only be done by a model that can penetrate and reach the patients without giving them the hassle of travel.”

“This is how the concept of Renal Project was found. Starting from 2019 to now, we have around 25 dialysis centres. Each of these is a 2 bed or 3-bed facility. These are in talukas and cater to 20 to 25 patients. But collectively we see it making a huge impact on India.”

An estimated around 1.8 lakh persons suffer from renal failure every year, however, the number of renal transplants done is around 6000 only.

Moddhia adds, “If there is a bypass surgery of 2 or 2.5 lakhs, then it is a one-time investment and you'll be all set for the next many years. But dialysis, with an average cost of 1400, needs to be done every 2 days or 10 dialyses a month. This would cost around 1,50,000 a month plus the cost of medicines. This can bring a financial burden of 10 lakhs. Many of these kidney patients cannot earn, making this more troublesome. Here affordability becomes a critical factor. We have to be very very sensitive about that."

Renal Project's USP

Moddhia elaborates, “I don't consider ventures like NephroPlus as competition. As we are not fighting against dialysis providers but are fighting against kidney disease. I have huge respect for other companies, as without them there would be far more mortalities in India. I salute them for their pan-India approach."

"What we provide is penetration. Renal Project compared to the rest have a high penetration model. You can open a 15 or 20-bed centre but if patients cannot reach then it's of no use. That is where our micro centre model which is able to penetrate and has a good co-existence with other players like NephroPlus."

"We are tech-enabled in which all the dialysis-related data is monitored and is made available via the app. This helps us not only monitor each dialysis centre but also each dialysis. Ours is a dialysis delivery management software that helps in managing centres with excellence and quality."

Renal Project's Patients Network

Moddhia says, “Each centre supports 50-60 patients. We even provide home dialysis. We currently have close to 1300 patients."

Renal Project's Funds

Moddhia states, “The funds by 100X.VC has channeled our startup in the direction of becoming an iconic brand and a unicorn. I didn't even know the term 'unicorn' and I am not aspiring towards it either. Since my father was a doctor, we are driven by patient care. That is all on my mind and my team's mind. We want to create an impact."

"Initially with only 1 and a half centres we received the funding. This was quite a validation. We opened 3 centres with the fund. We could have opened more but were guided by 100X.VC we instead created a core team and an organisation structure. And focused more on the software development so that we can support more centres."

"Six months after their intervention, we got an angel round of Rs 25 lakhs. With these funds, we could expand. We expanded into hiring a team, like the accounts and compliance department. Then we raised another round, recently, which will help us expand beyond the Mumbai and Pune region into Gujarat."

Renal Project's Expansion Plan

Moddhia mentions, “In terms of geography, laterally or vertically, we want to test waters slowly. We have opened a couple of centres within the reach of Mumbai. Then we expanded into the peripheries and tier 2 cities. Now we are venturing out and going to Gujarat and the interiors of Maharashtra. We now have a centre in Yeola, which is on the outskirts of Nashik, we have a centre in Shirdi, Amreli, Surendranagar and more."

"These are cities where there is no dialysis centre for many miles. We have a centre 40 km off of Baroda. These are the cities in the outskirts we are aiming for now. Currently, we are staying closer to the city, to make sure the supply chain is smooth. But once we have the muscle and extensive supply chain, then we will go further deep pan-India."

Renal Project's Revenue

Moddhia states, "We are a 3.6 Cr company, currently. We could have grown by 40 centres but we took a pause post the second wave. We took to developing our quality department, our SOPs and focused more on our technology. I've been in quality assurance all my life. So everything is quality controlled and processed based. We will be growing threefold at least in the next 6 months. And by next year it will be 5 times more. You will see a surge in our growth."

Renal Project's Goals

Moddhia says, "By the end of this year we want to achieve 100 plus centres. We also equally want to be a brand for dialysis. I personally take calls for all my home dialysis patients. This overloads me but this is the stage I want to understand the needs of dialysis patients. So my 3 goals are - 

• Understand the patient care better
• Become a quality brand
• Create 100 more centres by the end of the year."

Renal Project's Cost

Moddhia says, “We are pretty affordable. The cost would be anywhere from 1100 to 1400. Many of our centres, especially the ones in the interior, are covered under Government Yojanas. Through this, the patient gets the dialysis for free."

Advice for budding Entrepreneurs

Moddhia advises, “I don't know. I haven't read many books on entrepreneurship. I am a huge fan of boxing and one thing said by Mike Tyson stuck - 'It's not about talent, it's not about intelligence. The person who really wants it will get it.' If I had thought about the talents I have before starting this venture, I would have not started it. The ignorance of what I was ignorant about was bliss. I just wanted to have 1000 dialysis centres pan-India. I'm very passionate about the whole thing. I don't think I have the talent and the intelligence to do that."

(Edited by Priyal Shah)