Interview with Dr. Salman Shakoh – Karandaaz Newsletter Irtaza Mubarikl November 4, 2023

Interview with Dr. Salman Shakoh – Karandaaz Newsletter

Karandaaz Newsletter Issue 32 – Know Our Partner 

Interview of Dr. Salman Shakoh – Founder Renacon Pharma Ltd. 

Q. Can you share the story behind the creation of Renacon Pharma? What inspired you to start it? The company has a rich history in Hemodialysis product innovation. Could you share its journey and the motivation behind its establishment in 1997?

In 1997, while overseeing Mayo Hospital’s hemodialysis (HD) centre, I observed significant morbidity among patients receiving treatment. Symptoms such as nausea, vomiting, severe weakness, frequent low blood pressure leading to collapses, malnourishment, and early deaths were prevalent due to the use of a toxic Acetate Hemodialysis solution, administered mostly twice weekly instead of thrice weekly. This Acetate Solution had become obsolete in Europe and the USA, where a more natural and physiological Bicarbonate hemodialysis solution was employed, but this technology was lacking in Pakistan.

Recognizing the urgent need for change, I undertook the development of Bicarbonate Hemodialysis Concentrate, which offers a more physiological and natural alternative. This initiative launched an intensive research and development effort in the late 1990s, despite very limited resources. Collaborating with a brilliant scientist, we successfully navigated the complex chemistry involved in creating a bicarbonate-based solution. This endeavour involved extensive clinical and chemical research, for which there were no existing facilities available in the country at that time.

The introduction of this new Bicarbonate-based solution, with its critical pH balance, electrolyte concentration, and physiological balance, significantly enhanced the quality of hemodialysis. We implemented this innovation at our dialysis centre and established a partnership with Sheikh Zayed Hospital in Lahore, thereby transforming the quality of life for our patients.

Q. Renacon Pharma Ltd. is known for providing high-quality healthcare solutions at a competitive cost. How do you maintain this delicate balance in the market?

Before our entry into the market, only one manufacturer sold the hemodialysis (HD) product at PKR 240, significantly higher than the manufacturing cost, with a substantial profit margin. At times, due to market shortages, consumers had to pay additional premiums. In response, we developed Bicarbonate Hemodialysis Concentrate, which, despite consisting of two parts, was offered at a much more affordable price. This product gradually replaced the toxic Acetate dialysis, dramatically improving patients’ quality of life in Pakistan.

Upon obtaining a manufacturing license from the Ministry of Health in 1998, we pioneered the production of Bicarbonate Hemodialysis Concentrates in South Asia. Initially operating from a small factory producing 7,500 sets per month, our capacity has since grown to 200,000 sets monthly. Despite this expansion, our manufacturing capacity has become a limiting factor, leading us to decline some customer orders. Renacon has established itself as the market leader in Pakistan due to its commitment to quality.


Currently, we are constructing a larger facility at FIEDMC with ten times the capacity to meet growing local demand while focusing on expanding our export capabilities. We are currently the sole producer of the powdered form in the region.

Q. Your product range includes different types of Hemodialysis disposable like, Renapulv, Renacart, RenaBag, disinfectants ,Mixers, RO plants, etc. Could you elaborate on the significance of these products in the healthcare sector and how your strategies have aided their development and distribution?

A. Unlike nearly all other health-related companies in Pakistan, Renacon Pharma has maintained a steadfast commitment to research and development, independently introducing hemodialysis-related products without relying on foreign franchises. In 2005, we introduced various powdered forms of hemodialysis concentrates for both local use and export. These powdered forms offer significant advantages, including reduced volume, weight, freight, and storage requirements.

As a testament to our product’s quality, the Sindh Institute of Urology and Transplant (SIUT), among South Asia’s largest dialysis centers, adopted our powder-based solution, Renapulv. Three other prominent centers in Karachi followed suit, discontinuing their imports from Rockwell, USA. This shift underscored the superior quality and reliability of our products.

Additionally, through our dedicated research and development efforts, we introduced several other pioneering products in Pakistan. These include powder cartridges, bibags, various automated mixers, customised reverse osmosis (RO) water treatment plants, water softener salt tablets, and a range of hemodialysis disinfectants. These innovations have significantly enhanced patient care standards across the country.

Looking ahead, Renacon Pharma continues to innovate with upcoming products such as nutraceuticals and a Central Delivery System, further solidifying our commitment to advancing healthcare solutions in Pakistan and beyond.

Q. Renacon Pharma has a global footprint, exporting products to multiple countries in Asia and Africa. Can you share some success stories or challenges faced in expanding your business internationally?

A. Renacon Pharma exported its powder form HD concentrate for the first time to Nepal ‘through India, against India’ in 2007 owing to its quality for 8 years.  However, our distributor reported that local production of lower quality products eventually supplanted our exports. Nevertheless, Renacon has achieved substantial international success, exporting to countries such as Afghanistan, Sri Lanka, Vietnam, Philippines, Nigeria, Kenya, Ethiopia, Somalia, Madagascar, Bangladesh, Malaysia, and others.

These countries have recognized the superior quality and cost-effectiveness of Renacon Pharma’s products. Despite challenges stemming from geopolitical factors and logistical complexities associated with exporting heavy and voluminous medical products, Renacon Pharma remains resilient. We are actively pursuing opportunities in new markets and expanding our international footprint in regions including Europe, Russia, and CIS states.


This expansion underscores Renacon Pharma’s steadfast commitment to becoming a global leader in hemodialysis-related disposables, continuing to deliver excellence and innovation worldwide.

Q. Quality certifications like ISO 9001:2015, ISO 13485:2016, and CE 1639 have played a crucial role in your business. Can you explain how these certifications have contributed to your global growth and reputation?

A. In Pakistan, the government now requires an international quality certificate (CE/ISO) for tenders, a recent development. Our proactive approach led us to obtain international certifications such as CE, ISO-13485 (for medical devices), ISO-9001 through SGS UK, since 2007, apart from GMP certificate. Other certificates acquired later on are ISO-14001 and ISO-45001. These certifications primarily focus on enhancing our export capabilities owing to confirmation to international quality standards.

Q. Renacon Pharma has been actively participating in international healthcare exhibitions, such as “Arab Health, Dubai.” How has your presence in these events contributed to your global outreach and business growth?

A. Participating in exhibitions has been immensely beneficial for our business. These events provide a unique opportunity to engage with potential clients and international partners, all in one place. When we set up our stalls at exhibitions, we gain exposure to a decent number of customers, making it a highly cost effective strategy. Months before the exhibition, we initiate communication with potential customers to arrange meetings during the event, facilitating fruitful conversations about exporting our products. These exhibitions play a pivotal role in expanding our international reach. For instance, in the last Arab Health exhibition, we connected with 60 different companies from multiple countries, and many more visited. We’re now actively communicating with these previous contacts to explore export opportunities and get the maximum possible following registrations. Participation in such events has also been valuable in East, West and South Africa.

Q. Your vision for Renacon Pharma is to become one of the largest manufacturing companies in the world for dialysis disposables. What strategies are you implementing to achieve this ambitious goal, and how have these strategies evolved with Karandaaz’s support?

A. In our future endeavours, our primary focus rests on three pivotal aspects. First and foremost, we are dedicated to expanding our production capacity to meet the burgeoning demands of our market. This expansion will allow us to better cater to the needs of our customers while maintaining the highest quality standards. In tandem with capacity expansion, we are embracing automation to improve our production processes. This move not only bolsters our output but also leads to cost savings, which we believe is a critical aspect of ensuring the affordability and accessibility of our products. Lastly, as part of our commitment to transparency and cooperation, we will be warmly inviting local and international delegates and various entities to visit our new FIEDMC facility in Faisalabad. We believe that fostering collaboration and promoting visibility will not only benefit us but also further the cause of improving healthcare through our products locally as well as in developing countries. These strategic priorities form the cornerstone of our vision for the future. We deeply appreciate Karandaaz’s invaluable support, which came at a crucial time when it was greatly needed. Our objective is to provide the most favourable Quality-to-Cost ratio for our products, particularly in developing countries where the need is significant.

Q. Innovation is a core part of Renacon Pharma’s mission. Can you share insights into your research and development efforts and how they drive innovation within the company?

A. Developing the ‘Bicarbonate Hemodialysis Concentrates’ was a difficult process and calculations that involved significant research and development efforts owing to its complex mixing ratios of both parts with water and then with each other in the machine to achieve a final desired composition. This was in contrast to the conventional single-part toxic Acetate solution. One part of the solution is made using basically from pharmaceutical (BP) grade Sodium Bicarbonate, a high-quality pharmaceutical-grade form of Sodium Bicarbonate, that guarantees superior purity and safety compared to standard household baking soda used by some manufacturers. The solution is exchanged with the patient’s blood during dialysis and even the smallest impurities can significantly alter the patients quality of life and overall health. During each four-hour dialysis session performed thrice weekly, a minimum of 120 litres of salt solution (dialysate) circulates against the patient’s blood.

I collaborated with a senior Ph.D. scientist, a former nuclear scientist, during the late 90s to lead chemical research while I took on clinical research when we started our R&D. Developing the solution required a significant amount of investment because changing the toxic acid solution required precise calculations to achieve the required concentration and acidity level.


Q. Beyond Hemodialysis Concentrates, Renacon Pharma has diversified into products like hand sanitizers, disinfectants, RO plants, salt tablets, mixers, etc. How has this diversification contributed to your company’s growth?

A. Besides our core products, which are crucial for renal care, we have diversified into manufacturing other essential hemodialysis-related items. This involves manufacturing sanitizers, surface disinfectants developed in response to the COVID-19 pandemic, and various hemodialysis disinfectants. Additionally, we’re collaborating with a university to develop a new product not currently manufactured in Pakistan. We also manufacture salt tablets for regeneration of water softeners. I played a key role in developing the first local RO water treatment plant designed for Bicarbonate hemodialysis, working with a senior chemist from PCSIR. This technology, introduced at Lahore’s first free-standing hemodialysis centre, marked a cost-effective milestone for Bicarbonate dialysis initiation. Thereafter, hundreds of local RO plants were manufactured with improvement of quality, for dialysis centres. Currently, Renacon exports customised RO Water Treatment plants under our brand name to various countries. We provide installation and training by sending senior technicians. We’ve also developed customised manual, semi-automated, and fully automated mixers for powder forms, supplying them locally and exporting them to multiple countries.

Additionally, we’ve developed specialised nutraceuticals for kidney disease patients and diabetics. We’re also in the process of developing an HD Concentrate ‘Central Delivery System’ to replace cans, offering an eco-friendly, cost-effective, and hygienic solution.

As part of our future plans, we are in the process of addressing another significant gap in the market by manufacturing bloodlines. These bloodlines, an integral part of hemodialysis, are currently 100% imported. However, we are actively working towards producing them locally. This strategic move involves importing the initial semi-finished components and then fixing them into the final ready-to-use product.

Our innovative approach not only provides a more cost-effective solution but also significantly reduces the carbon footprint. By utilising powder components, we optimise volume, weight, freight, handling, storage, and environmental impact, offering a comprehensive and eco-friendly healthcare solution.


Q. As a Karandaaz investee company, how has Karandaaz’s support and investment influenced Renacon Pharma’s growth and impact in the healthcare sector, both in Pakistan and internationally?

A. Karandaaz has been instrumental in our journey of manufacturing life-saving healthcare products. When we were facing financial constraints, they provided funding at favourable rates and terms. This crucial support has significantly advanced our progress and brought us closer to our ultimate goals. Karandaaz also assisted by engaging a consultant to review the energy consumption of our manufacturing facility, who provided us with energy optimization recommendations. We look forward to continued collaboration with Karandaaz in the future.

Q. Collaboration and partnerships are crucial aspects of Karandaaz’s support. Can you tell us about any significant collaborations or partnerships facilitated by Karandaaz that have contributed to Renacon Pharma’s success and expansion?

A. Indeed, we’ve received support from Karandaaz Pakistan in the form of referrals to potential partner organisations. Because of this support, we have initiated discussions with multiple entities regarding various funding opportunities as we diligently work towards the fulfilment of our projects. This strategic collaboration and financial support are playing a crucial role in the successful realisation of our expansion plans.

Q. How do you envision your partnership with Karandaaz continuing to support your growth and impact in the healthcare sector?

A. One of our main focuses is to see Karandaaz Pakistan support us in completing this plant to the fullest extent possible. We believe that their continued support will be instrumental in making our project a resounding success.

As we look ahead, we are enthusiastic about the possibility of partnering with Karandaaz in future ventures. These ventures hold significant promise and include pioneering efforts in Pakistan, such as the production of bloodlines and dialyzers. We believe that Karandaaz’s collaboration in these future endeavours will not only be mutually beneficial but also pave the way for transformative contributions to the healthcare industry. We aspire to continue this partnership and forge a path to success together.


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