TY - JOUR
T1 - Interventional nephrology and vascular access practice
T2 - A perspective from South and Southeast Asia
AU - Ramachandran, Raja
AU - Bhargava, Vinant
AU - Jasuja, Sanjiv
AU - Gallieni, Maurizio
AU - Jha, Vivekanand
AU - Sahay, Manisha
AU - Alexender, Suceena
AU - Mostafi, Mamun
AU - Pisharam, Jayakrishnan K.
AU - Chi Wai, Tang Sydeny
AU - Jacob, Chakko
AU - Gunawan, Atma
AU - Leong, Goh Bak
AU - Thwin, Khin Thida
AU - Agrawal, Rajendra Kumar
AU - Vareesangthip, Kriengsak
AU - Tanchanco, Roberto
AU - Choong, Lina
AU - Herath, Chula
AU - Lin, Chih Ching
AU - Cuong, Nguyen The
AU - Akhtar, Syed Fazal
AU - Alsahow, Ali
AU - Rana, D. S.
AU - Kher, Vijay
AU - Rajapurkar, M. M.
AU - Jeyaseelan, L.
AU - Puri, Sonika
AU - Sagar, Gaurav
AU - Bahl, Anupam
AU - Verma, Shalini
AU - Sethi, Anil
AU - Vachharajani, Tushar
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021/5
Y1 - 2021/5
N2 - South and Southeast Asia is the most populated, heterogeneous part of the world. The Association of Vascular Access and InTerventionAl Renal physicians (AVATAR Foundation), India, gathered trends on epidemiology and Interventional Nephrology (IN) for this region. The countries were divided as upper-middle- and higher-income countries as Group-1 and lower and lower-middle-income countries as Group-2. Forty-three percent and 70% patients in the Group 1 and 2 countries had unplanned hemodialysis (HD) initiation. Among the incident HD patients, the dominant Vascular Access (VA) was non-tunneled central catheter (non-TCC) in 70% of Group 2 and tunneled central catheter (TCC) in 32.5% in Group 1 countries. Arterio-Venous Fistula (AVF) in the incident HD patients was observed in 24.5% and 35% of patients in Group-2 and Group-1, respectively. Eight percent and 68.7% of the prevalent HD patients in Group-2 and Group-1 received HD through an AVF respectively. Nephrologists performing any IN procedure were 90% and 60% in Group-2 and Group 1, respectively. The common procedures performed by nephrologists include renal biopsy (93.3%), peritoneal dialysis (PD) catheter insertion (80%), TCC (66.7%) and non-TCC (100%). Constraints for IN include lack of time (73.3%), lack of back-up (40%), lack of training (73.3%), economic issues (33.3%), medico-legal problems (46.6%), no incentive (20%), other interests (46.6%) and institution not supportive (26%). Routine VA surveillance is performed in 12.5% and 83.3% of Group-2 and Group-1, respectively. To conclude, non-TCC and TCC are the most common vascular access in incident HD patients in Group-2 and Group-1, respectively. Lack of training, back-up support and economic constraints were main constraints for IN growth in Group-2 countries.
AB - South and Southeast Asia is the most populated, heterogeneous part of the world. The Association of Vascular Access and InTerventionAl Renal physicians (AVATAR Foundation), India, gathered trends on epidemiology and Interventional Nephrology (IN) for this region. The countries were divided as upper-middle- and higher-income countries as Group-1 and lower and lower-middle-income countries as Group-2. Forty-three percent and 70% patients in the Group 1 and 2 countries had unplanned hemodialysis (HD) initiation. Among the incident HD patients, the dominant Vascular Access (VA) was non-tunneled central catheter (non-TCC) in 70% of Group 2 and tunneled central catheter (TCC) in 32.5% in Group 1 countries. Arterio-Venous Fistula (AVF) in the incident HD patients was observed in 24.5% and 35% of patients in Group-2 and Group-1, respectively. Eight percent and 68.7% of the prevalent HD patients in Group-2 and Group-1 received HD through an AVF respectively. Nephrologists performing any IN procedure were 90% and 60% in Group-2 and Group 1, respectively. The common procedures performed by nephrologists include renal biopsy (93.3%), peritoneal dialysis (PD) catheter insertion (80%), TCC (66.7%) and non-TCC (100%). Constraints for IN include lack of time (73.3%), lack of back-up (40%), lack of training (73.3%), economic issues (33.3%), medico-legal problems (46.6%), no incentive (20%), other interests (46.6%) and institution not supportive (26%). Routine VA surveillance is performed in 12.5% and 83.3% of Group-2 and Group-1, respectively. To conclude, non-TCC and TCC are the most common vascular access in incident HD patients in Group-2 and Group-1, respectively. Lack of training, back-up support and economic constraints were main constraints for IN growth in Group-2 countries.
KW - AV fistula
KW - Southeast Asia
KW - Vascular access
KW - interventional nephrology (IN)
KW - tunneled catheter
KW - vascular access surveillance
UR - http://www.scopus.com/inward/record.url?scp=85105758752&partnerID=8YFLogxK
U2 - 10.1177/11297298211011375
DO - 10.1177/11297298211011375
M3 - Editorial
C2 - 33934667
AN - SCOPUS:85105758752
SN - 1129-7298
VL - 23
SP - 849
EP - 860
JO - Journal of Vascular Access
JF - Journal of Vascular Access
IS - 6
M1 - 11297298211011375
ER -