Practice of dialysis access interventional nephrology procedures in the Asia-Pacific region: Getting lay of the land

Sanjiv Jasuja*, Maurizio Gallieni, Vivekanand Jha, Tushar Vachharajani, A. K. Bhalla, Jackson Tan, Cheih Suai Tan, Nabin Bahadur Basnet, Nalaka Herath, Ha Phan Hai An, Yong Soo Kim, Yaeni Kim, Krishnaswamy SampathKumar, Manisha Sahay, Raja Ramachandran, Suceena Alexander, Vinant Bhargava, J. Balasubramaniam, David Voss, Fredeick E. OgbacAtma Gunawan, Bak Leong Goh, Chih Ching Lin, Jamshaid Khan, Ibrahim Shiham, Haroon Ayub, Min Aung Hein, Sarwar Iqbal, Nattachai Srisawat, Bihu Gao, Cherian Sajiv, Catherine Wilkinson, Thim Pichthida, D. S. Rana, Gaurav Sagar, Anupam Bahl, Samir Tawakley, Mragank Gaur

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: This cross-sectional survey aimed to determine the prevalence of Interventional Nephrology (IN) practice amongst nephrologists in the Asia-Pacific Region (APR), specifically related to dialysis access (DA). Methods: The Association of VA and intervenTionAl Renal physicians (AVATAR) Foundation from India conducted a multinational online survey amongst nephrologists from the Asia-Pacific to determine the practice of IN in the planning, creation, and management of dialysis access. The treatment modalities, manpower and equipment availability, monthly cost of treatment, specifics of dialysis access interventions, and challenges in the training and practice of IN by nephrologists were included in the survey. Results: Twenty-one countries from the APR participated in the survey. Nephrologists from 18 (85.7%) countries reported performing at least one of the basic dialysis access-related IN procedures, primarily the placement of non-tunnelled central catheters (n-TCC; 71.5%). Only 10 countries (47.6%) reported having an average of <4% of nephrologists performing any of the advanced IN access procedures, the most common being the placement of a peritoneal dialysis (PD) catheter (20%). Lack of formal training (57.14%), time (42.8%), incentive (38%), institutional support (38%), medico-legal protection (28.6%), and prohibitive cost (23.8%) were the main challenges to practice IN. The primary obstacles to implementing the IN training were a lack of funding and skilled personnel. Conclusion: The practice of dialysis access-related IN in APR is inadequate, mostly due to a lack of training, backup support, and economic constraints, whereas training in access-related IN is constrained by a lack of a skilled workforce and finances. (Figure presented.).

Original languageEnglish
Pages (from-to)672-681
Number of pages10
Issue number12
StatePublished - Dec 2023


  • Asia-Pacific
  • dialysis access
  • interventional nephrology (IN)
  • survey
  • tunnelled-central catheter


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