TY - JOUR
T1 - Practice of dialysis access interventional nephrology procedures in the Asia-Pacific region
T2 - Getting lay of the land
AU - Jasuja, Sanjiv
AU - Gallieni, Maurizio
AU - Jha, Vivekanand
AU - Vachharajani, Tushar
AU - Bhalla, A. K.
AU - Tan, Jackson
AU - Tan, Cheih Suai
AU - Basnet, Nabin Bahadur
AU - Herath, Nalaka
AU - Hai An, Ha Phan
AU - Kim, Yong Soo
AU - Kim, Yaeni
AU - SampathKumar, Krishnaswamy
AU - Sahay, Manisha
AU - Ramachandran, Raja
AU - Alexander, Suceena
AU - Bhargava, Vinant
AU - Balasubramaniam, J.
AU - Voss, David
AU - Ogbac, Fredeick E.
AU - Gunawan, Atma
AU - Goh, Bak Leong
AU - Lin, Chih Ching
AU - Khan, Jamshaid
AU - Shiham, Ibrahim
AU - Ayub, Haroon
AU - Hein, Min Aung
AU - Iqbal, Sarwar
AU - Srisawat, Nattachai
AU - Gao, Bihu
AU - Sajiv, Cherian
AU - Wilkinson, Catherine
AU - Pichthida, Thim
AU - Rana, D. S.
AU - Sagar, Gaurav
AU - Bahl, Anupam
AU - Tawakley, Samir
AU - Gaur, Mragank
N1 - Publisher Copyright:
© 2023 Asian Pacific Society of Nephrology.
PY - 2023/12
Y1 - 2023/12
N2 - 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.).
AB - 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.).
KW - Asia-Pacific
KW - dialysis access
KW - interventional nephrology (IN)
KW - survey
KW - tunnelled-central catheter
UR - http://www.scopus.com/inward/record.url?scp=85170670594&partnerID=8YFLogxK
U2 - 10.1111/nep.14236
DO - 10.1111/nep.14236
M3 - Article
C2 - 37697492
AN - SCOPUS:85170670594
SN - 1320-5358
VL - 28
SP - 672
EP - 681
JO - Nephrology
JF - Nephrology
IS - 12
ER -