Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2022 Nov;23(6):849-860.
doi: 10.1177/11297298211011375. Epub 2021 May 3.

Interventional nephrology and vascular access practice: A perspective from South and Southeast Asia

Raja Ramachandran  1 , Vinant Bhargava  2 , Sanjiv Jasuja  3 , Maurizio Gallieni  4 , Vivekanand Jha  5 , Manisha Sahay  6 , Suceena Alexender  7 , Mamun Mostafi  8 , Jayakrishnan K Pisharam  9 , Tang Sydeny Chi Wai  10 , Chakko Jacob  11 , Atma Gunawan  12 , Goh Bak Leong  13 , Khin Thida Thwin  14 , Rajendra Kumar Agrawal  15 , Kriengsak Vareesangthip  16 , Roberto Tanchanco  17 , Lina Choong  18 , Chula Herath  18 , Chih-Ching Lin  19 , Nguyen The Cuong  20 , Syed Fazal Akhtar  21 , Ali Alsahow  22 , D S Rana  23 , Vijay Kher  24 , M M Rajapurkar  25 , L Jeyaseelan  7 , Sonika Puri  26 , Gaurav Sagar  3 , Anupam Bahl  3 , Shalini Verma  27 , Anil Sethi  27 , Tushar Vachharajani  28
Affiliations
Editorial

Interventional nephrology and vascular access practice: A perspective from South and Southeast Asia

Raja Ramachandran et al. J Vasc Access. 2022 Nov.

Abstract

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.

Keywords: AV fistula; Southeast Asia; Vascular access; interventional nephrology (IN); tunneled catheter; vascular access surveillance.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1. Schematic description of data collection.
Figure 2
Figure 2. Vascular accesses among incident HD patients.
Figure 3
Figure 3. Vascular accesses among prevalent HD patients.
See this image and copyright information in PMC

Comment in

References

    1. Efstratiadis G, Platsas I, Koukoudis P, et al. Interventional nephrology: a new subspecialty of nephrology. Hippokratia. 2007;11(1):22–24. - PMC - PubMed
    1. Southern Asia Population (LIVE) https://www.worldometers.info/world-population/southern-asia-population/
    1. South-Eastern Asia Population (LIVE) https://www.worldometers.info/world-population/south-eastern-asia-popula...
    1. What Are The Five Regions of Asia? https://www.worldatlas.com/articles/the-four-regions-of-asia.html .
    1. Human Development Indices and Indicators. 2018 Statistical Update, Published for the United Nations Development Programme (UNDP) http://hdr.undp.org/en/content/human-development-indices-indicators-2018... .

Publication types

MeSH terms

LinkOut - more resources