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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Global variability of vascular and peritoneal access for chronic dialysis
Nephrology, Year 2023
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Description
Aim: Vascular and peritoneal access are essential elements for sustainability of chronic dialysis programs. Data on availability, patterns of use, funding models, and workforce for vascular and peritoneal accesses for dialysis at a global scale is limited. Methods: An electronic survey of national leaders of nephrology societies, consumer representative organizations, and policymakers was conducted from July to September 2018. Questions focused on types of accesses used to initiate dialysis, funding for services, and availability of providers for access creation. Results: Data from 167 countries were available. In 31 countries (25% of surveyed countries), >75% of patients initiated haemodialysis (HD) with a temporary catheter. Seven countries (5% of surveyed countries) had >75% of patients initiating HD with arteriovenous fistulas or grafts. Seven countries (5% of surveyed countries) had >75% of their patients starting HD with tunnelled dialysis catheters. 57% of low-income countries (LICs) had >75% of their patients initiating HD with a temporary catheter compared to 5% of high-income countries (HICs). Shortages of surgeons to create vascular access were reported in 91% of LIC compared to 46% in HIC. Approximately 95% of participating countries in the LIC category reported shortages of surgeons for peritoneal dialysis (PD) access compared to 26% in HIC. Public funding was available for central venous catheters, fistula/graft creation, and PD catheter surgery in 57%, 54% and 54% of countries, respectively. Conclusion: There is a substantial variation in the availability, funding, workforce, and utilization of vascular and peritoneal access for dialysis across countries regions, with major gaps in low-income countries. (Figure presented.). © 2023 The Authors. Nephrology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Nephrology.
Authors & Co-Authors
Ghimire, Anukul
Canada, Edmonton
University of Alberta
Canada, Calgary
University of Calgary
Okpechi, Ikechi Gareth
Canada, Edmonton
University of Alberta
Ye, Feng
Canada, Edmonton
University of Alberta
Vachharajani, Tushar
United States, Detroit
Wayne State University
Levin, Adeera I.
Canada, Vancouver
The University of British Columbia
Johnson, David W.
Australia, Woolloongabba
Princess Alexandra Hospital
Ravani, Pietro
Canada, Calgary
University of Calgary
Tonelli, Marcello A.
Canada, Calgary
University of Calgary
Thompson, Stephanie
Canada, Edmonton
University of Alberta
Luyckx, Valerie Ann
Switzerland, Zurich
Universität Zürich
Jindal, Kailash K.
Canada, Edmonton
University of Alberta
Caskey, Fergus J.
United Kingdom, Bristol
University of Bristol
Kazanciog̈lu, Rümeyza Turan
Turkey, Istanbul
Bezmiâlem Vakıf Üniversitesi
Bello, Aminu Kasarawa
Canada, Edmonton
University of Alberta
Statistics
Authors: 14
Affiliations: 11
Identifiers
Doi:
10.1111/nep.14259
ISSN:
13205358
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative