{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:06:49Z","timestamp":1788232009147,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009891","name":"International Society of Nephrology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009891","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 167 countries were available. In 31 countries (25% of surveyed countries), &gt;75% of patients initiated haemodialysis (HD) with a temporary catheter. Seven countries (5% of surveyed countries) had &gt;75% of patients initiating HD with arteriovenous fistulas or grafts. Seven countries (5% of surveyed countries) had &gt;75% of their patients starting HD with tunnelled dialysis catheters. 57% of low\u2010income countries (LICs) had &gt;75% of their patients initiating HD with a temporary catheter compared to 5% of high\u2010income 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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\u2010income countries.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/nep14259-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.14259","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T11:50:15Z","timestamp":1701258615000},"page":"135-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Global variability of vascular and peritoneal access for chronic dialysis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9165-4920","authenticated-orcid":false,"given":"Anukul","family":"Ghimire","sequence":"first","affiliation":[{"name":"Division of Nephrology and Immunology University of Alberta  Edmonton Alberta Canada"},{"name":"Department of Medicine University of Calgary  Calgary Alberta 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4494-966X","authenticated-orcid":false,"given":"Tushar","family":"Vachharajani","sequence":"additional","affiliation":[{"name":"School of Medicine Wayne State University  Detroit Michigan United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeera","family":"Levin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Kidney and Transplant Services Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Ravani","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Calgary  Calgary Alberta 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AndersH\u2010J KellyDM et al.Global Kidney Health Atlas: A report by the International Society of Nephrology on the global burden of end\u2010stage kidney disease and capacity for kidney replacement therapy and conservative care across world countries and regions. International Society of Nephrology.2019."},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.02.029"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.14259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:15:07Z","timestamp":1708388107000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.14259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1111\/nep.14259"],"URL":"https:\/\/doi.org\/10.1111\/nep.14259","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,29]]},"assertion":[{"value":"2023-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}