ADVANCING KIDNEY HEALTH WORLDWIDE.
TOGETHER.

INTERVENTIONAL NEPHROLOGYTRAINING CENTERS
Practical Details for Interested Institutions
2023 Edition

ISN Programs Chair:
Tushar VachharajaniInterventional Nephrology Chair:
Jadranka Buturovic Ponikvar, Slovenia

Interventional Nephrology
Deputy Chair:
Mayuri Trivedi, India

Program Contact:
ISN Programs TeamE-mail: isnprograms@theisn.org

https://theisn.org

International Society of Nephrology (ISN)
Avenue des Art 1-2, 1210 Brussels, Belgium – 340 North Avenue Cranford, NJ 07016-2496, USA
info@theisn.org

TABLE OF CONTENTS
1.

Objectives of ISN Interventional Nephrology Training Centers ....................................................... 3

2.

Benefits of being an ISN Interventional Nephrology Training Center .............................................. 33.

How to apply ................................................................................................................................... 4

4.

Review of applications ..................................................................................................................... 55.

Role of ISN Interventional Nephrology Training Centers ................................................................. 6

6.

Renewal process for ISN Interventional Nephrology Training Centers ............................................ 9Page 2

1. OBJECTIVES OF ISN INTERVENTIONAL NEPHROLOGY TRAINING
CENTERSThe demand for interventional nephrology training has been steadily growing in low- and middleincome countries, where number of interventionalists is very limited, and patients often miss dialysis
treatment because of vascular access problems. For young nephrologists who want interventional
nephrology training, the opportunity to be trained in developed countries is rarely available. If they canbe trained in the ISN-recognized centers with some funds for training, they will provide better qualityof care for dialysis patients and train others interventional nephrologists in the same region.
The first IN Training Centers were selected in 2020, and applications rounds for the Interventional
Nephrology Scholarship Program have been held annually ever since. The Scholarship Program has
proved to extremely popular, with more high-quality applications than could be supported by the 12original IN Training Centers. As such, the ISN once again welcomes applications for new IN Training
Centers, as well as opening up possibilities for training in more topics.
ISN Interventional Nephrology Training Centers host trainees for two types of courses:•Foundation course (2-4 weeks) – designed for trainees who need training in a specificinterventional procedure. (hands-on or observership)•Advanced course (3 months) – designed for trainees who need training in a broad spectrum ofprocedures, especially endovascular procedures. (must be hands-on, with the Scholar being
able to practice the procedures themselves)

Both courses are accompanied by an online component – the Interventional Nephrology E-learning
Curriculum must be completed by all Scholars.

2. BENEFITS OF BEING AN ISN INTERVENTIONAL NEPHROLOGYTRAINING CENTER
Selected centers will receive approval as ISN Interventional Nephrology Training Centers for a five-yearterm.
At the end of this period, selected centers will have the option to re-apply to remain an ISN
Interventional Nephrology Training Center.
Selected centers will host trainees from low- and middle-income countries for a Foundation Course (24 weeks) or for an Advanced Course (3 months). ISN will support these trainees with a grant tocontribute to their travel, accommodation and living costs during the training.
ISN Interventional Nephrology Training Centers will benefit from increased visibility at national, regionaland global levels – they will be promoted on the ISN website and all other ISN communication channels.
Selected centers will receive a certificate and may state that they are an ‘ISN Interventional Nephrology
Training Center 20XX-20XX’ (with the ISN logo alongside this statement) on their letterhead and othercommunications.

Page 3

Please note that ISN recognition does not provide certification according to the criteria of any existing
postgraduate training organization.

3. HOW TO APPLY
The deadline to apply is September 1st. The application must be completed in English. Only
applications submitted via the application portal will be considered.

CLICK HERE TO APPLY
apAPPLYhttps://fellowship.theisn.org/prog/isn_interventional_ne
Eligibility criteria phrology_training_centers•No restriction in terms of country income category as classified by the World Bank•

The program liaison officer and senior nephrology staff involved in the training should be fullISN members.

•The center should either:ohave university affiliated programs or accredited academic programs as perregional/national regulations for at least 2 years
oro•

have performed specific procedures for at least 2 years such as tunnelled HD catheter
insertion, PD catheter insertion, diagnostic endovascular procedures, therapeutic
endovascular procedures (PTA, thrombectomy, stents insertion, coils embolization,etc), dialysis vascular access ultrasound, vascular access surgery, etc.

The center should have performed at least 200 interventional procedures in the previous yearof application.

Facility and equipment requirements
The center should:•

Have a designated space to perform procedures: interventional suite within radiology, surgery,cardiac cath. lab or designated nephrology suite•

Have the following equipment: Fluoroscopy C-arm (or equivalent), Vascular ultrasonographymachine, Operating table, Adequate lighting, Patient monitoring needs (pulse oximetry, cardiac
monitor, ECG, oxygen supply)•

Have a proper recovery area•

Have a storage area•

Meet safety needs as per local/regional requirements and regulations

Page 4

•

Maintain quality assurance records: procedure log, complications (as per ASDIN guidelines),
outcomes, radiation safety log. It should be ongoing with the aim of developing regionalguidelines•

Prioritise patient safety with contingency plans for management of complications,emergencies, and maintain standard operating procedure plan.

Requirements for Trainer•

The program liaison officer and senior nephrology staff involved in the training should be full
ISN members.

•Trainers should either be:onephrologists, surgeons, radiologists, cardiologists who have performed theseprocedures for at least 2 years
oronephrologists who were trained by ISN Educational Ambassadors and have performed
these procedures for at least 2 years.

General tips and comments
Application:
The application is a lengthy process and we recommend you allocate enough time for it before
submission. The ISN will select a limited number of ISN Interventional Nephrology Training Centers andonly candidates with a strong application file will be accepted.

Forms:Your application must be submitted via the online application system. Applications sent by email, fax
or post will not be considered.

ISN membership:
Interventional Nephrology Training Centers serve as ISN beacons within a region. The program liaison
officer and senior staff at these centers are expected to be active members of the ISN community withfull ISN Membership. Explore different ISN membership opportunities for your colleagues and become
part of the ISN community. If membership fees are not paid, the application will not be considered.

Language:
The application and all enclosed documents must be written in English. Documents submitted in any
other language will not be accepted.

4. REVIEW OF APPLICATIONSThe ISN Interventional Nephrology Working Group will review applications and forward its
recommendations to the ISN Programs Chair for approval. The names of centers selected will be
submitted to the ISN Executive Committee for final approval.

Page 5Assessment will be based on the criteria listed below:•Facilities and equipment available at the training center•

Number of procedures undertaken in the last 2 years•

Experience of the trainers•

Available curriculum and possibility of hands-on training•

Language of training•Local accreditation (by professional organization or government)•

Adequate governance, planning, staffing and with quality insurance•

Relevance of training offered to the region

The outcome of applications will be announced within two months of the deadline. The selected centerswill be encouraged to host trainees accepted by the ISN Interventional Nephrology Working Group in
the application sessions held in January each year.

5. ROLE OF ISN INTERVENTIONAL NEPHROLOGY TRAINING CENTERS
The primary objective of ISN Interventional Nephrology Training Centers is to provide interventional
nephrology training to young nephrologists in low, lower-middle, or upper-middle-income countries
from their region through the ISN Interventional Nephrology Training Courses.
Each application round for Interventional Nephrology Scholarships, IN Training Centers select whichapplicants they would be willing to train. The ISN then makes the final selection of who will receive
funding and certification as part of the Scholarship Program.
In addition, like all ISN Regional Training Centers, ISN Interventional Nephrology Training Centers areexpected to promote ISN activities in their region.

ISN Interventional Nephrology Training Courses
To be eligible to apply for the ISN Interventional Nephrology Training Courses, trainees should be full
ISN members, from a low, lower-middle, or upper-middle income country as classified by the World
Bank, and have the guarantee from the home institution of their re-employment once the training has
been completed.
There is one application session per year, and applications are reviewed by the ISN Interventional
Nephrology Working Group. Trainees must complete the ‘Interventional Nephrology eLearning
Program’ before starting the hands-on training at the host center.

Page 6

Interventional Nephrology eLearning Program:
Didactic components are standardized with the Interventional Nephrology eLearning Program on theISN Academy. It includes sessions on:•Introduction to interventional nephrology•

Fundamentals of vascular anatomy•

Fundamentals of vascular access – Catheter, AVF, AVG.

•Physiology of AV access dysfunction•

Monitoring and surveillance techniques principles•

Physical examination of AV access•Central venous catheter and its complications•

Management of catheter related blood stream infection•

Safety rules for IN procedures – sedation, radiation, infection prevention•

Physics of Ultrasonography and its roles in AV access assessment•

Basics knowledge on tools used to perform IN procedures•

CVC designs for temporary/bridge access•

PD catheter - design, placement steps, complications•

Kidney biopsy - needles, sample handling, indications and complications

Once the Interventional Nephrology eLearning Program is completed, trainees can start the hands-on
training, which includes the following procedures:•Tunneled and non-tunneled central venous catheter placement•

Peritoneal dialysis catheter placement•

Endovascular (angioplasty, thrombectomy, etc)

•Native and non-native kidney biopsy•

Point-of-care ultrasonography (specific to kidneys)

The ISN Interventional Nephrology Training Courses offer two levels of hands-on training: aFoundation Course and an Advanced Course.

Level 1 – Foundation Course:
The Foundation Course is a training of 2 to 4 weeks designed for trainees who need training in a
specific procedure listed in the training curriculum. Training Centers can provide observatory trainingor hands-on training with patients.

Page 7

This course is useful for trainees who want to learn specific procedure such as tunneled HD catheter
insertion, PD catheter insertion or kidney biopsy based on the resources and situation theyencountered. However, they can observe or assist cases in the curriculum, which broaden theirknowledge and expertise in dialysis access management.

Level 2 – Advanced Course
The Advanced Course is a training of up to 3 months designed for trainees who need training in a broad
spectrum of procedures listed in training curriculum, especially endovascular procedures. Training
Centers should provide hands-on training with patients.
This course is useful for trainees who want advanced-level training such as broad endovascular
procedures. The trainees will be able to start interventional nephrology program immediately after
return if facility and equipment for the procedures are ready.
Level 2 course mandates minimum number of procedures in 3 months as follows:
CVC (tunneled and non-tunneled)

10 procedures and 50% performed independently

Tunneled PD catheter

10 procedures and 50% performed independently

Acute PD catheter

10 procedures and 50% performed independently

Diagnostic angiography andEndovascular procedures
Kidney biopsy

20 procedures and 50% performed independently

Nephro-POCUS(total/independent)

5 native and 5 transplant biopsies performed
independently using USG. Simultaneous
understanding of the tissue processing needs forhistopathology reading.
• Kidney-Doppler ultrasonography: 30/10• Urinary bladder ultrasonography: 15/5
• Inferior v. cava (15/5)• Lung ultrasonography (15/5)• Basic echocardiography (15/5)• Preoperative mapping for arteriovenous
fistula (15/5)• Arteriovenous fistula with clinical problem(15/5)

Certificate:
Trainees will receive a certificate ‘Completion of Interventional Nephrology (Foundation or Advanced)
Training Course’ from ISN at the end of training period based on the type of trained procedures, numberof performed procedures, and a short report about trainee’s performance from host mentor (e.g.
certificate of endovascular procedures, certificate of tunneled HD catheter insertion, etc).

Page 8

6. RENEWAL PROCESS FOR ISN INTERVENTIONAL NEPHROLOGYTRAINING CENTERS
ISN Interventional Nephrology Training Centers will need to re-apply to keep their status every fiveyears.
The ISN Interventional Nephrology Working Group reviews quality assurance data (number of trainees,
number of procedures, individual trainee log of procedures, etc) and feedback from trainees.
The ISN Interventional Nephrology Working Group will review applications and forward its
recommendations to the ISN Programs Chair for approval. The names of centers selected will be
submitted to the ISN Executive Committee for final approval.

For any further questions or assistance with your application, please don’t
hesitate to get in touch at isnprograms@theisn.org.

Page 9