LATAM-AKID registry: an international multicentre, observational study of acute kidney injury requiring dialysis in Latin America.

BACKGROUND

Acute kidney injury requiring dialysis (AKI-D) is a major contributor to morbidity and mortality worldwide, with the highest burden observed in low- and lower-middle-income countries (LLMICs). In Latin America (LATAM), a region composed largely of LLMICs, the lack of region-specific data leads to variable clinical practices and inconsistent health policies for AKI, which remain major barriers to optimal kidney care. The LATAM-AKID registry aims to fill this gap and systematically characterise the epidemiology, processes of care and outcomes of patients with AKI-D across representative countries of LATAM.

METHODS AND ANALYSIS: LATAM-AKID is an international, multicentre, retrospective cohort study that will enrol consecutive critically ill adults with Kidney Disease: Improving Global Outcomes stage 3 AKI requiring dialysis. Different hospitals across 10 Latin American countries will contribute data through a standardised REDCap platform hosted at the University of Alabama at Birmingham. Deidentified data will be collected at baseline, intensive care unit (ICU) admission and renal replacement therapy (RRT) initiation, with follow-up for up to 7 days to capture ICU- and RRT-related clinical data. Study outcomes will be assessed at ICU and hospital discharge and at 90-day follow-up. The primary outcome is in-hospital mortality. Secondary outcomes include ICU mortality, 90-day mortality, ICU and hospital lengths of stay, status of renal recovery and RRT dependence at hospital discharge and at 90-day follow-up, and RRT processes and complications related to anticoagulation, catheter dysfunction, infection and circuit interruptions. Data will be analysed using multivariable logistic and Cox regression models, with planned subgroup analyses by RRT modality (continuous vs intermittent), patient-level illness severity, hospital characteristics and country gross national income categories.

ETHICS AND DISSEMINATION: This study has been approved by the institutional review board of the University of Alabama at Birmingham (IRB-300013633). Local ethics committee approvals will also be obtained at all participating sites. Results from this work will be disseminated by publications in peer-reviewed journals and presentations at national and international scientific meetings.

TRIAL REGISTRATION NUMBER: This study has been registered with clinicaltrials.gov (NCT07262320).