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Step-by-step guide to setting up a kidney replacement therapy registry: the challenge of a national kidney
Guillermo Rosa-Diez1,2, María Carlota González-Bedat1,3, Rosario Luxardo1,2
1Latin American Dialysis and Renal Transplantation Registry (RLADTR), Montevideo, Uruguay.
Insights
Establishing a kidney replacement therapy registry (KRTR) is crucial for understanding end-stage kidney disease (ESKD) globally. This guide provides essential steps for countries lacking a KRTR to improve data collection and patient care.
Area of Science:
- Nephrology
- Public Health
- Health Informatics
Background:
- Chronic kidney disease (CKD) is a major global health issue.
- End-stage kidney disease (ESKD) patients represent a high-cost, high-morbidity subgroup.
- Renal registry databases are vital for analyzing CKD prevalence and outcomes, but costly to implement comprehensively.
Purpose of the Study:
- To provide guidance on establishing a kidney replacement therapy registry (KRTR) in regions lacking one.
- To address data gaps in ESKD patient care and outcomes, particularly in emerging economies.
- To promote equitable access to kidney replacement therapy (KRT) worldwide.
Main Methods:
- The manuscript outlines sequential steps for setting up a new KRTR.
- It details essential personnel requirements for registry operation.
- Recommendations cover data set content and minimum quality indicators.
Main Results:
- The lack of KRTRs correlates with global inequities in KRT access.
- The Pan American Health Organization (PAHO) has actively promoted KRTR development in Latin America since 2014.
- Guidance is provided for implementing a systematic and continuous collection of population-based data for ESKD patients.
Conclusions:
- Implementing a KRTR is essential for understanding and managing ESKD.
- This guide offers practical steps for countries aiming to establish a KRTR.
- Standardized KRTRs can help reduce healthcare disparities and improve KRT outcomes.
Abstract:
Chronic kidney disease (CKD) has become one of the most important public health problems worldwide. Analysis, and understanding, of this global/national/regional reality would benefit from renal registry databases. The implementation of a CKD registry (including all categories) is difficult to achieve, given its high cost. On the other hand, patients with end-stage kidney disease (ESKD) are easily accessible and constitute the most severe subgroup in terms of comorbidities and healthcare costs. A kidney replacement therapy registry (KRTR) is defined as the systematic and continuous collection of a population-based data set from ESKD patients treated by dialysis/kidney transplant. The lack of available data, particularly in emerging economies, leaves information gaps on healthcare and outcomes in these patients. The heterogeneity/absence of a KRTR in some countries is consistent with the inequities in access to KRT worldwide. In 2014, the Pan American Health Organization (PAHO) proposed to determine the prevalence of patients on dialysis for at least 700 patients per million inhabitants by 2019 in every Latin American (LA) country. Since then, PAHO and the Sociedad LatinoAmericana de Nefrología e Hipertensión have provided training courses and certification of KRTR in LA. The purpose of this manuscript is to provide guidance on how to set up a new KRTR in countries or regions that still lack one. Advice is provided on the sequential steps in the process of setting up a KRTR, personnel requirements, data set content and minimum quality indicators required.
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