Implementation of the AAMATES Platform as a National Registry for Stage 5 CKD in Mexico

Chronic kidney disease (CKD) poses a major public health challenge in Mexico. Despite this burden, no national registry exists, hindering an accurate understanding of the disease. This study sought to characterize patients with stage 5 CKD using the Administration and Management Environment for Health Services (AAMATES) digital platform and assess its potential as a national registry model.

A cross-sectional observational registry collected demographic and clinical data for stage 5 CKD through the AAMATES platform.

Patients treated between January and December 2023 at hospitals and institutes affiliated with Mexico's Coordinating Commission of National Institutes of Health and High-Specialty Hospitals (CCINSHAE) were included. The registry captured 969 patients; mean age was 49.8 years and 56% were male.

The main etiologies of CKD were type 2 diabetes mellitus (37.1%) and unknown causes (23.1%). Initial renal replacement therapy (RRT) was also documented: hemodialysis in 55%, peritoneal dialysis in 38%, preemptive transplant in 2%, and no RRT in 5%. Additional variables included residual urine volume and laboratory values (creatinine, hemoglobin, sodium, potassium, calcium, phosphorus, and albumin).

Outcomes comprised the distribution and intensity of RRT, residual urine output, biochemical parameters, time from CKD diagnosis to registry entry, and whether patients had been evaluated by a nephrologist.

Descriptive statistics were used to summarize the collected data, presented as frequencies, means ± standard deviations, and medians with interquartile ranges.

Among 537 patients receiving hemodialysis, 71% received ≤2 sessions per week; and among 365 patients receiving peritoneal dialysis, 32% received intermittent peritoneal dialysis. Residual urine volumes of 100-500 mL/d were observed in 46.6% of participants; the median time from CKD diagnosis to registry entry was 282 days, and 14% had not been evaluated by a nephrologist at diagnosis.

The registry is voluntary, is limited to stage 5 CKD, lacks data on time since diagnosis for nearly half of participants, and includes only CCINSHAE hospitals, excluding other major Mexican health care systems.

AAMATES demonstrates CCINSHAE's effort to map advanced CKD. Making this registry mandatory could enable robust epidemiological monitoring and targeted public health strategies to lessen Mexico's CKD burden.