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

Rationale & Objective: 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. Study Design: A cross-sectional observational registry collected demographic and clinical data for stage 5 CKD through the AAMATES platform. Setting & Population: 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. Exposures or Predictors: 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: 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. Analytical Approach: Descriptive statistics were used to summarize the collected data, presented as frequencies, means ± standard deviations, and medians with interquartile ranges. Results: 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. Limitations: 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. Conclusions: 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.