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Introduction Epidemiology of acute kidney injury (AKI) is highly dependent on patient characteristics, context and geography. Considering the limited information in Latin America and the Caribbean, we performed a study with the aim to contribute to improve its better understanding. Methods Observational, prospective, longitudinal, multinational cohort study addressed to determine risk factors, clinical profile, process of care and outcomes of AKI in the region. Patients meeting KDIGO AKI definition were included over a 9-month period and designated community or hospital-acquired. De-identified clinical and lab data were entered in a specifically designed on-line platform. Co-variables potentially linked to AKI onset, in-hospital and 90-days mortality, were recorded and correlated using a multiple logistic regression model. Results Fifty-seven physicians from 15 countries provided data on 905 patients, most with acceptable basic needs coverage. Median age 64 (50–74) yrs; most of them were male (61%) and mestizos (42%). Comorbidities were present in 77%. AKI was community-acquired in 62%. Dehydration, shock and nephrotoxic drugs were the commonest causes. During their process of care, 77% of patients were assessed by nephrologists. Kidney replacement therapy (KRT) was performed in 29% of cases. In-hospital mortality was 26.5% and independently associated to older age, chronic liver disease, hypotension, shock, cardiac disturbances, hospital-acquired sepsis, KRT and mechanical ventilation. At 90-days follow up partial or complete renal recovery was 81% and mortality 24%. Conclusions AKI was mainly community-acquired, in patients with comorbidities and linked to fluid loss and nephrotoxic drugs. Mortality was high and long-term follow up poor. Notwithstanding, the study shows partially the situation in the participant countries rather than the actual epidemiology of AKI in Latin America and Caribbean, a pending and needed task.

Dept. of Nephrology School of Medicine Universidad de la República

Division of Nephrology Hospital Obrero #2 - C.N.S. Universidad Mayor de San Simon School of Medicine

LIM 12 Division of Nephrology University of Sao Paulo Medical School

Dept. of Nehrology Hospital Italiano

Dept. of Internal Medicine University of Rio de Janeiro

Hospital Provincial

Hospital Civil de Guadalajara Centro Universitario de Ciencias de la Salud

Nephrology Division Hospital do Servidor Público Estadual Universidade Nove de Julho

Botucatu School of Medicine São Paulo State University-UNESP

Clinica Renalle Pontifícia Universidade Católica Petrópolis

Sanatorio Casa de Galicia

Hospital Nacional Daniel Alcides Carrión Dept. de Medicina Servicio de Nefrología

Medical Research Unit of Renal Diseases Hospital de Especialidades CMNO IMSS

Botucatu School of Medicine São Paulo State University-UNESP