Epidemiology of First Renal Replacement Therapy (RRT) in a Guatemalan Military Teaching Hospital: Cohort Study

Background: Acute or chronic kidney disease (CKD) develops different stages,most advanced stages usually requiring RRT to maintain functions that native kidneys are unable to perform.Indications of RRT such as:intoxications,fluid overload,metabolic and solute disturbances.We present the epidemiology,clinical characteristics and main causes for initiation of RRTin hospitalized patients Methods: Cohort study and retrospective analysis data at a tertiary Guatemalan level teaching-hospital.The primary outcome was to characterize the main criteria to start RRT with conventional hemodialysis (HD) exclusively.Epidemiological data:sex,comorbidities,hospitalization time for RRT and all-cause death were evaluated Results: From Jun 2021 to Nov 2024, a total of 130 patients were selected, the mean age was 67 years and women accounted for 36% of patients Fig1.HBP, CKD and DM were present in 70%, 63%, and 55% of patients respectively Fig 2.The mean estimated FGR for initiation of HD was 11.7ml/min/1.73m2.Uremic syndrome,fluid overload and metabolic acidosis were the main criteria for RRT in 59.2%,12% and 5.3% of patients respectively Fig3.The average time to initiate RRT within hospitalization was 6.61 days with a 24% of in-hospital mortality Conclusion: This cohort reported clinical data of patients receiving RRT for the 1st time, uremic syndrome was the most common cause of initiation RRT, similar to world literature.Over 60% of patients were in the ICU,requiring high amounts of IV fluids/medications,being susceptible to severe underlying disease with the development of oliguria.29% with CKD progressed to RRT, making volume overload the 2nd most common criteria for initiation RRT. Male patients presented higher incidence of RRT than female, this was attributed to a larger proportion of male patients.The in-hospital mortality for RRT was 24% is lower than the 49% reported in the literature.This is the first study in Guatemala that analyzes the clinical and epidemiological characteristics of patients requiring the initiation of RRT Funding: Government Support – Non-U.S.