More than two-thirds of patients initiating RRT in Europe have at least one co-morbidity. With the rising age at the start of RRT over the last decade, there have been changes in the co-morbidity pattern: the prevalence of cardiovascular co-morbidities decreased, while the prevalence of DM and malignancy increased.

Chronic Kidney Disease (CKD) has become one of the most important public health problems worldwide. The analysis and understanding of this global/national/regional reality would benefit from the data of the renal registries. 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 subgroup of greater severity. A Kidney Replacement Therapy Registry (KRTR) is defined as a systematic and continuous collection of a population-based dataset of ESKD patients treated by dialysis/kidney transplant. The lack of available data, particularly in emerging economies, leaves information gaps on health care and outcomes in these patients. The heterogeneity/absence of KRTR in some countries is consistent with the inequities in the access to kidney replacement therapy (KRT) all over the world. In 2014, The Pan American Health Organization (PAHO) proposed to achieve at least a prevalence of KRT patients of 700 pmp by 2019 in every Latin American (LA) country. Since then, PAHO and SLANH (Sociedad Latino Americana de Nefrología e Hipertensión) lead courses of training and certification of KRTR in Latin America. The purpose of this manuscript is to provide guidance on how to set-up a new KRTR in countries or regions still lacking one. Advice is provided on the sequence of steps to setup a KRTR, personnel requirements, dataset content and minimum quality indicators required.