International Society Of Nephrology Research Articles

Acute Kidney Injury and Associated Factors in Intensive Care Units at a Tertiary Hospital in Northern Tanzania.

Background:Acute kidney injury (AKI) is a recognized complication in critically ill patients. The epidemiology of AKI varies worldwide, depending on the diagnostic criteria used and the setting. The International Society of Nephrology has called for a reduction in preventable deaths from AKI to zero by the year 2025. It is suspected that the majority of AKI cases are in limited-resource countries, but the true burden of AKI in these settings remains unknown.Objective:We aimed to determine, using standardized KDIGO (Kidney Disease Improving Global Outcomes) criteria, the prevalence of AKI, associated factors, and clinical characteristics of adult (≥18 years) patients admitted to intensive care units (ICUs) at a tertiary hospital in Tanzania.Design:Prospective observational study from November 2017 to May 2018.Methods:In all, 320 patients admitted to medical and surgical ICUs were consecutively enrolled. Baseline, clinical, and laboratory data were collected on admission and during their ICU stay. Serum creatinine and urine output were measured, and KDIGO criteria were used to determine AKI status.Results:More than half (55.3%) of ICU patients were diagnosed with AKI. Of these, 80% were diagnosed within 24 hours of admission. Acute kidney injury stage 3 accounted for 35% of patients with AKI. Patients with AKI were older, more likely to have cardiovascular comorbidities, and with higher baseline serum levels of creatinine, potassium, universal vital assessment admission scores, and total white cell count ≥12. Sepsis (odds ratio [OR] = 3.81; confidence interval [CI] = 1.21-11.99), diabetes (OR = 2.54; CI = 1.24-5.17), and use of vasopressors (OR = 3.78; CI = 1.36-10.54) were independently associated with AKI in multivariable logistic regression. Less than one-third of those who needed dialysis received it. There was 100% mortality in those who needed dialysis but did not receive (n = 19).Limitations:Being based at a referral center, the findings do not represent the true burden of AKI in the community.Conclusion:The prevalence of AKI was very high in ICUs in Northern Tanzania. The majority of patients presented with AKI and were severely ill, suggesting late presentation, underscoring the importance of prioritizing prevention and early intervention. Further studies should explore locally suitable AKI risk scores that could be used to identify high-risk patients in the community health centers from where patients are referred.

Availability and Affordability of Kidney Health Laboratory Tests around the Globe

Background: Kidney disease is a major global public health problem, and laboratory testing of kidney health measures is essential for diagnosis and monitoring. The availability and affordability of kidney health laboratory tests across countries has not been systematically described. Methods: The International Society of Nephrology (ISN), in partnership with leaders of a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference, surveyed a representative subset of ISN-Global Kidney Health Atlas (ISN-GKHA) respondents from April to June 2020. We assessed the association between country gross national income (GNI) per capita and laboratory testing availability and affordability. Results: Of 33 regional expert nephrologists invited, 24 (73%) responded, representing all 10 ISN regions around the world. Availability of kidney health laboratory tests was as follows: serum Cr (100%), serum cystatin C (67%), urine albumin (96%), urine Cr (100%), and dipstick urinalysis (100%). Median (IQR) reimbursement values in international dollars were as follows: serum Cr Int$ 6.61 (3.42–8.84), serum cystatin C Int$ 31.51 (17.36–46.25), urine albumin Int$ 10.22 (5.90–15.42), urine Cr Int$ 7.50 (1.66–8.84), and dipstick urinalysis Int$ 6.26 (2.56–8.40). Reimbursement values did not differ significantly by World Bank income group or by GNI per capita. Conclusion: There was widespread availability of kidney health laboratory tests and substantial variation in reimbursement values. To achieve meaningful progress across nations in mitigating the growth of kidney disease, access to affordable diagnostic technology is essential. Our results are highly relevant to policymakers and researchers as countries increasingly consider national strategies for kidney disease detection and management.

Hemodialysis Use and Practice Patterns: An International Survey Study

Hemodialysis (HD) is the most common form of kidney replacement therapy. This study aimed to examine the use, availability, accessibility, affordability, and quality of HD care worldwide. A cross-sectional survey. Stakeholders (clinicians, policy makers, and consumer representatives) in 182 countries were convened by the International Society of Nephrology from July to September2018. Use, availability, accessibility, affordability, and quality of HD care. Descriptive statistics. Overall, representatives from 160 (88%) countries participated. Median country-specific use of maintenance HD was 298.4 (IQR, 80.5-599.4) per million population (pmp). Global median HD use among incident patients with kidney failure was 98.0 (IQR, 81.5-140.8) pmp and median number of HD centers was 4.5 (IQR, 1.2-9.9) pmp. Adequate HD services (3-4 hours 3 times weekly) were generally available in 27% of low-income countries. Home HD was generally available in 36% of high-income countries. 32% of countries performed monitoring of patient-reported outcomes; 61%,monitoring of small-solute clearance; 60%,monitoring of bone mineral markers; 51%,monitoring of technique survival; and 60%, monitoring of patient survival. At initiation of maintenance dialysis, only 5% of countries used an arteriovenous access in almost all patients. Vascular access education was suboptimal, funding for vascular access procedures was not uniform, and copayments were greater in countries with lower levels of income. Patients in 23% of the low-income countries had to pay >75% of HD costs compared with patients in only 4% of high-income countries. A cross-sectional survey with possibility of response bias, social desirability bias, and limited data collection preventing in-depth analysis. In summary, findings reveal substantial variations in global HD use, availability, accessibility, quality, and affordability worldwide, with the lowest use evident in low- and lower-middle-income countries.

Advancing Nephrology: Division Leaders Advise ASN.

New treatments, new understanding, and new approaches to translational research are transforming the outlook for patients with kidney diseases. A number of new initiatives dedicated to advancing the field of nephrology-from value-based care to prize competitions-will further improve outcomes of patients with kidney disease. Because of individual nephrologists and kidney organizations in the United States, such as the American Society of Nephrology, the National Kidney Foundation, and the Renal Physicians Association, and international nephrologists and organizations, such as the International Society of Nephrology and the European Renal Association-European Dialysis and Transplant Association, we are beginning to gain traction to invigorate nephrology to meet the pandemic of global kidney diseases. Recognizing the timeliness of this opportunity, the American Society of Nephrology convened a Division Chief Retreat in Dallas, Texas, in June 2019 to address five key issues: (1) asserting the value of nephrology to the health system; (2) productivity and compensation; (3) financial support of faculty's and divisions' educational efforts; (4) faculty recruitment, retention, diversity, and inclusion; and (5) ensuring that fellowship programs prepare trainees to provide high-value nephrology care and enhance attraction of trainees to nephrology. Herein, we highlight the outcomes of these discussions and recommendations to the American Society of Nephrology.

Peritoneal Dialysis Use and Practice Patterns: An International Survey Study

Approximately 11% of people with kidney failure worldwide are treated with peritoneal dialysis (PD). This study examined PD use and practice patterns across the globe. A cross-sectional survey. Stakeholders including clinicians, policy makers, and patient representatives in 182 countries convened by the International Society of Nephrology between July and September2018. PD use, availability, accessibility, affordability, delivery, and reporting of quality outcome measures. Descriptive statistics. Responses were received from 88% (n=160) of countries and there were 313 participants (257 nephrologists [82%], 22 non-nephrologist physicians [7%], 6 other health professionals [2%], 17 administrators/policy makers/civil servants [5%], and 11 others [4%]). 85% (n=156) of countries responded to questions about PD. Median PD use was 38.1 per million population. PD was not available in 30 of the 156 (19%) countries responding to PD-related questions, particularly in countries in Africa (20/41) and low-income countries (15/22). In 69% of countries, PD was the initial dialysis modality for≤10% of patients with newly diagnosed kidney failure. Patients receiving PD were expected to pay 1% to 25% of treatment costs, and higher (>75%) copayments (out-of-pocket expenses incurred by patients) were more common in South Asia and low-income countries. Average exchange volumes were adequate (defined as 3-4 exchanges per day or the equivalent for automated PD) in 72% of countries. PD quality outcome monitoring and reporting were variable. Most countries did not measure patient-reported PD outcomes. Low responses from policy makers; limited ability to provide more in-depth explanations underpinning outcomes from each country due to lack of granular data; lack of objective data. Large inter- and intraregional disparities exist in PD availability, accessibility, affordability, delivery, and reporting of quality outcome measures around the world, with the greatest gaps observed in Africa and South Asia.

Acute Kidney Injury: Risk Factors and Management Challenges in Low- and Middle-Income Countries

Acute kidney injury (AKI) is a major global health problem, occurring in >13 million people and responsible for >2.3 million deaths every year, 85% of which are in developing countries. Although the International Society of Nephrology (ISN) set a goal of eliminating preventable deaths by AKI by 2025, implementation of this program in developing countries presents major challenges for several reasons: there are few data on the epidemiology and causes of AKI in low- and middle-income countries (LMIC); health care resources to diagnose, manage, and treat AKI are often limited; and governments, institutions, and global health initiatives have not focussed sufficiently on the AKI problems. Thus, developing and implementing effective strategies to eliminate preventable deaths from AKI in LMIC have required efforts to better understand how to increase the awareness of AKI by health care workers and institutions.

Editorial introductions

Editorial introductions

Nomenclature for Kidney Function and Disease: Executive Summary and Glossary From a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference.

This article is being published in Kidney International Reports and reprinted concurrently in several journals. The articles cover identical concepts and wording but vary in minor stylistic and spelling changes, detail, and length of manuscript, in keeping with each journal's style. Any of these versions may be used in citing this article. Excerpts are adapted with permission of KDIGO and the International Society of Nephrology.

Glomerular Diseases: Systemic Lupus Erythematosus is Most Common Finding: A Cross-Sectional Study

The objective of this study was to assess the connection amongst’s immunological and histopathological findings of renal biopsy acquired from patients with glomerular diseases. This cross sectional study was done in Al-Kafil private hospital and included 110 patients who were diagnosed by nephrologist as having glomerulonephritis as per clinical introduction, physical examination and laboratory findings of biopsy. The age scope of patients enlisted in the present investigation was between 2.8 to 72 years. The study included 67 male patients (60.9%) and 43 female patients (39.1%). The examination began at January 2016 and reached out through January 2017. At the point when clinical introduction and the entire workup of examination were at long last joined, with exceptional accentuation on histopathology and immunofluorescent tiny examination, the accompanying classification was gotten. Cases with glomerular association optional to foundational lupus erythematosis represented 27 out of 110 (24.5%). Consequently lupus nephritis is the most incessant reason for glomerulonephritis obsereved in the present examination. As indicated by the International Society of Nephrology (ISN)/Renal Pathology Society (RPS) grouping of lupus nephritis, the most incessant compose was ISN/RPS class IV (A/C) represented 14 case (12.7%), trailed by ISN/RPS class III ( A/C) (8 case, 7.3%)

The International Society of Nephrology and the Renal Society of Australasia: towards a global impact

The International Society of Nephrology and the Renal Society of Australasia: towards a global impact

SAT-485 NEW METHODS OF CONFERENCE COVERAGE ON SOCIAL MEDIA –DO THEY HELP INCREASE THE REACH?

Over the past decade, there is an increase in the utilization of various Social Media (SoMe) platforms in disseminating & sharing information from medical conferences. Twitter’s popularity among nephrologists for this purpose is widespread. At the World Congress of Nephrology (WCN) in Mexico in April 2017, a SoMe Task Force was created by the International Society of Nephrology (ISN). One of the main objectives of this was a comprehensive coverage of the lectures & presentations shared via different SoMe platforms. In a similar manner, an ISN WCN SoMe Team was created to cover the World Congress of Nephrology in Melbourne in April 2019 to disseminate scientific info from the conference. The ISN WCN SoMe Team launched Poster Talks (PTs), where the Author gives a voice over describing the poster. Also, Visual Abstracts (VA) of posters/oral papers & live talks (Live VAs) were created. Interviews of speakers & poster presenters as well as live stream of late breaking clinical trial (LBCT) were additional distinctive methods adopted. This was the first time Facebook was used to extend an international nephrology conference’s reach & its own analytics were used. Twitter analysis of these newer methods were done using Symplur & NOD Analytics. Periscope and YouTube data was analyzed looking at interviews & how they impacted on information spread. Over 17000 tweets from the conference were accessed in 90 countries (see figure 1). There were 1943 unique participants. There were 34 video interviews - 25 poster interviews & 9 speaker interviews. An index for the quantity of education delivered during these interviews was created (see figure 2). 21 Poster Talks and 29 VAs were created, (21 poster VAs & 8 Live VAs). When compared, these new methods of coverage were accessed, retweeted and commented upon more frequently than traditional slide-based tweets. YouTube data analysis showed 696 unique viewers and 824 min watch time. Highest attention span was of 3:21. Facebook data analysis showed that the Social Media reach was 340K, with 1786 interactions, 30 shares & 1720 likes. Live stream data of LBCT showed 2713 playbacks with 587 peak concurrent viewers, 798 hours of total view time with an average session length of 17.6 min with participants from 59 countries tuning in, generating a volume of more than 7000 tweets.View Large Image Figure ViewerDownload Hi-res image Download (PPT) The newer methods of Social Media information dissemination from Conferences namely Poster Talks, Interviews, Visual Abstracts, Late Breaking Clinical Trials - Live streams as well as adding Facebook and & Youtube as platforms of sharing, helped increase the interaction and & reach of the conference to a significant extent.

SAT-304 Availability, accessibility, and quality of conservative kidney management worldwide: a substudy of the Global Kidney Health Atlas

People with end-stage kidney disease (ESKD) typically receive kidney replacement therapy (KRT) in the form of dialysis or transplantation. However, studies have suggested that not all patients with ESKD are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management (CKM) is an alternate ESKD therapy, which focuses on symptom management, psychological health, and family and social support. Despite its importance in ESKD care, several barriers exist that impact the uptake or quality of CKM. The Global Kidney Health Atlas (GKHA) is an ongoing initiative of the International Society of Nephrology (ISN), which aims to monitor and evaluate the status of global kidney care worldwide. This study reports on findings from the 2018 GKHA survey, specifically addressing the availability, accessibility, and quality of CKM. Respondents from 160 countries completed the survey and 154 answered questions pertaining to CKM. Of these, 124 (81%) stated that CKM was available. Several gaps were reported across most quality indicators, particularly in low-income countries. Overall, CKM is available in most countries; however, is not optimally accessible or of highest quality. Efforts to increase the awareness and adoption of practices recommended for CKM are needed to ensure high quality of care.

SUN-284 MINITHEATER: A VIABLE OPTION FOR INTERVENTIONAL NEPHROLOGY PRACTICE IN RESOURCE POOR SETTINGS

Interventional Nephrology (IN) is a new and emerging subspecialty of Nephrology that mainly deals with: renal ultrasonography and ultrasound-guided renal biopsy, dialysis access creation and dialysis access related percutaneous endovascular procedures. The dependence on other specialists to perform these procedures often resulted in delays in renal patient treatment, hence the birth of IN. Unfortunately, cost prohibits the establishment of an ideal IN centre in resource poor settings. To establish a viable IN practice in resource poor settings using minitheater. A minitheater space, trained nephrologist, couch, light source, trolley, surgical instruments, biopsy set, ultrasound machine and skin cleaning agents. UNTH Interventional nephrology minitheater At the Renal Unit of University of Nigeria Teaching Hospital Enugu, Nigeria, we set up a minitheater and organized an International Society of Nephrology (ISN) Continuing Medical Education (CME) training programme for nephrologists and nephrology trainees in May 2019. Seventy- seven participants from 17 centers in 4 out of the 6 geopolitical zones in Nigeria were in attendance. During the pilot study, 2 arteriovenous fistulae, 6 tunneled right internal jugular vein catheter placements, 5 adult and 4 pediatric real- time ultrasound- guided kidney biopsies were performed in the minitheater by the nephrologists. There was no procedural complication. Following this training programme, 3 centers have set up and are utilizing minitheaters for IN. It is feasible to set up and run a viable IN programme in resource poor settings using a mnitheater. This removes reliance on surgeons and radiologists making the nephrologist independent and ensuring prompt care of renal patients.

Insuffisance rénale terminale au Maghreb et en Afrique : panorama des programmes de transplantation au Maghreb et en Afrique

Kidney transplantation is the best treatment for the patient with end stage kidney disease in term of increasing the survival rate, reducing complications, improving quality of live and its lower cost compared to peritoneal dialysis or hemodialysis. However, the number of patients waiting for kidney transplantation is growing day by day and the gap between demand and supply is still huge. This situation is even more complicated in developing countries where the lack of legislation, infrastructure and government involvement is common. Some national transplantation programs have been implemented, with the support of the International Society for Transplantation and the International Society of Nephrology, in order to increase the transplantation activity of these countries in accordance with the Istanbul Declaration on organ trafficking and transplant tourism.

Clinical impact of repeat renal biopsies in patients with lupus nephritis: Renal biopsy is essential especially later in the course of the disease.

The clinical impact of repeat renal biopsies in patients with lupus nephritis (LN) is still debatable. The aim of this retrospective analysis was to assess whether repeat renal biopsy is a reliable tool in guiding therapeutic decisions. Laboratory and histological parameters and therapeutic changes in 35 patients with LN and repeat renal biopsies were retrospectively analyzed. Biopsies were performed in the presence of clinical evidence of an active glomerular disease. Biopsy specimens were retrospectively re-assessed by two renal pathologists and were compared according to the last International Society of Nephrology/ Renal Pathology Society classification. Thirty-five patients had two, 13 had three, 5 had four, 4 had five, and 1 had six renal biopsies. Fifty-eight comparisons of renal biopsies were made. Median times between the first and second, second and third, third and fourth, and fourth and fifth biopsies were 31, 27, 34, and 28 months, respectively. The mean activity indices from the first to the fifth biopsy were 8.7, 6.6, 7.8, 9.4, and 4.7, whereas the mean chronicity indices were 1.7, 2.3, 4.3, 5.2, and 7.7, respectively. Conversion was observed in 65.5% of cases with the most frequent (21%) being between classes III and IV. Conversion to a more severe type of nephritis occurred in 19% of cases. There was no correlation of laboratory parameters to the type of nephritis upon conversion. In 79% of cases, immunosuppressive therapy was modified after repeat biopsy. Repeat biopsy is a reliable tool for monitoring the activity and chronicity status of LN and for tailoring immunosuppressive therapy to the needs of the patient, especially late in the course of the disease.

Kidney care in low- and middle-income countries.

Optimal kidney care requires a trained nephrology workforce, essential healthcare services, and medications. This study aimed to identify the access to these resources on a global scale using data from the multinational survey conducted by the International Society of Nephrology (ISN) (Global Kidney Health Atlas (GKHA) project), with emphasis on developing nations. For data analysis, the 125 participating countries were sorted into the 4 World Bank income groups: low income (LIC), lower-middle income (LMIC), upper-middle income (UMIC), and high income (HIC). A severe shortage of nephrologists was observed in LIC and LMIC with < 5 nephrologists per million population. Many LIC were unable to access estimated glomerular filtration rate (eGFR) and albuminuria (proteinuria) tests in primary-care levels. Acute and chronic hemodialysis was available in most countries, although acute and chronic peritoneal dialysis access was severely limited in LIC (24% and 35%, respectively). Most countries had kidney transplantation access, except for LIC (12%). HIC and UMIC funded their renal replacement therapy (RRT) and renal medications primarily through public means, whereas LMIC and LIC required private and out-of-pocket contributions. In conclusion, this study found a huge gap in the availability and access to trained nephrology workforce, tools for diagnosis and management of CKD, RRT, and funding of RRT and essential medications in LIC and LMIC.

Glomerular Filtration Rate Calculation Based on Serum Creatinin and Cystatin C in Type 2 Diabetic Patients

Glomerular Filtration Rate Calculation Based on Serum Creatinin and Cystatin C in Type 2 Diabetic Patients

Congress Report from Highly Scientific Nephrology Congresses in the Balkans, 15th Bantao and 6th MSNDTAO Congress.

In the period from 26th until 29th of September 2019, the 15th BANTAO Congress (Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs) in conjunction with the 6th Congress of the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO) was held in Skopje, Republic of North Macedonia, hosted by the Macedonian Academy of Sciences and Arts (MASA). MSNDTAO was created in 1992 and the First Congress of the MSNDTAO was held on 9th October 1993 in Ohrid when, also, the Balkan Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO) was established, as the only professional association of this kind in the Balkans and Southern Europe. Since then, MSNDTAO has been very active in education and collaboration with BANTAO, the European Renal Association (ERA-EDTA) and the International Society of Nephrology (ISN). The 15th BANTAO and the 6th MSNDTAO Congress were highly professional events in honor of the 80th anniversary of Academician Momir Polenakovic from the Republic of North Macedonia, one of the founders of BANTAO and MSNDTAO, who was unselfishly dedicated to the education and guidance for many generations of young doctors in this region. This year's Congress was endorsed by the ERA-EDTA, and supported by the ISN. On the first day of the Congress, a European Renal Best Practice (ERBP) session was held, in which the Chair of the ERBP Working Group, Prof. Dr. Jonathan Fox gave a comprehensive insight of the purpose and aims of ERBP, the methods used for their achievement, and an overview of the recently produced and guidelines in development. The second day was organized in four sessions: Clinical nephrology and renal registries; CKD Diagnosis, comorbidities and treatment; Kidney transplantation and Acute and chronic renal failure management. On the third congress day, the ISN CME Course with ERA-EDTA endorsement was held. The course was entitled "Possibility of diagnosis and treatment of the CKD progression and complications/Possibility of diagnosis and treatment of the CKD progression - current perspective" and was chaired by Prof. Dr. Caskey Fergus and Prof. Dr. Serhan Tuglular. On the last Congress day, before the official closure and the best wishes from the President of the Congress, Prof. Dr. Goce Spasovski, a session about CKD and the renal replacement therapy complications was held. This event was of an exceptional importance for the region, considering the charred international achievements and the most up-to-date methods used in the Nephrology field, bringing out continuous quality improvement in the treatment of patients with renal diseases.

A Walking Intervention to Increase Weekly Steps in Dialysis Patients: A Pilot Randomized Controlled Trial

Patients receiving dialysis report very low physical activity. We implemented a pilot trial to assess the feasibility of a pedometer-based intervention to gather preliminary evidence about its impact on physical activity, symptoms, and surrogates of cardiovascular risk. Pilot randomized controlled trial. 60 dialysis patients from San Francisco dialysis clinics. Participants were randomly assigned 1:1 to receiving pedometers with weekly step goals or usual care for 3 months. The primary outcome was step counts, measured using pedometers. Secondary outcomes included physical performance using the Short Physical Performance Battery, the Physical Function and Vitality scales of the 36-Item Short Form Health Survey, the Dialysis Symptoms Index, and the Center for Epidemiologic Studies-Depression Scale, with endothelial function as a secondary and heart rate variability as an exploratory surrogate measure of cardiovascular risk. Targeted enrollment was 50% and targeted completion was 85%. 49% of approached patients were enrolled, and 92% completed the study. After 3 months, patients randomly assigned to the intervention (n=30) increased their average daily steps by 2,256 (95% CI, 978-3,537) more than the 30 controls (P<0.001). Heart rate variability (standard deviation of N-N intervals) increased by 14.94 (95% CI, 0.31-33.56) millisecondsin the intervention group as compared with controls (P= 0.05). There were no statistically significant differences across intervention groups in symptoms, physical performance, or endothelial function. Participants in the intervention group reverted to baseline steps during the postintervention follow-up. The Northern California study setting may limit generalizability. Walking does not capture the full spectrum of physical activity. A short-term pedometer-based intervention led to increased step counts in dialysis patients, but the increase was not sustained. Pedometer-based interventions are feasible for dialysis patients, but future studies are needed to address whether more prolonged interventions can improve physical function or symptoms. Supported by grants from the American Kidney Fund, National Institutes of Health-National Institute of Diabetes and Digestive and Kidney Diseases, and International Society of Nephrology. Registered at ClinicalTrials.gov with study identifier NCT02623348.

Epidemiology and Outcomes of Acute Kidney Injury Among Patients in the Intensive Care Units in Laos: A Nationwide Multicenter, Prospective, and Observational Study

Background: Acute kidney injury (AKI) has become a global health issue. Still, little is known about the disease burden in Laos. Thus, we aimed to evaluate the burden and outcomes of AKI as well as assess the availability of diagnosis and treatment in Laos. Methods: We performed a multi-centric prospective observational study in adult patients who had been admitted to 5 intensive care units in Laos. The data was serially collected on the first 28 days of ICU admission by registration in an electronic web-based format. Patients were diagnosed by the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) criteria for AKI. We used AKI occurrence as the primary outcome and explored modifiable and non-modifiable risk factors on the development and outcomes of AKI. Findings: We enrolled 1480 patients from 5 ICU centers across Laos from January to December 2016. After excluding patients with end-stage renal disease and those with incomplete data, AKI occurred in 508 of the 1460 enrolled patients (34·8%). Overall, the maximum AKI stage was stage 1 in 4%, stage 2 in 10·3% and stage 3 in 20·5%. The mortality rate was 28·4% in non-AKI patients compared with 44·5% in AKI patients, which increased according to the stage of AKI (stage 1 = 4·9%, stage 2= 28·3%, stage 3= 66·8%, p < 0·001). There were 13·6% who were discharged against medical advice. Interpretation: AKI is a huge burden in Laos with under-recognition and poor outcomes. Funding Statement: The International Society of Nephrology (ISN); Kidney Foundation of Thailand; Medical Association of Thailand. Declaration of Interests: The authors stated: None. Ethics Approval Statement: The study protocol was reviewed by the National Ethics Committee for Health Research (No.072 NIOPH/NECHR) and the need for informed consent was waived. This study was a part of the Southeast Asia-Acute Kidney Injury (SEA-AKI) study previously published by Srisawat et al.