Observations in a Saudi-Arabian dialysis population over a 13-year period.

In contrast to Europe and the USA, data concerning dialysis treatment in Middle Eastern countries like Saudi Arabia are lacking. We therefore studied 325 patients (150 females and 175 males) in one dialysis centre over a 13-year period. The number of primary renal diseases of uncertain aetiology and of pyelo/interstital nephritis caused by renal stone disease was high (46% and 4.9% resp.), that of diabetic nephropathy (14.8%) not much different from EDTA figures, while adult polycystic kidney disease was seen in only four patients (1.2%, versus EDTA: 5.5%). Sixty-one percent needed antihypertensive medication to control the blood pressure, less than reported by the EDTA. Nineteen patients (5.8%) had pericarditis, 38% radiographic signs of renal bone disease and eight patients required parathyroidectomy. Only two patients had carpal tunnel syndrome. Over the 13-year period the number of HBsAg-positive patients was 14%, reflecting the high prevalence of this disease in the country, but in the last 4-5 years the incidence dropped markedly (3% in 1993). In 1993, 40% of the 67 patients on dialysis had hepatitis C (HCV) antibodies of which 19 (70%) were HCV-RNA positive. Although tuberculosis (mainly extra-pulmonary) was common (9.2%), no patient died because of this disease. Cardiovascular factors contributed in the same degree to the causes of death as in Europe: 63% versus 62%. One hundred and fourteen patients (35%) had a successful kidney transplant.