Year : 2020 | Volume
: 31 | Issue : 6 | Page : 1458--1469
Renal replacement therapy in the Kingdom of Saudi Arabia
Besher Al Attar
Medical Department, Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
Besher Al Attar
Medical Department, Saudi Center for Organ Transplantation, Riyadh
|How to cite this article:|
Al Attar B. Renal replacement therapy in the Kingdom of Saudi Arabia.Saudi J Kidney Dis Transpl 2020;31:1458-1469
|How to cite this URL:|
Al Attar B. Renal replacement therapy in the Kingdom of Saudi Arabia. Saudi J Kidney Dis Transpl [serial online] 2020 [cited 2021 Apr 23 ];31:1458-1469
Available from: https://www.sjkdt.org/text.asp?2020/31/6/1458/308375
Renal Replacement therapy in the Kingdom of Saudi Arabia consist of hemodialysis (HD), peritoneal (PD) dialysis and Kidney transplant from living and deceased donors. In 2019, a total of 21,068 patients were on renal replacement therapy (HD and PD) with 19,522 patients on hemodialysis and 1,546 on peritoneal dialysis treatment. Prevalence rate of renal failure among patients on dialysis is 631 pmp and the incidence rate with 4,740 new patients on dialysis is 142 pmp while death among patients on dialysis is 1,737 (8.2%).
In 2019, there were 278 hemodialysis center in the Kingdom of Saudi Arabia divided into 5 sectors the Ministry of Health (MOH), Outsourcing Dialysis Centers (Diaverum and Davita under the umbrella of MOH), Government Non–MOH, Private and Charitable Dialysis Centers and the King Abdullah Hemodialysis Projects. These facilities were equipped with 6,920 outlets with a ratio of 2.8 patients/outlet and 8,165 HD machines facilitated by 5,879 health care providers consisting of consultant nephrologist, specialist, general practitioners and nurses catering to 19,522 permanent chronic hemodialysis patients. Patient distribution in each sectors, the MOH together with the outsourcing dialysis centers (Davita and Diaverum) caters to the largest number of patients with 12,334 (62%) followed by Private and Charitable Dialysis Centers
Hemodialysis Facilities and Patient Distribution
Hemodialysis Facilities per Affiliation
Dialysis Health Care Providers
A total of 5,879 health care providers in the hemodialysis centers are in the Kingdom and were composed primarily of consultant nephrologists, specialist, general practitioners and nurses. Manpower was distributed in 5 sectors of hemodialysis centers all throughout the Kingdom.
Hemodialysis Patient Demographics
Hemodialysis patient’s demographics, age distribution among HD patients have shown that most patients were on the age group of 26 – 65 years old composing of (67%) of the total HD patients in KSA. The prevalence of end-stage renal failure were predominant in males with 56% and 44% were females. Blood groups of patients on HD, have shown that (49%) of patients have blood group O, followed by A (27%), B (19%) and AB (5%). Patient nationalities were composed of Saudi (83%) and non-Saudi’s (17%).
Patient Age and Sex
Patient Blood Groups and Nationalities
Causes of Renal Disease and Patient Serological status among Hemodialysis Patients
In 2019, the major causes of renal failure among HD patients were Diabetic Nephropathy and Hypertensive Nephropathy.
The prevalence rate of Diabetes Mellitus (DM), Hypertension (HTN) and combined DM and HTN on patients have shown that the highest rate were those with combined DM and HTN with 39%; followed by HTN only patients at 32% and DM only at 15%. The prevalence trend on each category had shown an increasing trend in patients with combined DM and HTN, followed by HTN only patients which had slightly increased this year. On the contrary patients with DM only, BCOcTeEteeased this year compared to last year’s record.
Prevalence and Incidence Rate of DM, HTN and both DM and HTN
Patient serology results have shown that patients who were HCV+ve has been on decline over the last 4 years with 8% infection rate this year. HBsAg+ve patients had slightly increased from last year but maintain a 3% infection rate, while patients with HIV had also decreased this year.
Hemodialysis Patient Quality Care
Hemodialysis patient quality care includes the available HD machines and outlets, patient’s vascular access and patient management.
Hemodialysis Machines and Outlet per Sector
In 2019, a total of 8,165 hemodialysis machines with 6,920 outlets were available in the Kingdom, utilized by different dialysis sectors.
Hemodialysis Vascular Access
The most common site of vascular access is the (arteriovenousfistula) AVF with 62% of the total dialysis patients, followed by permanent jugular catheter with 30%, femoral catheter being the least used access with 2%.
Hemodialysis Patient Management
Hemodialysis patient management were characterized with patient treatment plan and laboratory test to monitor the patient’s health and effectiveness of treatment.
Total HD patients: 19,522
Total HD patients: 19,522
Erythropoietin treatment among HD patients was used in 14,363 patients, (74%) of the entire HD population. Over the years, there was an increasing numbers of patients receiving EPO-r.
Hemodialysis Patient Waiting List
Hemodialysis patient on waiting list were also recorded for HD patients and by the end of this year, a total of 3,198 patients (16%) were on the active list and ready for renal transplantation with another 3,904 (20%) on the waiting list for work-up. Comparing with the previous year numbers, the percentage of patients who on the list for work-up remain the same (20%).
2019 Hemodialysis Statistical Tables Summary per Sector
Peritoneal Dialysis (PD)
In 2019, a total of 36 active peritoneal dialysis centers were recorded from MOH, Gov’t. Non-MOH, and Private dialysis centers. Among these centers, 18 centers were from MOH, 16 from Gov’t Non-MOH, and 2 from private centers. Types of PD modalities were Automated/Continuous Cyclic Peritoneal Dialysis or (APD/CCPD) with 76% of patients, 15% were on Continuous Ambulating Peritoneal Dialysis (CAPD) and 9% were on Intermittent Peritoneal Dialysis (IPD).
In 2019, a total of 1,546 patients were on peritoneal dialysis, of these 594 were new patients. Age Distribution of patients with ESRD have shown that 86% were adults and 14% were pediatric age less than 15 (<15). Patient serology have shown that HCV+ve patient were 38 (2%) and HBsAg+ve patients 15 (1%).
PD Patient Modality of Treatment
Adult and Pediatric PD Patients
Among the 1,546 PD patients, 1,333 (86%) were adults and 213 (14%) were pediatric patients, age <15 years old.
In 2019, HBsAg+ve and HCV+ve status among PD patients were reported in SCOT and have shown that HBsAg+ve infected patients were 15 (1%) showing less infection rate for the past 2 years while, HCV+ve PD patients this year have shown an slightly increased compared to previous year with an infection rate of 2% this year.
2019 Peritoneal Dialysis Statistical Tables Summary per Sector
Summary of Renal Replacement Therapy in the Kingdom of Saudi Arabia
Prevalence Rate of Dialysis Ppatients (HD and PD) According to Region 2019
Incidence Rate of Dialysis Patients (HD and PD) According to Region 2019
2019 Kidney Transplantation Activity
In the year 2019, 1,121 kidneys was transplanted inside the kingdom of Saudi Arabia with 981 kidneys transplanted from living and 140 were transplanted from deceased donors.
It is worth mentioning that a total of 13,641 kidneys were transplanted inside the kingdom from 1979-2019; of these transplantation activities, 9,471 (69%) were from living related, 3,394 (25%) were from deceased donors and 776 (6%) from living unrelated kidney donor.
Cumulative Living and Deceased Kidney