Incidence, prevalence, and treatment of end-stage renal disease in the Middle East.

INTRODUCTION: This article reviews the status of end-stage renal disease in the Middle East, with emphasis on its incidence, prevalence, and treatment.

METHODS: Data were obtained from English-language published literature through a Medline search over the past 40 years. Supplementary information was gathered from regional congresses and symposia, websites of specialized nephrology centers, and direct communications.

RESULTS: Of the 14 Middle East countries, attention was focused on 10 countries with similar renal care systems: 7 Arabian Peninsula countries and 3 eastern Mediterranean countries. Collectively, they have a population of 72.5 million. Incidence of ESRD ranged between 64 and 212 patients per million population (pmp) with an average of 93 patients pmp. The lowest prevalence was 320, the highest was 462, and the average was 352 patients pmp. Hemodialysis is the preferred dialysis modality and is freely available in all countries for citizens. Non-citizen residents' access to hemodialysis is markedly restricted. Peritoneal dialysis is available on a limited scale. Renal transplantation is available in all countries with variable program activities. Most of the transplants are from living, related donors. Active deceased donor transplant programs exist in four countries. The results from countries with active programs are excellent, with 5-year patient and graft survival of > 90%.

CONCLUSIONS: This review provides information on the incidence, prevalence and treatment modalities of ESRD in 10 Middle East countries.