POS-685 STRUCTURE OF RENAL REPLACEMENT THERAPY IN THE KINGDOM OF SAUDI ARABIA

Abstract

Renal replacement therapy (RRT) is the mainstay in the clinical management and treatment of patients with chronic renal disease and end-stage renal disease (ESRD) aimed to support, maintain and improved the quality of life and may even decreased the mortality of patients having the disease, and with the increasing demand on renal replacement therapy in Kingdom it is imperative to improve the facilities, patient quality care and even types of RRT in the Kingdom. A review of renal replacement therapy in the Kingdom of Saudi Arabia published by Saudi Center for Organ Transplantation (SCOT) data in 2019; based on the cross-sectional study of annual questionnaires from all the dialysis centers in the Kingdom and annual post-transplantation follow-up from the accredited renal transplant centers in KSA. Renal replacement therapy (RRT) in the Kingdom were composed of 3 modalities: hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KTx). In 2019, a total of 28,256 patients were on RRT with 19,522 patients on HD, 1,546 on PD and, 7,188 patients with post-renal transplant follow-up. The prevalence and incidence rate of patients on dialysis were 631 and 142 per million population (PMP) respectively. Mortality rate on patients on dialysis were 8.2% this year. Kidney transplantation from deceased and living donors was the highest kidney transplants performed with a total of 1,121 kidneys transplanted, 140 (12%) from deceased and 981 (88%) kidneys from living donation making the Saudi Arabia the 2nd highest kidney transplant from living donor rate worldwide 29.37 pmp and 3rd highest living organ donors rate worldwide with 36.59 pmp (IRODAT: 2019). Graft loss and mortality rate on the same year were also recorded on living kidney recipients with 6 (0.6%) recipients loss their graft and 2 (0.2%) recipients died on the same year, while recipients from deceased donors, graft loss were 4 (2.8%) and a mortality rate were 2 (1.4%). Renal replacement therapy is the cornerstone in clinical management of patients with end-stage renal disease. Hemodialysis is the most common modality of renal replacement therapy providing greater convenience and accessibility, followed by peritoneal dialysis which needs to be encouraged, other modality such as home hemodialysis should be explored and considered. While, the Kingdom has reached a milestone in kidney transplantation making it one of the highest living organ donors rate worldwide, Saudi Arabia is still working on to improve its deceased organ donation which has a great potential in buffering the increasing demand of kidney transplant. Mortality rate post-renal transplant at one year was also considerably low with 4 deaths (0.3%) from both living and deceased kidney transplant at the same year.