PRINCIPLES OF EPIDEMIOLOGY

Review of End-stage Renal Disease's Epidemiology in GCC Nations

Abstract

The countries of the Gulf Cooperation Council (GCC) which consist of Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman. Defined to have ESRD or patients on regular dialysis for a minimum dialysis period of at least three months. Since many outcomes were reviewed, studies that estimated the incidence and prevalence of ESRD as outcomes should not have defined the study population as ESRD population or patients on regular dialysis. Studies where the study population mainly comprised children or pregnant woman were excluded. The trends of the incidence, prevalence, and mortality rate of ESRD; also, causes of mortality, primary causes and co-morbid conditions associated with ESRD. 44 studies included in this review show that the incidence of ESRD has increased while the prevalence and mortality rate of ESRD in the GCC has not been reported sufficiently. The leading primary causes of ESRD recorded in the countries of the GCC is diabetes with the most prevalent co-morbid conditions being Hypertension and Hepatitis C Virus infection; the most common cause of death was cardiovascular disease and sepsis. This review highlights that the lack of national renal registries data is a critical issue in the countries of the GCC. The available data also do not provide an accurate and updated estimate for relevant outcomes. Additionally, considering the increasing burden of chronic kidney disease (CKD), these results stressed the needs and the importance of preventative strategies for leading causes of ESRD. Furthermore, more studies are needed to describe the epidemiology of ESRD and for assessing the overall quality of renal care.

Abstract2

Introduction4

Systematic review6

Data analysis7

Results8

Epidemiology of ESRD in the GCC countries12

Primary causes of ESRD15

Co-morbidities associated with ESRD18

Causes of mortality in ESRD patients19

Discussion20

Conclusion25

References26

Review of End-stage Renal Disease's Epidemiology in GCC Nations

Introduction

End-stage renal disease (ESRD) is defined as irreversible decline in kidney function, when renal replacement therapy (RRT) is needed for survival (Deeks et al.2010 ). There are two main types of RRT: dialysis and kidney transplantation. Kidney transplantation is preferred for patients with ESRD since it offers a longer life span, superior quality of life, and is more cost effective than long-term dialysis. ESRD has become a public health concern worldwide, with recent reports showing that the total number of ESRD patients has been growing dramatically. The rising prevalence is due largely to two main factors; the ageing of the population and the global epidemic of diabetes. (El Nahas 2010)

The countries of the Gulf Cooperation Council (GCC), which consist of Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman, share a similar background of culture and ethnicity, while their socio-demographic distributions and socioeconomic development are also similar (Ibrahim 2008). Although the countries of the GCC have experienced noticeable advances in delivering healthcare, the burden of non-communicable diseases is increasing rapidly. Many reports have shown evidence of increasing prevalence of the most common causes of ESRD in the GCC: the prevalence of obesity in these countries, which is associated with multi-chronic diseases, exceeds that ...