Renal replacement therapy in Kuwait.

The reported incidence of end-stage renal disease (ESRD) in Kuwait is 72 patients per million population per year. All modalities of dialysis therapy are available and are offered free of cost. There are 232 patients of whom 166 are on hemodialysis, five on hemofiltration, 45 on intermittent peritoneal dialysis and 16 on continuous ambulatory peritoneal dialysis. Chronic tubulo-interstitial disease resulting from atrophic pyelonephritis was the leading cause of ESRD in these patients. Nearly half of the patients on dialysis receive recombinant human erythropoietin. From 1979 until March 1990, 500 renal transplantations were performed in Kuwait of which 350 were performed using kidneys from live related donors, 100 from cadaveric donors, 50 from live unrelated, but emotionally related, donors. The limited pool of potential kidney donors continues to be a major problem. Our experience with imported cadaver kidneys showed that they were unsafe. Commercial kidney transplantation, in our experience, was associated with high morbidity and mortality rates. Despite the governmental laws, religious approval, and adequacy of transplantation facilities in Kuwait, the progress in the field of local organ procurement has remained very slow.