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Our objective is to study the outcomes and complications of peritoneal dialysis (PD) including comparison of self-care PD with home-care assisted PD during a five-year period. A retrospective study of PD data at King Saud University-affiliated hospital in Riyadh from January 1, 2009, to December 31, 2013. One hundred and eleven patients were included (female 55%). The average age was 47.4 (1-83) years. Twenty-one (18.91%) patients were on continuous ambulatory PD and 90 (81.08%) on automated PD. The mean time on PD was 23.5 (3-60) months. At the end of five years, 47 (42.34%) patients were continuing on PD, 12 (10.81%) had renal transplant, 33 (29.73%) patients were transferred to hemodialysis, and two (1.8%) patients were transferred to other centers. Seventeen patients died during this period giving a mortality rate of 7.13 deaths/100 patient-year during the five-year period. Six patients died due to cardiovascular causes, while five had sepsis. There was one death each due to prostate cancer, hyperoxaluria, and toxic epidermal necrolysis. Three patients died suddenly at home. Peritonitis rate was one episode/35.28 patient/month or one episode/2.94 patient/year. We compared the results for patients doing the dialysis themselves [56 (50.45%)] "self-care PD" to 55 (49.5%) patients assisted by a family member or other caregivers "assisted PD." We found no significant difference in the incidence of complications, technical outcome, mortality, and peritonitis episodes. However, we found a high prevalence of diabetes mellitus and significant increase in exit site infection in assisted PD. Our study suggests that PD patients in Saudi Arabia have a good overall outcome. Furthermore, assisted PD showed good patient and technique outcome.

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While the prevalence of diabetes mellitus is increasing worldwide, one third of the diabetic patients will eventually develop chronic kidney disease. The aim of this review is to present the available data on diabetic nephropathy and its complications in the Arab Gulf countries. This will eventually help to raise the awareness of both government and healthcare systems towards the substantial value of prevention, early detection as well as proper management of both diabetes mellitus and chronic kidney disease. This could be achieved by funding large-scale longitudinal studies, improving training programs (both research and clinical) and increasing the role of media in fighting this epidemic.

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A 54 year man from Sri Lanka, presented to the emergency department of a university hospital, in Riyadh with severe reterosternal chest pain of one day duration. This was associated with nausea, sweating, palpitations and shortness of breath which happened one day after reaching Saudi Arabia. He was a heavy smoker and hypertensive for last ten years, on irregular treatment.Examination revealed patient was hypotensive, with

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