IntroductionThe number of persons receiving renal replacement therapy (RRT) is estimated at more than 2.5 million worldwide, and is growing by 8% annually. Registries in the developing world are not up to standards compared to the United States Renal Data System (USRDS). Herein we examine the causes, progression, and magnitude of end-stage kidney disease (ESKD) over 3 decades in Oman.MethodsWe examined ESKD data from 1983 to 2013. Data from 1998 to 2013 were obtained through an Information Management System. Data before 2008 were collected from patients’ files. A questionnaire based on USRDS form 2728 was completed by nephrologists once a citizen reached ESKD.ResultsA total of 4066 forms were completed, with a response rate of 90% (52% male). The mean (SD) age was 50.1 (14.0) years. By 31 December 2013, there were 2386 patients alive on RRT, of whom 1206 were on hemodialysis (50.5%), 1080 were living with a functioning kidney transplant (45.3%), and 100 were receiving peritoneal dialysis (4.2%). The incidence of ESKD on RRT was 21, 75, and 120 per million population in 1983, 2001, and 2013, respectively. Similarly, the prevalence of ESKD was 49, 916, and 2386 in 1983, 2001, and 2013 respectively. Among patients with ESKD on RRT, a progressive rise was seen in diabetic nephropathy, with 5.8%, 32.1%, and 46% in 1983, 2001, and 2013 respectively.DiscussionThe incidence and prevalence of ESKD has increased progressively over last 30 years. This is anticipated to continue at an even higher rate in view of the progressive rise in noncommunicable diseases. Continuous improvement in registries is required to improve capturing of ESKD patients for providing accurate data to health authorities, and enhancing public awareness of the magnitude, future trends, treatments, and outcomes regarding ESKD.

Risk factors that had effect of outcomes includes increased age, diabetes, uncontrolled hypertension and anaemia, hypoalbunaemia and infection mainly catheter related infection who stat dialysis with temporary catheter. Cost of dialysis includes dialysis cost, transport cost, medicine cost and cost of helping persons. Total monthly average cost of dialysis in government hospital about 12000-15000 taka.(15-20USD) Conclusions: We concluded that 23% patients leave dialysis due to financial or helping personal or social support. They leave dialysis within 3-4 months. 35% patients died due to multiple risk factors within 8-9 months. Further study required to identify risk factors for early mortality and increase dialysis support and quality of dialysis. For early discontinuation there might be increase social security and social support and government level.

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