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Abstract. In contrast to Europe and the USA, data concerning dialysis treatment in Middle Eastern coun-tries like Saudi Arabia are lacking. We therefore studied 325 patients (150 females and 175 males) in one dialysis centre over a 13-year period. The number of primary renal diseases of uncertain aetiology and of pyelo/interstital nephritis caused by renal stone disease was high (46 % and 4.9 % resp.), that of diabetic nephropathy (14.8%) not much different from EDTA figures, while adult polycystic kidney disease was seen in only four patients (1.2%, versus EDTA: 5.5%). Sixty-one percent needed antihypertensive medication to control the blood pressure, less than reported by the EDTA. Nineteen patients (5.8%) had pericarditis, 38 % radiographic signs of renal bone disease and eight patients required parathyroidectomy. Only two patients had carpal tunnel syndrome. Over the 13-year period the number of HBsAg-positive patients was 14%, reflecting the high prevalence of this disease in the country, but in the last 4-5 years the incidence dropped markedly (3 % in 1993). In 1993, 40 % of the 67 patients on dialysis had hepatitis C(HCV) antibod-ies of which 19 (70%) were HCV-RNA positive. Although tuberculosis (mainly extra-pulmonary) was common (9.2%), no patient died because of this dis-ease. Cardiovascular factors contributed in the same degree to the causes of death as in Europe: 63 % versus 62%. One hundred and fourteen patients (35%) had a succesful kidney transplant. Key words: dialysis; Middle East; registr