Stratifying Renal Risk in End-Stage Renal Disease: Evidence From a Population-Based Dialysis Registry in Northern Saudi Arabia

Objectives: We examined the relationship of age, gender, smoking, nationality, and place of residence with renal dysfunction severity in end-stage renal disease (ESRD) patients. Methods: We performed a cross-sectional study of ESRD registry data collected from King Khalid Hospital in Hail, Saudi Arabia. Adults (≥ 15 years) treated from March 2023 - February 2024 were enrolled. Serum creatinine and urinary albumin concentrations were measured (based on primary [≥ 625 μmol/L and ≥ 18 mg/L, respectively] and sensitivity thresholds). Bivariate analyses, interaction testing, sensitivity models, and multivariable logistic regression were employed. Results: Of 212 patients (50.9% male), based on primary thresholds, 24.5% had elevated serum creatinine and 21.2% had elevated albuminuria levels. In multivariate adjusted models, male sex (odds ratio = 2.45, 95% confidence interval: 1.21–4.913, p = 0.012) and older age (35–74 years) were significantly associated with high creatinine levels. There was a borderline inverse age relationship with albuminuria (ORs ≈ 2.5–2.8, p ≈ 0.05–0.06). Sensitivity analyses indicated that female sex is a predictor of albuminuria (OR = 2.33, p = 0.040), and non-Saudi nationality is a protective variable for high creatinine levels (OR = 0.20, p = 0.001). There were no strong interaction effects. Conclusion: Sex and age significantly influence renal biomarker profiles in ESRD patients. These findings highlight the utility of including nonbiochemical measures in renal risk assessments and integrating stratified surveillance strategies into dialysis care.