Chronic kidney disease has become a worldwide public health problem as it is linked with an increase in the incidence and prevalence rate of patients with renal failure who require renal replacement therapy with high healthcare costs and poor outcomes. Moreover, chronic kidney disease (CKD) in its earlier stages is associated with a higher prevalence of many adverse outcomes such renal failure, cardiovascular disease, and premature death. In Saudi Arabia, the total number of patients who are receiving renal replacement therapy has been increasing rapidly in recent decades, as the Saudi Centre for Organ Transplantation data has demonstrated, while the estimated annual cost for treating end-stage renal disease uses around 3.8% of the total Ministry of Health's budget in Saudi Arabia. This means that more attention is required for the prevention and management of CKD and its risk factors in Saudi Arabia. Therefore, this thesis was formulated to review the quality of healthcare management for patients with chronic kidney disease in Saudi Arabia. This review was achieved based on: (I) assessing and describing the epidemiology of end-stage renal disease, (II) assessing pre end-stage renal disease care practice, (III) examining the indications for hospital admission among haemodialysis patients. The findings have revealed that the burden of end-stage renal disease has increased substantially in Saudi Arabia particularly among middle-aged diabetic and hypertensive patients, while the most prevalent co-morbid conditions were hypertension and Hepatitis C virus infection. Detecting patients with chronic kidney disease in the earlier stages, and pre end-stage renal disease care practices and its outcomes should be improved in Saudi Arabia. Furthermore, cardiovascular diseases play a major role in increasing the rate of hospitalization and mortality among patients with end-stage renal disease. In conclusion, this review stressed the needs and the importance of multidisciplinary preventive strategies for leading causes of end stage renal disease (ESRD) and improving pre ESRD nephrology care practices and its outcomes in Saudi Arabia. This will not be possible to achieve without collaboration between healthcare providers and a comprehensive national health information system to allow consistent assessment of the quality of healthcare management and provide an updated evidence-based health policy that will help healthcare providers to choose the best intervention that will help to improve healthcare practice outcomes and allocate healthcare resources.