Background: Anemia is a common complication of chronic kidney disease. We investigated the prevalence, characteristics and management of anemia in patients on chronic hemodialysis and assessed the response to blood-transfusion based management in Cameroon. Methods: This was a cohort study of five months' duration (August-December 2008) conducted at the Yaoundé General Hospital's hemodialysis center, involving 95 patients (67 men, 70.5%) on chronic hemodialysis by a native arterio-venous fistula. A monthly evaluation included full blood counts, number of pints of red cell concentrates transfused, and vital status. Results: At baseline, 75 (79%) patients had anemia which was microcytic and hypochromic in 32 (43%). Anemia was corrected in 67 (70.5%) patients using blood transfusion only, while 28 (29.5%) patients were receiving erythropoietin (11 regularly, 39%). Only 77.2% of 342 pints (median 3.0, range 0-17 per patients) of red cell concentrates prescribed were effectively received during the follow-up at an unacceptably high cost to patients and families. Mean hemoglobin and mean corpuscular hemoglobin levels remained stable during follow-up, while mean corpuscular volume increased. Erythropoietin treatment was the main determinant of favorable trajectories of hematological markers. Conclusions: Patients on chronic hemodialysis have predominantly microcytic hypochromic anemia, with limited capacity for correction using blood transfusion.

No abstract

Background Kidney dysfunction is common in patients with heart failure (HF) and has been associated with poor outcomes. This study aimed to determine the prevalence, correlates, and prognosis of kidney dysfunction in patients with HF in Cameroon, an understudied population. Methods We conducted a cross-sectional study in consecutive patients hospitalized with HF between June 2016 and November 2017 in the Buea Regional Hospital, Cameroon. Kidney dysfunction was defined as an estimated glomerular filtration rate < 60 ml/min/1.73m2. Prognostic outcomes included death and prolonged hospital stay (> 7 days). We also performed a sensitivity analysis excluding racial considerations. Results Seventy four patients (86.1% of those eligible) were included. Their median age was 60 (interquartile range: 44–72) years and 46.0% (n = 34) were males. Half of patients (n = 37) had kidney dysfunction. Correlates of kidney dysfunction included previous diagnosis of HF (adjusted odds ratio [aOR]4.3, 95% CI: 1.1–17.5) and left ventricular hypertrophy (aOR3.4, 95% CI: 1.1–9.9). Thirty-six (48.9%) had prolonged hospital stay, and seven (9.5%) patients died in hospital. Kidney dysfunction was not associated with in-hospital death (aOR 0.4, 95% CI: 0.1–2) nor prolonged hospital stay (aOR 2.04, 0.8–5.3). In sensitivity analysis (excluding racial consideration), factors associated with Kidney dysfunction in HF were; anemia (aOR: 3.0, 95% CI: 1.1–8.5), chronic heart failure (aOR: 4.7, 95% CI: 0.9–24.6), heart rate on admission < 90 bpm (aOR: 3.4, 95% CI: 1.1–9.1), left atrial dilation (aOR: 3.2, 95% CI: 1.04–10), and hypertensive heart disease (aOR: 3.1, 95% CI: 1.2–8.4). Kidney dysfunction in HF was associated with hospital stay > 7 days (OR: 2.6, 95% CI: 1–6.8). Conclusion Moderate-to-severe kidney dysfunction was seen in half of the patients hospitalized with HF in our setting, and this was associated with a previous diagnosis of HF and left ventricular hypertrophy. Kidney dysfunction might not be the main driver of poor HF outcomes in this population. In sensitivity analysis, this was associated with anemia, chronic heart failure, heart rate on admission less than 90 bpm, left atrial dilatation, and hypertensive heart disease. Kidney dysfunction was associated with hospital stay > 7 days.

Despite advances in clinical management and dialysis care, the outcome of unplanned pregnancy in women on maintenance hemodialysis (MHD) remains a difficult journey for the patient, fetus, and healthcare staff, particularly in low-resource countries. We report the successful outcome of a pregnancy in an anuric woman on twice-weekly maintenance hemodialysis for chronic glomerulonephritis since November 2012 in Cameroon. She was discovered pregnant at 18 weeks of gestation. The pregnancy was maintained until 36 weeks when a healthy 2,270 g female baby was delivered by elective cesarean section for tight nuchal cords and intrauterine growth retardation. The mother’s post-partum period was uneventful. Except for hypoglycemia shortly after birth, the baby was fine. The patient is still on hemodialysis after 4 years, and the child is healthy and attending school.

Background Despite progress in haemodialysis and conventional medicine approaches, many patients still struggle to maintain an acceptable quality of life and turn to complementary and alternative medicine (CAM) to address their unmet needs. Objective This study aims to determine the prevalence, types, indications, and factors associated with CAM use by patients on maintenance haemodialysis (MHD) in Cameroon. Materials and methods This was a multicentric cross-sectional study involving MHD patients in Cameroon from February 2019 to May 2019. We included all consenting participants on MHD for at least 3 months and excluded participants with cognitive and behavioral problems. Face-to-face interviews were conducted. Results A total of 224 participants (145 males) with a mean age of 56.5 ± 14.2 years and a median haemodialysis vintage of 34.5 [IQR: 17.3–64.4] months were recruited. In all, 89.7% (n = 201) reported having used CAM before, while 71.6% (n = 144) were still using it. Biologically based therapies were the most popular (94%, n = 189), with herbal medicine (81.5%, n = 154) and Calabar chalk (52.4%, n = 99) being the most common. Physical well-being (57.2%), nausea (52%), and insomnia (42.7%) were the main indications for CAM use. Most respondents did not disclose their CAM use to their physicians (61.2%). Long haemodialysis vintage was associated with CAM use (AOR: 7.9; CI = 2.8–22.3; p < 0.001). Conclusions The use of CAM is common among Cameroon’s haemodialysis population, with herbal medicines and Calabar chalk being the most frequent. The high symptom burden makes CAM attractive to them. Healthcare teams should be aware of these practices, initiate an open discussion, and appropriately advise patients about dangers, risks, and safety associated with their use. Trial registration The institutional review board of the University of Bamenda. Reference: 2019/0038H/UBa/IRB UPM/TNCPI/RMC/1.4.18.2.