Anemia in patients on chronic hemodialysis in Cameroon: prevalence, characteristics and management in low resources setting

Abstract

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.

Profile of Anemia in Chronic Kidney Disease Patients at a Rural Tertiary Care Centre: A Prospective Observational Study

“…5 Accordingly, The prevalence of anemia ranges from about 1% in stage 2 of CKD to almost 100% in end stage renal disease (ESRD) patients. 6 Pathophysiologically, Anemia in patients of CKD is determined by multiple factors. 7 The most important and primary factor is the deficient production of Erythropoetin (EPO) by the damaged kidneys.…”

Association of interleukin 17 / angiotensin II with refractory hypertension risk in hemodialysis patients

“…Furthermore, patients with ESRD who are going for dialysis tend to have refractory hypertension, anemia, and other complications 2,3 . Many ESRD patients have to take several kinds of anti-hypertensive drugs, but even when they receive the maximum permissible doses; it remains difficult to treat their hypertension.…”

Epidemiology of Impaired Renal Function in the Bamenda Health District, North West Region of Cameroon

“…Kidney disease is an important cause of death and loss of disability-adjusted life-years but awareness is low among patients and health-care providers [1]. Although decreased GFR can be caused by primary kidney disease (predominantly glomerular diseases, tubulo-interstitial diseases, obstruction, and polycystic kidney disease), in the vast majority of patients with decreased GFR, the kidney damage is associated with other medical conditions such as diabetes and hypertension [14].…”

“…In a study to assess the prevalence and correlates of CKD in an urban adults Cameroonian population by [14] using the commonest estimators of kidney function, there was a high frequency of CKD and related risk factors in this population, with over one in ten participants having CKD. This high prevalence of CKD appeared to be driven mostly by advanced age, hypertension, diabetes mellitus and adiposity.…”