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Anemia in patients on chronic hemodialysis in Cameroon: prevalence,characteristics and management in low resources setting
Authors:Francois Folefack Kaze  Andre-Pascal Kengne  Alex Tatang Mambap  Marie-Patrice Halle  Dora Mbanya  Gloria Ashuntantang
Abstract:
BackgroundAnemia 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.MethodsThis 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 arteriovenous fistula. A monthly evaluation included full blood counts, number of pints of red cell concentrates transfused, and vital status.ResultsAt 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.ConclusionsPatients on chronic hemodialysis have predominantly microcytic hypochromic anemia, with limited capacity for correction using blood transfusion.
Keywords:Anemia   Blood transfusion   End stage renal disease   Hemodialysis   Sub-Saharan Africa
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