Francois Folefack Kaze1, Andre-Pascal Kengne2, Alex Tatang Mambap1, Marie-Patrice Halle3, Dora Mbanya4, Gloria Ashuntantang1. 1. Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences & Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon. 2. South African Medical Research Council & University of Cape Town, Cape Town, South Africa. 3. Department of Internal Medicine, Faculty of Medicine and Pharmaceutical Sciences & Douala General Hospital, University of Douala, Douala, Cameroon. 4. Department of morphological sciences, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
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 arteriovenous 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.
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 arteriovenous 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.
Entities:
Keywords:
Anemia; Blood transfusion; End stage renal disease; Hemodialysis; Sub-Saharan Africa
Authors: Aliyu Abdu; F Arogundade; B Adamu; A I Dutse; A Sanusi; M U Sani; M S Mijinyawa; A Akinsola; M M Borodo Journal: West Afr J Med Date: 2009 Sep-Oct
Authors: Ronald L Pisoni; Eric W Young; Dawn M Dykstra; Roger N Greenwood; Erwin Hecking; Brenda Gillespie; Robert A Wolfe; David A Goodkin; Philip J Held Journal: Kidney Int Date: 2002-01 Impact factor: 10.612
Authors: Aishatu Mohammed Nalado; Johnny N Mahlangu; Bala Waziri; Raquel Duarte; Graham Paget; Gbenga Olorunfemi; Saraladevi Naicker Journal: Int J Nephrol Renovasc Dis Date: 2019-02-18