Nutritional status of patients on maintenance hemodialysis in urban sub-Saharan Africa: evidence from Cameroon.
BACKGROUND
Malnutrition is an important predictive factor for morbidity and mortality in patients on maintenance dialysis. The evidence on the magnitude of the problem in sub-Saharan Africa is scanty. We assessed the nutritional status of patients on maintenance hemodialysis in the renal unit of the Douala General Hospital (Cameroon).


METHODS
Patients on maintenance hemodialysis for ≥3 months were enrolled between March and June 2012. Nutritional status was assessed via dietary recalls, anthropometric, and biochemical measurements including body mass index (BMI), triceps skinfold thickness, mid-arm circumference, mid-arm muscle circumference (MAMC), serum albumin, C-reactive protein (CRP) and hemoglobin, calcium, phosphorus, and vitamin D.


RESULTS
A total of 113 patients (75 men) were included. They were aged 49.4 years, and had been on dialysis for a median of 25 months. The mean BMI, MAMC and serum albumin was 22.4 kg/m(2), 23.7 cm and 42.4 g/l respectively. We observed that 28.3 % of patients were underweight (BMI ≤20 kg/m(2)), 23.9 % had muscle wasting (MAMC < adequacy to 50th percentile), and 31.6 % had low serum albumin (≤40 g/dl), while 21 % of patients had a combination of the three abnormalities. Prevalence rates for other indicators of under-nutrition were 26.3 % (low plasma cholesterol), 28 % (positive CRP) and 82.7 % (anemia). Female gender, younger age, less meals/day and frequent vegetable intake were associated with malnutrition risk.


CONCLUSIONS
Patients on maintenance hemodialysis in this setting have rates of malnutrition similar to those reported elsewhere. However, the high prevalence of malnutrition among women and young patients deserves further consideration.
Faculty of Medicine and Pharmaceutical Sciences, Douala University, Douala, Cameroon.
Marie Patrice
MP
Halle
Paul Narcisse
PN
Zebaze
Carl M
CM
Mbofung
Francois
F
Kaze
Hilaire
H
Mbiatat
Gloria
G
Ashuntantang
Andre Pascal
AP
Kengne
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D002163:Cameroon; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006769:Hospitals, General; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D006435:Renal Dialysis; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers