title: 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 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.
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences & Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Francois Folefack
authors.initials: FF
authors.lastname: Kaze
authors.affiliation: South African Medical Research Council & University of Cape Town, Cape Town, South Africa.
authors.forename: Andre-Pascal
authors.initials: AP
authors.lastname: Kengne
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences & Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Alex Tatang
authors.initials: AT
authors.lastname: Mambap
authors.affiliation: Department of Internal Medicine, Faculty of Medicine and Pharmaceutical Sciences & Douala General Hospital, University of Douala, Douala, Cameroon.
authors.forename: Marie-Patrice
authors.initials: MP
authors.lastname: Halle
authors.affiliation: Department of morphological sciences, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Dora
authors.initials: D
authors.lastname: Mbanya
authors.affiliation: Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences & Yaoundé General Hospital, University of Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Gloria
authors.initials: G
authors.lastname: Ashuntantang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000747:Anemia, Hypochromic / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D001803:Blood Transfusion; D002163:Cameroon / Q000453:epidemiology; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006454:Hemoglobins
keywords: Anemia; Blood transfusion; End stage renal disease; Hemodialysis; Sub-Saharan Africa
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