Prevalence and Factors Associated with the Severity of Anaemia among Patients on Chronic Haemodialysis in Lagos, Nigeria
DOI:
https://doi.org/10.30442/ahr.0903-03-205Abstract
Background: Anaemia is a global public health problem with high mortality and morbidity. It is also a common consequence of chronic kidney disease (CKD). There is a paucity of data on the actual burden of anaemia among patients on chronic haemodialysis (CHD) in Lagos, Nigeria.
Objectives: To determine the prevalence and factors associated with the severity of anaemia among Nigerian patients undergoing chronic haemodialysis.
Methods: This was a retrospective analysis of adult patients with end-stage renal disease (ESRD) on maintenance haemodialysis at the Lagos State University Teaching Hospital, Ikeja, Lagos. The data extracted from the clinical case files included the bio-demographic and clinical parameters, including the treatment modalities.
Results: A total of 92 patients comprising 69 (75%) males and 23 (25.0%) females with the overall mean age of 48.2±14.0 years were included. Hypertension was the commonest aetiology of CKD and the average duration of haemodialysis was 16.6 months. The commonest access route for haemodialysis was a central line while 96.7% and 81.5% received erythropoietin and intravenous iron sucrose respectively. Seventy-three (79.3%) patients have had intra-dialysis blood transfusions in the past. Mild, moderate, and severe anaemia were recorded in 17%, 67%, and 16% respectively. The use of erythropoietin, iron sucrose, and increased frequency of blood transfusions correlated with the severity of anaemia.
Conclusion: Anaemia is highly prevalent among patients with CKD on chronic haemodialysis. Increased frequency of blood transfusions, inadequate utilization of erythropoietin, and iron sucrose administration are predictors of anaemia severity.
References
Domenica Cappellini M, Motta I. Anaemia in Clinical Practice—definition and classification: does haemoglobin change with aging? Semin Hematol 2015;52:261–269. https://doi.org/10.1053/j.seminhematol.2015.07.006.
Mcmurray J, Parfrey PS, Adamson JW, Aljama P, Berns JS, Bohlius J, et al. Kidney disease: Improving Global Outcomes (KDIGO) Anaemia Work Group. KDIGO clinical practice guideline for anaemia in chronic kidney disease. Kidney Int Suppl (2011). 2012;2:279–335.
Lamerato L, James G, van Haalen H, Hedman K, Sloand JA, Tang A, et al. Epidemiology and outcomes in patients with anaemia of CKD not on dialysis from a large US healthcare system database: a retrospective observational study. BMC Nephrol 2022;23:166. https://doi.org/10.1186/s12882-022-02778-8.
Palaka E, Grandy S, Van Haalen H, McEwan P, Darlington O. The Impact of CKD Anaemia on Patients: incidence, risk factors, and clinical outcomes - a systematic literature review. Int J Nephrol 2020;2020:7692376. https://doi.org/10.1155/2020/7692376.
Porter AC, Lash JP, Xie D, Pan Q, DeLuca J, Kanthety R, et al. Predictors and Outcomes of Health-Related Quality of Life in Adults with CKD. Clin J Am Soc Nephrol 2016;11:1154–1162. https://doi.org/10.2215/CJN.09990915.
Bhatta S, Aryal G, Kafle R. Anaemia in chronic kidney disease patients in predialysis and postdialysis stages. J Pathol Nepal 2011;1:26–29. https://doi.org/10.3126/jpn.v1i1.4446
Chukwuonye I, Oviasu E. The Plight of Chronic Kidney Patients in Nigeria. IOSR J Dent Med Sci 2012;2:52–55. https://doi.org/10.9790/0853-0225255.
Furuland H, Linde T, Ahlmén J, Christensson A, Strö mbom U, Danielson BG. A randomized controlled trial of haemoglobin normalization with epoetin alfa in pre-dialysis and dialysis patients. Nephrol Dial Transplant 2003;18:353–361. https://doi.org/10.1093/ndt/18.2.353.
Domenica Cappellini M, Motta I. Anaemia in Clinical Practice—Definition and Classification: Does Haemoglobin Change with Aging? Semin Hematol 2015;52:261–269. https://doi.org/10.1053/j.seminhematol.2015.07.006.
National Kidney Foundation. Clinical practice guidelines for chronic kidney disease: Evaluation, classification and stratification. National Kidney Foundation; 2002.
Akinsola A, Durosinmi MO, Akinola NO. The haematological profile of Nigerians with chronic renal failure. Afr J Med Med Sci 2000;29:13-16.
Iyawe I, Adejumo O. Hematological profile of predialysis chronic kidney disease patients in a tertiary hospital in Southern Nigeria. J Med Trop. 2018;20:36-41. https://10.4103/jomt.jomt_1_18.
Ijoma C, Ulasi I, Ijoma U, Ifebunandu N. High prevalence of anaemia in predialysis patients in Enugu, Nigeria. Nephrol Rev 2010;2:61–65. https://doi.org/10.4081/NR.2010.E14.
Afolabi M, Abioye-Kuteyi A, Arogundade F, Bello I. Prevalence of Chronic Kidney Disease in a Nigerian Family Practice Population. South Afr Family Pract 2009;51:132–137.
Olutayo Alebiosu C, Ayodele OO, Abbas A, Olutoyin IA, Alebiosu O. Chronic renal failure at the Olabisi Onabanjo university teaching hospital, Sagamu, Nigeria. Afr Health Sci 2006;6:132-138. https://doi.org/10.5555/afhs.2006.6.3.132.
Portolés J, Martín L, Broseta JJ, Cases A. Anaemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments, to Future Agents. Frontiers Med 2021; 8. https://doi.org/10.3389/fmed.2021.642296.
Nalado AM, Mahlangu JN, Waziri B, Duarte R, Paget G, Olorunfemi G, et al. Ethnic prevalence of anaemia and predictors of anaemia among chronic kidney disease patients at a tertiary hospital in Johannesburg, South Africa. Int J Nephrol Renovasc Dis. 2019;12:19–32. https://doi.org/10.2147/IJNRD.S179802.
Adera H, Hailu W, Adane A, Tadesse A. Prevalence of anaemia and its associated factors among chronic kidney disease patients at university of gondar hospital, northwest Ethiopia: A hospital-based cross-sectional study. Int J Nephrol Renovasc Dis. 2019;12:219–228. https://doi.org/10.2147/IJNRD.S216010.
Taderegew MM, Wondie A, Terefe TF, Tarekegn TT, GebreEyesus FA, Mengist ST, et al. Anaemia and its predictors among chronic kidney disease patients in Sub-Saharan African countries: A systematic review and meta-analysis. PLoS One. 2023;18. https://doi.org/10.1371/journal.pone.0280817.
Ulasi II, Ijoma CK. The enormity of chronic kidney disease in Nigeria: The situation in a teaching hospital in south-east Nigeria. J Trop Med. 2010;2–6.
Alasia DD, Emem-Chioma P, Wokoma FS. A single-center 7-year experience with end-stage renal disease care in Nigeria - A surrogate for the poor state of ESRD care in Nigeria and other sub-Saharan African countries: Advocacy for a global fund for ESRD care program in Sub-Saharan African countries. Int J Nephrol. 2012;2012:2–8. https://doi.org/10.1155/2012/639653.
Arogundade F, Sanusi A, Hassan M, Akinsola A. The pattern, clinical characteristics and outcome of ESRD in Ile-Ife, Nigeria: Is there a change in trend? Afr Health Sci 2011;11:594–601.
Abdu A, Lawrence A, Shuaibu A, Sani T. Haemodialysis outcome at Rasheed Shekoni Hospital. Niger J Basic Clin Sci. 2019;16:42. https://doi.org/10.4103/njbcs.njbcs_30_18
Barsoum RS. Chronic Kidney Disease in the Developing World. New Eng J Med. 2006;354:997–999. https://doi.org/10.1056/NEJMp058318.
Robinson BM, Joffe MM, Berns JS, Pisoni RL, Port FK, Feldman HI. Anaemia and mortality in haemodialysis patients: Accounting for morbidity and treatment variables updated over time. Kidney Int. 2005;68:2323–2330. https://doi.org/10.1111/j.1523-1755.2005.00693.x.
McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, et al. The prevalence of anaemia in patients with chronic kidney disease. Curr Med Res Opin 2004;20:1501–1510. https://doi.org/10.1185/030079904X2763.
Ueda N, Takasawa K. Impact of inflammation on ferritin, hepcidin and the management of iron deficiency anaemia in chronic kidney disease. Nutrients. 2018;10:2–33. https://doi.org/10.3390/nu10091173.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Annals of Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.
