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.