Assessing the Nutritional Status of Hemodialysis Patients in Sub-Saharan Africa: Experience of Two Hemodialysis Centers in Niger

Abstract

Introduction: Patients with end-stage chronic renal failure (ESKD) have a significant impairment in their nutritional status. Our study is aiming at evaluating the nutritional status based on clinical and biological parameters. Patient and method: This is a prospective, cross-sectional, descriptive and analytical study carried out in two departments of nephrology/dialysis in Niger from 1 December 2014 to 31 March 2015. The assessment of nutritional status relied on the Body Mass Index (BMI), albuminemia, serum phosphate, hemoglobin, CRP, urea, creatinine levels. Results: Sixty-five patients were involved in the study. The mean age was 44.35 ± 13 years with a sex ratio of 2.09 in favor of men and an average dialysis duration of 43.47 ± 36.55 months. The mean BMI was 21.60 ± 4.47 kg/m2. Undernutrition was noted in 19 patients (29.23%), hypoalbuminemia was found in 13 patients, C-reactive protein (CRP) level was high in 11 patients. In comparative analysis according to the BMI, several parameters were significantly related to undernutrition: hypo-albuminemia, hyperphosphatemia, high CRP, hyperazotemia, anorexia, MUAC, comorbidities, central venous catheter. Conclusion: The prognostic value of undernutrition in chronic hemodialysis patients fosters early recognition and management of all nutritional disturbances in these patients. Assessment and monitoring of nutritional status in chronic hemodialysis require the simultaneous determination of several markers in order to weight the limits of each of the criteria taken in isolation.