Prevalence and Management of Anemia in Chronic Hemodialysis Patients in the Souss-Massa Region Morocco

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Introduction: The prevalence of anemia in chronic kidney disease and among chronic hemodialysis patients is very high and is associated with significant morbidity and mortality. The aim of this study was to determine the prevalence of anemia in chronic hemodialysis patients in the Souss-Massa region and to evaluate its management. Materials and Methods: This was a retrospective, analytical, and descriptive study conducted between July 2023 and July 2024, including chronic hemodialysis patients from the Souss-Massa region. Anemia was defined according to the 2024 Kidney Disease Improving Global Outcomes (KDIGO) guidelines as hemoglobin levels <13 g/dL in men and <12 g/dL in women. Results: A total of 1,346 patients out of 1,800 participants were included, corresponding to an anemia prevalence of 74.7%. The mean age of the patients was 57.52 ± 15.54 years, with a male-to-female ratio of 1.12. Half of the patients had been on hemodialysis for less than 5 years. The leading causes of kidney disease were diabetic nephropathy and hypertensive nephropathy in 38.8% and 16.9% of cases, respectively. The mean hemoglobin, ferritin, and transferrin saturation (TSAT) levels were 10.02 ± 1.5 g/dL, 386.42 ng/mL, and 32.61% ± 15.4, respectively. Anemia management included erythropoietin (EPO) therapy, injectable iron, and blood transfusions in 85%, 13.4%, and 20% of patients, respectively. Multivariate analysis revealed significant correlations between anemia and history of hypertension (p=0.008), hepatitis C virus infection (p<0.001), secondary hyperparathyroidism (p=0.04), prior catheter-related infectious complications (p=0.003), and chronic inflammatory syndrome (p=0.02). Discussion and Conclusion: Our study confirms a high prevalence of anemia in hemodialysis patients. Despite therapeutic advances, blood transfusion reliance remains high, increasing the risk of immunologic complications and limiting access to kidney transplantation.

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