Assessment of Anaemia Management in Patients with End-Stage Renal Disease on Haemodialysis at Plateau State Specialist Hospital, North Central Nigeria

This study evaluates anaemia management practices in end-stage renal disease (ESRD) patients receiving maintenance haemodialysis at the Plateau State Specialist Hospital, Jos, Plateau State, North Central Nigeria. Renal anaemia is a universal complication of ESRD on haemodialysis, and its optimal management requires erythropoiesis-stimulating agents (ESAs), iron supplementation, and monitoring to achieve target haemoglobin. A retrospective audit of 80 ESRD patients maintained on haemodialysis for at least six months was conducted. Data extracted included haemoglobin levels, ESA type and dosing, iron status indices, transfusion frequency, and target haemoglobin achievement rates. Target haemoglobin of 10 to 12 g/dL was achieved in only 34 percent of patients. ESAs were prescribed for 71 percent of patients, but supply interruptions resulted in an average of 2.4 months per year without ESA access. Absolute iron deficiency was identified in 48 percent of patients, and only 28 percent were receiving intravenous iron supplementation despite this high deficiency rate. The mean transfusion requirement was 4.2 units per patient per year, far exceeding the target of minimal transfusions in the haemodialysis population to reduce allosensitisation risk for potential future renal transplantation. The study recommends a structured renal anaemia management protocol, procurement planning to ensure ESA availability, intravenous iron supplementation as a standard component of haemodialysis anaemia management, and monthly haemoglobin and iron status monitoring at Plateau State Specialist Hospital. Keywords: renal anaemia, haemodialysis, erythropoiesis-stimulating agents, iron supplementation, Plateau State.