Inflammatory Syndrome and Malnutrition in Chronic Hemodialysis Patients in Brazzaville: Prevalence and Factors Associated with Hypoalbuminemia

Abstract

Background: Chronic kidney disease and its terminal stage represent a growing global health burden, particularly in sub-Saharan Africa where access to optimal renal replacement therapy remains limited. Among hemodialysis patients, chronic inflammation and protein-energy wasting are major determinants of poor outcomes and are closely interrelated within the Malnutrition-Inflammation-Atherosclerosis (MIA) syndrome. However, data from Central Africa remain scarce. Objective: To assess the prevalence of hypoalbuminemia and inflammatory syndrome, and to identify factors independently associated with hypoalbuminemia in chronic hemodialysis patients in Brazzaville. Methods: We conducted a cross-sectional analytical study including adult patients undergoing chronic hemodialysis in two public dialysis centers in Brazzaville between March and December 2025. Hypoalbuminemia was defined as serum albumin 6 mg/L. Multivariate logistic regression was performed to identify factors independently associated with hypoalbuminemia. Results: A total of 60 patients were included (mean age: 53.0 ± 12.1 years; 70% male). The prevalence of hypoalbuminemia was 26.7%, while inflammatory syndrome was observed in 56.7% of patients. Hypoalbuminemia was associated with longer dialysis duration (p = 0.013), elevated CRP levels (p = 0.049), and inflammatory syndrome (p = 0.007). In multivariate analysis, inflammatory syndrome (adjusted OR = 9.97; 95% CI: 1.75 - 56.75; p = 0.010) and diabetes mellitus (adjusted OR = 4.81; 95% CI: 1.05 - 21.95; p = 0.043) were independently associated with hypoalbuminemia. Conclusion : Hypoalbuminemia is frequent among chronic hemodialysis patients in Brazzaville and is strongly associated with persistent systemic inflammation. These findings highlight the central role of the MIA syndrome and the need for integrated management strategies targeting both inflammation and nutritional status to improve patient outcomes.