Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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2018 - 20192

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Author: search.filters.author.Lakmini, K.M.S.Has files: No

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    Prevalence, associations and treatment outcome of anaemia in a cohort of patients with Chronic Kidney Disease
    (Sri Lanka Medical Association, 2019) Luke, W.A.N.V.; Lakmini, K.M.S.; Nadeeka, D.; de Silva, S.T.
    INTRODUCTION & OBJECTIVES: Anaemia is a common complication of chronic kidney disease (CKD) that can adversely affect cardiovascular health and quality of life. We conducted a study to assess prevalence, associations and treatment response of anaemia in a cohort of patients with CKD. METHODS: A descriptive cross sectional study was conducted among consecutive, consenting adult patients with stable CKD attending clinics and wards of University Medical Unit, Colombo North Teaching Hospital, Ragama. RESULTS: Of 149 patients with CKD [86/149 males (57.7%)], 105 (70.5%) had diabetes, 125 (83.9%) had hypertension and 57 (37.6%) had ischemic heart disease. 58/63 (90.6%) females and 80/86 (93%) males had anaemia. Severity of anaemia was associated with female sex (p=0.02), advancing CKD stage (p<0.01), diabetes (p=0.03), chronic liver cell disease (p=0.03), being on dialysis (p<0.005) and increasing degree of proteinuria (p<0.001). Of 91 patients investigated for the cause of anaemia, 55/91 (60.4%) had iron deficiency with anaemia of chronic disease while 25/91 (27.5%) had anaemia of chronic disease only. Of 88 patients with haemoglobin <10g/dL, only 40 (45.4%) were on erythropoietin and 50 (56.8%) had received blood transfusions. 76.1% (67/88) of the anaemic patients continued to have hemoglobin below 10g/dL at follow up despite treatment. CONCLUSION: Anaemia was highly prevalent in the CKD cohort we studied, compared to similar populations in other countries. Timely evaluation of anaemia, treatment of coexistent nutritional deficiencies and initiation of erythropoietin therapy are important to prevent anaemia-related complications and minimize the need for transfusions.
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    Pseudo polycythaemia and its association with cardio-metabolic risk factors: A preliminary descriptive analysis from a tertiary care hospital
    (Sri Lanka Medical Association, 2018) de Silva, S.T.; Amarasena, P.; Dias, M.A.D.H.; Lakmini, K.M.S.; Premathilaka, L.H.R.A.; Ranatunga, R.J.K.L.D.; Moratuwegama, H.M.D.; Siriwardana, S.R.; Niriella, M.A.; Premawardhena, A.P.
    INTRODUCTION AND OBJECTIVES: Polycythaemia is the result of either an actual increase in red cell mass (true) or relative reduction in plasma volume (spurious). Spurious or pseudo-polycythaemia (PP) is a poorly-researched entity with unexplained increase in mortality noted in previous studies. We aimed to characterize PP and determine an association between PP and metabolic syndrome (MS) in a Sri Lankan clinic-based population. METHODS: Consecutive, consenting adults > 18 years, with two consecutive haemoglobin levels> l 6.5mg/dL and > 16mg/dL and/or PCV >49% and >48% in men and women respectively, with non-tourniquet samples taken few days apart in a well-hydrated state, were recruited from clinics of University Medical Unit, Colombo North Teaching Hospital and from the private sector. Interviewer-administered questionnaire was used to gather data.RESULTS: 46 participants were recruited: 3 (6.5%) had primary polycythemia, 5 (10.9%) had secondary polycythemia due to identifiable causes. 38 (82.6%) patients had PP [mean age 42.2 (SD=l5.2) years and 36 (94.7%) were males]. Of these 14 (36.8%) had diabetes, 22 (57.9%) had hypertension, 25 (65.8%) had hyperlipidemia and 25 (65.8%) were obese. 19 (50%) had fatty liver, 23 (60.5%) were light smokers, 8 (21.1%) consumed alcohol beyond safe limits, 6 (15.8%) had increased neck circumference, 1 (2.6%) had ischemic heart disease, 2 (5.3%) had chronic kidney disease and 2 (5.3%) had hyperuricaemia. Comparison of PP and secondary polycythemia with regard to prevalent components of MS was not possible due to small numbers.CONCLUSION: Components of MS were prevalent among those with PP. The significance of this finding remains unexplained. This needs to be replicated in a larger sample to establish whether these are independent risk factors for the development of PP.