SLMAResearch Symposium on CKDu Objectives: To study the increasing trend of urolithisis in Thanamalwila and Lunugamvehera areas. Methodology: Descriptive study of incidence of urolithiasis has been performed by using IMMR based statistics of DH Thanamalwila and DH Lunugamvehera.. Multiple random sampling of drinking water sources from these areas was done. They were analyzed for hardness and arsenic content using atomic absorption spectrometer with graphite furnace detector. Results: Increasing trend of cases of urolithiasis has been identified. Three, 07 and 15 cases have been reported from Thanamalwila in year 2009,2010 and 2011 respectively. Seven, 11,09,46 and 48 cases have been reported from Lunugamwehera from 2007 to 2011. Water samples from Lunugamwehera and Thanamalwila detected to contain 12+3– 352+34 mg L‐1 and 170+8 ‐ 500+24 mg L‐1 hardness respectively. Water hardness had shown a correlation with the arsenic levels. Arsenic levels were 2.14+0.84 – 52.47+6.71 μg L‐1 in Lunugamvehera and 39.37+5.21‐ >100.42+9.45 μg L‐1in Thanamalvila. Conclusion: There is an increasing trend of urolithiasis and high hardness and arsenic content of drinking water sources. Further studies are needed to find out any possible link between urolithiasis, high water hardness and high arsenic content of the drinking water sources. In CKDu endemic areas it was found to be having very high hardness and high arsenic content in ground water. Though such a very high level of hardness and arsenic is not observed, possible role by those factors in urolithiasis cannot be excluded. SOCIOECONOMIC IMPACT OF CKDu: A PRELIMINARY ANALYSIS Liyanage C1, Jayathilake R1, de Silva A1, Kasthuriratne A2, Jayasinghe S University of Colombo1 and Kelaniya2 sarojoffice@yahoo.com Introduction: CKDu is estimated to affect 8 to 9% of adults in rural NCP, and led to NCP having the highest number of deaths due to CKD in the country. The present study describes the socio‐economic impact of the disorder in these areas. Methods: Studies included a community‐based study to describe social impact and estimate costs at the household and community level, and a hospital‐based study to estimate costs to the health system. The community‐based study consisted of interviewing 200 patients with CKDu patients selected from registers. Results: Most were poorly educated (12.5% had passed GCE O‐Level) and from poor socio‐economic group. 131 (65.5%) were males and 184 (92%) above 40 years. 157 (78.5%) found that CKDu reduced their contribution to household income. Costs of agriculture increased because of shortage of labour, costs of hiring workers and machinery. However, medical costs increased due to laboratory tests, medication and transport. Allowances from social service sector were meager and families were stigmatized as a result of the diagnosis. Conclusions: CKDu is devastating rural communities in NCP. Its national impacts could include slower economic growth and depopulation of areas. The aetiology appears to be linked to water. Focus on bio‐ medical aetiologies and interventions to tackle it should work at least in parallel or perhaps take a back seat and instead the government should invest in a massive development effort to provide safe water and social protection. Irrespective of CKDu, safe water is immensely beneficial and rights of this voiceless group should be respected.
PREVALENCE OF MAJOR DEPRESSIVE EPISODE AMONG PREDIALYSIS CHRONIC KIDNEY DISEASE PATIENTS Sumanathissa M1, De Silva V2, Hanwella R2 1Teaching Hospital, Kegalle; 2University of Colombo. msthissa@yahoo.com Objective: To ascertain the prevalence of depression among pre‐dialysis chronic kidney disease (CKD) patients. Methods: A cross‐sectional study was carried out using the Structured Clinical Interview for DSM IV (SCID) to detect major depressive episode. Study was carried out in the nephrology out‐patient clinic at Teaching Hospital Anuradhapura. Every fifth patient with CKD diagnosed according to the K/DQOI of the National Kidney Foundation of USA criteria stages 2‐5 not undergoing dialysis was recruited. Primary
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