{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:58:24Z","timestamp":1755226704466,"version":"3.43.0"},"reference-count":27,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,22]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>Thalassaemia is a genetic disorder of haemoglobin synthesis characterised by life-long chronic anaemia. Although the endocrine and cardiac complications of thalassaemia are well-studied, hepatic and renal complications are understudied. This study aims to describe the hepatic and renal functions and to understand their determinants among paediatric patients with \u03b2-thalassaemia.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Design<\/jats:title>\n<jats:p>Cross-sectional study.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Setting<\/jats:title>\n<jats:p>Two largest thalassaemia centres in Sri Lanka.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Participants<\/jats:title>\n<jats:p>All haematologically confirmed patients with \u03b2-thalassaemia aged 1\u201316 years attending the study sites were recruited between 1 January and 31 March 2023. Data were collected by interviewing parents and patients, performing physical examinations and perusing clinical records.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>72 children (girls 52.8%) were recruited. The mean age was 7.3 years (SD 3.8). A majority (44 (61.1%)) had \u03b2-thalassaemia major, while 22 (30.6%) had haemoglobin E \u03b2-thalassaemia. 55 children (76.4%) were transfusion dependent. Hepatomegaly was found in 47 (65.3%), while 28 (38.9%) had elevations of both alanine and aspartate transaminases. Haemoglobin E \u03b2-thalassaemia type (OR 13.6, 95% CI 2.0 to 92, p=0.008) and high ferritin above 1000\u2009ng\/mL (OR 6.2, 95% CI 1.0 to 38, p=0.047) were independent factors associated with high transaminases. 11 (15.5%) patients had an estimated glomerular filtration rate (eGFR) below 90\u2009mL\/min. The proportion of children with low eGFR was higher in \u03b2-thalassaemia major (23.3%), transfusion-dependent (18.5%) and deferasirox treatment (18.5%) groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Elevation of hepatic transaminases is common among children with thalassaemia, especially among the subset of patients with haemoglobin E \u03b2-thalassaemia and those with high ferritin. Milder reductions in eGFR are noted in some patients with transfusion-dependent \u03b2-thalassaemia major.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089784","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T05:30:45Z","timestamp":1738819845000},"page":"e089784","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatic and renal functions of paediatric patients with thalassaemia: a cross-sectional study from two large thalassaemia centres in Sri Lanka"],"prefix":"10.1136","volume":"15","author":[{"given":"Wasana","family":"Wijenayake","sequence":"first","affiliation":[{"name":"Colombo North Teaching Hospital, Ragama, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3787-6714","authenticated-orcid":false,"given":"Raveen","family":"Thennakoon","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Kelaniya, Kelaniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hashan","family":"Pathiraja","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Kelaniya, Kelaniya, Sri Lanka"},{"name":"Provincial General Hospital, Kurunegala, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayananda","family":"Bandara","sequence":"additional","affiliation":[{"name":"Provincial General Hospital, Kurunegala, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roshitha","family":"De Silva","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Kelaniya, Kelaniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuja","family":"Premawardhena","sequence":"additional","affiliation":[{"name":"Colombo North Teaching Hospital, Ragama, Sri Lanka"},{"name":"Department of Medicine, University of Kelaniya, Kelaniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meranthi","family":"Fernando","sequence":"additional","affiliation":[{"name":"Colombo North Teaching Hospital, Ragama, Sri Lanka"},{"name":"Department of Paediatrics, University of Kelaniya, Kelaniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0760-0418","authenticated-orcid":false,"given":"Sachith","family":"Mettananda","sequence":"additional","affiliation":[{"name":"Colombo North Teaching Hospital, Ragama, Sri Lanka"},{"name":"Department of Paediatrics, University of Kelaniya, Kelaniya, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"2025070104270870000_15.2.e089784.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2017.11.003"},{"key":"2025070104270870000_15.2.e089784.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31822-6"},{"key":"2025070104270870000_15.2.e089784.3","unstructured":"Premawardhena A , Mudiyanse R , Jifri M , et al . 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