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Abstrak :

Batu saluran kemih (BSK) didefinisikan sebagai pembentukan batu pada ginjal, ureter, atau kandung kemih. Beberapa penelitan menunjukkan bahwa ketidaknormalan parameter metabolik merupakan hal yang umum pada pasien BSK. Tujuan penelitian ini adalah untuk melihat hubungan antara indeks massa tubuh (IMT), asam urat serum, glukosa serum, dan tekanan darah dengan opasitas batu pada pasien BSK. Penelitian ini dilakukan secara retrospektif dengan melihat data rekam medis dari pasien BSK yang menjalani prosedur ESWL pada Januari 2008 – Desember 2013 di Departemen Urologi RS Cipto Mangunkusumo. Data yang yang diambil adalah indeks masa tubuh (IMT), kadar asam urat serum, glukosa serum, tekanan darah, dan opasitas BSK. Hubungan antara IMT, kadar asam urat serum, glukosa serum, dan tekanan darah, dengan opasitas batu dianalisis menggunakan uji chi-square. Terdapat 2.889 pasien yang menjalani prosedur ESWL pada Januari 2008 – Desember 2013. Analisis dilakukan terhadap 242 pasien yang memiliki rekam medis lengkap. Rerata usia adalah 48,02±12,78 tahun.  Rasio laki-laki terhadap perempuan adalah 2,27:1. Rerata IMT adalah 29,91±3,78 kg/m². IMT berisiko didapatkan pada 66,52% pasien.  Proporsi batu radioopak adalah 77,69% (188 pasien). Dua puluh dua pasien (9,1%) memiliki tekanan darah normal. Pasien dengan kadar serum asam urat tinggi sebanyak 34,30% (83 pasien). Secara statistik didapatkan hubungan yang bermakna antara kadar serum glukosa sewaktu dengan opasitas batu (p < 0,05). Terdapat hubungan yang bermakna antara kadar serum glukosa sewaktu dengan opasitas batu pada pasien BSK. Pasien hiperglikemia cenderung memiliki batu radiolusen. Sementara pasien normoglikemia cenderung memiliki batu radioopak.

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Urolithiasis refers to formation of stone in the kidney, ureter, or bladder. Several studies showed metabolic abnormalities were common in urolithiasis patients. The aim of this study was to describe the association between body-mass-index (BMI), serum uric acid, serum glucose, and blood pressure toward stone opacity in urinary tract stone patients. This study was done retrospectively by reviewing registry data of urinary tract stone patients that had undergone ESWL on January 2008 – December 2013 in Department of Urology Cipto Mangunkusumo Hospital. Data concerning body mass index, serum uric acid, serum glucose, blood pressure, and urinary tract stone opacity were recorded. Associations between body mass index, serum uric acid, serum glucose and blood pressure with urinary tract stone opacity were using chi-square test. There were 2,889 patients who underwent ESWL on January 2008 – December 2013. We analyzed 242 subjects with complete data. Mean age was 48.02 (± 12.78 years). Male-to-female ratio was 2.27:1. Mean BMI was 29.91 (± 3.78) kg/m². High risk BMIs were found in 161 patients (66.52%). The proportion of radioopaque stone was 77.69% (188 patients). Twenty two patients (9.1%) had normal blood pressure. Patients with high serum uric acid were 34.30 % (83 patients). We found a significant association between random serum glucose level and stone opacity (p < 0.05). There is significant association between random serum glucose level and stone opacity in urolithiasis patients. Hyperglycemia patients tend to have radiolucent stone, whereas normoglycemia patients tend to have radioopaque stone.

Abstrak :
Pencegahan parut ginjal di kemudian hari pada tata laksana PNA belum memuaskan. Mekanisme vitamin E dalam menekan inflamasi dan sebagai antioksidan pada tata laksana anak dengan febrile UTI belum diteliti. Penelitian ini menelaah efek inhibisi vitamin E terhadap IL-6, IL-8, dan MDA urin. Efek perancu seperti usia, ASI, riwayat ibuprofen, dan infeksi E. coli, juga diteliti. Uji klinis acak tersamar ganda (n = 40) dilakukan di RS Fatmawati pada anak berusia 6?60 bulan dengan febrile UTI. Kelompok kasus diberikan 40 UI DL-α- tocopherol dan kelompok kontrol diberikan saccharum lactis selama 10 hari. Kedua kelompok mendapat terapi antibiotik yang sama. Pemantauan demam, leukosit darah, IL-6, IL-8, dan MDA urin dilakukan pada H0, H3 dan H10. Analisis IL-6 dan IL-8 dan MDA urin dilakukan di Laboratorium Biokimia FKUI. Kadar IL-6 urin lebih rendah pada kelompok vitamin E. Vitamin E menurunkan IL-8 urin namun tidak berbeda bermakna dibanding plasebo. Vitamin E tidak terbukti menurunkan demam lebih baik dibanding plasebo. Leukosit darah pada kelompok vitamin E lebih menurun dibanding kelompok plasebo, namun keduanya dalam batas normal. Perubahan MDA urin kedua kelompok tidak berbeda. Pemberian ASI menurunkan IL-6 dan IL-8 urin secara bermakna. Riwayat ibuprofen meningkatkan IL-6 dan IL-8 urin secara bermakna. Infeksi E. coli lebih meningkatkan MDA urin dibanding uropatogen lain. Manfaat penambahan vitamin E pada tata laksana febrile UTI masih perlu diteliti lebih lanjut.

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Prevention of subsequent renal scarring in APN treatment has not been encouraging. The mechanism of vitamin E in suppressing inflammation and as an anti-oxidant in pediatric febrile UTI patients has not been studied. This study aimed to examine the inhibitory effects of vitamin E on urinary IL-6, IL-8, and MDA. Confounding effects of age, breastfeeding, previous treatment with ibuprofen, and E. coli infection were studied. A randomized double blind placebo controlled clinical trial (n = 40) was conducted in Fatmawati Hospital on 6 to 60 months old subjects with febrile UTI. The intervention group received 40 IU DL- α-tocopherol while the control received saccharum lactis as placebo for 10 days. Both groups were treated with antibiotics equally. Fever monitoring as well as blood leukocyte, urinalysis, and urinary IL-6, IL-8, and MDA were performed on day 0, day 3 and day 10. Analyses of urinary IL-6, IL-8 and MDA levels were conducted at Biochemistry Laboratory of Faculty of Medicine University of Indonesia. Urinary IL-6 levels were lower in the vitamin E group. Vitamin E suppressed urinary IL-8 but this result was not statistically significant compared to that of the placebo group. Vitamin E was not proven to reduce fever better than placebo. Leukocyte was lower in the vitamin E group compared to the placebo group, but both counts were within normal limit. Changes of urinary MDA levels between the two groups was statistically insignificant. Breastfeeding significantly lowered urinary IL-6 and IL-8 levels. Ibuprofen withdrawal significantly increased urinary IL-6 and IL-8 levels. E. coli infection increased urinary MDA more than any other uropathogens. The supplementation of vitamin E in the treatment of febrile UTI in children needs to be further investigated.