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Abstrak :
Defisiensi besi merupakan salah satu penyebab komorbid anemia renal yang dapat meningkatkan mortalitas anak dengan penyakit ginjal kronik (PGK) sehingga dibutuhkan parameter yang bernilai diagnostik baik. Diagnosis defisiensi besi pada PGK sulit karena memerlukan kombinasi parameter yang dipengaruhi inflamasi sehingga tidak praktis dan mahal. Rekomendasi parameter baru yang mudah, lebih murah, dan tidak dipengaruhi oleh inflamasi adalah reticulocyte hemoglobin equivalent (RET-He). Tujuan penelitian adalah mencari titik potong RET-He untuk diagnosis anemia defisiensi besi absolut dan fungsional pada anak PGK. Studi ini merupakan studi potong lintang terhadap 59 anak PGK berusia 2-18 tahun di Indonesia. Kurva receiver operating characteristic (ROC) dikerjakan untuk menentukan titik potong RET-He optimal dengan menggunakan IBM SPSS versi 20. Reticulocyte hemoglobin equivalent dengan titik potong ≤ 25,75 pg (sensitivitas 90,00%, spesifisitas 73,47%, NDP 40,91%, NDN 97,30%, dan akurasi 76,27%) dapat digunakan untuk diagnosis anemia defisiensi besi absolut sedangkan RET-He dengan titik potong ≤ 30,15 pg (sensitivitas 85,71%, spesifisitas 32,79%, NDP 14,63%, NDN 94,44%, dan akurasi 38,98%) tidak dapat digunakan untuk diagnosis anemia defisiensi besi fungsional. Peneliti menarik kesimpulan bahwa RET-He dapat digunakan sebagai parameter anemia defisiensi besi pada anak PGK dengan nilai batasan ≤ 25,75 pg dan penggunaan RET-He dalam mendiagnosis defisiensi besi harus disertai dengan parameter lain seperti hemoglobin (Hb). ......Iron deficiency are one causes of comorbid renal anemia that can increase mortality in pediatric chronic kidney disease (CKD) so that parameters with good diagnostic value are needed. The diagnosis of iron deficiency in CKD is difficult because it requires a combination of parameters which are affected by inflammation so it is impractical and expensive. The new parameter recommendation which is easy, cheaper, and not affected by inflammation is reticulocyte hemoglobin equivalent (RET-He). The aim of the study was to look for RET-He cut-off points in diagnosing absolute and functional iron deficiency anemia in pediatric CKD. This is a cross-sectional study of 59 children aged 2-18 years diagnosed as CKD in Indonesia. The receiver operating characteristic (ROC) curve was performed to determine the optimal RET-He cut off points using IBM SPSS version 20. Reticulocyte hemoglobin equivalent ≤ 25.75 pg (sensitivity 90.00%, specificity 73.47%, PPV 40.91%, NPV 97,30%, and accuracy 76.27%) can be used for the diagnosis of absolute iron deficiency anemia in pediatric CKD while RET-He with a cut off point ≤ 30.15 pg (sensitivity 85.71%, specificity 32.79%, PPV 14.63%, NPV 94.44%, and accuracy 38.98%) cannot be used for the diagnosis of functional iron deficiency anemia. The researcher draws the conclusion that REt-He can be used as a parameter of iron deficiency anemia in pediatric CKD with a cut-off value ≤ 25.75 pg and the usage of RET-He must be accompanied by other parameters such as hemoglobin (Hb).

Abstrak :
Latar Belakang: Indonesia bagian Timur memiliki beban ganda dalam infeksi parasit di negara tropis yaitu cacing usus dan malaria. Infeksi parasit tersebut secara tunggal maupun bersama-sama dapat menyebabkan kejadian anemia. Di Indonesia, kejadian anemia berhubungan dengan asupan nutrisi zat besi yang kurang dan infeksi parasit Belum diketahui bagaimana hubungan antara infeksi parasit dan anemia pada populasi anak sekolah di Kecamatan Nangapanda yang merupakan daerah ko-endemis malaria dan cacing usus. Tujuan: Mengetahui hubungan antara infeksi parasit dengan prevalensi anemia pada anak-anak sekolah dasar di Nangapanda Provinsi Nusa Tenggara Timur. Metode: Penelitian ini menggunakan data sekunder yang diperoleh studi potong lintang dari tim peneliti Departemen Parasitologi FKUI. Populasi terjangkau adalah populasi anak sekolah di Ende Provinsi Nusa Tenggara Timur berusia 6-10 tahun. Teknik pengambilan sampel menggunakan total population sampling. Penentuan status gizi menggunakan aplikasi WHO AnthroPlus untuk anak usia 5-18 tahun. Pemeriksaan infeksi cacing usus pada tinja menggunakan pemeriksaan Katokatz. Pemeriksaan malaria menggunakan metode polymerase chain reaction (PCR). Data diuji menggunakan uji chisquare dengan alternatifnya uji Fisher. Hubungan bermakna bila nilai p < 0,05. Hasil: Didapatkan 240 subyek penelitian dengan rerata usia 8,21 tahun, rerata hemoglobin 11,92g/dL dengan proporsi anemia 53,3%. Proporsi infeksi cacing usus sebesar 24,2% dan infeksi malaria sebesar 6,7%. Hasil analisis didapatkan bemakna pada variabel jenis kelamin (p<0,001) sedangkan variabel infeksi cacing usus dan malaria didapatkan hasil tidak bermakna terhadap kadar hemoglobin dengan masing-masin nilai p=0,747 dan p=0,782. Kesimpulan: Tidak terdapat hubungan antara infeksi cacing usus dan malaria dengan tingkat keparahan anemia pada anak-anak sekolah dasar yang tinggal di daerah Nangapanda, Nusa Tenggara Timur. ......Background: East Region of Indonesia has double burden for parasitic infection endemic in tropical country such as soil transmitted helminths and malaria. These parasitic infections alone or together can cause anemia. In Indonesia, anemia was associated with low nutrition intake of iron and parasitic infection. However, this association was not known in the population of school children in Nangapanda Distric, Nusa Tenggara Timur Province which was ko-endemic between malaria and soil transmitted helminths. Aim: To find the association between parasitic infection and prevalence of anemia in children who attends primary school in Nangapanda, Nusa Tenggara Timur. Method: This research used secondary data from cross-sectional study conducted by FKUI Parasitology Team. Target population was children 6-10 year who attended primary school in Ende, Nusa Tenggara Timur. The sampling method was using total population sampling. The nutritional status was determined using the application of WHO AnthroPlus for children aged 5-18 years old. Soil-transmitted helminths infection was being detected by Katokatz method and malaria infection is using PCR method. Data was being analyzed with chi-square test and Fisher test as the alternative. Association is significant when p value is<0,05. Result: Total sample is 240 subjects with mean age 8,21 years old, mean hemoglobin is 11,92 g/dL and anemic proportion is 53,3%. Soil-transmitted helminths infection proportion is 24,2% and malaria infection is 6,7%. The analytical results is significant for gender(p<0,001) and not significant for Soil-transmitted helminths infection and malaria with p=0,747 and p=0,782, respectively versus hemoglobin concentration. Conclusion: There is no association between Soil-transmitted helmints infection and malaria with the severity of anemia in children who attends primary school and live in Nangapanda, Nusa Tenggara Timur.

Abstrak :
ABSTRAK
Latar Belakang: Defisiensi besi merupakan salah satu penyebab anemia pada anak dengan penyakit ginjal kronik PGK derajat 5 yang menjalani hemodialisis HD regular. Pemberian besi intravena IV dosis loading terbukti bermanfaat mengoreksi kekurangan besi, namun belum ada studi yang baik mengenai manfaat pemberian besi IV dosis rumatan setelah terjadi replesi besi, untuk mempertahankan kadar hemoglobin Hb dan profil besi. Metoda: Disain studi adalah kohort retrospektif menggunakan data rekam medis, pada anak usia ABSTRACT Background Iron deficiency is a common cause of anemia in children with chronic kidney disease CKD on hemodialysis HD . Iron repletion with intravenous IV iron sucrose formulations has been studied in children, however effectiveness of maintenance IV iron regimens has not been reported extensively. Methods We conducted a retrospective cohort study on children with CKD on HD. Medical records were reviewed on all patients at the Children rsquo s Kidney Center, Cipto Mangunkusumo Hospital between January 1, 2015 and May 31, 2016. Patients with normal hemoglobin Hb and iron values were grouped into patients received IV iron sucrose maintenance and patients without IV iron sucrose maintenance. In the first group, patients received 2 mg kg dose of IV iron sucrose once every other week for 2 doses. Laboratory tests for Hb and iron values were recorded twice. First laboratory test was the baseline, shows normal Hb and iron values in both groups. The second laboratory test was taken after 6 weeks of baseline test. Objectives We assessed effects of IV iron sucrose maintenance by the difference in proportions of iron deficiency anemia between two groups based on repeat laboratory test 6 weeks after baseline test. Results During the study period, a total of 74 children had normal Hb and iron values at the beginning of the study. Forty seven patients received IV iron sucrose maintenance and 27 children did not receive IV iron maintenance. Repeat laboratory test 6 weeks after baseline test shows proportion of iron deficiency anemia was 5 47 10.64 in patients with IV iron and 16 27 59.26 in patients without IV iron. Between group difference for proportions was 48.62 P