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Abstrak :
Nilai Glomelural Filtration Rate (GFR) sebagai salah satu hasil pemeriksaan renogram, saat ini diperoleh dengan cara membuat Region of Interest (ROI) secara manual pada kedua ginjal. ROI ini akan menghasilkan jumlah cacahan dari kedua ginjal yang akan digunakan untuk menghitung GFR. Karena dibuat secara manual, maka ROI dan nilai GFR tersebut hasilnya subyektif dan bergantung pada kemampuan operator. Oleh karena itu, pembuatan ROI ginjal secara otomatis menggunakan prinsip segmentasi citra dengan algoritma pengolahan citra yang sudah ada dapat menjadi solusi. Proses pembuatan ROI ginjal secara otomatis meliputi 3 tahap yaitu pre-processing, image contrast enhancement, dan image segmentation. Hasil akhir yang diperoleh adalah citra hasil pemeriksaan renogram dengan kedua ginjal yang sudah dibROI secara otomatis. Hasil pengujian yang dilakukan terhadap 35 pasien diperoleh 26 pasien berhasil di ROI secara otomatis dan 9 pasien gagal. Dari 26 pasien yang berhasil, hasilnya dibandingkan secara kuantitatif dengan ROI manual yang dilihat dari nilai true positive (TP), false negative (FN), dan false positive (FP). Diperoleh nilai rata-rata dari semua pasien yang berhasil yaitu TP 82,42%, FN 16,86%, dan FP 14,57%. ...... Glomelural Filtration Rate (GFR) value as one of the result of renogram examination, is obtained by delineate Region of Interest (ROI) manually on both kidney. This ROI will produce counts from both kidney which is used to calculate GFR. Because of delineate manually, the result would be subjective and depend on operators’ skill. Therefore, automatic kidney ROI using image segmentation with image processing algorithm that have been widely used can be one solution to relieve this problem. The process to make this automatic kidney ROI include 3 steps: pre-processing, image contrast enhancement, and image segmentation. The final result is renogram examination image that both kidney have ROI automatically. Results of the test performed on 35 patients show 26 patients were successful and 9 patients failed because of some reasons. From this 26 successful patients, the results were compared quantitatively with manual delineation ROI as seen from true positive (TP), false negative (FN), dan false positive (FP) value. The average values ​​obtained from all patients who successfully ie TP 82.42%, FN 16.86%, and 14.57% FP.

Abstrak :
Penderita thalassemia β mayor berisiko mengalarni hemokromatosis yang dapat merusak dan menurunkan fungsi ginjal. Pemeriksaan kadar kreatinin serum secara rutin telah digunakan untuk menilai fungsi ginjal namun cara ini banyak kekurangannya, sedangkan parameter baru cystatin C serum diketahui febih baik dibandingkan kreatinin namun belum pernah diteliti pada penderita thalassemia β mayor dengan hemokromatosis. Dengan mengetahui Iebih dini adanya penurunan fungsi ginjal maka diharapkan dapat menghambat progresititas penurunan fungsi ginjal pada penderita thalassemia β mayor dengan hemokromatosis. Penelitian ini bertujuan menilai fungsi ginjal penderita thalassemia β mayor dengan hemokromatosis. Janis penelitian, potong lintang diiaporkan dalam bentuk deskriptif analitik. Pengambilan darah dan data subyek dilaksanakan di pusat Tfralassemia ilmu Kesehatan Anak dan pengukuran laboratorium dilaksanakan di Departemen Patologi Klinik FKU/RSCM. Semua pasien yang memenuhi kriteria masukan diambil yaitu usia 10-21 tahun, saturasi transferin > 55%, pengobatan desferal < 3 kali per minggu, tidak mendapat obat yang mengganggu sekresi kreatinin. Hasil penelitian didapatkan, kadar kreatinin serum berkisar 0,2-0,7 mg/dL kadar cystatin C serum berkisar 0,69-1,31 mg/L, laju filtrasi glomerulus berdasarkan kadar cystatin C serum dengan menggunakan rumus Hoek (LFG-C) berkisar 57-112,1mL/menit/1,73m2, laju filtrasi glomerulus berdasarkan kadar kreatinin serum menggunakan rumus Counahan-Barrat (LFG-K) berkisar 95,2-288,1 mL/menit/1,73 m2 dan tidak dijumpai perbedaan hasil antara lelaki dan wanita pada parameter tersebut diatas. Dare 62 penderita thalassemia β mayor dengan hemokromatosis didapatkan penurunan fungsi ginjal yaitu laju filtrasi glomerulus < 90 mL/menit/1,73m2 sebesar 75,8% jika ditetapkan dengan LFG-C yang mulai terlihat setelah 96 bulan mendapat transfusi berulang. Namun jika ditetapkan dengan LFG-K semuanya belum menunjukkan adanya penurunan fungsi ginjal. Dijumpai korelasi antara lamanya mendapat transfusi darah dan LFG-C dengan r = - 0,475; sedangkan antara total volum darah transfusi dengan LFG-C dengan r = - 0,467; antara kadar kreatinin dan cystatin C serum dengan r = 0,504. Dijumpai korelasi lemah antara LFG-K dan LFG-C dengan r = 0,37. Tidak djumpai adanya korelasi antara kadar cystatin C serum dengan saturasi transferin. Didapatkan persamaan garis linier regresi pengaruh lamanya mendapat transfusi darah (Y} terhadap rerata LFG-C (X) yaitu Y = 569,1 - 5,06X, sedangkan pengaruh total volum darah transfusi (Y) terhadap LFG-C (X) yaitu Y 107380,7 - 617,414X. Pada penderita thalassemia p mayor dengan hemokromatosis kadar kreatinin serum cenderung rendah oleh karena itu pemantauan fungsi ginjal tidak dianjurkan menggunakan LFG-K, sebaiknya menggunakan LFG-C.

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Patients with j3-thalassemia major are at risk of developing hemochromatosis that will deteriorate and decrease renal function. Routine serum creatinine measurement has utilized to assess renal function, but this method has a lot disadvatages, while cystatin C a new parameter is known to be better than serum creatinine but had never been studied in p-thalassemia major patiens with hemochromatosis. Early detection of decreased renal function cans hopefully, slower the progressivity of renal function decrease in 13-thalassemia major patiens with hemochromatosis. The aim of this study was to access renal function in p-thalassemia major patiens with hemochromatosis. This study was designed as cross-sectional study, and the report was analytic descriptive. Blood and subject data collection was performed in the Thalassemic Center, Departement of Child's Health, FMU1 and laboratory test were performed in the Departement of Clinical Pathology, FMUI, Cipto Mangunkusumo National Hospital. All eligible patiens, i.e aged 10-21 years, with transferrin saturation of > 55%, on desferal with frequency of less than 3 timelweek, not on any medication that affect creatinine secretion, were included in this study. Result of this study showed that serum creatinine level ranged between 0.2-0.7 mg/dL, serum cystatin C level ranged between 0.69-1.31 mg/dL, glomerular filtration rate based on serum cystatin C level calculated with Hoek formula (GFR-C) ranged from 57- 112.1 mUminll.73 m2, glomerular filtration rate base on serum creatinine level calculated with Counahan-Barrat formula (GFR-K) ranged from 95.2-288.1 mL/min/1.73 m2 and there were no significant difference between male and female for all the parameters above. Of 62 subjects, we found decreased renal function, Le. GFR < 90 mL/min/1.73 m2 in 75,8% if GFR-C was used, and decrease was evident approximately 96 months after first administration of repeated transfusion regiment. But, if GFR-K was used, none of the patiens showed decrease renal function. There were negative correlation between the time interval from first transfusion and GFR-C (r = - 0.475) and between total volume of transfused blood (r = -0.467). Positive correlation was observed between serum creatinine and cystatine C level (r = 0.504). Weak correlation was found between serum cystatin C level and transferrin saturation. The equation of linear regression between the length of transfusion (Y) and mean GFR-C (X) was Y = 569.1 - 5.06X, while linear regression line between total volume of transfused blood (Y) and GFR-C (X) was Y = 107380,7 - 617.414X. In p-thalassemia major patiens with hemochromatosis, serum creatinine level tended to be low, thus GFR-K is not recommended for determination of renal function, and instead, GFR-C is a better measure of renal function in those patiens.

Abstrak :
Latar Belakang: Penyakit ginjal kronik (PGK) dilaporkan berhubungan dengan peningkatan risiko kejadian ulkus pedis dan amputasi pada diabetes melitus (DM). Namun, data mengenai hal tersebut masih terbatas termasuk di Indonesia. Tujuan penelitian ini adalah untuk mengetahui pengaruh PGK terhadap kejadian ulkus pedis dan amputasi ekstremitas bawah dalam 3 tahun. Metode: Penelitian ini merupakan studi kohort retrospektif pada DM berusia >18 tahun dengan menggunakan data sekunder di RSUP Fatmawati pada periode Januari – Desember 2016. Kesintasan terhadap ulkus pedis dan amputasi ekstremitas bawah berdasarkan LFG dihitung dan dianalisis melalui kurva Kaplan Meier. Adjusted hazard ratio (aHR) dinilai dengan menggunakan analisis multivariate Cox proportional hazards. Hasil: Dari 204 subjek penelitian, 108 orang (52,9%) memiliki LFG > 60, 54 orang (26,5%) memiliki LFG 30-59, dan 42 orang (20,6%) memiliki LFG <30 ml/menit/1,73 m2. Kesintasan ulkus pedis dalam 3 tahun adalah 75,7% untuk LFG <30; 86,4% untuk LFG 30-59; dan 94,1% untuk LFG > 60 ml/menit/1,73 m2. Laju insidens ulkus pedis per 1000 orang per bulan adalah 7,98 untuk LFG <30; 4,08 untuk LFG 30-59; dan 1,61 untuk LFG >60 ml/menit/1,73m2. Pasien dengan LFG 30-59 dan LFG <30 ml/menit/1,73 m2 memiliki adjusted HR 1,36 (IK 95% 0,39-4,66) dan 4,39 (IK 95% 1,18-16,4) terhadap ulkus pedis dibandingkan dengan LFG > 60 ml/menit/1,73 m2. Tidak dilakukan analisis lebih lanjut pada luaran amputasi ekstremitas bawah karena tidak ada pasien yang mengalami luaran pada kelompok LFG >60 ml/menit/1,73 m2 Kesimpulan: PGK mempengaruhi kejadian ulkus pedis dalam 3 tahun pada pasien DM dan risiko ulkus pedis dalam 3 tahun semakin meningkat seiring dengan semakin berat derajat PGK. Pengaruh PGK terhadap kejadian amputasi ekstremitas bawah masih belum dapat disimpulkan pada penelitian ini. ......Background: Chronic kidney disease (CKD) has been reported associated with poor prognoses in foot ulcers and lower extremity amputation (LEA) in patients with diabetes melitus (DM). However, the study is still limited and never been done in Indonesia. The objective of this study is to evaluate the impact of CKD on foot ulcers and LEA in patients with diabetes. Methods: This was a retrospective cohort study in Internal Medicine out-patient clinic in Fatmawati General Hospital. All subjects were enrolled between January-December 2016 who had history of DM, age >18 years old and had a history of DM. Foot ulcer-free and amputation-free survival for estimated glomerular filtration rate (eGFR) >60, 30-59, and <30 ml/min/1,73 m2 were calculated and analyzed by Kaplan-Meier curves. Adjusted hazard ratio (HR) was analalyzed using multivariate Cox proportional hazards. multivariate model. Results: A total of 204 individuals were included: 108 (52,9%) in eGFR >60, 54 in eGFR 30-59, and 42 in eGFR <30 ml/min/1,73 m2. Foot ulcer free survival for patient with eGFR <30, 30-59, >60 ml/min/1.73 m2 were 75,7%; 86,4%; and 94,1% respectively. Unadjusted foot ulcer incidence rates per 1000 patients per month were 7,98 for eGFR <30; 4,08 for eGFR 30-59; and 1,61 for eGFR >60 ml/menit/1.73m2. For the development of foot ulcer compared with eGFR > 60 ml/min/ 1.73 m2, adjusted HR for patient with eGFR 30-59 ml/min/1.73 m2 was 1,36 (CI 95% 0,39-4,66) and for eGFR < 30 ml/min/1.73 m2 was 4,39 (CI 95% 1,18-16,4). HR for LEA could not be analyzed because there were no patient who had been amputated after 3 years follow up in group eGFR >60 ml/min/1.73 m2. Conclusion: CKD increased the risk of foot ulcer in 3 years among DM patients. The risk was increased concomitant with the severity of CKD. The impact of CKD on LEA could not be concluded in this study.

Abstrak :
Komplikasi penyakit ginjal pada pasien diabetes melitus ditandai oleh eksresi albumin secara progresif melalui urin dan penurunan laju filtrasi glomerulus. Komplikasi tersebut dapat dicegah atau diperlambat progresivitasnya dengan pemberian terapi antidiabetes. Metformin dan kombinasi metformin-sulfonilurea adalah antidiabetes yang sering diberikan kepada pasien diabetes melitus tipe 2, terutama di puskesmas. Penelitian ini bertujuan membandingkan urine albumine-to-creatinine ratio UACR dan estimation of glomerular filtration rate eGFR sebagai parameter fungsi ginjal antara dua kelompok pengobatan pada pasien diabetes melitus tipe 2. Desain penelitian yang digunakan adalah potong lintang dengan tehnik consecutive sampling. Sebanyak 88 sampel pasien diabetes melitus tipe 2 yang menggunakan metformin n=37 atau kombinasi metformin-sulfonilurea n=51 minimal selama satu tahun berpuasa selama 8 jam sebelum pengambilan urin dan darah untuk analisis UACR dan eGFR. Nilai UACR diperoleh dari perbandingan kadar albumin urin dengan kreatinin urin. Nilai eGFR diperoleh dengan menggunakan persamaan The Chronic Kidney Disease Epidemiology Collaboration CKD-EPI. Kreatinin serum dan kreatinin urin diukur secara kolorimetri enzimatik sedangkan albumin urin diukur secara imunoturbidimetri. Hasil menunjukan bahwa rata-rata nilai eGFR kelompok metformin dan kelompok kombinasi metformin-sulfonilurea berada pada kategori yang sama yaitu 60-89 mL/menit/1,73 m2 meskipun rata-rata nilai eGFR pada kelompok metformin lebih rendah daripada kelompok kombinasi metformin-sulfonilurea. Nilai UACR pada kelompok metformin lebih rendah daripada kelompok kombinasi metformin-sulfonilurea tetapi tidak menunjukan adanya perbedaan bermakna p>0,05. ...... Complication of renal disease in diabetes melitus patient is characterized by progressive urinary albumin excretion and decreased glomerular filtration. The complication could be prevented or slowed down by theraphy antidiabetic. Metformin and sulphonylurea is the most comonly drugs prescribed as antidiabetic theraphy especially at public health centre. This study aimed to comparing urine albumin to creatinine ratio UACR and estimation of glomerular filtration rate eGFR as paramter of renal function between two type of theraphy on diabetes mellitus type 2 patient Design of this study was cross sectional and consecutive sampling method. A total of 88 samples of diabetes mellitus type 2 patient who was enrolled had taken metformin n 37 or combination of metformin sulphonylurea n 51 for at least one year fasted for 8 hours prior to urine and blood collection for UACR and eGFR analysis. UACR value was obtained from comparison of urine albumin with urine creatinine concentration. The value of eGFR was obtained using The Chronic Kidney Disease Epidemiology Collaboration CKD EPI equation. Serum creatinine and urine creatinine was measured by colorimetric enzymatic assay meanwhile urine albumin was measured by immunoturbidimetry. The result showed the average eGFR value in two groups were in the same category 60 89 mL menit 1,73 m2 although eGFR value average in metformin group lower than combination metformin sulphonylurea group. UACR in metformin group was lower than combination metformin sulphonylurea group but didn rsquo t show a significant different p 0,05.

Abstrak :
Latar Belakang: Gagal jantung merupakan salah satu penyebab kematian utama di Indonesia. Jantung dan ginjal berhubungan dengan erat yang dapat dijelaskan oleh sindrom kardiorenal. Saat ini, ada kekurangan data di rumah sakit tersier di Indonesia mengenai hubungan Ejection Fraction (EF) dengan fungsi ginjal. Metode: Penelitian ini merupakan penelitian cross-sectional yang mengikutsertakan pasien gagal jantung di RSUP Dr. Cipto Mangunkusomo tahun 2018 – 2020 sebagai populasi sasaran. Uji Chi-squared digunakan untuk menganalisis korelasi antar variabel. Izin etik diperoleh karena penelitian ini menggunakan manusia sebagai subjeknya. Hasil: Sebanyak 158 subjek diikutsertakan dalam penelitian ini setelah menerapkan kriteria inklusi dan eksklusi. Terdapat 37 (36,6%) pasien HF pada kelompok HFrEF yang memiliki eGFR stadium 3, 4, atau 5. Sedangkan di kelompok HFmrEF atau HFpEF, terdapat 29 (50,9%) dengan eGFR stadium 3, 4 , atau 5 (p-value = 0,115, RR = 0,72). Pasien gagal jantung dengan eGFR stadium 3, 4, atau 5 (n = 8;12,1%) dan eGFR stadium 1 atau 2 (n = 4; 4,3%) termasuk dalam kelompok NYHA kelas III atau IV (p-value = 0,125, RR = 2,79). Kesimpulan: Tidak ada perbedaan proporsi pasien HFrEF dengan HFpEF untuk memiliki eGFR stadium 3, 4, atau 5 serta proporsi pasien HF yang eGFR stadium 3,4 atau 5 dengan eGFR stadium 1 atau 2 untuk dimasukkan pada kelompok NYHA kelas III atau IV. ......Background: Heart failure is considered one of leading cause of death In Indonesia. The heart and kidneys are tightly related which can be explained by the cardiorenal syndrome. There is a paucity of current data in a tertiary hospital in Indonesia regarding the association of Ejection Fraction (EF) with kidney function. Method: This is a cross-sectional study that includes heart failure patients in Dr. Cipto Mangunkusomo Hospital year 2018 – 2020 as the target population. The Chi-squared test is used to analyse the association between the variables. Ethical permission was obtained since this research used humans as the subject. Results: A total of 158 subjects were included in this study after applying the inclusion and exclusion criteria. There were 37 (36,6%) HF patients in the HFrEF group had eGFR stage 3, 4, or 5. Meanwhile, among HFmreEF or HFpEF group, there were 29 (50,9%) with eGFR stage 3, 4, or 5 (p-value = 0,115, RR = 0,72). HF patients in both eGFR stage 3, 4, or 5 (n = 8;12,1%) and eGFR stage 1 or 2 (n = 4; 4,3%) were included in the NYHA class III or IV group (p-value = 0,125, RR = 2,79). Conclusion: There are no differences in the proportion of HFrEF patients with HFpEF to have eGFR stage 3, 4, or 5 as well as in the proportion of HF patients whose eGFR stages 3,4 or 5 with eGFR stages 1 or 2 to be included in the NYHA class III or IV group.

Abstrak :
Latar belakang: Dislipidemia merupakan keadaan kadar profil lipid tidak dalam rentang optimal yang saat ini banyak ditemukan pada masyarakat di Indonesia. Dislipidemia dipengaruhi oleh faktor genetik, pola hidup, atau penyakit lain yang sudah ada. Status sosioekonomi juga dapat mempengaruhi kesadaran dalam mengontrol dislipidemia. Hal ini dapat ditemukan pada masyarakat kampung kota yang cenderung rendah pengetahuan dan kesadarannya akan dislipidemia. Dislipidemia yang tidak ditangani berpotensi mengakibatkan kerusakan ginjal, sebagaimana yang disebutkan beberapa studi terdahulu bahwa adanya hubungan dislipidemia dengan penurunan fungsi ginjal. Oleh karena itu, penelitian ini dilakukan dengan tujuan meneliti hubungan dislipidemia dengan penanda fungsi ginjal subjek dewasa yang tinggal di kawasan kampung kota Jakarta dan Tangerang. Metode: Studi dilakukan dengan metode potong lintang pada subjek dewasa yang tinggal di kawasan kampung kota Jakarta dan Tangerang. Studi menggunakan data sekunder yang diambil pada September 2019-Maret 2020. Data subjek diseleksi berdasarkan kriteria inklusi dan eksklusi yang telah ditentukan. Hasil: Dari 215 subjek yang dianalisis, didapatkan peningkatan kolesterol total sebanyak 43,7%; peningkatan trigliserida (TG) sebanyak 28,4%; penurunan high-density lipoproteins (HDL) sebanyak 15,3%; peningkatan low-density lipoproteins (LDL) sebanyak 64,7%; dan penurunan estimated glomerular filtration rate (eGFR) sebanyak 4,7% subjek. Hasil analisis menggunakan uji Fisher menemukan adanya hubungan antara peningkatan kolesterol total dengan penurunan eGFR (p=0,023). Kesimpulan: Terdapat hubungan antara dislipidemia berdasarkan peningkatan kolesterol total dan penurunan fungsi ginjal pada masyarakat yang tinggal di kampung kota Jakarta dan Tangerang, sedangkan TG, HDL, dan LDL tidak berhubungan dengan penurunan fungsi ginjal. ......Introduction: Dyslipidemia is the state of the lipid profile that is not in the optimal range which is currently found in many people in Indonesia. Dyslipidemia is affected by genetics, lifestyle, or certain comorbidities. Low socioeconomic status also could influence awareness in controlling dyslipidemia. It could be found in kampung kota people which have relatively low knowledge and awareness of dyslipidemia. Untreated dyslipidemia could potentially causes kidney damage, as mentioned by previous studies that dyslipidemia is correlated with decreased kidney function. Therefore, this research is conducted to examine the relationship between dyslipidemia and kidney function markers in adults who live in kampung kota in Jakarta and Tangerang. Method: This study use cross-sectional design on adult subjects who live in kampung kota in Jakarta and Tangerang. This study used secondary data taken in September 2019-March 2020. Subjects’ data were selected based on defined inclusion and exclusion criteria. Result: From the 215 subjects analyzed, there were found increased total cholesterol in 43.7%; increased triglycerides (TG) in 28.4%; decreased high-density lipoproteins (HDL) in 15.3%; increased low-density lipoproteins (LDL) in 64.7%; and decreased estimated glomerular filtration rate (eGFR) in 4.7% subjects. Analysis using Fisher’s test found an association between increased total cholesterol and decreased eGFR (p=0.023). Conclusion: There is an association between dyslipidemia, based on increased total cholesterol, and decreased kidney function in people who live in kampung kota in Jakarta and Tangerang, meanwhile TG, HDL, and LDL are not associated with decreased kidney function.

Abstrak :
Renal dysfunction which frequently occurs in type 2 diabetes mellitus patients caused by oxidative stress. The effectiveness of the type 2 diabetes mellitus treatment to renal dysfunction is unknown. This study compare and analyze the correlation between urinary hydrogen peroxide which is a product of oxidative stress and estimated glomerular filtration rate (eGFR) in the treatment groups of sulfonylurea and combination biguanide-sulfonylurea. This study used a retrospective cohort study design with 50 sampels that was taken in Dr. Sitanala Tangerang hospital with total sampling technique. Estimated GFR value obtained based on serum creatinine values were measured using a kinetic Jaffe method, while the urinary hydrogen peroxide using FOX 1 (Ferrous ion Oxidation Xylenol Orange1). Value of urinary hydrogen peroxide in the two treatment groups did not have significant difference (p = 0.69), while the eGFR value of two groups did not have significant differences with the Cockroft Gault is p = 0.884; MDRD p = 0.886; and CKDEPI p = 0.490. Correlation analysis of urinary hydrogen peroxide and eGFR based on the MDRD equation and CKDEPI generate significant positive correlation (r = 0.326; p = 0.021) and (r = 0.282; p = 0.047). There is no antioxidant activity in the treatment groups. Urinary hydrogen peroxide may play a role in the pathophysiologic significance of diabetic nephropathy.

Abstrak :
Latar belakang: Komplikasi neurologis dan tumbuh-kembang sering diteliti pada neonatus cukup bulan (NKB), tetapi masalah pada ginjal masih jarang diperhatikan. Mayoritas NKB lahir ketika ginjal masih berkembang, sehingga lebih rentan mengalami gangguan fungsi ginjal. Profil fungsi ginjal dan faktor yang memengaruhinya penting untuk diketahui. Tujuan: Penelitian ini bertujuan untuk mengetahui profil fungsi ginjal, prevalens gangguan fungsi ginjal, dan faktor yang memengaruhi fungsi ginjal pada NKB. Metode: Penelitian ini merupakan studi deskriptif analitik dengan rancangan penelitian kohort retrospektif observasional di Rumah Sakit Cipto Mangunkusumo menggunakan data rekam medik dari Oktober 2022-Oktober 2023. Partisipan penelitian adalah seluruh NKB yang dirawat dan melakukan pemeriksaan kreatinin darah dengan kriteria eksklusi meninggal sebelum usia 48 jam. Faktor risiko yang diteliti adalah nutrisi maternal, diabetes gestasional, hipertensi pada kehamilan, anemia pada kehamilan, steroid antenatal, berat lahir, pertumbuhan janin terhambat, sepsis neonatorum, asfiksia neonatorum, anemia prematuritas, steroid pascanatal, dan gentamisin. Hasil: Kreatinin serum diperiksa pada 26,1% (192/737) NKB. Terdapat 169 subyek yang diinklusi. Median usia gestasi subyek adalah 31 (24–36) minggu dan berat lahir (BL) 1.335 (500–2.815) gram. Gangguan fungsi ginjal ditemukan pada 66,3% (112/169) subyek. Gangguan fungsi ginjal yang ditemukan berupa penurunan LFG 6(3,6%), hipertensi 91(53,8%), proteinuria 1(0,6%), dan campuran dari ketiganya 71(42,0%) subyek. Neonatus yang mengalami gangguan fungsi ginjal terbanyak pada usia gestasi 28–31 minggu (45,5%). Berdasar berat lahir terbanyak < 1000 g (81,6%), 1000–1499 (67,2%), 1500–2499 (59,6%). Variabel yang secara bersama-sama memengaruhi gangguan fungsi ginjal pada pasien neonatus kurang bulan adalah BL < 1.000 gram (OR 8,38; IK 95% 1,14–61,34; p=0,036), sepsis berat (OR 2,20; IK 95% 1,06–4,54; p=0,034) dan adanya anemia prematuritas (OR 2,86; IK 95% 1,15–7,12; p=0,024). Simpulan: Faktor risiko terjadinya gangguan fungsi ginjal pada NKB adalah BL < 1.000 gram, sepsis berat, dan anemia prematuritas. ......Background: Neurodevelopmental complication is often studied in preterm neonates (PTNs), but nephrological problem is usually overlooked. The majority of PTNs are born when the kidneys are still developing. Therefore, PTN is more susceptible to impaired kidney function (IKF) and is important to know the risk factors. Objective: his study aims to determine the prevalence of IKF and identify risk factors in PTN. Methods: This research is an analytical descriptive study with an observational cohort retrospective study methods at Cipto Mangunkusumo Hospital using medical record data from October 2022-October 2023. Subjects studied were all treated PTN who had creatinine evaluated during treatment and criteria exclusion of death within 48 hours was applied. The risk factors studied were maternal nutrition, gestational diabetes, hypertension in pregnancy, anemia in pregnancy, antenatal steroids, birth weight, fetal growth restriction, neonatal sepsis, neonatal asphyxia, anemia of prematurity, postnatal steroids, and gentamycin use. Results: Serum creatinine was assessed in 26,1% (192/737) PTN. One-hundred-and-sixtynine subjects were included. The median gestational age (GA) was 31 (24–36) weeks and birth weight (BW) 1,335 (500–2,815) grams. Impaired kidney function was found in 112/169 (66,33%) subjects. Abnormalities found were decreased in GFR 6(3.6%), hypertension 91(53.8%), proteinuria 1(0.6%), and mixture of the aboves 71(42.0%) subjects. Neonates with IKF mostly found with GA 28–31 weeks (45,5%). Based on birth weight, IKF was found in < 1000 g (81.6%), 1000–1499 (67.2%), 1500–2499 (59.6%). Variables that influence IKF in PTN are BW < 1,000 grams (OR 8.38; 95% CI 1.14 – 61.34; p=0.036), severe sepsis (OR 2.20; CI 95% 1.06–4.54; p=0.034), and the presence of anemia of prematurity (OR 2.86; 95% CI 1.15 – 7.12; p=0.024). Conclusion: Risk factors for IKF in PTN were BW < 1,000 grams, severe sepsis and anemia of prematurity.

Abstrak :
Malondialdehida merupakan produk peroksidasi lipid yang diduga bertanggung jawab sebagai penyebab terjadinya nefropati diabetik. Penelitian ini menilai hubungan antara kadar malondialdehida serum dengan UACR dan laju filtrasi glomerulus sebagai parameter fungsi ginjal. Penelitian ini menggunakan 54 pasien diabetes melitus tipe 2 sebagai sampel (3 laki-laki dan 51 perempuan, rentang usia 42-74 tahun). Kadar malondialdehida serum diukur secara spektrofotometri menggunakan asam tiobarbiturat. Laju filtrasi glomerulus diperoleh dari nilai kreatinin serum. Kreatinin urin diukur dengan metode Jaffe dan albumin urin diukur dengan metode bromkresol hijau. Kadar malondialdehida pasien diabetes diperoleh sebesar 2,46 ± 2,58 nmol/mL; nilai UACR sebesar 42,32 ± 76,67; dan nilai laju filtrasi glomerulus sebesar 104,75 ± 46,16 (Cockroft-Gault); 89,52 ± 25,86 (MDRD study); dan 99,49 ± 46,11 (CKD-EPI). Hasil analisis hubungan antara malondialdehida dengan Cockroft-Gault (p = 0,491, r = -0,096); MDRD study (p = 0,618, r = -0,069); CKD-EPI (p = 0,611, r = -0,071); UACR (p = 0,583, r = 0,076). Ditemukan hubungan yang bermakna antara nilai UACR dengan laju filtrasi glomerulus Cockroft-Gault (p = 0,019, r = -0,318); MDRD study (p = 0,007, r = -0,361); CKD-EPI (p = 0,010, r = -0,348). Tidak ditemukan hubungan yang bermakna antara malondialdehida dengan laju filtrasi glomerulus dan UACR. ...... Malondialdehyde is a product of lipid peroxidation that is suspected as a cause of diabetic nephropathy. This study assessed the relation between malondialdehyde level with UACR and glomerular filtration rate as renal function parameters. This study is using 54 patients type 2 diabetes mellitus as samples (3 men and 51 women, age range 42-74 years). Malondialdehyde was measured by spectrophotometry using tiobarbiturat acid. Glomerular filtration rate was obtained from serum creatinine value. Urine creatinine was measured based on Jaffe method and urine albumin was measured with bromcressol green. Malondialdehyde level of diabetic patients was 2.46 ± 2.58 nmol/mL; UACR was 42.32 ± 76.67; and glomerular filtration rate were 104.75 ± 46.16 (Cockroft-Gault); 89.52 ± 25.86 (MDRD study); and 99.49 ± 46.11 (CKD-EPI). The analysis result of the relationship between malondialdehyde and Cockroft-Gault (p = 0.491, r = -0.096); MDRD study (p = 0.618, r = -0.069); CKD-EPI (p = 0.611, r = -0.071); and UACR (p = 0.583, r = 0.076) . There were significant correlation between UACR and glomerular filtration rate Cockroft-Gault (p = 0.019, r = -0.318); MDRD study (p = 0.007, r = -0.361 ); CKD-EPI (p = 0.010, r = -0.348). There were no significant correlation between malondialdehyde level and glomerular filtration rate or UACR.

Abstrak :
Gangguan fungsi ginjal merupakan salah satu komplikasi yang sering terjadi pada pasien diabetes melitus tipe 2. Pendeteksian dini dengan menggunakan senyawa 8-iso-Prostaglandin F2α dan KIM-1 diperlukan untuk mencegah progresifitasnya. Dalam penelitian ini dilakukan analisis hubungan antara kadar 8-iso-Prostaglandin F2α dan KIM-1 urin dengan estimasi laju filtrasi glomerulus (eLFG). Sampel yang dianalisis adalah 40 orang pasien diabetes melitus tipe 2 di Puskesmas Pasar Minggu, dengan teknik total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang diukur menggunakan metode kinetik Jaffe, sedangkan kadar 8-iso-Prostaglandin F2α dan KIM-1 diukur dengan menggunakan metode ELISA (Enzyme Linked Immunosorbent Assay). Kadar 8-iso-Prostaglandin F2α diperoleh 6633,87 ± 1292,62 pg/mg kreatinin, kadar KIM-1 diperoleh 8,23 ± 3,23 ng/mL dan nilai eLFG diperoleh 99,65 ± 41,12 (Cockroft-Gault); 96,59 ± 41,90 (MDRD study); dan 100,79 ± 40,07 (CKD-EPI). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (r = 0,520; p = 0,001), MDRD (r = 0,477; p = 0,004) dan CKD-EPI (r = 0,403; p = 0,013), serta setelah perokok dieksklusi, berdasarkan ketiga persamaan, yaitu Cockroft-Gault (r = 0,595; p = 0,001), MDRD (r = 0,554; p = 0,003) dan CKD-EPI (r = 0,559; p = 0,003). Hubungan antara kadar KIM-1 dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (r = -0,155; p = 0,339), MDRD (r = -0,173; p =0,285) dan CKD-EPI (r = -0,024; p = 0,883). Sehingga diketahui terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dan tidak terdapat hubungan yang bermakna antara KIM-1 dengan nilai eLFG.

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Renal dysfunction is one of complication that most common in type 2 diabetes mellitus patients. The earlier detection is needed to prevent its progression with 8-iso-Prostaglandin F2α and KIM-1. The aim of this study was to analyze concentration of 8-iso-Prostaglandin F2α and KIM-1urine and its correlation with estimated glomerular filtration rate (eGFR). Samples analyzed were 40 type 2 diabetes mellitus patients at Pasar Minggu Local Government Clinic, used total sampling method. eGFR was obtained based on the measurement of serum creatinine on kinetic Jaffe method, 8-iso-Prostaglandin F2α and KIM-1 was measured by ELISA (Enzyme Linked Immunosorbent Assay) method. Concentration of 8-iso-Prostaglandin F2α was 6633,87 ± 1292,62 pg/mg creatinine, concentration of KIM-1 was 8,23 ± 3,23 ng/mL and the eGFR values were 99,65 ± 41,12 (Cockroft-Gault); 96,59 ± 41,90 (MDRD study); and 100,79 ± 40,07 (CKD-EPI). The correlation between 8-iso-Prostaglandin F2α concentration and eGFR is based on Cockroft-Gault (r = 0,520; p = 0,001), MDRD (r = 0,477; p = 0,004) and CKD-EPI (r = 0,403; p = 0,013), and the correlation between 8-iso-Prostaglandin F2α concentration after smoker exclution and eGFR based on Cockroft-Gault (r = 0,595; p = 0,001), MDRD (r = 0,554; p = 0,003) and CKD-EPI (r = 0,559; p = 0,003). But the correlation between KIM-1 concentration and eGFR based on Cockroft-Gault (r = -0,155; p = 0,339), MDRD (r = -0,173; p =0,285) and CKD-EPI (r = -0,024; p = 0,883). So there was a significant correlation between 8-iso-Prostaglandin F2α concentration and eGFR, and also there were no significant correlation between KIM-1 concentration and eGFR.