Profil Pasien Tuberkulosis Paru dengan Penyakit Ginjal Kronik yang Dirawat di RSUP Prof. Dr. R. D. Kandou Manado Periode Oktober 2017 – Oktober 2018

Abstract

Abstract: Patients with chronic kidney disease (CKD) have increased risk of tuberculosis compared to patients with normal renal function. This is due to impaired cell-mediated immunity, imunosupressive medication, HIV infection, and diabetes mellitus (DM). Uremia is also associated with immunodeficiency in CKD patients due to functional abnormality of neutrophils, reduced T and B cell function, and impaired monocyte and monocyte-derived dendritic cell function. This study was aimed to obtain the profile of TB patients associated with CKD at Prof. Dr. R. D. Kandou Hospital Manado This was a descriptive retrospective study using medical record data of CKD patients with TB co-infection within one-year. The results showed that of 1369 CKD patients, 32 patients had coinfection with TB (2.34%). The majority of patients were males (81%); 62.5% were in the age range of 46-65 years old. Most of them worked as agricultural farmer (28%). Forty-four percent of the patients had CKD stage 5; 11 of them did not undergo dialysis. Most CKD patients were caused by NSAID nephropathy (65%). Conclusion: The majority of TB patients associated with CKD were males, aged 45-65 years, and worked as farmers. The major cause of CKD was NSAID nephropathy. Most patients suffered from CKD stage 5, some did not undergo dialysis.

Keywords: chronic kidney disease, lung tuberculosis

Abstrak: Pasien dengan penyakit ginjal kronik (PGK) mempunyai peningkatan risiko tuberkulosis (TB) dibanding pasien dengan fungsi ginjal yang normal. Hal ini terkait dengan penurunan cell-mediated immunity, pengobatan imunosupresif, koinfeksi human immune-deficiency virus (HIV), dan diabetes melitus (DM). Uremia juga berhungan dengan imuno-defisiensi pada PGK yang disebabkan oleh abnormalitas fungsional dari neutrofil, penurunan fungsi sel T dan B dan terganggunya fungsi monosit dan sel dendritik turunan monosit. Penelitian ini bertujuan untuk mendapatkan profil pasien TB paru disertai PGK yang dirawat di RSUP Prof. dr. R. D. Kandou Manado periode Oktober 2017-Oktober 2018. Jenis penelitian ialah deskriptif retroskpektif menggunakan data rekam medik pasien PGK dengan koinfeksi TB paru selama satu tahun. Hasil penelitian mendapatkan 1369 pasien PGK; 32 pasien dengan koinfeksi TB paru (2,34%). Mayoritas pasien berjenis kelamin laki-laki (81%), berada pada rentang usia 46-65 tahun (62,5%), dan bekerja sebagai petani (28%). Sebesar 44% dari pasien dengan PGK derajat 5; 11 diantaranya non-dialisis. Paling banyak disebabkan oleh nefropati OAINS (65%). Simpulan: Mayoritas pasien PGK di RSUP Prof. Dr. R. D. Kandou Manado berjenis kelamin laki-laki, berusia 45-65 tahun, dan bekerja sebagai petani. Penyakit penyebab PGK-nya terbanyak ialah nefropati OAINS. Mayoritas pasien PGK dengan derajat 5, sebagian di antaranya non dialisis.

Kata kunci: penyakit ginjal kronik, tuberkulosis paru