Gambaran Fungsi Ginjal pada Anak Penderita Diare dengan Dehidrasi di RSUP Prof. Dr. R. D. Kandou Manado
DOI:
https://doi.org/10.35790/msj.v6i2.53577Abstract
Abstract: Diarrhea associated with dehydration can cause decreased tissue perfusion and circulating volume, thus inhibiting kidney function characterized by a decrease in glomerular filtration rate (GFR) and an increase in metabolic waste. This study aimed to determine the description of kidney function in children with diarrhea and dehydration at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective and descriptive study with a cross-sectional design. Samples were children with diarrhea and dehydration hospitalized at Prof. Dr. R. D. Kandou Hospital from July 1, 2020 to June 30, 2023. The results obtained 120 patients predominantly between the ages of 1 month -<1 year (50.0%), male (59.2%), and had mild to moderate dehydration (78.3%). Kidney function features showed normal serum ureum and serum creatinine in most samples by 89% and 91%, respectively, while GFR decreased in less than half of the samples by 49.2%. Increased serum ureum, serum creatinine, and decreased GFR were most common in severely dehydrated children by 69.2%, 73.1%, and 84.6%, respectively. In conclusion, diarrheal children with dehydration had normal serum ureum and serum creatinine levels, and decreased GFR. Increased serum ureum, serum creatinine, and decreased GFR were most common in diarrheal children with severe dehydration.
Keywords: diarrhea; dehydration; children; serum ureum; serum creatinine; glomerular filtration rate
Abstrak: Diare yang disertai dehidrasi dapat menyebabkan penurunan perfusi jaringan dan volume sirkulasi sehingga menghambat fungsi ginjal yang ditandai dengan penurunan laju filtrasi glomerulus (LFG) dan peningkatan limbah metabolisme di dalam tubuh. Penelitian ini bertujuan untuk mengetahui gambaran fungsi ginjal pada pasien anak penderita diare dengan dehidrasi di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif dengan desain potong lintang. Sampel penelitian yaitu pasien anak diare dengan dehidrasi yang dirawat inap di RSUP Prof. Dr. R. D. Kandou Manado selama periode 1 Juli 2020–30 Juni 2023. Hasil penelitian mendapatkan 120 pasien anak diare dehidrasi didominasi usia 1 bulan -<1 tahun (50,0%), jenis kelamin laki-laki (59,2%), dan dehidrasi ringan-sedang (78,3%). Gambaran fungsi ginjal pada anak diare dengan dehidrasi memperlihatkan ureum serum dan kreatinin serum normal pada sebagian besar sampel (89% dan 91%), sedangkan LFG menurun pada kurang dari setengah sampel (49,2%). Peningkatan ureum serum, kreatinin serum, serta penurunan LFG paling sering pada anak dengan dehidrasi berat (69,2%, 73,1%, dan 84,6%). Simpulan penelitian ini ialah pada anak diare dengan dehidrasi, kadar ureum serum dan kreatinin serum didapatkan normal, sedangkan LFG menurun. Peningkatan ureum serum, kreatinin serum, dan penurunan LFG pada anak diare dengan dehidrasi paling sering pada derajat dehidrasi berat.
Kata kunci: diare; dehidrasi; anak; ureum serum; kreatinin serum; laju filtrasi glomerulus
References
Subagyo B, Santoso NB. Diare akut. In: Juffrie M, Soenarto SSY, Oswari H, Arief S, Rosalina I, Mulyani NS, editors. Buku Ajar Gastroenterologi-Hepatologi Jilid 1. Jakarta: Ikatan Dokter Anak Indonesia; 2012. p. 87–120.
World Health Organization. Diarrhoeal disease [Internet]. 2017 [cited 2023 Jul 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/diarrhoeal-disease
Laporan Nasional Riset Kesehatan Dasar 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2018.
Juvitha DC, Nurbaiti L, Suryani D. Gambaran kasus diare akut pada anak di bawah 5 tahun yang dirawat inap di RSU Provinsi NTB tahun 2015. Jurnal Kedokteran Unram [Internet]. 2019;8(1):13–6. Available from: https://doi.org/10.29303/jku.v8i1.328
Sudiarti PE, Salma, Aprilla N. Gambaran kejadian diare pada anak usia <2 tahun di Puskesmas Kampar Kabupaten Kampar tahun 2019. Jurnal Ners Universitas Pahlawan [Internet]. 2020;4(2):107–9. Available from: https://doi.org/10.31004/jn.v4i2.1121
Canadian Paediatric Society. Dehydration and diarrhea. Paediatr Child Health [Internet]. 2003;8(7):459–60. Available from: https://doi.org/10.1093/pch/8.7.459
Vega RM, Avva U. Pediatric Dehydration. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Jul 22]. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK436022/
Yusuf S. Profil diare di Ruang Rawat Inap Anak. Sari Pediatri [Internet]. 2011;13(4):265–70. Available from: http://doi.org/10.14238/sp13.4.2011.265-70
Yusuf S, Haris S, Kadim M. Gambaran derajat dehidrasi dan gangguan fungsi ginjal pada diare akut. Sari Pediatri [Internet]. 2013;13(3):221–5. Available from: http://doi.org/10.14238/sp13.3.2011.221-5
Shahrin L, Sarmin M, Rahman AS, Hasnat W, Mamun GM, Shaima SN, et al. Clinical and laboratory characteristics of acute kidney injury in infants with diarrhea: a cross-sectional study in Bangladesh. Journal of International Medical Research [Internet]. 2020;48(1):1–10. Available from: https://doi.org/10.1177/0300060519896913
Imanadhia A, Ranuh IRG, Nuswantoro D. Etiology based on clinical manifestation of acute diarrhea incidence of children hospitalized in Dr. Soetomo General Hospital Surabaya period 2011- 2013. Biomolecular and Health Science Journal (BHSJ) [Internet]. 2019;2(1):31–5. Available from: http://doi.org/10.20473/bhsj.v2i1.12744
Bauhofer AFL, Sambo J, Chilaúle JJ, Conjo C, Munlela B, Chissaque A, et al. Examining comorbidities in children with diarrhea across four provinces of Mozambique: a cross-sectional study (2015 to 2019). PLoS One [Internet]. 2023;18(9):1–12. Available from: https://doi.org/10.1371%2F journal.pone.0292093
Utami KY, Armerinayanti NW, Lely AAO. Gambaran kejadian diare pada balita di Rumah Sakit Umum Daerah Wangaya Denpasar. Aesculapius Medical Journal [Internet]. 2023;3(3):309–15. Available from: https://www.ejournal.warmadewa.ac.id/index.php/amj/article/view/5503/4954
Dahlan AR, Aminyoto M, Muhyi A. Profil elektrolit dan hematologi pasien balita diare akut dengan dehidrasi ringan-sedang di RSUD Abdoel Wahab Sjahranie Samarinda. Jurnal Sains dan Kesehatan [Internet]. 2023;5(4):466–74. Available from: http://doi.org/10.25026/jsk.v5i4.1179
Alim MC, Hasan M, Masrika NUE. Hubungan diare dengan status gizi pada balita di Rumah Sakit Umum Daerah Dr. H. Chasan Boesoirie. Kieraha Medical Journal [Internet]. 2021;3(1):1–6. Available from: https://doi.org/10.33387/KMJ.V3I1.3262
Satrianjaya IDM, Nesa NNM, Mahalini DS. Karakteristik diare pada anak di RSUP Sanglah Denpasar tahun 2017. Intisari Sains Medis [Internet]. 2019;10(2):159–67. Available from: http://doi.org/ 10.15562/ism.v10i2.194
Jarman AF, Long SE, Robertson SE, Nasrin S, Alam NH, McGregor AJ, et al. Sex and gender differences in acute pediatric diarrhea: a secondary analysis of the DHAKA study. J Epidemiol Glob Health [Internet]. 2018;8(1–2):42–7. Available from: https://doi.org/10.2991%2Fj.jegh.2018.08.102
Siziya S, Muula A, Rudatsikira E. Correlates of diarrhoea among children below the age of 5 years in Sudan. Afr Health Sci [Internet]. 2013;13(2):376–83. Available from: https://doi.org/10.4314 %2Fahs.v13i2.26
Vatandas NS, Yurdakok K, Yalcin SS, Celik M. Validity analysis on the findings of dehydration in 2 to 24-month-old children with acute diarrhea. Pediatr Emerg Care [Internet]. 2020;00(00):1–6. Available from: https://doi.org/10.1097/pec.0000000000001980
Hoxha TF, Azemi M, Avdiu M, Ismailijaha V, Grajqevci V, Petrela E. The usefulness of clinical and laboratory parameters for predicting severity of dehydration in children with acute gastroenteritis. Medical Archives [Internet]. 2014;68(5):304–7. Available from: https://doi.org/10.5455%2F medarh.2014.68.304-307
Bonadio WA, Hennes HH, Machi J, Madagame E. Efficacy of measuring BUN in assessing children with dehydration due to gastroenteritis. Ann Emerg Med [Internet]. 1989;18(7):755–7. Available from: https://doi.org/10.1016/s0196-0644(89)80011-3
Shankar P, Mahamud S, Anjum ACA. Study of electrolyte disturbances and renal parameters in acute gastroenteritis under 5 years of age in a tertiary care hospital of Bengaluru, India. Int J Contemp Pediatrics [Internet]. 2020;7(9):1910–7. Available from: https://doi.org/10.18203/2349-3291.ijcp20203654
Gupta BK, Gupta NK, Agrawal N, Gupta BK, Chetri P. Renal involvement in acute gastroenteritis under 5 years of age in a tertiary care hospital of Western Nepal – a prospective observational study. Scholars Acad J Biosci [Internet]. 2020;08(03):68–74. Available from: http://doi.org/ 10.36347/sajb.2020.v08i03.003
Bakker ED, Gemke RJBJ, Bökenkamp A. Endogenous markers for kidney function in children: a review. Crit Rev Clin Lab Sci [Internet]. 2018;55(3):163–83. Available from: https://doi.org/10.1080/ 10408363.2018.1427041
Mehta AR. Why does the plasma urea concentration increase in acute dehydration? Adv Physiol Educ [Internet]. 2008;32(4):336. Available from: https://doi.org/10.1152/advan.90185.2008
Feher J. Tubular reabsorption and secretion. In: Quantitative Human Physiology [Internet]. Elsevier; 2017. p. 719–29. Available from: https://doi.org/10.1016/B978-0-12-800883-6.00072-0
Mogre SS. Study of electrolyte disturbances and renal parameters in acute gastroenteritis under 5 years of age in a tertiary care hospital of Chhattisgarh, India. J Adv Med Dent Sci Res [Internet]. 2015;3(1):254–8. Available from: http://jamdsr.com/uploadfiles/13vol3issue1pp254-258. 20210615065858.pdf
Shahbaz H, Gupta M. Creatinine Clearance. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jul 27]. Available from: https://pubmed.ncbi.nlm.nih.gov/31334948/
Marzuillo P, Baldascino M, Guarino S, Perrotta S, Miraglia del Giudice E, Nunziata F. Acute kidney injury in children hospitalized for acute gastroenteritis: prevalence and risk factors. Pediatr Nephrol [Internet]. 2021;36(6):1627–35. Available from: https://doi.org/10.1007/s00467-020-04834-7
Bogari MH, Munshi A, Almuntashiri S, Bogari A, Abdullah AS, Albadri M, et al. Acute gastroenteritis-related acute kidney injury in a tertiary care center. Ann Saudi Med [Internet]. 2023;43(2):82–9. Available from: https://doi.org/10.5144%2F0256-4947.2023.82
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