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Profil Pasien Tuberkulosis Paru dengan Penyakit Ginjal Kronik yang Dirawat di RSUP Prof. Dr. R. D. Kandou Manado Periode Oktober 2017 – Oktober 2018 Putranto, Michael; Wongkar, Maarthen C. P.; Sugeng, Cerelia
e-CliniC Vol 6, No 2 (2018): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.6.2.2018.22113

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
Perbandingan Estimasi Laju Filtrasi Glomerulus Berdasarkan Formula Cockroft-Gault dengan Estimasi Laju Filtrasi Glomerulus Berdasarkan Formula Chronic Kidney Disease Epidemiology Collaboration pada Subyek Penyakit Ginjal Kronik Non-Dialisis Periode Januari – Desember 2017 Kaitang, Fricilia Y.; Moeis, Emma S.; Wongkar, Maarthen C. P.
e-CliniC Vol 7, No 1 (2019): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.7.1.2019.23541

Abstract

Abstract: Chronic kidney disease (CKD) is one of the health problems worldwide. Evaluation of kidney function could be done by measuring and calculating glomerular filtration rate (GFR). The direct measurement of GFR using exogenous or endogenous substance is difficult to be performed and inconvenience, therefore, the estimation of GFR (eGRF) is more preferable. The eGRF is used for assessing the grades of kidney diseases and their underlying mechanisms. Meanwhile, determination of eGRF is based on the formula of Cockroft-Gault (eGRFCG) and the formula of Chronic Kidney Disease Epidemiology Collaboration (eGRFCKD-EPI).. This study was aimed to evaluate the difference between the eGRFCG and eGRFCKD-EPI among non-dialysis CKD patients. The results showed that there was a confirmity of 79.2% between the two formulas. The gamma test obtained an r of 0.873 (P<0.01) for the two formulas. Conclusion: There was a confirmity of 79.2% between the eGFR formula of Cockroft-Gault and the eGFR formula of Chronic Kidney Disease Epidemiology Collaboration among non-dialysis CKD patients.Keywords: CKD, eGFR CG, eGFR CKDEPI Abstrak: Penyakit ginjal kronik (PGK) merupakan salah satu masalah kesehatan dunia. Penilaian fungsi ginjal dapat dilakukan dengan cara pengukuran dan perhitungan laju filtrasi glomerulus (LFG). Pengukuran LFG secara langsung dengan substansi eksogen atau endogen pada pelaksanaannya sulit dan tidak praktis sehingga saat ini digunakan perhitungan estimasi LFG (eLFG). Estimasi LFG digunakan untuk menilai stadium gangguan ginjal dan perjalanan penyakit ginjal. Penentuan estimasi LFG berdasarkan rumus formula eLFG Cockroft-Gault (eLFGCG) dan formula eLFG dari Chronic Kidney Disease Epidemiology Collaboration (eLFGCKD-EPI). Penelitian ini bertujuan untuk mengetahui perbandingan eLFG berdasarkan eLFG CG dengan eLFG CKDEPI pada PGK non-diaisis (PGK ND). Hasil penelitian mendapatkan adanya kesesuaian dari kedua formula eLFG sebesar 79,2 %. Hasil uji Gamma mendapatkan hasil kesesuaian eLFG Cockroft-Gault dengan eLFG CKDEPI dengan r= 0,873 (P<0,01). Simpulan: Terdapat kesesuaian sebesar 79,2% dari hasil pemeriksan eLFG berdasarkan formula eLFG Cockroft-Gault dengan formula eLFG CKDEPI pada penderita PGK non dialisis.Kata kunci: PGK, eLFG CG, eLFG CKDEPI
St. George’s Respiratory Questionnaire (SGRQ) sebagai Alat Bantu Diagnostik serta Prediktor Terjadinya Chronic Pulmonary Aspergillosis (CPA) pada Pasien Tuberkulosis Paru Pasca Terapi Wangko, William S.; Kurniawan, Indra; Wongkar, Maarthen C. P.; Nugroho, Agung; Polii, Efata B
Medical Scope Journal Vol 3, No 1 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.3.1.2021.32890

Abstract

Abstract: Patients of post therapy lung tuberculosis (TB) that still have permanent or worsened clinical signs might be caused by chronic pulmonary aspergillosis (CPA). Diagnosis of CPA is difficult to confirmed without complete supporting tests. This study was aimed to establish whether Saint George’s Respiratory Questionnaire (SGRQ) could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients. This was an analytical observational study with a cross sectional design. There were 72 patients who had negative Gene Xpert sputum; 34.7% with positive Aspergillus-specific IgG. Their clinical signs were evaluated with SGRQ. The results showed that there was a very significant relationship between clinical score and CPA (p<0.0001). The lower the clinical score the less the probability of CPA. In this analysis we determined the diagnosis value of clinical score with a probability cut-off point = 0.5 which led to clinical score cut-off point of 45.6 with further results, as follows: sensitivity 68.0%; specificity 95.7%; positive predictive value 89.5%; negative predictive value 84.9%; OR 47.8, and CI 95% (9,2-248,2). In conclusion, SGRQ could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients.Keywords: post therapy lung TB; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)  Abstrak: Pasien TB paru pasca terapi yang masih memperlihatkan gejala klinis menetap atau bahkan memberat dapat disebabkkan oleh adanya chronic pulmonary aspergillosis (CPA). Diagnosis CPA sulit ditegakkan tanpa adanya pemeriksaan penunjang yang lengkap. Penelitian ini bertujuan untuk menentukan apakah Saint George’s Respiratory Questionnaire (SGRQ) dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Hasil penelitian mendapatkan 72 pasien dengan sputum Gene Xpert negatif (34,7% dengan positif IgG Aspergillus) dilakukan penilaian skor klinis menggunakan SGRQ. Hasil uji menunjukkan terdapat hubungan sangat bermakna antara skor klinis dengan terjadinya CPA (p<0,0001). Makin rendah skor klinis makin kecil peluang terjadinya CPA. Melalui analisis ini dapat ditentukan nilai diagnosis skor klinis SGRQ dengan mengambil titik potong peluang = 0,5. Nilai peluang = 0,5 memberikan titik potong skor klinis = 45,6.  Dengan titik potong skor klinis SGRQ = 45,6 diperoleh nilai-nilai diagnosis sebagai berikut: Sensitivitas = 68,0%; Spesifisitas = 95,7%; Nilai Prediksi Positif = 89,5%; Nilai Prediksi Negatif = 84,9%; OR = 47,8 dengan CI 95% (9,2-248,2). Simpulan penelitian ini ialah SGRQ dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi.Kata kunci: tuberkulosis paru pasca terapi; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)