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All Journal Sari Pediatri Paediatrica Indonesiana
Cahya Dewi Satria
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada
Health Professions Medicine & Pharmacology

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Faktor Prediktor Kematian Anak dengan Infeksi HIV yang Mendapat Terapi Antiretrovirus di RSUP Dr. Sardjito Yogyakarta dan RSUP Dr. Kariadi Semarang Dyah Perwitasari; Eggi Arguni; Cahya Dewi Satria; MMDEAH Hapsari
Sari Pediatri Vol 18, No 3 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (82.321 KB) | DOI: 10.14238/sp18.3.2016.204-8

Abstract

Latar belakang. Kasus infeksi HIV pada anak di Indonesia semakin meningkat dengan angka kematian yang cukup tinggi. Angka kematian anak HIV yang menjalani terapi antiretrovirus disebabkan oleh berbagai faktor.Tujuan. Mengetahui faktor prediktor yang memengaruhi kematian anak dengan infeksi HIV yang telah mendapat terapi antiretrovirus.Metode. Penelitian studi kasus-kontrol dengan matching usia pada anak dengan infeksi HIV yang mendapat terapi ARV di RSUP Dr. Sardjito dan RSUP Dr. Kariadi dari Januari 2007 sampai dengan Desember 2013. Kelompok kasus adalah pasien meninggal dan kelompok kontrol adalah pasien yang hidup setelah mendapat terapi ARV. Data diambil dari catatan medis dengan kuesionerterstruktur. Data dianalisis dengan SPSS 17.0.Hasil. Didapatkan 96 anak dirawat dengan infeksi HIV dan menggunakan terapi ARV selama periode penelitian. Dua puluh pasien meninggal setelah menerima ARV sebagai kasus dan 20 pasien hidup sebagai kelompok kontrol. Pada analisis bivariat terdapat hubungan yang bermakna antara status gizi, stadium klinis WHO, ketaatan kunjungan, lama terapi ARV terhadap kematian. Pada analisis multivariat, ketidaktaatan kunjungan memiliki OR 13,8 (IK95%: 1,04-184,02) dengan nilai p<0,05 dan lama terapi ARV ≤6 bulan memiliki OR 22,133 (IK95%: 1,202-407,60).Kesimpulan. Ketidaktaatan kunjungan ke Poliklinik dan lama terapi ARV ≤6 bulan merupakan faktor prediktor yang berpengaruh terhadap kematian pada anak dengan infeksi HIV yang mendapat terapi ARV. Namun, lama terapi ARV ≤6 bulan merupakan faktor yang paling berpengaruh terhadap kematian.
Antibodi Anti DS-DNA Sebagai Faktor Prognosis Mortalitas pada Lupus Erimatosus Sistemik Muslikhah Yuni Farkhati; Sunartini Hapsara; Cahya Dewi Satria
Sari Pediatri Vol 14, No 2 (2012)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp14.2.2012.90-6

Abstract

Latar belakang.Angka kejadian lupus eritematosus sistemik (LES) di RSUP Dr Sardjito meningkat dengan mortalitas tinggi. Antibodi anti double stranded-DNA (ds- DNA ) merupakan antibodi patognomonik pada SLE.Tujuan.Mengetahui hubungan antara antibodi anti ds-DNA dengan mortalitas pasien SLE.Metode.Penelitian kohort retrospektif terhadap pasien SLE yang berusia kurang dari 18 tahun yang didapatkan secara konsekutif. Survivaldihitung menggunakan metode Kaplan Meier. Analisis log rankdan regresi Coxdigunakan untuk mengidentifikasi faktor yang berhubungan dengan mortalitas.Hasil.Didapatkan 46 pasien ikutserta dalam penelitian, 8 (17,4%) laki-laki dan 38 (82,6%) perempuan dengan rerata usia terdiagnosis 11,9 tahun, 21 subyek (45,7%) diantaranya meninggal. Survivalpada tahun pertama, ketiga dan kelima adalah 85%, 60%, dan 30 %. Rerata waktu follow uppasien dengan antibodi anti ds-DNA sebesar 885,5 hari (IK 95% 631,9–1139,1) tampak lebih pendek secara bermakna dibanding pasien dengan antibodi anti ds DNA negatif 4807,5 (IK 95% 4025,4–5389,0). Analisis multivariat menunjukkan antibodi anti ds-DNA merupakan satu – satunya faktor prognostik terhadap mortalitas pasien SLE (hazard ratio6,7; IK 95% 1,38–12,40). Kesimpulan.Antibodi anti ds-DNA merupakan faktor prognosis terhadap mortalitas pasien SLE.
Acute Kidney Injury sebagai prediktor kematian pada SIndrom Syok Dengue di RSUp dr. Sardjito Budyarini Prima Sari; Eggi Arguni; Cahya Dewi Satria
Sari Pediatri Vol 19, No 5 (2018)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (57.857 KB) | DOI: 10.14238/sp19.5.2018.252-9

Abstract

Latar belakang. Sindrom syok dengue (SSD) merupakan salah satu dari spektrum kompleks dan berat infeksi dengue. Tatalaksana SSD masih merupakan tantangan besar, khususnya pada kondisi yang terjadi komplikasi multiorgan. Acute kidney injury (AKI) sebagai salah satu penyakit ginjal terkait infeksi dengue perlu diperhitungkan dampaknya pada SSD.Tujuan. Untuk menentukan frekuensi, keparahan, dan prediktor mortalitas pada pasien SSD berdasarkan kondisi AKI.Metode. Kami melakukan penelitian kohort retrospektif pada anak usia 1 bulan sampai 18 tahun yang dirawat di RSUP dr. Sardjito dengan diagnosis sindrom syok dengue sejak Januari 2010 sampai Desember 2015. Kami menggunakan data produksi urin dan rumus formula Pottel untuk menghitung laju filtrasi glomerulus. Uji chi square digunakan untuk menganalisis hubungan antara data klinis dan luaran pasien sindrom syok dengueHasil. Dari 151 anak yang memenuhi kriteria, kondisi gangguan ginjal akut terjadi pada 65 pasien (43%). Berdasarkan kriteria pRIFLE, 42 (62%) pasien termasuk ke derajat risk, 23 (35%) pasien derajat injury. Angka kematian pasien SSD di RSUP 21,2% dan secara signifikan paling tinggi terdapat pada kelompok AKI (p=0,000) terutama pada kelompok derajat injury (p=0,001) dengan RR 2,656 (IK 95%: 1,494-4,721). Di kelompok AKI, hanya koagulasi intravaskular disseminata (KID) yang berhubungan dengan meningkatnya risiko kematian (P=0,003) dengan RR 2,483 (IK 95%: 1,318-4,677).Kesimpulan. Insiden AKI pada SSD lebih tinggi dari yang diperkirakan dan berhubungan dengan kematian pasien SSD.
Hubungan antara Kadar 25-OH D3 dengan Derajat Fungsi Ginjal pada Pasien Lupus Sistemik Eritematosus Aninditya Dwi Messaurina; Agung Triono; Retno Palupi Baroto; Cahya Dewi Satria; Sumadiono Sumadiono
Sari Pediatri Vol 21, No 4 (2019)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp21.4.2019.213-7

Abstract

Latar belakang. Defisiensi vitamin D banyak ditemukan pada anak lupus eritematosus sistemik (LSE) dibandingkan dengan anak normal. Berbagai penelitian membuktikan defisiensi vitamin D berkontribusi terhadap perkembangan chronic kidney disease. Belum ada penelitian hubungan vitamin D dengan derajat fungsi ginjal pada anak Lupus. Tujuan. Mengetahui hubungan antara 25-hidroksivitamin D dengan derajat fungsi ginjal pada anak Lupus.Metode. Menggunakan desain cross sectional dengan melibatkan 62 anak Lupus di bagian Ilmu Kesehatan Anak RSUP Dr. Sardjito yang telah mendapatkan protokol dari Januari 2014 sampai April 2018. Hubungan antara kadar serum 25-hidroksivitamin D dan derajat fungsi ginjal dianalisis menggunakan Independent T-test, sedangkan jenis kelamin, kalsium, steroid, dan aktivitas penyakit dengan uji chi-square. Defisiensi vitamin D didefinisikan konsentrasi 25-hidroksivitamin D<20 ng/ml, sedangkan gangguan ginjal didefinisikan GFR<90/ml/mnt/1.73m2.Hasil. Sebagian besar subyek berjenis kelamin perempuan, 93,5% vs 6,5% dengan rerata usia 14,6±3,1 tahun, dan rerata skor Mex-SLEDAI 7,6±5,6. Secara keseluruhan 66% subyek penelitian mengalami defisiensi vitamin D. Analisis dengan Independent T-tes menunjukkan rerata vitamin D yang mengalami gangguan ginjal 14,14±4,9 lebih rendah dibandingkan normal dengan rerata 19,43±10,3 dengan perbedaan yang bermakna p=0,004. Jenis kelamin, kalsium, steroid, dan aktivitas penyakit tidak berpengaruh signifikan terhadap derajat fungsi ginjal, p>0,05.Kesimpulan. Terdapat hubungan signifikan 25-hidroksivitamin D dengan derajat fungsi ginjal pada anak lupus.
Faktor Prediktor Nefritis pada Anak dengan Purpura Henoch-Schonlein Ahmad Wisnu Wardhana; Cahya Dewi Satria; Sunartini Hapsara
Sari Pediatri Vol 18, No 3 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (54.094 KB) | DOI: 10.14238/sp18.3.2016.209-13

Abstract

Latar belakang. Penyakit purpura Henoch-Schonlein (PHS) dapat menyebabkan komplikasi nefritis. Nefritis PHS dapat membaik sendiri atau berkembang menjadi penyakit ginjal kronik. Beberapa faktor prediktor telah diketahui berhubungan dengan kejadian nefritis PHS.Tujuan. Menentukan usia ≥10 tahun, purpura persisten, gejala abdomen berat dan relaps sebagai faktor prediktor nefritis pada PHS.Metode. Dilakukan studi kohort retrospektif. Sampel penelitian adalah anak berusia 1 tahun – 18 tahun dengan PHS yang dirawat di Instalasi Kesehatan Anak RSUP Dr. Sardjito Yogyakarta periode Januari 2008-Agustus 2016 yang memenuhi kriteria inklusi. Sampel diambil secara konsekutif, kemudian diidentifikasi adanya faktor prediktor nefritis berdasarkan data rekam medis. Analisis bivariat untuk menghitung nilai p serta analisis multivariat dengan regresi logistik.Hasil. Diikutsertakan 80 pasien yang yang diikuti selama 6 bulan. Didapatkan nefritis pada 31 pasien (38,75%). Analisis bivariat dan multivariat menunjukkan bahwa hanya gejala abdomen berat yang merupakan faktor prediktor nefritis dengan nilai p=0,027 dan p=0,021, dan RR 3,759 (IK95%: 1,222-11,562).Kesimpulan. Gejala abdomen berat merupakan faktor prediktor pada kejadian nefritis PHS dan meningkatkan risiko 3,75 kali terjadinya nefritis PHS. Usia ≥10 tahun, purpura persisten, dan relaps tidak terbukti berpengaruh pada kejadian nefritis PHS.
Immunotherapy and probiotic treatment for allergic rhinitis in children Sumadiono Sumadiono; Cahya Dewi Satria; Nurul Mardhiah; Grace Iva Susanti
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (224.823 KB) | DOI: 10.14238/pi58.6.2018.280-5

Abstract

Background Allergic rhinitis is a global health problem that is increasing in prevalence. Many kinds of therapy have been tried, such as antihistamines, probiotics, and immunotherapy. Immunotherapy may restore the patient’s normal immunity against the specific allergen, while probiotics may modify the natural course of allergy. Objective To evaluate probiotics and immunotherapy for improving clinical symptoms of allergic rhinitis. Methods This randomized controlled trial (RCT) involved 64 patients, aged 3-18 years, and diagnosed with persistent allergic rhinitis in the Department of Child Health, Sardjito General Hospital from April 2016 until May 2017. Patients were randomly allocated into three therapy groups: group A (standard therapy/cetirizine only), group B (standard and probiotic therapy), and group C (standard therapy and immunotherapy). Clinical symptoms of allergic rhinitis including sneezing, rhinorrhea, and itchy nose, were evaluated for 7 weeks and classified as improved or not improved. The significance of the data was analyzed using proportion test. Results Sixty-four patients completed 7 weeks of therapy, 15 subjects in group A, 26 in group B, and 23 in group C. Group C showed significantly more improvement of sneezing and rhinorrhea compared to both group A (Z=5.71; Z=7.57, respectively) and group B (Z=2.82; Z=6.90, respectively). However, itchy nose was not significantly improved in group C compared to group B (Z=0.50), but was significantly improved in group C compared to group A (Z=10.91). Group B had significant improvement of sneezing, rhinorrhea, and itchy nose compared to group A (Z=3.81, Z=2.86, and Z=10.91, respectively). Conclusion The combined standard-immunotherapy group has significantly superior improvement compared to the combined standard-probiotic group and the standard therapy group, in terms of sneezing and rhinorrhea in children with persistent allergic rhinitis.
Predictors of mortality in children with systemic lupus erythematosus Fanny Listiyono; Indah K. Murni; Sumadiono Sumadiono; Cahya Dewi Satria
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.818 KB) | DOI: 10.14238/pi59.1.2019.1-6

Abstract

Background Systemic lupus erythematosus (SLE) is a multisystem chronic disease with a relatively high mortality rate in children, despite improvements in prognosis and survival rate over the past decade. Studies on the predictors of mortality in children with SLE, especially in low- and middle-income countries, are limited. Objective To determine the predictors of mortality of children with SLE. Methods This was case-control study using data from medical records of children with SLE at Dr. Sardjito Hospital, Yogyakarta, Indonesia, between 2009 and 2017. Subjects were children aged <18 years diagnosed with SLE. Cases were those who died within one year of diagnosis; the controls were those who were discharged alive. From subjects’ medical records, we collected clinical data including age, sex, date of diagnosis, nutritional status, anti-dsDNA antibody, antinuclear antibody (ANA), hypertension, disease activity based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, proteinuria, thrombocytopenia, mortality/survival outcome, date of death, cause of death, and clinical data including fever, seizures, antibiotic used, microbial culture outcomes, and infection-related diagnoses. We performed bivariate analysis of the association between predictor variables (SLEDAI score, proteinuria, infection, hypertension, and seizures) and mortality outcome (survival or death), followed by logistic regression analysis. Results Eighty-four patients with SLE were included, of which 72 were female. Median age at diagnosis was 14 (range 4-18) years. Twenty-three patients (27%) died within one year after diagnosis. The most common causes of death were infection and renal failure in 8/23 and 7/23 subjects, respectively. On bivariate analysis, the variables significantly associated with mortality were hypertension (OR 3.34, 95%CI 1.22 to 9.14) and infection (OR 3.71; 95%CI 1.36 to 10.12). Seizures, proteinuria, and SLEDAI score were not found to be significantly associated with mortality. On logistic regression analysis, infection was the only significant predictor of mortality (OR 3.22; 95%CI 1.15 to 9.05). Conclusion Among the factors studied, infection is significantly associated with mortality in children with SLE.
Linear growth and systemic glucocorticoid therapy in children with systemic lupus erythematosus Dikahayu Alifia Anugrah; Suryono Yudha Patria; Cahya Dewi Satria
Paediatrica Indonesiana Vol 62 No 1 (2022): January 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.1.2022.37-43

Abstract

Background The use of long-term oral glucocorticoid therapy, specifically in the treatment of systemic lupus erythematosus (SLE), has increased in the past two decades. Chronic glucocorticoid use may lead to a linear growth disturbances. Objective To determine the association between linear growth and systemic glucocorticoid therapy in pediatric SLE patients. Methods This retrospective cohort study used medical record data of pediatric SLE patients. All subjects received systemic glucocorticoids. The linear growth parameters recorded in this study were height-for-age z-score (HAZ) and height velocity at 0, 6, and 12 months of treatment. We recorded potential risk factors of linear growth disturbance, such as pubertal status, sex, SLE severity, pulse methylprednisolone use, daily glucocorticoid dose, and nutritional status. Results Of 42 patients with SLE, 83.3% were female, with a mean age of 13 years at diagnosis. Eighteen subjects (42.9%) experienced abnormal height velocity. There was a significant reduction in HAZ between 0, 6, and 12 months of treatment (P=0.016). Between 0 and 6 months of treatment, there was a mean HAZ decrease of 0.11 (P=0.015). There was a trend towards a risk for decreased HAZ at 6 and 12 months of treatment with pulse methylprednisolone (RR 1.25 and 1.27, respectively), as well as for abnormal height velocity (RR 1.73), but they did not reach statistical significance. Conclusion There is a reduction in linear growth in the first 12 months of systemic glucocorticoid therapy in children with SLE. Administration of systemic glucocorticoid significantly reduced HAZ in the first six months of therapy.
Predictive factors of advanced chronic kidney disease in children with congenital anomalies of kidney and urinary tract Dea Puspitarini; Elisabeth Siti Herini; Cahya Dewi Satria; Kristia Hermawan
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.96-101

Abstract

Background Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of chronic kidney disease (CKD) in children. Delayed diagnosis of CAKUT due to lack of universal screening (such as prenatal ultrasound screening or postnatal ultrasound screening in neonates with risk of CAKUT) has led to more cases of advanced CKD in children. CKD has high morbidity and mortality, and early detection is required to prevent the progression of CKD. Objective To determine the factors that predict the development of advanced CKD in children with CAKUT. Methods This retrospective cohort study included children with CAKUT at Dr. Sardjito Hospital, Yogyakarta, Indonesia from January 2016 to February 2021. Patients who were diagnosed with CAKUT were followed up to 5 years or until the onset of advanced CKD. Advanced CKD was defined as a decreased estimated glomerular filtration rate (eGFR) of less than 30mL/min/1.73m2 based on the revised Schwartz formula. CKD progression-free survival was determined with Kaplan-Meier and Cox regression analyses. Results Among 62 subjects with CAKUT, 7 (11.3%) subjects progressed to advanced CKD. The mean time of advanced CKD progression was 52.2 (95%CI 46.9 to 57.5) months. The overall incidence rate was 22 per 1,000 person-years. Based on Kaplan-Meier analysis, children with eGFR <60 mL/min/1.73m2 at the time of diagnosis had more rapid progression to advanced CKD than patients with eGFR ?60 mL/min/1.73m2 [40.2 (95%CI 33.4 to 46.6) months vs. 58.2 95%CI 46.9 to 57.5) months; P=0.02, respectively]. Conclusion Reduced eGFR at the time of diagnosis showed rapid progression to advanced CKD.
Co-Authors Agung Triono Ahmad Wisnu Wardhana Aninditya Dwi Messaurina Budyarini Prima Sari Dea Puspitarini Dikahayu Alifia Anugrah Dyah Perwitasari Eggi Arguni Elisabeth Siti Herini Fanny Listiyono Grace Iva Susanti Indah K. Murni Kristia Hermawan MMDEAH Hapsari Muslikhah Yuni Farkhati Nurul Mardhiah Retno Palupi Baroto Sumadiono Sumadiono Sumadiono Sumadiono Sunartini Hapsara Suryono Yudha Patria