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All Journal Sari Pediatri Paediatrica Indonesiana
Kristia Hermawan
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Health Professions Medicine & Pharmacology

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Validasi Kriteria Diagnosis Infeksi Saluran Kemih Berdasarkan American Academy of Pediatrics 2011 pada Anak Usia 2-24 Bulan Ikhsan Trinadi; Eggi Arguni; Kristia Hermawan
Sari Pediatri Vol 18, No 1 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (505.359 KB) | DOI: 10.14238/sp18.1.2016.17-20

Abstract

Latar belakang. Gejala klinis infeksi saluran kemih (ISK) pada anak yang tidak spesifik dapat menyebabkan keterlambatan diagnosis. Keterlambatan penanganan berkaitan dengan risiko terbentuknya parut ginjal. Tahun 2011 American Academy of Pediatrics (AAP) mengeluarkan panduan klinis diagnosis ISK anak usia 2-24 bulan dengan akurasi yang baik. Penggunaan lokal kriteria ini belum divalidasi.Tujuan. Validasi kriteria diagnosis ISK AAP 2011 pada anak usia 2-24 bulan di RSUP Dr Sardjito, Yogyakarta.Metode. Penelitian cross sectional periode Januari 2013 hingga Juni 2015 dilakukan terhadap anak usia 2-24 bulan dengan demam yang memiliki data urinalisis dan kultur urin. Hasil penilaian kriteria AAP dibandingkan dengan pemeriksaan kultur urin.Hasil. Berdasarkan hasil kultur didapatkan 21 pasien menderita ISK, sementara 64 pasien di diagnosis diare akut, demam dengue, pneumonia, dan infeksi CMV. Didapatkan sensitifitas, spesifisitas, rasio kemungkinan positif, rasio kemungkinan negatif kriteria diagnosis AAP 2011 adalah 85,7%, 92,2%, 11,0%, dan 0,2%.Kesimpulan. Kriteria AAP 2011 bisa digunakan sebagai alat diagnostik yang reliable untuk memprediksi ISK pada anak.
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 Cahya Dewi Satria Dea Puspitarini Eggi Arguni Elisabeth Siti Herini Ikhsan Trinadi