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Relationship between protein energy malnutrition and urinary tract infection in children Arief Wijaya Rosli; Syarifuddin Rauf; J. S. Lisal; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Urinary tract infections (UTI) is a common healthproblem in children. Its occurrence depends on several predis-posing factors and individual immunocompetence. Childrenwith protein energy malnutrition (PEM) have impaired immunefunction. Thus early detection and prompt treatment of associatedinfections in children with PEM are very important.Objective To determine the relationship between PEM and theoccurrence of UTI in children.Methods This cross sectional study conducted in Dr. Wahidin Sud-irohusodo Hospital and Labuang Baji General Hospital, Makassarbetween March 1, 2007 and June 30, 2007. The target populationincluded PEM patients aged 2 to 5 years. Well-nourished patientsmatched for age and sex were selected for control group.Results Out of 220 patients, 25 had UTI consisted of 12 malesand 13 females. Eighteen of them had PEM and 7 were well-nourished subjects. There was a statistical significant difference(P=0.019) in the occurrence of UTI between children with PEMand in well- nourished children. The relationship between PEMand UTI as determined by prevalence ratio value (PR) was 2.6with 95% confidence interval (CI) of 1.1 to 5.9, suggested therisk of getting UTI was 2.6 times higher in children with PEM ascompared to normal controls.Conclusions The frequency of UTI in PEM was 16.4%. Chil-dren with PEM have the risk of getting UTI 2.6 times higheras compared to well-nourished children

Plasma lipids as risk factors in relapsing nephrotic syndrome Sitti Aizah Lawang; Syarifuddin Rauf; J. S. Lisal; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Nephrotic syndrome is primarily a pediatric disorderand is 15 times more common in children than in adults.Relapse rate after corticosteroid discontinuation is 39 - 59%.Hyperlipidemia is an important characteristic of nephroticsyndrome. The plasma concentrations of cholesterol, triglyceride,LDL, and VLDL are increased. Persistent hyperlipidemia afterremission can be found in frequent relapse nephrotic syndrome.Objective To determine plasma lipids as risk factor for relapsingnephrotic syndrome.Methods Thirty children with nephrotic syndrome were includedin this cohort study from March 2005 until June 2007 at WahidinSudirohusodo Hospital, Makassar. Thirty children without renal diseasewere enrolled as control. Blood specimens were collected to determineplasma lipids (cholesterol, triglyceride, LDL, and HDL) levels and LDUHDL ratio. Plasma lipids were examined in the acute and remissionphases. Follow up was carried out six months after remission todetermine the occurrence of relapsing nephrotic syndrome.Results Of 30 nephrotic syndrome patients, 12 had relapsed.There were highly significant differences in total cholesterol, HDL,LDL, triglyceride, and LDL/HDL ratio between acute nephroticsyndrome and nephrotic syndrome in remission. There were nosignificant differences in cholesterol, LDL, triglyceride, LDL!HDL ratio between nephrotic syndrome in remission and control.There was also no significant difference in the incidence in relapsebetween first attack and nephrotic syndrome with more than twoattacks. Acute lipid fraction levels were not risk factors in relapsingmephrotic syndrome. Remission triglyceride level was a risk factorin relapsing nephrotic syndrome with the prevalence risk of 5.2 andCI 95% of 1.06 to 25.3.Conclusion Persistent hypertriglyceride in remission phase isassociated with an increased risk of relapse in children withnephrotic syndrome.

The profile of acute glomerulonephritis among Indonesian children Husein Albar; Syarifuddin Rauf
Paediatrica Indonesiana Vol 45 No 6 (2005): November 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.6.2005.264-9

Background Acute glomerulonephritis (AGN) is a form of glom-erulonephritis characterized by sudden and explosive onset of glom-erular injury symptom. It usually occurs after recent infection bygroup A beta-hemolytic streptococcus. AGN among Indonesianchildren seems to be less frequently reported than that among othercountries.Objective To determine the current profile of AGN among Indo-nesian children hospitalized in eleven teaching centers.Methods This was a descriptive, cross-sectional study, based ona review of the standard medical records of 509 children with AGNhospitalized in 11 teaching centers in Indonesia over a five-yearperiod (1997-2002). Data extracted from the medical records con-sisted of history of illness, clinical and laboratory findings, and chestX-rays.Results Age of the patients at the onset of AGN ranged from 2.5 to15 years, with peak age of 8.5 years. The majority (76.4%) wasabove 6 years old with male predominance (58.3%). About 68.9%and 82% of the patients came from low socioeconomic and low edu-cational status families. Antecedent upper respiratory infections wereobserved in 45.8% cases and pyoderma in 31.6%. The diseaseseemed to be more commonly elicited by streptococcal infectionthan by other infections, as proved by an elevated anti-streptolisinO (ASO) titer (66.6%) and decreased C 3 concentrations (60.4%).The frequent clinical features included periorbital edema (76.3%),hypertension (61.8%), and gross hematuria (53.6%). The most preva-lent laboratory findings were microhematuria (99.3%), proteinuria(98.5%), raised erythrocyte sedimentation rate (85.3%). The initialchest X-rays showed pleural effusion (81.6%) and cardiomegaly(80.2%), whereas echocardiogram documented pericardial effusion(81.6%). Acute pulmonary edema (11.5%), hypertensive encepha-lopathy (9.2%), and acute renal failure (10.5%) were frequent com-plications noted in our study.Conclusion Despite no adequate data on throat or skin cul-tures, AGN among Indonesian children seems mostly to bepoststreptococcal AGN as proved by the elevated ASO titerand decrease in serum C 3 concentration

Clinical Edema and Chest X-Ray Findings in Acute Poststreptococcal Glomerulonephritis Husein Albar; Syarifuddin Rauf; Dasril Daud; Azis Tanra; M. Faried Kaspan
Paediatrica Indonesiana Vol 37 No 3-4 (1997): March - April 1997
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi37.3-4.1997.69-75

We report the results of a retrospective study evaluating clinical edema and chest X-ray findings in 17b patients with acute poststreptococcal glomeruÂ¬lonephritis (APSGN), hospitalized in the Pediatric Nephrology Unit of Ujung Pandang General Hospital, from January 1, 1980 through December 31, 1990. Of the total 194 patients, only 176 fulfilled the criteria and could be evaluated. There were 98 boys (55,7%) and 78 girls (44.3%) aged between 1 year 9 months and 14 years, mostly beÂ¬tween 6-12 years (72.8%). We found that edema of the palpebra was more frequently noted (98.9%) than that of the pretibia (71.6%), face (64.2%) and ascites (21.0%). This study showed evidence of cardiomegaly (84.1%), pulmonary vascular congestion (68.2%), pleural effusion (65.9%) and pulmonary' edema (48.9%). Our study results documented that roentgenographic abnormality of the chest of patients with APSGN, included each of the following findings, e.g., cardiomegaly, pleural effusion, pulmonary vascular congestion, and pulmonary edema, was significantly more frequent in patients with clinical evidence of severe edema than those with moderate and mild edema (p < 0.01).

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