Evaluasi Fungsi Ginjal pada Penyandang Talasemia-β Mayor Anak
Sari
Latar belakang. Informasi keterlibatan ginjal pada penyandang talasemia-β mayor anak masih sedikit. Disfungsi ginjal dipengaruhi berbagai faktor seperti anemia kronis, hipoksia kronis, dan hemosiderosis. Neutrophil gelatinase associated lipocaline urin (NGALu) merupakan penanda biologis dini yang sensitif dan spesifik terhadap gangguan ginjal.
Tujuan. Menilai disfungsi ginjal pada penyandang talasemia-β mayor anak menggunakan NGALu.
Metode. Penelitian dengan rancang potong lintang dilaksanakan Oktober–November 2018. Subjek adalah penyandang talasemia β mayor anak di RS. Hasan Sadikin yang menggunakan kelasi besi deferiprondan dipilih secara consecutive sampling. Heteroanamnesis pada orang tua mengenai riwayat penyakit dan frekuensi transfusi. Terhadap subjek penelitian dilakukan pemeriksaan feritin serum, kreatinin serum, dan NGALu. Uji statistik menggunakan uji korelasi rank Spearman dengan nilai kemaknaan p<0,05.
Hasil. Sebanyak 71 subjek yang memenuhi kriteria penelitian, terdiri dari 46 laki-laki dan 25 perempuan. Kadar rerata kreatinin serum 0,38±0,08 mg/dL, median feritin 2897,1 ng/mL, median NGALu 13,8 ng/mL. Peningkatan kadar NGALu ditemukan 11 (15%) subjek. Didapatkan korelasi negatif antara frekuensi transfusi dan kadar NGALu (r= -0,294, p=0,006). Tidak terdapat korelasi baik antara feritin serum dengan kreatinin serum maupun feritin serum dan NGALu
Kesimpulan. Disfungsi ginjal sudah terindikasi terjadi pada penyandang talasemia-β mayor anak.
Kata Kunci
Teks Lengkap:
PDFReferensi
Sleiman J, Tarhini A, Taher AT. Renal complications in thalassemia. Thalassemia Reports 2018;8:41–9.
Bekhit OE, Dash HHE, Ahmed MS. Early detection of kidney dysfunction in Egyptian patients with beta-thalassemia major. Egypt Pediatr Assoc Gazette 2017;65:85–9.
Adly AAM, Toaima DN, Mohamed NR, Seoud KMAE. Subclinical renal abnormalities in young thalassemia major and intermedia patients and its relation to chelation therapy. Egypt J Med Hum Genet 2014;15:369–77.
Slocum JL, Heung M, Pennathur S. Marking renal Injury: can we move beyond serum creatinine? Transl Res 2012;159:277–89.
Bolignano D, Donato V, Coppolino G, Campo S, Buemi A, Lacquaniti A, dkk. Neutrophil gelatinase-associated lipocalin (NGAL) as a marker of kidney damage. Am J Kidney Dis 2008;52:595–605.
Schmidt-Ott KM, Mori K, Li JY, Kalandadze A, Cohen DJ, Devarajan P, dkk. Dual action of neutrophil gelatinase–associated lipocalin. Am Soc Nephrol 2007;18:407–13.
Mori K, Nakao K. Neutrophil gelatinase-associated lipocalin as the real-time indicator of active kidney damage. Kidney Int 2007;71:967–70.
Mårtensson J, Bellomo R. The rise and fall of NGAL in acute kidney injury. Blood Purif 2014;37:304–10.
Nurisya D, Nataprawira HM, Sekarwana N. Hubungan kadar albumin serum dengan neutrophil gelatinase-associated lipocalin urine pada penderita sindrom nefrotik anak. MKB 2014;46:130–3.
Chakraborty S, Kaur S, Tong Z, Batra SK, Guha S. Neutrophil gelatinase associated lipocalin: structure, function and role in human pathogenesis. Dalam: Veas F, penyunting. Acute phase proteins-regulation and functions of acute phase proteins. Rijeka: InTech; 2011.h.345–68.
Hooman N, Nakhaii S, Sharif MR. Update on acute kidney injury in pediatrics. J Ped Nephrol 2014;2:56–62.
Sen V, Ece A, Uluca U, Soker M, Gunes A, Kaplan I, dkk. Urinary early kidney injury molecules in children with beta-thalassemia major. Ren Fail 2015;37:607–13.
Bhandari S, Galanello R. Renal aspects of thalassaemia a changing paradigm. Eur J Haematol 2012;89:187–97.
Hari P, Bagga A, Mahajan P, Lakshmy R. Effect of malnutrition on serum creatinine and cystatin C levels. Pediatr Nephrol 2007;22:1757–61.
Hashemieh M, Radfar M, Azarkeivan A, Tabatabaei SMTH, Nikbakht S, Yaseri M, dkk. Renal hemosiderosis among Iranian transfusion dependent β-thalassemia major patients. IJHOSCR 2017;11:133–8.
Milo G, Nevo RFG, Pazgal I, Gafter-Gvili A, Shpilberg O, Gafter U, dkk. GFR in patients with β-thalassemia major. Clin J Am Soc Nephrol 2015;10:1–7.
Ghasemi A, Azimzadeh I, Afghan M, Momenan AA, Bagheripour F. Pediatric reference values for serum creatinine and estimated glomerular filtration rate in Iranians: Tehran lipid and glucose study. Arch Iran Med 2015;18:753–8.
Finney H, Newman DJ, Thakkar H, Fell JME, Price CP. Reference ranges for plasma cystatin C and creatinine measurements in premature infants, neonates, and older children. Arch Dis Child 2000;82:71–5.
Patsaoura A, Tatsi E, Margeli A, Kanavaki I, Delaporta P, Kyriakopoulou D, dkk. Plasma neutrophil gelatinase-associated lipocalin levels are markedly increased in patients with non-transfusion-dependent thalassemia: Lack of association with markers of erythropoiesis, iron metabolism and renal function. Clin Biochem. 2014;47:1060–4.
Roudkenar MH, Halabian R, Oodi A, Roushandeh AM, Yaghmai P, Najar MR, dkk. Upregulation of neutrophil gelatinase-associated lipocalin, NGAL/Lcn2, in β-thalassemia patients. Arch Med Res 2008;39:402–7.
Lai ME, Spiga A, Vacquer S, Carta MP, Corrias C, Ponticelli C. Renal function in patients with β-thalassaemia major: a long-term follow-up study. Nephrol Dial Transplant 2012;27:3547–51.
Kementerian Kesehatan (Kemenkes). Pedoman Nasional Pelayanan Kedokteran Tatalaksana Thalasemia. Jakarta: Kemenkes; 2018.h.1–90.
Bakr A, Al-Tonbary Y, Osman G, El-Ashry R. Renal complications of beta-thalassemia major in children. Am J Blood Res 2014;4:1–6.
DOI: http://dx.doi.org/10.14238/sp21.2.2019.89-95
Refbacks
- Saat ini tidak ada refbacks.
##submission.copyrightStatement##
##submission.license.cc.by-nc-sa4.footer##
Email: editorial [at] saripediatri.org
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.