Perdarahan Saluran Cerna pada Anak dengan Penyakit Ginjal Tahap Akhir
Sari
Penyakit ginjal tahap akhir (PGTA) adalah penyakit ginjal kronik (PGK) stadium 5 yang ditandai dengan laju filtrasi glomerulus (LFG) < 15 mL/menit/1,73m2 selama tiga bulan atau lebih, atau suatu kondisi dengan pasien memerlukan terapi pengganti ginjal seperti hemodialisis, dialisis peritoneal, atau transplantasi ginjal. Pasien dengan PGTA sering mengalami gangguan saluran cerna, termasuk perdarahan saluran cerna, yang dapat terjadi dari atas maupun bawah. Perdarahan saluran cerna atas lebih umum ditemukan dan berkaitan dengan erosi saluran cerna. Pada pasien anak dengan PGTA, erosi saluran cerna umum ditemukan namun angka kejadian perdarahan saluran cerna berkaitan dengan erosi pada anak dengan PGTA belum diketahui. Patofisiologi perdarahan saluran cerna pada pasien PGTA belum sepenuhnya diketahui, namun diduga berkaitan dengan disfungsi trombosit akibat uremia, anemia, dan penggunaan obat-obatan. Mekanisme perdarahan saluran cerna tergantung etiologinya, terutama erosi dan angioektasia. Belum ada pendekatan dan tata laksana perdarahan saluran cerna khusus pada anak dengan PGTA yang terbukti secara uji klinis, namun optimalisasi dialisis dan tata laksana anemia dapat dilakukan sebagai tindakan pencegahan.
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DOI: http://dx.doi.org/10.14238/sp25.2.2023.130-6
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