Koreksi Anemia dengan Terapi Recombinant Human Erythropoietin pada Anak dengan Penyakit Ginjal Kronis
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Latar belakang. Anemia merupakan salah satu komplikasi tersering pada penyakit ginjal kronis serta dapat meningkatkan risiko mortalitas hingga 52%. Terapi anemia dengan recombinant human erythropoietin mampu meningkatkan kadar hemoglobin dengan sifat dose dependent.
Tujuan. Untuk mengetahui hubungan dosis terapi recombinant human erythropoietin dengan kadar hemoglobin dan kebutuhan transfusi darah pasien anak dengan anemia pada penyakit ginjal kronis.
Metode. Dilakukan studi kohort retrospektif dengan subjek pasien anak usia 2-18 tahun dengan anemia dan penyakit ginjal kronis di Rumah Sakit Umum Pusat Dr. Sardjito periode Januari 2019 - Januari 2023. Sampel diambil secara consecutive sampling. Pengolahan data menggunakan perangkat lunak program pengolah data yang terkomputerisasi. Kurva receiver operating character digunakan untuk menghitung cut-off, kemudian dilakukan analisis bivariat dan analisis multivariat. Hubungan antar variabel dinyatakan dengan risk ratio dan interval kepercayaan 95% dengan tingkat kemaknaan statistik p<0,05.
Hasil. Empat belas (23%) dari 61 total sampel yang mendapat dosis optimal sesuai rekomendasi KDIGO. Berdasarkan kurva ROC, didapatkan ambang batas dosis 76 IU/kgBB/minggu untuk mencapai target Hb >10 g/dL. Dosis ?76 IU/kgBB/minggu dapat meningkatkan pencapaian target Hb >10 g/dL dibandingkan dengan dosis yang lebih rendah (RR 2,02; IK95%: 1,19-3,42; p=0,007). Dosis ?76 IU/kgBB/minggu tidak signifikan dalam menurunkan kebutuhan transfusi darah dibandingkan dosis yang lebih rendah (RR 0,3; IK95% 0,08-1,46; p>0,05).
Kesimpulan. Dosis recombinant human erythropoietin ?76 IU/kgBB/minggu dapat meningkatkan pencapaian target hemoglobin, tetapi tidak signifikan dalam menurunkan kebutuhan transfusi darah pasien anak anemia dengan penyakit ginjal kronis.
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DOI: http://dx.doi.org/10.14238/sp25.6.2024.363-70
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