Nilai Diagnostik Neutrophil Gelatinase-Associated Lipocalin Urin, Kelainan Urinalisis, dan Kombinasi Keduanya pada Infeksi Saluran Kemih Anak Usia 2–5 Tahun
Sari
Latar belakang. Infeksi saluran kemih (ISK) pada anak memiliki manifestasi klinis yang tidak khas sehingga sulit untuk diagnosis dini. Biakan urin memerlukan waktu hingga lima hari sehingga dapat menyebabkan keterlambatan terapi serta tingginya komplikasi ISK. Kelainan urinalisis yang saat ini digunakan masih memiliki spesifisitas yang rendah.
Tujuan. Mengetahui nilai diagnostik Neutrophil gelatinase-associated lipocalin (NGAL) urin, kelainan urinalisis, dan kombinasi keduanya untuk mendiagnosis dini ISK pada anak usia 2-5 tahun.
Metode. Uji diagnostik menggunakan biakan urin sebagai baku emas dengan desain potong lintang pada anak berusia 2-5 tahun dengan tersangka ISK dan dirawat di Rumah Sakit Dr. Cipto Mangunkusumo.
Hasil. Pemeriksaan NGAL urin diketahui memiliki sensitivitas 85,7% (IK95%: 63,6-96,9%), spesifisitas 74,3% (IK95%: 57,8-86,9%), positive predictive value 64,3% (IK95%: 50,6–75,9%), dan negative predictive value 90,6% (IK95%: 76,9-96,5%) pada anak dengan minimal satu kelainan urinalisis. Pemeriksaan NGAL urin hanya meningkatkan spesifisitas kelainan urinalisis berupa leukosituria saja dan tidak meningkatkan spesifisitas pada yang telah memiliki tiga kelainan urinalisis.
Kesimpulan. Neutrophil gelatinase-associated lipocalin urin tidak dianjurkan untuk meningkatkan spesifisitas urinalisis dalam diagnosis ISK pada anak usia 2–5 tahun. Gabungan tiga kelainan urinalisis tanpa NGAL urin sudah memiliki spesifisitas yang baik. Perlu dilakukan penelitian biomarker lain untuk mendiagnosis dini ISK dengan lebih baik.
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DOI: http://dx.doi.org/10.14238/sp26.3.2024.137-45
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