KARAKTERISTIK PASIEN GANGGUAN GINJAL AKUT DI RSUD Dr. H. CHASAN BOESOIRIE TERNATE
DOI:
https://doi.org/10.51878/healthy.v5i4.14599Keywords:
Gangguan Ginjal Akut, Karakteristik, RSUD Dr. H. Chasan BoesoirieAbstract
Acute Kidney Injury (AKI) is a condition characterized by a sudden decline in kidney function in previously healthy kidneys, typically occurring over a period ranging from a few hours to several weeks. This results in the retention of metabolic waste products and imbalances in the body's fluid, electrolyte, and acid-base status. Southeast Asia records the highest prevalence of AKI cases, at 31.0%. If not promptly managed, AKI can lead to significant morbidity and mortality. This study aimed to identify the characteristics of AKI patients at Dr. H. Chasan Boesoirie Regional General Hospital (RSUD) in Ternate. A descriptive, cross-sectional study design was employed, involving 46 AKI patients selected via total sampling of medical records. The results showed that the majority of patients were elderly (52.2%), male (60.9%), had a high school education (56.5%), and worked as farmers (26.1%); notably, all patients (100.0%) had at least one comorbid condition. Furthermore, all patients exhibited elevated creatinine levels (100.0%), while the majority showed increased urea levels (87.0%) and decreased hemoglobin levels (56.5%). Conversely, electrolyte levels specifically sodium (41.3%), potassium (65.2%), and chloride (50.0%) predominantly fell within the normal range. In conclusion, the most common characteristics among AKI patients were being elderly, male, having a high school education, working as a farmer, and having comorbidities (with the largest subgroup having a single comorbidity), alongside decreased hemoglobin, elevated creatinine and urea, and normal sodium, potassium, and chloride levels. These findings demonstrate that the assessment of laboratory parameters particularly creatinine, urea, hemoglobin, and electrolytes plays a crucial role in characterizing the clinical status of AKI patients and supporting the ongoing evaluation of their management.
ABSTRAK
Gangguan Ginjal Akut (GGA) merupakan kondisi di mana fungsi ginjal menurun secara tiba-tiba pada ginjal yang sebelumnya sehat, umumnya terjadi dalam rentang waktu beberapa jam hingga beberapa minggu. Akibatnya, terjadi retensi sisa metabolisme dan gangguan keseimbangan pada cairan, elektrolit, dan asam-basa tubuh. Prevalensi kasus tertinggi di Asia Tenggara sebesar 31,0%. Jika tidak segera ditangani, GGA dapat mengakibatkan morbiditas dan mortalitas. Penelitian ini bertujuan untuk mengetahui karakteristik pasien GGA di RSUD Dr. H. Chasan Boesoirie Ternate. Jenis penelitian ini deskriptif dengan pendekatan cross-sectional terhadap 46 sampel pasien GGA yang diambil menggunakan data rekam medis dengan teknik total sampling. Hasil penelitian terhadap 46 pasien menunjukkan mayoritas pasien berusia lansia (52,2%), laki-laki (60,9%), berpendidikan SMA (56,5%), bekerja sebagai petani (26,1%), serta seluruh pasien memiliki penyakit penyerta (100,0%). Selain itu, seluruh pasien mengalami peningkatan kadar kreatinin (100,0%), sebagian besar mengalami peningkatan kadar ureum (87,0%) dan penurunan kadar hemoglobin (56,5%), sedangkan kadar elektrolit terbanyak berada pada kategori normal, yaitu natrium (41,3%), kalium (65,2%), dan klorida (50,0%). Kesimpulan karakteristik kasus GGA tertinggi yakni lansia, laki-laki, SMA, petani, memiliki penyakit penyerta, dengan kelompok terbanyak adalah pasien yang memiliki 1 penyakit penyerta, hemoglobin menurun, kreatinin meningkat, ureum meningkat, natrium normal, kalium normal, dan klorida normal. Temuan ini menunjukkan bahwa pemeriksaan parameter laboratorium, terutama kreatinin, ureum, hemoglobin, dan elektrolit, memiliki peran penting dalam menggambarkan kondisi klinis pasien GGA serta mendukung evaluasi penatalaksanaan secara berkelanjutan.
References
Abebe, A., Kumela, K., Belay, M., Kebede, B., & Wobie, Y. (2021). Mortality and predictors of acute kidney injury in adults: A hospital-based prospective observational study. Scientific Reports, 11, 16940. https://doi.org/10.1038/s41598-021-94946-3
Acevedo, A. F., Echavarria, R., & Melo, Z. (2021). Sex differences in renal function: Participation of gonadal hormones and prolactin. Endocrines, 2(3), 185–202. https://doi.org/10.3390/endocrines2030019
Alayyannur, P. A., & Ramdhan, D. H. (2022). Relationship of heat stress with acute kidney disease and chronic kidney disease: a literature review. Journal of Public Health Research, 11(2), 22799036221104149. https://doi.org/10.1177/22799036221104149
Alkhunaizi, A. M., & Al-Shammary, M. (2020). In-hospital acute kidney injury. Eastern Mediterranean Health Journal, 26(8), 967–970. https://doi.org/10.26719/emhj.19.100
Balci, C., Haftaci, E., & Kunt, A. T. (2018). Use of cerebral oxygen saturation and hemoglobin concentration to predict acute kidney injury after cardiac surgery. Journal of International Medical Research, 46(3), 1130–1137. https://doi.org/10.1177/0300060517741064
Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Graham-Brown, M. P. M. (2023). Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: A systematic review. Journal of Nephrology, 36(5), 1267–1281. https://doi.org/10.1007/s40620-022-01537-0
Cai, J. J., Wang, K., Jiang, H. Q., & Han, T. (2019). Characteristics, risk factors, and adverse outcomes of hyperkalemia in acute?on?chronic liver failure patients. BioMed research international, 2019(1), 6025726. https://doi.org/10.1155/2019/6025726
Chen, X., Xu, J., Li, Y., Xu, X., Shen, B., Zou, Z., et al. (2021). Risk scoring systems including electrolyte disorders for predicting the incidence of acute kidney injury in hospitalized patients. Clinical Epidemiology, 13, 383–396. https://doi.org/10.2147/CLEP.S311364
Chen, Y. T., Jenq, C. C., Hsu, C. K., Yu, Y. C., Chang, C. H., Fan, P. C., ... & Chen, Y. C. (2020). Acute kidney disease and acute kidney injury biomarkers in coronary care unit patients. BMC nephrology, 21(1), 207. https://doi.org/10.1186/s12882-020-01872-z
de Vasconcellos, K., & Skinner, D. L. (2018). Hyperchloraemia is associated with acute kidney injury and mortality in the critically ill: A retrospective observational study in a multidisciplinary intensive care unit. Journal of Critical Care, 45, 45–51. https://doi.org/10.1016/j.jcrc.2018.01.019
Farooqi, S., & Dickhout, J. G. (2016). Major comorbid disease processes associated with increased incidence of acute kidney injury. World Journal of Nephrology, 5(2), 139–146. https://doi.org/10.5527/wjn.v5.i2.139
Fatoni, A. Z., & Kestriani, N. D. (2018). Acute kidney injury (AKI) pada pasien kritis. Anesthesia & Critical Care, 36(2), 64–75. https://macc.perdatin.org/index.php/my-journal/article/view/115
Fajrin, S. M., & Binuko, K. P. E. (2022). Seorang anak laki-laki 13 tahun dengan gagal ginjal akut et causa glomerulonefritis akut paska streptokokus. Dalam Proceeding book call for papers Fakultas Kedokteran Universitas Muhammadiyah Surakarta (hlm. 449–459). https://proceedings.ums.ac.id/kedokteran/article/view/2136
Georges, T. D., Marie-Patrice, H., Ingrid, T. S., Mbua, R. G., Hermine, F. M., & Gloria, A. (2022). Causes and outcome of acute kidney injury amongst adult patients in two hospitals of different category in Cameroon: A 5-year retrospective comparative study. BMC Nephrology, 23, 358. https://doi.org/10.1186/s12882-022-02992-4
Hidayat, H., Pradian, E., & Kestriani, N. D. (2020). Angka kejadian, lama rawat, dan mortalitas pasien acute kidney injury di ICU RSUP Dr. Hasan Sadikin Bandung. Jurnal Anestesi Perioperatif, 8(2), 108–118. https://doi.org/10.15851/jap.v8n2.2054
Houser, M. C., Mac, V., Smith, D. J., Chicas, R. C., Xiuhtecutli, N., Flocks, J. D., et al. (2021). Inflammation-related factors identified as biomarkers of dehydration and subsequent acute kidney injury in agricultural workers. Biological Research for Nursing, 23(4), 676–688. https://doi.org/10.1177/10998004211016070
Kementerian Kesehatan Republik Indonesia. (2022). Gangguan ginjal akut. Direktorat Jenderal Pelayanan Kesehatan. https://yankes.kemkes.go.id/view_artikel/1872/gangguan-ginjal-akut?utm_source=chatgpt.com
Khanam, E., Rahman, S., Islam, A., & Rahman, N. T. (2023). Outcome of acute kidney injury (AKI) patients in the intensive care unit of Enam Medical College & Hospital during the period of July 2018 to May 2019. Journal of Enam Medical College, 11(1), 24–33. https://doi.org/10.3329/jemc.v11i1.63170
Lee, S. W., Baek, S. H., Ahn, S. Y., Na, K. Y., Chae, D. W., Chin, H. J., et al. (2016). The effects of pre-existing hyponatremia and subsequent-developing acute kidney injury on in-hospital mortality: A retrospective cohort study. PLOS ONE, 11(9), e0162990. https://doi.org/10.1371/journal.pone.0162990
Li, Y. (2016). Acute kidney injury in Asia. Kidney Diseases, 2(3), 95–102. https://doi.org/10.1159/000441887
Loutradis, C., Pickup, L., Law, J. P., Dasgupta, I., Townend, J. N., Cockwell, P., et al. (2021). Acute kidney injury is more common in men than women after accounting for socioeconomic status, ethnicity, alcohol intake and smoking history. Biology of Sex Differences, 12, 30. https://doi.org/10.1186/s13293-021-00373-4
Lv, Q., Li, D., Wang, Y., Yu, P., Zhao, L., Chen, S., et al. (2022). Admission electrolyte and osmotic pressure levels are associated with the incidence of contrast-associated acute kidney injury. Scientific Reports, 12, 6260. https://doi.org/10.1038/s41598-022-08597-z
Marzuki, M. J., Nursamsu, N., & Rifai, A. (2022). Perbandingan mortalitas, lama rawat, perbaikan fungsi ginjal, dan kebutuhan hemodialisis selama perawatan pada pasien acute kidney injury (AKI) dengan dan tanpa sepsis, serta faktor yang memengaruhi mortalitas pasien. Jurnal Penyakit Dalam Indonesia, 9(1), 4–12. https://doi.org/10.7454/jpdi.v9i1.623
Moyce, S., Armitage, T., Mitchell, D., & Schenker, M. (2021). Acute kidney injury and workload in a sample of California agricultural workers. American Journal of Industrial Medicine, 64(7), 555–564. https://doi.org/10.1002/ajim.23076
Perhimpunan Nefrologi Indonesia. (2023). Konsensus gangguan ginjal akut. PERNEFRI.
Ramires, M. L. V., Leite, M. F. B., Lo, D. Z. Y., Silveira, L. B. da, Ferraz, L. J. R., Pardini, A., et al. (2022). Relation between red blood cell distribution width and acute kidney injury in patients with sepsis. Einstein (São Paulo), 20, eAO6828. https://doi.org/10.31744/einstein_journal/2022AO6828
Rossouw, E., & Chetty, S. (2023). Acute kidney injury after major non-cardiac surgery: Incidence and risk factors. South African Medical Journal, 113(3), 135–140. https://hdl.handle.net/10520/ejc-m_samj_v113_n3_a10
Sabaghian, T., Honarvar, M., Safavi-Naini, S. A. A., Fadaki, A. S. S., Pourhoseingholi, M. A., & Hatamabadi, H. (2022). Effect of electrolyte imbalance on mortality and late acute kidney injury in hospitalized COVID-19 patients. Iranian Journal of Kidney Diseases, 16(4), 228–237. https://www.sid.ir/paper/1094403/en
Setiati, S., Alwi, I., Sudoyo, A. W., Simadibrata, M., Setiyohadi, B., & Syam, A. F. (Eds.). (2014). Buku ajar ilmu penyakit dalam (Edisi ke-6, Jilid II). Interna Publishing.
Utami, R., Virgiandhy, I. G. N., & Kahtan, M. I. (2016). Angka kejadian acute kidney injury berdasarkan kriteria AKIN di ruangan ICU di RSU Dr. Soedarso. Jurnal Fakultas Kedokteran Universitas Tanjungpura, 3(1), 1–10. https://jurnal.untan.ac.id/index.php/jfk/article/view/10601
Waikar, S. S. (2022). Acute kidney injury. Dalam Harrison’s principles of internal medicine (Edisi ke-21, hlm. 8434–8475). McGraw Hill.
Workeneh, B. T. (2022). Acute kidney injury. Medscape.
Workeneh, B. T., & Batuman, V. (2022). Acute kidney injury treatment & management. Medscape.
