Gambaran Gangguan Fungsi Ginjal Kasus Baru Penderita Diabetes Melitus, Jantung Koroner, dan Strok pada Studi Kohor di Bogor Indonesia

Profile of Chronic Kidney Disease on New Cases of Diabetes Mellitus, Coronary Heart Dissease and Stroke Patients of Cohort Study in Bogor Indonesia

  • Woro Riyadina Puslitbang Ukesmas Balitbangkes Kemenkes RI
  • Ekowati Rahajeng
  • Srilaning Driyah
Keywords: gangguan fungsi ginjal, eLFG, diabetes melitus, jantung koroner, strok, chronic kidney disease (CKD), eGFR, diabetes mellitus, coronary heart disease, stroke

Abstract

One of the adverse effect of prolonged patients with diabetes mellitus (DM), coronary heart disease (CHD), and stroke was the emerge of chronic kidney disease (CKD) and it would be burden of the economic. The prognosis of CKD in new cases of DM, CHD, and stroke during followed up in Cohort Study Noncommunicable Disease Risk Factor in Bogor was not yet known. Aim to study was to obtain to CKD profile in DM, CHD, stroke, and comorbid incidences during Cohort Study Noncommunicable Disease Risk Factor. This article has been result of cross sectional further analysis of secondary data on 370 new cases of DM, CHD, and stroke that who were examined for blood creatinine levels and calculated eGFR on 2018 and 2019. DM was diagnosed from fasting glucose ≥126 mg/dl or post prandial glucose ≥200mg/dl. CHD was diagnosed by ECG examination and validated by cardiologist and stroke was diagnosed by anamnesis by a neurologist. The main variable is eGFR as an indicator of CKD which is the result of CKP-epi calculation based on creatinine levels in the blood. Other variables are age, sex, type of disease (DM, CHD, and stroke). Data were analyzed using chi-square test. The results showed that average age patients with CKD on new cases of DM, CHD, stroke, and comorbid in Bogor were 48.2 ± 8.6 years old. Proportions CKD on new cases of DM, CHD, strok and comorbid were 59.5%, 56.7%, 66.7% and 50.0%. CKD was higher in older woman than others. The prevalence of CKD was found very high in subjects with stroke, DM, CHD, and comorbid. So, it is necessary to prevent complications by early diagnosis of NCD with regular monitoring of kidney function by creatinine level test and avoid using drugs that caused kidney damage.

Abstrak

Salah satu komplikasi buruk dari penderita diabetes melitus (DM), penyakit jantung koroner (PJK), dan strok yang berkepanjangan adalah munculnya gangguan fungsi ginjal dan akan membebani ekonomi bagi penderitanya. Gambaran prognosis gangguan fungsi ginjal pada insiden DM, PJK, dan strok selama pemantauan Studi Kohor Faktor Risiko PTM (FRPTM) Bogor belum diketahui. Tujuan penelitian untuk mendapatkan gambaran gangguan fungsi ginjal pada kasus baru DM, PJK, dan strok yang muncul selama pemantauan Studi Kohor FRPTM. Artikel ini merupakan hasil analisis lanjut secara potong lintang dari data sekunder kasus baru (insiden) DM, PJK, dan strok pada Studi Kohor FRPTM sebanyak 370 subjek yang diperiksa kadar kreatinin darah dan dihitung eLFG pada tahun 2018 dan 2019. DM didiagnosis dari kadar gula darah puasa ≥126 mg/dl atau post prandial ≥200mg/dl. PJK dari hasil pemeriksaan EKG dan validasi dokter spesialis jantung dan strok hasil anamnesis oleh spesialis saraf dan sudah mengalami rawat jalan. Variabel utama adalah eLFG merupakan indikator terjadinya gangguan fungsi ginjal yang merupakan hasil hitung kadar kreatinin dalam darah dengan CKD-epi. Variabel lain adalah umur, jenis kelamin, jenis penyakit (DM, PJK, dan strok). Data dianalisis dengan uji chi-square. Hasil menunjukkan temuan gangguan fungsi ginjal pada penderita DM, PJK, strok, dan komorbid di Bogor berumur 48,2 ± 8,6 tahun dan proporsi masing-masing 59,5%, 56,7%, 66,7%, dan 50%. Subjek yang mengalami gangguan fungsi ginjal menunjukkan lebih banyak pada umur lebih tua dan perempuan. Tingginya proporsi gangguan fungsi ginjal pada penderita strok, DM, PJK, dan komorbid diperlukan pencegahan komplikasi sejak awal terdiagnosis PTM dengan memantau fungsi ginjal dengan pemeriksaan kadar kreatinin secara teratur, serta menghindari penggunaan obat yang menimbulkan kerusakan ginjal.

References

World Health Organization. Noncommunicable Diseases Progress Monitor. Geneva: World Health Organization; 2017.

Mboi N, Surbakti IM, Trihandini I, et al. On the road to universal health care in Indonesia, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet 2018; 392: 581–91. http://dx.doi.org/10.1016/ S0140- 6736(18)30595-6

Badan Penelitian dan Pengembangan Kesehatan. Laporan Nasional Riskesdas tahun 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2018.

Badan Penelitian dan Pengembangan Kesehatan. Laporan Nasional Riskesdas tahun 2013. Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2014.

Riyadina W, et al. Laporan penelitian studi kohort faktor risiko penyakit tidak menular tahun 2019. Jakarta: Pusat Penelitian dan Pengembangan Upaya Kesehatan Masyarakat, Badan Penelitian dan Pengembangan Kesehatan; 2019.

Rahajeng E. Masalah gagal ginjal dan pola hidup sehat untuk mencegahnya. Seminar Nasional Interprofesional Healthcare, 29 November 2014. Yogyakarta: Direktorat Pengendalian Penyakit Tidak Menular P2PL Kementerian Kesehatan RI.

BPJS. Info BPJS kesehatan, program SCP, bantu jaga likuiditas RS. Media BPJS Kesehatan. 2019; Edisi 77.

Azalea M, Andayani TM, Satibi. Analisis biaya pengobatan penyakit ginjal kronis rawat inap dengan hemodialisis di rumah sakit. Jurnal Manajemen dan Pelayanan Farmasi. 2016;6(2): 41 -150.

Kementerian Kesehatan RI. ‘Direktur BUKR: Tingkatkan Komitmen Penanganan Kasus Ginjal Kronik Melalui Transplantasi Ginjal’. [internet]. Jakarta; 2015. Tersedia pada : yankes.kemkes. go.id/read-direktur-bukr-tingkatkan-komitmen- penanganan-kasus-ginjal-kronik-melalui- transplantasi-ginjal-530.html. (diakses tanggal 23 April 2020).

Sulistiowati E, Idaiani S. Faktor risiko penyakit ginjal kronik berdasarkan analisis cross-sectional data awal studi kohort penyakit tidak menular penduduk usia 25-65 tahun di Kelurahan Kebon Kelapa, Kota Bogor tahun 2011. Buletin Penelitian Kesehatan. 2015;43(3):163-172.

Pusat Data dan Informasi Kementerian Kesehatan RI. Situasi penyakit ginjal kronis. Infodatin; 2017.

Doloksaribu R, Husna R, Oehadian A. Gambaran eGFR menurut CKD-EPI pada penderita thalassemia mayor di Rumah Sakit Dr. Hasan Sadikin Bandung. Majalah Kedokteran Bandung. 2017;49(1):22-7.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Inter. Suppl. 2013;3:5.

Eriksen BO, Ingebretsen OC. The progression of chronic kidney disease: a 10-year population based study of the effects of gender and age. Kidney Int. 2006;69(2):375–82. [PubMed: 16408129].

Munir B, Rasyid HA, Rosita R. Hubungan antara kadar glukosa darah acak pada saat masuk instalasi gawat darurat dengan hasil keluaran klinis penderita stroke iskemik fase akut. MNJ. 2015;1(2):52-60.

Pálsson R, Patel UD. Cardiovascular complications of diabetic kidney disease. Adv Chronic Kidney Dis. 2014;21(3):273–280. doi:10.1053/j.ackd.2014.03.003.

Damtie S, Biadgo B, Baynes HW, Ambachew S, Melak T, Asmelash D. Chronic kidney disease and associated risk factors assessment among diabetes melitus patients at a tertiary hospital, Northwest Ethiopia. Ethiop J Health Sci. 2018;28(6):691- 700.

Rivandi J, Yonata A. Hubungan diabetes melitus dengan kejadian gagal ginjal kronik. Majority. 2015;4(9):27-34.

Canto ED, Ceriello A, Ryde L, Ferrini M, Hansen TB, Schnell O, et al. Diabetes as a cardiovascular risk factor: an overview of global trends of macro and micro vascular complications. European Journal of Preventive Cardiology. 2019;26(2S):25–32.

ShahAD,LangenbergC,RapsomanikiE,Denaxas S, Rodriguez MP, Gale CP, et al. Type 2 diabetes and incidence of cardiovascular diseases: a cohort study in cohort study in 1·9 million people. Lancet Diabetes Endocrinol. 2015 Feb;3(2):105- 13. doi: 10.1016/S2213-8587(14)70219-0. Epub 2014 Nov 11. PMID: 25466521; PMCID: PMC4303913.

Yuan J, Zou XR, Han SP, Cheng H, Wang L, Wang JW, et al; C-STRIDE study group. Prevalence and risk factors for cardiovascular disease among chronic kidney disease patients: results from the Chinese cohort study of chronic kidney disease (C-STRIDE). BMC Nephrol. 2017 Jan 14;18(1):23. doi: 10.1186/s12882-017-0441- 9. PMID: 28088175; PMCID: PMC5237491. 22. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007– 2017. Cardiovasc Diabetol 2018;17(83);2-19.

Siriwardhana C, Lim E, Davis J, Chen JJ. Progression of diabetes, ischemic heart disease, and chronic kidney disease in a three chronic conditions multistate model. BMC Public Health. 2018;18:752. https://doi.org/10.1186/s12889- 018-5688-y.

Delima, et al. Faktor risiko penyakit ginjal kronis: studi kasus kontrol di empat rumah sakit di Jakarta tahun 2014. Buletin Penelitian Kesehatan. 2017;45(1):17-26.

Published
2020-12-31
Section
Articles