PENAMPILAN DIAGNOSIS FORMULA SIMPLE CYSTATIN C UNTUK DETEKSI PENURUNAN LAJU FILTRASI GLOMERULUS PADA PENDERITA DIABETES MELITUS TIPE 2

ROSE INDRIYATI, Dr. Windarwati, M.Sc., Sp. PK(K);DR. dr. Siti Muchayat P., M.S., Sp.PK(K)

2016 | Tesis-Spesialis | SP ILMU PATOLOGI KLINIK

Latar Belakang. Diabetes mellitus merupakan salah satu masalah kesehatan yang berdampak pada produktivitas dan dapat menurunkan sumber daya manusia. Komplikasi pada DM meliputi komplikasi mikrovaskuler dan makrovaskuler salah satunya adalah berbagai gangguan pada ginjal. Deteksi penurunan laju filtrasi glomerulus (LFG) diperlukan. Formula Simple Cystatin C dikatakan sensitif mendeteksi penurunan LFG pada stadium awal/ringan. Tujuan. Penelitian ini bertujuan untuk menguji sensitivitas dan spesifisitas diagnostik Formula Simple Cystatin C untuk deteksi penurunan LFG. Metode. Penelitian observasional analitik cross-sectional pada subyek 80 penderita DM tipe 2 rawat jalan di RSUP DR. Sardjito Yogyakarta. Nilai eLFG menggunakan Formula Simple Cystatin C (100/CysC). Analisis kurva ROC dan tabel 2x2 untuk menilai sensitivitas dan spesifisitas diagnostik dengan menggunakan reference standard creatinine clearance test pada cut-off 90 mL/menit/1,73m2. Hasil. Pada 80 penderita DM tipe 2 rawat jalan, rerata usia 60,2+8,5 tahun, jenis kelamin laki-laki 52,5%, rerata CysC serum 1,61+0,90 mg/L, kreatinin serum 1,59+1,22 mg/dL, kreatinin urin 76,1+41 mg/dL. Penampilan diagnostik Formula Simple Cystatin C memiliki nilai sensitivitas 82%, spesifisitas 100%, NRP 100%, NRN 35%, LR(-) 0,18 dan LR(+) ~. Kesimpulan. Formula Simple Cystatin C untuk mendeteksi adanya penurunan eLFG dengan sensitivitas 82%, spesifisitas 100%, NRP 100%, NRN 35%, LR(-) 0,18 dan LR(+) ~. Formula Simple Cystatin C sangat disarankan untuk deteksi penurunan LFG pada cut-off 90 mL/menit/1,73m2.

Background. Diabetes mellitus is one of the health problems that affect productivity and may reduce the quality of human resource. Complications in DM include microvascular and macrovascular complications, one of which is various kidney problems. Early detection of reduced glomerular filtration rate (GFR) is required. Simple Cystatin C Formula is said to be sensitive to detect reduced GFR at an early/mild stage. Objective. This study aimed to test the diagnostic sensitivity and specificity of Simple Cystatin C formula for the detection of reduced GFR. Method. The study was observational analytic with cross-sectional design in subjects of 80 outpatients with type 2 diabetes at RSUP DR. Sardjito Hospital. Estimated GFR values were calculated using the Simple Cystatin C formula (100/CysC). ROC curve and 2x2 table analysis were employed to assess diagnostic sensitivity and specificity by using reference standard creatinine clearance test at a cut-off of 90 mL/min/1.73m2. Results. Of the 80 outpatients with type 2 diabetes mellitus, the average age was 60,2+8.5 years, 52.5% was female, CysC serum was 1.61+0.90 mg/dL, serum creatinine was 1.59+1.22 mg/dL, creatinine urine 76.1+41 mg/dL. The performance diagnostic of Simple Cystatin C formula has a sensitivity of 82%, specificity of 100%, PPV 100%, NPV 35%, LR (-) 0.18 and LR (+) ~. Conclusion. The performance diagnostic of Simple Cystatin C formula for detection indicated the reduced eGFR with a sensitivity of 82%, specificity of 100%, PPV 100%, NPV 35%, LR (-) 0.18 and LR (+) ~. Simple Cystatin C formula is strongly recommended for detection of reduced GFR with the cut-off of 90 mL/min/1.73m2.

Kata Kunci : Diabetes Mellitus Type 2, Simple Cystatin C Formula, Cystatin C,