HUBUNGAN ANTARA RASIO NEUTROFIL-LIMFOSIT PREOPERATIF DAN ANGKA CREATININ PASKA OPERASI PADA PASIEN RESIPIEN TRANSPLANTASI GINJAL DI RSUP DR. SARDJITO

BAGUS GILANG SAMUDRA, dr. Tanaya Ghinorawa, Sp. U (K)

2021 | Tesis-Spesialis | UROLOGI

Tujuan: Rasio neutrofil-limfosit (NLR) merupakan indikator respon inflamasi, dan respon inflamasi memainkan peran penting dalam reaksi cedera iskemik dan reperfusi pada cangkok ginjal. Dalam penelitian ini, kami akan mengamati efek NLR praoperasi yang tinggi pada penerima dalam kaitannya dengan risiko kadar kreatinin yang tinggi setelah transplantasi ginjal. Metode: Kami melakukan penelitian retrospektif terhadap 33 pasien yang terdaftar di Rumah Sakit Umum Sardjito Yogyakarta antara tahun 2017 dan 2020. Dalam penelitian ini, NLR pra operasi diamati dan dibandingkan dengan tingkat kreatinin pasca operasi. Data tersebut dibandingkan dan dianalisis. Hasil: Studi ini menunjukkan bahwa NLR pra operasi pada 33 pasien ini adalah 4,17+ 2,82. Kadar kreatinin pascaoperasi adalah 2,38 + 1,75 mg/dL. Dalam penelitian ini, kami mengamati ada korelasi lemah terbalik antara NLR dan kadar kreatinin serum pasca operasi (r= -0,379, p=<0,01) Kesimpulan: Studi ini menunjukkan NLR pra operasi dan kadar kreatinin serum pasca operasi berkorelasi bahkan lemah. NLR dapat dianggap sebagai faktor prediktor untuk menentukan komplikasi transplantasi pasca operasi, bahkan masih memerlukan penelitian lebih lanjut.

Objective:It is known that neutrophil-lymphocyte ratio (NLR) is an indicator of inflammatory status. The inflammatory response plays a major role in the reaction of ischemic injury and reperfusion to kidney grafts. We studied the effect of high preoperative in recipient in association to the risk of high creatinine levels after kidney transplantation. Method: In this retrospective study, 33 patients were enrolled in this study between 2017 and 2020 in Sardjito General Hospital in Yogyakarta. In the recipient patient, we observed the preoperative NLR and compared it with the postoperative creatinine level. The data were compared and analyzed by Wilcoxon and Spearman. Result: The results of this study showed that the mean of preoperative NLR in these 33 patients was 4.17, with a range of 1.52-13.8. The mean of postoperative creatinine levels was 10.51, with a range of 0.67-8.95). The postoperative creatinine levels were higher in patients who had low preoperative NLR, and statistically (P=0.00). In addition, the correlation is weak and had a positive correlation direction (r=0.379), this means that when the preoperative NLR is higher, the postoperative creatinine rate is also higher. Conclusion: Our study showed that there is a significant association between preoperative NLR and postoperative creatinin levels in recipient. It is showed when the preoperative lymphocyte neutrophil ratio is higher, the postoperative creatinine rate is also higher. This study demonstrated that NLR can be used as predictor factor for determining postoperative transplantation complications.

Kata Kunci : Neutrophil-lymphocyte ratio, kidney transplantation