KORELASI ESTIMASI LAJU FILTRASI GLOMERULUS METODE COCKCROFT GAULT (CG) DAN MODIFICATION OF DIET IN RENAL DISEASE (MDRD) DALAM MENILAI FUNGSI GINJAL PADA PASIEN DI RAWAT INTENSIVE

CHANDRA TRIANNA DEWI, Dr. dr. Teguh Triyono, M. Kes, Sp.PK(K); dr. Ira Puspitawati,M. Kes, Sp.PK(K)

2021 | Tesis | MAGISTER ILMU KEDOKTERAN KLINIS

Latar belakang: Deteksi adanya gangguan fungsi ginjal pada pasien critical ill untuk mencegah kejadian cedera ginjal akut. Pada praktek klinis serum kreatinin digunakan dalam memantau fungsi ginjal, namun banyak kekurangannya. Parameter yang lain dalam evaluasi fungsi ginjal adalah estimasi Laju filtrasi glomerulus (eLFG) dengan menggunakan formula Cockcroft-Gault (CG) dan formula Modification of Diet in Renal Diasease (MDRD). Tujuan Penelitian: Penelitian ini bertujuan untuk mengetahui korelasi nilai estimasi LFG yang dihitung dengan metode Cockcroft-Gault (CG) dan Modification of Diet in Renal Disease (MDRD) dalam menilai fungsi ginjal pada pasien pasien rawat intensive. Metode Penelitian: Penelitian potong lintang dengan subjek pasien yang masuk di rawat intensive (ICU) RSUP Dr Sardjito Yogyakarta yang memenuhi kriteria inklusi dan eksklusi. Sampel darah diambil untuk pemeriksaan kreatinin serum pada saat admisi di rawat intensive. Perhitungan estimasi LFG menggunakan metode Cockcroft-Gault (CG) dan Modification of Diet in Renal Disease (MDRD). Analisis data karakteristik subjek secara deskriptif, disajikan dengan tabel dan grafik. Uji beda rerata antara metode CG dan MDRD dengan uji t-test tidak berpasangan. Uji korelasi Spearmann untuk menilai kekuatan hubungan antara metode CG dan MDRD. Hasil: Subjek penelitian berjumlah 77 orang dan sebagian besar subjek adalah laki-laki (51,9%). Median usia 48 tahun dengan rentang 18-92 tahun. Nilai median formula CG dan MDRD berturut-turut 84,7 ml/min (38,5-408,1 ml/min) dan 101,7 ml/min/1,73m2 (36,6-459,7 ml/min/1,73m2). Uji beda rerata metode CG dan MDRD didapat hasil p=0,0507. Uji korelasi Spearmann didapatkan r=0,697(p<0,0001) hal ini menunjukkan kedua metode berkorelasi positif kuat. Simpulan: eLFG berdasarkan metode Cockcroft-Gault (CG) tidak berbeda dan berbanding lurus (berkorelasi positif, dengan kekuatan korelasi kuat) dengan metode Modification of Diet in Renal Disease (MDRD).

Background: Detection of renal disfunction in critically ill patients is to prevent Acute Kidney Injury (AKI). Clinical practice, creatinine serum used to monitoring the renal function, but it is a lot of limitation. Another parameter to evaluate renal function are estimation of Glomerular Filtration Rate (eGFR) with the Cockcroft-Gault (CG) equation and Modification of Diet in Renal Diasease (MDRD) equation. Objective: The aim of this research was to determine the correlation of the estimated GFR based on Cockcroft Gault (CG) equation and Modification of Diet in Renal Disease (MDRD) equation in assessing kidney function in intensive care patients. Method: This is cross sectional study with patient subjects who were admitted to the intensive care unit (ICU) of RSUP Dr. Sardjito. Blood samples were taken for serum creatinine examination at the time of admission in intensive care. Equation of eGFR uses the Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD). Data analysis of subject characteristics descriptively, presented with tables and graphs. The mean difference test between the CG and MDRD metods with an unpaired t-test. Spearmann's correlation test to assesing the strength of the relationship between CG and MDRD methods. Result: The research subjects were 77 people and most of the subjects were male (51.9%). Median age was 48 years with ranging from 18 to 92 years. The median values of the CG and MDRD formulas were respectly 84.7 ml/min (38.5-408.1 ml/min) and 101.7 ml/min/1,73m2 (36.6-459.7 ml/min/1,73m2). The mean of difference test for CG and MDRD methods was p=0.0507. The Spearmann's correlation test was r=0.697 (p<0.0001) this shows that both methods are strongly positive correlated. Conclusion: Estimated of GFR based on Cockcroft-Gault (CG) metods is not different and is directly proportional (positively correlated, with strongly correlation) with the Modification of Diet in Renal Disease (MDRD) methods

Kata Kunci : Laju filtrasi glomerulus, estimasi Laju filtrasi glomerulus, perhitungan Cockcroft-Gault (CG) dan MDRD