Hubungan antara kesadahan air minum kadar kalsium dan sedimen Kalsium Oksalat urin pada anak usia Sekolah Dasar :: Studi di desa Sidowangi Kecamatan Kajoran Kabupaten Magelang

IZHAR, M. Dody, dr. Haripurnomo K., MPH.,DrPH

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Epidemiologi Lapanga

Latar Belakang: Kesadahan air yang mengandung mineral kalsium (Ca2+) di dalamnya di duga meningkatkan absorbsi di lumen intestinal dan ekskresi kalsium (hiperkalsiuria) dalam urin, bila urin dalam keadaan alkali dapat mengakibatkan perubahan konsentrasi saturasi menjadi upersaturasi kalsium sehingga terjadi kristalisasi kalsium oksalat. Tujuan: Untuk mengidentifikasi hubungan antara kesadahan air minum, kebiasaan minum dan makan terhadap kadar kalsium dan sedimen alsium oksalat urin. Metode: Penelitian observasional dengan rancangan potong lintang. Analisa pemeriksaan kesadahan air minum (mg/l), kadar kalsium urin (mg/dl) dan sedimen kalsium oksalat dalam sampel urin pertama/pagi pada 128 orang anak usia sekolah dasar (6-12 tahun) di ambil secara one-stages cluster random sampling di Desa Sidowangi Kecamatan Kajoran Kabupaten Magelang Propinsi Jawa Tengah. Kebiasaan minum dan makan makanan sumber : protein hewani, protein nabati, kalsium & phospor, asam urat, asam oksalat dan asam sitrat pada subjek penelitian di peroleh dari wawancara dengan menggunakan kuesioner dan format food frequency. Keseluruhan analisis menggunakan program Stata for indows ver. 8,0, dengan tingkat kemaknaan uji p< 0,05. Hasil: Nilai rerata dan simpangan baku kesadahan air minum (66,75±8,36), kadar kalsium urin (10,43±6,40) dan 52 subjek (40,63%) dengan kristal kalsium oksalat. Hasil analisis statistik menunjukkan bahwa kesadahan air minum tidak berpengaruh terhadap kadar kalsium urin (rs = 0,004; p = 0,967; POR = 1,017; 95% CI = 0,476-2,172) dan sedimen kalsium oksalat (rs = - 0,007; p = 0,937; POR = 0,972; 95% CI = 0,480-1,969). Kebiasaan minum (p = 0,007; POR = 3,509; 95% CI = 1,339-8,802) dan kebiasaan makan sumber asam sitrat (cukup : p = 0,066; POR = 3,037; 95% CI = 0,931-9,903, jarang : p = 0,000; POR = 10,996; 95% CI = 3,533-34,218) adalah dua variabel predisposisi terhadap status sedimen lsium oksalat. Kesimpulan: Kesadahan air minum tidak berpengaruh terhadap kadar kalsium dan sedimen kalsium oksalat urin. Kebiasaan minum dan kebiasaan makan sumber asam sitrat merupakan dua hal yang sangat menentukan, yaitu sebagai proteksi atau inhibitor pembentukan kristalisasi kalsium oksalat.

Background: Water hardness containing calcium mineral (Ca2+) is supposed to increase absorption in intestinal lumen and calcium excretion (hyper-calciuria) of urine. Alkalic conditioned urine can cause changes of saturation concentration to become calcium supersaturation leading to the rystalization of calcium oxalate. Objective: To identify the relationship between drinking water hardness, drinking and eating habit to calcium level and urine calcium oxalate ediment. Method: The study was observational with cross sectional design. Examination analysis of drinking water hardness (mg/l), level of urine calcium (mg/dl) and calcium oxalate sediment of first/morning urine samples of 128 elementary school students (6-12 years old) was carried out using one-stage cluster random sampling technique at Sidowangi Subdistrict of Kajoran, District of Magelang, Central Java. Data of drinking and eating habit for bestial protein, vegetable protein, calcium and phospor, uric acid, oxalic acid and citric acid of the subject of the study were obtained from interview using questionnaires and food frequency forms. Data analysis used Stata version 8.0 program for windows at ignificance level p<0.05. Result: Average value and main deviation of drinking water hardness was 66.75 + 8.36, level of urine was 10.43+ 6.40 and there were 52 subjects (40.63%) with calcium oxalate crystal. The result of statistical analysis showed that drinking water hardness did not affect level of urine calcium (rs=0.004; p=0.967; POR=1,017; 95% CI=0.476-2.172) and calcium oxalate sediment (rs=-0.007; p=0.937; POR=0.972; 95% CI= 0.480-1,969). Drinking habit (p=0.007; POR=3.509; 95% CI=1.339-8.802) and eating habit of citric acid sources (adequate p=0.066; POR=3.037; 95%CI=0.931-9,903, less p=0.000; POR=10,996; 95% CI=3.533-34.218) were 2 predisposition variables of calcium oxalate sediment status. Conclusion: Drinking water hardness had no effect to calcium level and urine calcium oxalate sediment. Drinking habit and eating habit for citric acid sources were 2 most determining factors, i.e. as protection or inhibitor of calcium oxalate crystalization formation.

Kata Kunci : Kadar Kalsium dan Sedimen Kalsium Oksalat Urin,Kesadahan Air, water hardness, calcium level, calcium oxalate sediment