Correlation between Serum Creatinine Level, Blood Hemoglobin Level and Tubular Injury in Kidney Fibrosis Model in Mice

ARDILES VARIAN, dr. Nur Arfian, Ph. D; dr. Santosa Budiharjo, M. Kes., PA(K); dr. Dyah Samti Mayasari, Ph. D

2016 | Skripsi | S1 PENDIDIKAN DOKTER

LATAR BELAKANG: Belakangan ini, gagal ginjal kronis menjadi salah satu isu kesehatan global. Diperkirakan prevalensinya meningkat sebanyak 10% di dunia. Meskipun dipengaruhi oleh beberapa faktor, serum kreatinin adalah marker paling umum untuk mendeteksi kerusakan ginjal awal. Di lain pihak, anemia - yang ditandai dengan penurunan hemoglobin darah - sangat berhubungan kuat dengan gagal ginjal kronis. TUJUAN: untuk menguraikan hubungan antara kerusakan tubulus, kreatinin serum, dan hemoglobin darah METODE: Kita melakukan obstruksi ureter unilateral pada mencit Swiss untuk menginduksi fibrosis ginjal. Kelompok kontrol (SO) (n=7) hanya dibedah kulitnya dan dijahit kembali. Lima mencit kemudian diambil ginjalnya pada hari ke-7 (d7UUO; n=5) bersamaan dengan kelompok SO, dan lima lainnya pada hari ke-14 (d14UUO; n=5) setelah obstruksi ureter unilateral. Skor kerusakan tubulus dihitung berdasarkan pewarnaan Periodic Acid Schiff (PAS). Kita mencatat level kreatinin serum dan hemoglobin darah dengan menggunakan darah dari vena retroorbital. HASIL: Obstruksi ureter unilateral menginduksi kenaikan skor kerusakan tubulus pada kelompok d7UUO dan d14UUO (p<0,005 VS SO), kemudian diikuti dengan kenaikan kreatinin serum pada kelompok d14UUO (p<0,05 VS SO), dan juga penurunan hemoglobin darah pada kelompok d14UUO (p<0,05 VS SO). KESIMPULAN: Skor kerusakan tubulus memiliki hubungan positif (berbanding lurus) dengan kreatinin serum dan juga hubungan negatif (berbanding terbalik) dengan hemoglobin darah.

BACKGROUND: Recently, Chronic Kidney Disease (CKD) has been recognized as one of the global health issues. It was estimated to increase to 10% worldwide. Despite being affected by many factors, serum creatinine is the most common marker to detect early kidney deterioration. On the other hand, anemia - which is marked by decreasing blood hemoglobin - is strongly associated with CKD. PURPOSE: to elucidate the correlation between tubular injury, serum creatinine, and blood hemoglobin METHOD: We performed Unilateral Ureteral Obstruction (UUO) in male strain Swiss mice to induce kidney fibrosis. Sham operation was performed to control group (SO) (n=7). The mice were sacrificed in day 7 (d7UUO; n=5) - along with SO group - and day 14 (d14UUO; n=5) after UUO. Tubular injury score was quantified based on Periodic Acid Schiff (PAS) staining. We measure the serum creatinine and blood hemoglobin by using blood from the retroorbital vein. RESULT: Unilateral Ureteral Obstruction (UUO) induced an increment of tubular injury score in d7UUO and d14UUO (p < 0,05 VS SO), and followed by the increasing of serum creatinine in d14UUO (p < 0,05 VS SO), also reduction of blood hemoglobin in d14UUO (p < 0,05 VS SO). CONCLUSION: Tubular injury score has strong positive correlation with serum creatinine, while it has negative correlation with blood hemoglobin.

Kata Kunci : UUO, Unilateral Ureteral Obstruction, CKD, Chronic Kidney Disease, Serum Creatinine, Tubular Injury, Blood Hemoglobin, Mice, Kidney, Renal