UJI BEDA PROPORSI PENURUNANESTIMASI LAJU FILTRASI GLOMERULUS ANTARA FORMULA CYSTATIN C SEDERHANA DAN MDRDBERBASIS KREATININ PADA PENDERITA DM TIPE 2

ROSE INDRIYATI, dr windarwati M fsc sp PK(K); Dr. dr. Siti N4uihayat P, VlS, Sp.PK(K)

2016 | Tesis | S2 Ilmu Kedokteran Klinik

Latar Belakang. Diabetes mellitus (DM) adalah suatu kelainan metabolisme kronis yang terjadi karena kelainan sekresi hormon insulin, kelainan kerja insulin atau kedua-duanya. Salah satu komplikasi kronik DM adalah penyakit ginjal kronik (PGK). Pengukuran LFG merupakan hal yang penting dalam pengelolaan pasien dengan penyakit ginjal. Tujuan. Untuk mengetahui apakah ada perbedaan proporsi penurunan eLFG antara formula Cystatin C Sederhana dan MDRD berbasis kreatinin pada penderita DM tipe 2. Metode. Penelitian observasional analitik cross-sectional pada subyek 94 penderita DM tipe 2 rawat jalan di RSUP DR. Sardjito Yogyakarta. Semua subyek diperiksa kreatinin dan cystatin C serum. Uji beda antara formula MDRD berbasis kreatinin dan Cystatin C Sederhana (100/CysC) menggunakan uji Chi-Square. Hasil. Pada 94 penderita DM tipe 2 rawat jalan, rerata usia 61+8,7 tahun, jenis kelamin laki-laki 54,3%, rerata formula MDRD berbasis kreatinin 58,5+20 mL/min/1.73m2, rerata formula Cystatin C Sederhana 80+21,7 mL/min/1.73m2. Proporsi stage 2 klasifikasi PGK, formula Cystatin C Sederhana 54,3%, MDRD berbasis kreatinin 39,4%, p=0,001. Proporsi stage 3 klasifikasi PGK, formula Cystatin C Sederhana 14,9%, MDRD berbasis kreatinin 56,4%, p=0,001. Persamaan formula Cystatin C Sederhana = 31,5+0,84(MDRD berbasis kreatinin). Kesimpulan. Terdapat perbedaan proporsi penurunan eLFG pada stage 2, formula Cystatin C Sederhana proporsinya lebih banyak dengan nilai p=0,001. Pada stage 3 formula Cystatin C Sederhana proporsinya lebih sedikit dengan nilai p=0,001. Untuk aplikasi klinis dalam menentukan tingkat keparahan PGK diperlukan penelitian lebih lanjut dengan menggunakan formula Cystatin C Sederhana.

Background. Diabetes mellitus (DM) is a chronic metabolic disorder that occurs due to abnormal insulin secretion, abnormal insulin action or both. One of the chronic complications of diabetes mellitus is a chronic kidney disease (CKD). Measurement GFR is important in the management of patients with kidney disease. Aim. To investigate the difference between the decrease eGFR in Simple Cystatin C and MDRD formula in patients with type 2 diabetes mellitus. Method. The research was observational analytic cross-sectional study in 94 patients with type 2 diabetes outpatient in RSUP. DR. Sardjito hospital. All subjects examined serum creatinine and cystatin C. Test the difference between the formula MDRD creatinine based and Simple Cystatin C (100/CysC) using Chi-Square test. Results. In 94 outpatients with type 2 diabetes mellitus, the mean age was 61+8.7 years, male gender was 54.3%, the mean of MDRD creatinine based was 58.5+20 mL/min/1.73m2, the mean Simple Cystatin C formula was 80+21.7 mL/min/1.73m2. The proportion of stage 2 CKD classification, Simple Cystatin C formula was 54.3%, MDRD creatinine based formula was 39.4%, p=0.001. The proportion of stage 3 CKD classification, Simple Cystatin C formula was 14.9%, MDRD creatinine based formula was 56.4%, p=0.001. The equation of Simple Cystatin C formula=31.5+0.84(MDRD creatinine based formula). Conclusion. There is difference proportion of decline in eGFR between MDRD creatinine-based and Simple Cystatin C formula. Clinical application in determining the severity of CKD required further research by using the Simple Cystatin C formula.

Kata Kunci : Key words: DM tipe 2, Simple Cystatin C, MDRD creatinine based, Cystatin C.