BIOMARKER TERKINI SEBAGAI ALAT DIAGNOSIS DAN PROGNOSIS GAGAL GINJAL AKUT PADA ANAK: SEBUAH REVIEW
DOI:
https://doi.org/10.31004/jkt.v4i3.15121Keywords:
anak, biomarker terkini, diagnosis, penyakit ginjal akut, prognosisAbstract
Gagal ginjal akut atau acute kidney injury (AKI) merupakan sindrom klinis yang mengancam jiwa disebabkan oleh gangguan fungsi ginjal secara mendadak. Pada anak, prevalensi AKI mencapai 10-20% pada pasien anak yang dirawat di Pediatric Intensive Care Unit (PICU). Sistem skoring yang sering dipakai adalah Pediatric Risk Injury Failure Loss End Stage (PRIFLE), Acute Kidney Injury Network (AKIN), dan Kidney Disease Improving Global Outcomes (KDIGO). Namun, penggunaan kadar kreatinin serum sebagai basis skoring tidak terlalu akurat untuk menggambarkan perubahan laju filtrasi glomerulus pada keadaan fungsi ginjal yang terus berubah, sehingga dibutuhkan biomarker yang lebih presisi untuk mendeteksi dini gagal ginjal akut. Tujuan penelitian untuk mengetahui biomarker terkini untuk mendeteksi dan memprediksi prognosis AKI pada anak. Metode penelitian tinjauan literatur dari tiga database PubMed, DOAJ, dan Cochrane yang diterbitkan dalam rentang waktu 5 tahun terakhir yaitu dari 2018-2022. Terdapat 41 literatur melaporkan biomarker yang efektif untuk mendiagnosis AKI pada anak, seperti NGAL, IL-18, Cystatin C urin dan serum, uNAG, IGFBP-7 dan TIMP-2, KIM-1. Kadar uNGAL sangat dapat memprediksi AKI dengan interval kepercayaan 95% [(CI) 0,61-0,92]. Sensitivitas 72,7% dan spesifisitas 89,9%. Kesimpulan yaitu NGAL, IL-18, fosfat, Cystatin C urin dan serum, IGFBP-7 dan TIMP-2, KIM-1 serta uNAG dapat mendeteksi AKI lebih baik pada anak dengan penyakit kritis.References
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