COMPREHENSIVE MANAGEMENT OF NEPHROTIC SYNDROME AND LUPUS NEPHRITIS IN A PATIENT WITH MULTIPLE COMORBIDITIES : A CASE REPORT

Lifia Virginia Windiyanti; Ita  Murbani

doi:10.31004/prepotif.v8i3.36350

Authors

Lifia Virginia Windiyanti Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia
Ita Murbani Department of Internal Medicine, KRMT Wongsonegoro Regional Hospital, Central Java

DOI:

https://doi.org/10.31004/prepotif.v8i3.36350

Keywords:

diabetes melitus, gagal ginjal, hipertensi, nefritis lupus, sindrom nefrotik

Abstract

Laporan kasus ini membahas manajemen komprehensif pasien perempuan berusia 62 tahun yang didiagnosis dengan sindrom nefrotik, yang rumit dengan berbagai penyakit penyerta. Pasien datang dengan proteinuria signifikan dan urin berbusa, yang merupakan indikator utama sindrom nefrotiknya. Biopsi ginjal mengonfirmasi nefritis lupus, dan intervensi farmakologis berikutnya termasuk kortikosteroid, imunosupresan (Myfortic), insulin, antihipertensi (Ramipril), dan agen penurun lipid (Simvastatin), yang bertujuan untuk mengatasi masalah kesehatan multifaktorialnya. Meskipun pengobatan agresif, pasien terus menunjukkan kadar kreatinin dan proteinuria yang berfluktuasi, yang menunjukkan insufisiensi ginjal yang berkelanjutan. Kasus ini menyoroti kompleksitas pengelolaan pasien dengan berbagai kondisi kronis, yang memerlukan penyesuaian dinamis dalam pengobatan berdasarkan hasil klinis dan laboratorium. Tidak adanya riwayat keluarga dan psikososial yang terperinci dicatat sebagai keterbatasan dalam kasus ini, yang dapat memberikan wawasan lebih jauh tentang perkembangan penyakit. Pada akhirnya, laporan ini menggarisbawahi pentingnya pendekatan multidisiplin untuk mengelola sindrom nefrotik dan nefritis lupus, terutama bila disertai dengan gangguan metabolik lain seperti diabetes dan hipertensi.

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