PENGARUH NON-STEROIDAL ANTI-INFLAMMATORY DRUG TERHADAP KEPARAHAN PENYAKIT GINJAL KRONIS PADA PASIEN DEWASA : LITERATURE REVIEW
DOI:
https://doi.org/10.31004/jkt.v6i4.51931Keywords:
ckd, egfr, penyakit ginjal kronis, nefrotoksisitasAbstract
Penyakit ginjal kronik (CKD) merupakan salah satu penyebab utama morbiditas dan mortalitas global dengan prevalensi yang terus meningkat. Salah satu faktor penting yang diduga memperburuk keparahan CKD adalah penggunaan obat antiinflamasi nonsteroid (NSAID), yang sering digunakan untuk mengatasi nyeri pada pasien dengan komorbid kronik. Penelitian ini bertujuan untuk menilai hubungan antara penggunaan NSAID dengan keparahan CKD berdasarkan bukti terkini melalui tinjauan literatur. Metode yang digunakan berupa studi literatur dengan pencarian artikel pada database PubMed/Medline menggunakan kata kunci terkait “NSAID” dan “Chronic Kidney Disease”, dengan kriteria publikasi lima tahun terakhir, berbahasa Inggris, dan open access. Dari hasil penelusuran, diperoleh enam artikel yang memenuhi kriteria inklusi, terdiri dari dua studi kohort prospektif, satu kohort retrospektif, dua systematic review dan meta-analisis, serta satu literature review. Hasil telaah menunjukkan adanya hubungan signifikan antara penggunaan NSAID dengan peningkatan risiko penurunan eGFR, perburukan CKD, dan kejadian acute on chronic kidney injury. Risiko nefrotoksisitas meningkat seiring durasi dan dosis NSAID yang lebih tinggi, serta bervariasi antarjenis obat, di mana etoricoxib menunjukkan efek nefrotoksik paling kuat dan ibuprofen terendah. Meskipun beberapa studi menyatakan tidak ada hubungan bermakna pada dosis rendah dan durasi singkat, bukti konsisten menunjukkan peningkatan risiko pada penggunaan kronik. Kesimpulannya, terdapat hubungan antara penggunaan NSAID dengan keparahan CKD, sehingga diperlukan pemantauan fungsi ginjal dan penyesuaian dosis pada penggunaannya, terutama pada pasien dengan faktor risiko ginjal.References
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