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Penanda biologis kerusakan ginjal pada penderita sirosis hepatis

Abstract

Gangguan fungsi ginjal merupakan komplikasi utama pada pasien sirosis hepatis dengan angka morbiditas dan mortalitas yang tinggi. Acute kidney injury (AKI) merupakan prediktor penting terjadi kematian jangka waktu pendek dan berhubungan dengan prognosis yang buruk. Diagnosis AKI umumnya ditegakkan berdasarkan parameter SCr dan UO. Namun, dalam kondisi darurat penegakan dengan parameter tersebut dapat memperlambat terapi oleh karena peningkatan kadarnya dapat mencapai 24-48 jam setelah pemicu AKI. Biomarker kerusakan ginjal yang telah banyak diteliti adalah urine neutrophil gelatinase-associated lipocalin (uNGAL), interleukin-18 (IL-18), dan liver type-fatty acid binding protein (L-FABP). Dalam kondisi darurat uNGAL dan L-FABP telah direkomendasikan (2B) untuk diagnosis AKI. IL-18 merupakan sitokin pro-inflamasi yang memegang peranan penting pada AKI yang dapat dipicu salah satunya oleh iskemia. Studi meta analisis menunjukkan IL-18 memiliki sensitivitas 80% dan spesifisitas 88% dalam diagnosis AKI. L-FABP dapat membantu membedakan dari kondisi ATN dengan cut off 25 ng/mL dengan AUC 0.688. uNGAL memiliki akurasi yang lebih tinggi daripada biomarker lain, nilai UAC uNGAL sebesar 0,787, sementara IL-8 dengan AUC 0,711, L-FABP dengan AUC 0,688. Namun, kelemahan dari uNGAL adalah terjadi peningkatan kadar pada perburukan penyakit ginjal kronis, infeksi saluran kemih, dan kanker. Sehingga kadarnya perlu disesuaikan. Biomarker uNGAL, IL-18, dan L-FABP dapat digunakan dalam diagnosis dini kerusakan ginjal yang lebih baik dibandingkan parameter serum kreatinin dan produksi urin.

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How to Cite

Putra, I. G. N. P. S., Saputra, I. P. G. H., Eryana, I. M., & Wijaya, I. G. H. A. (2023). Penanda biologis kerusakan ginjal pada penderita sirosis hepatis. Intisari Sains Medis, 14(3), 1032–1032. https://doi.org/10.15562/ism.v14i3.1862

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I Gusti Ngurah Putu Sugiartha Putra
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I Putu Gde Hendra Saputra
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I Made Eryana
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I Gede Herry Ananta Wijaya
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