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Hubungan Copeptin dengan Estimated Glomerular Filtration Rate (eGFR) dan Urine Albumin Creatinine Ratio (UACR) pada pasien nefropati diabetik

Abstract

Background: Diabetic nephropathy (DN) is one of the most common causes of end-stage renal disease. The time span between the first UACR examination and the next one can delay the diagnosis of DN, which can hinder the initiation of appropriate management. The general objective of this study was to assess the relationship of copeptin with diabetic nephropathy biomarkers such as UACR and eGFR and determine whether copeptin can be used as a biomarker in diabetic nephropathy cases.

Methods: This research design is an observational analytic study with a cross-sectional design conducted from January - August 2021 at the Dr. Saiful Anwar Hospital, Malang. Subjects were patients with diabetes mellitus (DM) aged 18 - 65 who were selected using consecutive sampling techniques. UACR, eGFR, and copeptin were calculated when patients came to RSSA for treatment and will be examined with Cobas® blood chemistry autoanalyzer and Copeptin Elisa kit. Data analysis was performed using SPSS version 23.0 for Windows.

Results: UACR and copeptin had a significant relationship with a weak positive correlation strength. (correlation coefficient: 0.329, p: 0.005). The results of the Mann-Whitney analysis showed that there was a significant difference in copeptin levels in the group of DM patients with UACR <30 mg/g and the group of DM patients with UACR ≥30 mg/g (p = 0.001). The AUROC value for copeptin was 0.747 (CI: 95%, 0.624 - 0.870, p = 0.01). Using Youden's index, the optimal cut-off for Copetin was 1,862 ng/mL with a sensitivity of 81.6% and specificity of 60.9%, which could distinguish patients with diabetic nephropathy or DM without nephropathy.

Conclusions: There is a significant difference in copeptin levels in diabetic and non-diabetic nephropathy conditions. A cut-off of 1,862 ng/mL (sensitivity 81.6% and specificity 60.9%) can indicate that the DM patient has experienced nephropathy with UACR ≥30 mg/g.

 

Latar Belakang: Nefropati diabetik (DN) merupakan salah satu penyebab paling umum dari penyakit ginjal stadium akhir. Rentang waktu antara pemeriksaan UACR yang pertama dengan yang selanjutnya dapat memperlama penegakkan diagnosis dari DN sehingga dapat menghambat dimulainya penatalaksanaan yang tepat. Tujuan umum dari penelitian ini adalah untuk menilai hubungan copeptin dengan biomarker nefropati diabetik seperti UACR dan eGFR, dan mengetahui apakah copeptin dapat digunakan sebagai biomarker pada kasus nefropati diabetik.

Metode: Desain penelitian ini adalah penelitian analitik observasional dengan desain potong lintang yang dilakukan dari Januari – Agustus 2021 di RS Dr. Saiful Anwar, Malang. Subjek merupakan penderita diabetes mellitus (DM) berusia 18 – 65 tahun yang dipilih dengan menggunakan teknik consecutive sampling. UACR, eGFR, dan copeptin dihitung ketika pasien datang berobat ke RSSA, dan akan diperiksa dengan alat autoanalyzer kimia darah Cobas® dan Elisa kit Copeptin. Analisis data dilakukan dengan menggunakan SPSS versi 23.0 untuk WIndows.

Hasil: UACR dengan copeptin memiliki hubungan yang signifikan dengan kekuatan korelasi positif lemah (koefisien korelasi: 0,329, p = 0,005). Hasil analisis Mann-Whitney menunjukkan bahwa terdapat perbedaan yang signifikan antara kadar copeptin pada kelompok pasien DM dengan UACR <30 mg/g dengan kelompok pasien DM dengan UACR 30 mg/g (p= 0,001). Nilai AUROC untuk copeptin adalah 0,747 (CI: 95%, 0,624 – 0,870, p= 0,01). Dengan menggunakan Youden’s index didapatkanlah cut-off optimal untuk Copetin adalah 1,862 ng/mL dengan sensitivitas 81,6% dan spesifisitas 60,9% yang dapat membedakan pasien nefropati diabetik atau DM tanpa nefropati.

Simpulan: Terdapat perbedaan signifikan kadar copeptin pada kondisi nefropati diabetik dan non-nefropati diabetik. Menggunakan cut-off 1,862 ng/mL (sensitivitas 81,6% dan spesifisitas 60,9%) dapat menunjukan bahwa pasien DM tersebut telah mengalami nefropati dengan UACR 30 mg/g.

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How to Cite

Chandra, M., Susianti, H., & Hanggara, D. S. (2024). Hubungan Copeptin dengan Estimated Glomerular Filtration Rate (eGFR) dan Urine Albumin Creatinine Ratio (UACR) pada pasien nefropati diabetik. Intisari Sains Medis, 15(1), 78–85. https://doi.org/10.15562/ism.v15i1.1922

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