Research Article

Analisis rasio BUN/kreatinin pada pasien infark miokard akut di RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia

Andi Ahmad Tarau , Sulina Yanti Wibawa, Tenri Esa, Darmawati E. Rauf

Andi Ahmad Tarau
Program Pendidikan Dokter Spesialis Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia. Email: ahmadtarau@gmail.com

Sulina Yanti Wibawa
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia Rumah Sakit Umum (RSU) Stella Maris, Makassar, Indonesia

Tenri Esa
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia Rumah Sakit Khusus Daerah (RSKD) Dadi, Makassar, Indonesia

Darmawati E. Rauf
Departemen Ilmu Patologi Klinik, Fakultas Kedokteran, Universitas Hasanuddin, RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia Rumah Sakit Islam (RSI) Faisal, Makassar, Indonesia
Online First: December 01, 2020 | Cite this Article
Tarau, A., Wibawa, S., Esa, T., Rauf, D. 2020. Analisis rasio BUN/kreatinin pada pasien infark miokard akut di RSUP Dr. Wahidin Sudirohusodo, Makassar, Indonesia. Intisari Sains Medis 11(3): 1282-1287. DOI:10.15562/ism.v11i3.704


Background: Heart disease is one of the highest mortality diseases and 30% is caused by acute myocardial infarction (AMI). Kidney disease is one of the complications that occurred in patients with acute myocardial infarction.  Several previous studies have reported a high incidence of Acute Kidney Injury (AKI) in patients with AMI (10-27%); the incidence is more elevated when accompanied by cardiogenic shock (50%). Serum BUN and creatinine tests are used to monitor the course and prognosis of renal disorder. This study aims to analyze the BUN/creatinine ratio in IMA patients.

Methods: A retrospective cohort study by taking secondary data from medical records in 80 AMI patients (STEMI and NSTEMI) at Dr. Wahidin Sudirohusodo Hospital, Makassar, for January 2017-December 2018. The variables assessed in this study were age, gender, diagnosis, history of the disease, BUN, creatinine, and BUN/creatinine ratio. Data were analyzed using SPSS version 17 for Windows.

Results: There was a significant difference between the first examination of ureum (p<0.001), creatinine (p=0.047), and the ratio of BUN/creatinine (p<0.001) with the second examination during treatment in IMA patients, which was higher at the second examination, but there was no association between BUN/creatinine ratio of IMA patients at the first examination with the incidence of renal disorder during treatment (p=0.757).

Conclusion: A significant increase of urea and creatinine levels, as well as BUN/creatinine ratio, was found in AMI patients treated at Dr. Wahidin Sudirohusodo Hospital, Makassar. However, no association was found between an increase in the BUN/creatinine ratio and the patient's renal impairment.

 

 

Latar Belakang: Penyakit jantung merupakan salah satu penyebab kematian tertinggi dan sebanyak 30% disebabkan oleh infark miokard akut (IMA). Penyakit ginjal merupakan salah satu komplikasi yang dapat terjadi pada pasien infark miokard akut. Beberapa penelitian sebelumnya telah melaporkan tingginya insiden AKI pada pasien IMA (10-27%), insidennya semakin tinggi bila disertai syok kardiogenik (50%). Tes serial BUN dan Kreatinin serum digunakan untuk memantau perjalanan dan prognosis penyakit ginjal. Penelitian ini bertujuan untuk menganalisis hubungan rasio BUN/kreatinin pada pasien IMA.

Metode: Penelitian ini bersifat kohort retrospektif dengan mengambil data sekunder dari rekam medis pada 80 pasien IMA (STEMI dan NSTEMI) yang dirawat di RSUP DR. Wahidin Sudirohusodo, Makassar periode Januari 2017-Desember 2018. Variabel yang dinilai pada penelitian ini meliputi usia, jenis kelamin, BUN, kreatinin, maupun rasio BUN/kreatinin serum. Data dianalisis dengan piranti lunak SPSS versi 17 untuk Windows.

Hasil: Penelitian ini menunjukkan terdapat perbedaan bermakna pemeriksaan pertama ureum (p<0,001), kreatinin (p=0,047), dan rasio BUN/kreatinin (p<0,001) dengan pemeriksaan kedua selama perawatan pada pasien IMA, yaitu lebih tinggi pada pemeriksaan kedua, akan tetapi tidak terdapat hubungan rasio BUN/kreatinin pasien IMA pada pemeriksaan pertama dengan kejadian gangguan fungsi ginjal selama perawatan (p=0,757).

Simpulan: Berdasarkan hasil penelitian, ditemukan peningkatan yang signifikan dari kadar ureum, kreatinin, dan rasio BUN/kreatinin pasien IMA yang dirawat di RSUP Dr. Wahidin Sudirohusodo, Makassar. Akan tetapi, rasio BUN/kreatinin tidak dapat dijadikan sebagai prediktor terhadap gangguan fungsi ginjal pasien IMA.

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