Electronic Theses and Dissertation

Latar belakang: Gangguan ginjal akut progresif atipikal (GgGAPA) merupakan bentuk dari gangguan ginjal akut (GGA) yang ditandai dengan progresi cepat menjadi stadium akhir dan memiliki mortalitas tinggi. Indonesia dengan lonjakan GGA yang signifikan sejak Agustus 2022, terutama pada anak sehat, memicu investigasi yang menghubungkan kasus tersebut dengan kontaminasi dietilen glikol (DEG) dan etilen glikol (EG) dalam obat sirup.
Tujuan: Mengetahui profil dan luaran GgGAPA pada anak di RSUD dr. Zainoel Abidin Banda Aceh.
Metode: Penelitian ini adalah studi analitik observasional menggunakan data rekam medis anak usia 1 tahun–18 tahun pada Juni–Desember 2022. Analisis statistik dengan analisis bivariat uji chi square dan uji fisher.
Hasil: Penelitian ini terdapat 31 pasien GgGAPA, mayoritas laki-laki (64,5%), usia 1-5 tahun (93,5%), berdomisili di luar Kota Banda Aceh (58,1 %), status gizi baik (80,6%) dan meninggal (74,2%). Gejala klinis dominan adalah genatourinaria (87.1%), terapi utama adalah dialisis (64,5%). Hubungan signifikan terhadap luaran pasien GgGAPA ditemukan pada; gejala respirasi (p=0,01; OR=16; IK95%: 1,643–155,77), skor PELOD-2 ≥10 (p=0,03; OR=10,89; IK95%: 1,140–103,98), penggunaan ventilator (p=0,01; OR=16; IK95%: 1,643–155,777), leukosit (p=0,01; OR=11,11; IK95%: 1,701–72,564), trombosit (p=0,00; OR=1,90; IK95%: 1,207–2,957), ureum (p=0,04; OR=13,2; IK95%: 1,125–154,920), kreatinin (p=0,02; OR=36,67; IK95%: 3,124–430,333), eGFR (p=0,01; OR=22; IK95%: 1,924–251,539), SGOT (p=0,00; OR=22; IK95%: 1,924–251,539), SGPT (p=0,00; OR=36,67; IK95%: 3,124–430,333) dan toksikologi (p=0,04; OR=0,07; IK95%: 0,006–0,889).
Kesimpulan: GgGAPA merupakan kondisi progresif dengan mortalitas tinggi. Profil klinis, terapi dan laboratorium berhubungan signifikan terhadap luaran pasien.
Kata kunci: GgGAPA, EG, DEG, profil klinis, laboratorium, terapi dan luaran

Background: Atypical progressive acute kidney injury (APAKI) in children is a form of acute kidney injury (AKI) characterised by rapid progression to end-stage and high mortality. Indonesia with a significant spike in AKI since August 2022, especially in healthy children, triggered investigations linking the cases to diethylene glycol (DEG) and ethylene glycol (EG) contamination in syrup medications. Objective: This study aims to determine the profile and outcomes of APAKI in children at RSUD dr. Zainoel Abidin Banda Aceh. Methods: This study is an observational analytic study using medical record data of children aged 1 year-18 years in June-December 2022. Statistical analysis with bivariate analysis of Chi-square test and Fisher's test Results: There were 31 APAKI patients, the majority were male (64.5%), aged 1-5 years (93.5%), domiciled outside Banda Aceh City (58.1%), good nutritional status (80.6%) and most patients died (74.2%). The dominant clinical symptom was genatourinary (87.1%), the main therapy was dialysis (64.5%). Significant associations with APAKI patient outcomes were found in; respiratory symptoms (p=0.01; OR=16; 95% CI: 1.643-155.77), PELOD-2 score ≥10 (p=0.03; OR=10.89; 95% CI: 1.140-103.98), ventilator use (p=0.01; OR=16; 95% CI: 1.643-155.777), leucocytes (p=0.01; OR=11.11; 95% CI: 1,701-72,564), platelets (p=0.00; OR=1.90; 95% CI: 1,207-2,957), ureum (p=0.04; OR=13.2; 95% CI: 1,125-154,920), creatinine (p=0.02; OR=36.67; 95% CI: 3,124-430,333), eGFR (p=0.01; OR=22; 95% CI: 1,924-251,539), SGOT (p=0.00; OR=22; 95% CI: 1.924-251.539), SGPT (p=0.00; OR=36.67; 95% CI: 3.124-430.333) and toxicology (p=0.04; OR=0.07; 95% CI: 0.006-0.889). Conclusion: APAKI is a progressive condition with high mortality. Clinical, therapeutic and laboratory profiles are significantly associated with patient outcomes. Keywords: APAKI, EG, DEG, clinical profile, laboratory, therapy and outcome.