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All Journal Althea Medical Journal Paediatrica Indonesiana

Dedi Rachmadi

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Author-ID : 2502033

Health Professions Medicine & Pharmacology

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A Study of Hypoalbuminemia and Pleural Effusionin Pediatric Nephrotic Syndrome Tovan Perinandika; Dedi Rachmadi; Fenny Dwiyatnaningrum
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Faculty of Medicine Universitas Padjadjaran

Background: Nephrotic syndrome (NS) is a kidney disease that is most often found in children. Hypoalbuminemia in NS can cause a decrease in oncotic pressure causing extravasation of fluid into the interstitial space. In conditions of severe hypoalbuminemia, fluid extravasation may cause occurrence of pleural effusion. The objectives of this study was to analyze the correlation between hypoalbuminemia and pleural effusion in children with NS. Methods: An analytical study was conducted on 69 medical records of pediatric nephrotic syndrome from 1 January 2008–31 December 2013 in dr. Hasan Sadikin General Hospital. Inclusion criteria were pediatric patients between 1-14 years old with NS. Exclusion criteria were patients who already had albumin transfusion, malnutrition, patients with chronic disease, and incomplete medical record information. Contingency coefficient test was carried out to discover the correlation between variables. Results: Out of 89 samples, 69 samples were included. Characteristics of the included patients are male (n=48), female (n=21), age 1–5 (n=24), 6–10 (n=22), 11–14 (n=23), mild hypoalbuminemia (n=3), moderate hypoalbuminemia (n=27), severe hypoalbuminemia (n=39), patients with pleural effusion (n=23), and non-pleural effusion (n=46). There was a significant correlation between hypoalbuminemia and pleural effusion with p=0.000 (p<0.05) and moderate correlation (r=0.437). Conclusions: Hypoalbuminemia has correlation with pleural effusion in pediatric nephrotic syndrome.Keywords: Hypoalbuminemia, pediatric nephrotic syndrome, pleural effusionDOI: 10.15850/amj.v4n2.1075

Trombocytosis in childhood relapsing nephrotic syndrome Ade Hafni; Danny Hilmanto; Dedi Rachmadi; Nanan Sekarwana
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Background Thrombosis is a serious complication of nephroticsyndrome (NS). Long-term steroid treatment may inducethrombocytosis in relapsing NS that may predispose to thrombosis.Most children with idiopathic NS respond to steroids; however, asubstantial number of patients will relapse frequently and requirerepeated high dose steroid therapy, thus increase the risk ofthrombocytosis.Objective To compare the occurrence of thrombocytosis betweenchildren with frequent relapses of NS (FRNS) and those withinfrequent relapses (IFRNS).Methods We reviewed the medical records of children aged 1-14years diagnosed as FRNS and IFRNS at the Department of ChildHealth, Hasan Sadikin General Hospital Bandung from 2000-2005. We excluded children with iron deficiency anemia,hemolytic anemia, acute haemorrhage, malignancy, and those whoreceived cyclophosphamide.Results There were 33 children (26 males, 7 females) with FRNSand 33 children (27 males, 6 females) with IFRNS. The meanplatelet level of children with FRNS (517,909+165,670/ml) washigher than that of children with IFRNS (416,272+145,763/ml)(P=0.005). The occurrence of thrombocytosis in children withFRNS (18) was higher than that of children with IFRNS (7)(P=0.005).Conclusion This study shows that thrombocytosis is morecommon in FRNS than IFRNS, therefore we should take moreprecaution to the occurrence of thrombosis in FRNS.

The value of urinalysis in presumptive diagnosis of urinary tract infection in children Dedi Rachmadi; Andaningrum Setyastuti
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.199-203

Background Definite diagnosis of urinary tract infection (UTI)should only be established based on culture of urine specimen,otherwise it would be considered presumptive. Since urinalysisprovides more rapid information than urine culture, cliniciansshould consider to utilize urinalysis as a decision-making tool forinitiating treatment of UTI.Objective To determine the sensitivity, specificity, predictive val-ues, and accuracy of several urinalysis parameters, namely the ni-trite, leukocyte esterase (LE), Gram staining, and methylene bluereductase (MBR) tests, in supporting the diagnosis of UTI.Methods This diagnostic test was done on 30 subjects with pyuriaduring the period of April to June 2004. The sensitivity, specific-ity, positive predictive value (PPV), negative predicitve value(NPV) as well as the accuracy were calculated for each urinalysisparameter with urine culture as the gold standard. The relation-ship between categorical variables was analyzed by Fisher's exacttest or chi square test.Results The sensitivity, specificity, PPV, NPV and accuracy fornitrite test, leukocyte esterase (LE) test, Gram staining, and MBRtest were respectively as follows: nitrite test showed 90.5%, 66. 7%,86.4%, 75%, and 83.3%; LE test yielded 95.2%, 33.3%, 76.9%,75%, and 76.4%; Gram staininglOO%, 44.4%, 80.8%, 100%, and83.3%; and MBR test 85.7%, 100%, 100%, 75%, and 90%.Conclusions The MBR, among other urinalysis routine tests, hasthe highest specificity and accuracy as well as high sensitivity inestablishing a presumptive diagnosis of UTI

Correlation between serum albumin and creatinine levels in children with nephrotic syndrome Gartika Sapartini; Dedi Rachmadi; Herry Garna
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Nephrotic syndrome is a glomerular disordercharacterized by massive proteinuria, hypoalbuminemia, edema,and hyperlipidemia. Hypoalbuminemia in nephrotic syndromeleads to hypovolemia, a decrease in renal perfusion and glomerularfiltration rate. Serum creatinine level reflects the glomerularfiltration rate.Objective The aim of this study was to determine the correlationbetween serum albumin and creatinine levels in children withnephrotic syndrome.Methods A cross-sectional study was carried out on children withidiopathic nephrotic syndrome, aged between 1 to 14 years old,admitted to Pediatric Department in Hasan Sadikin Hospitalfrom January 2001 to September 2007. We used data frompatients' medical records to obtain serum albumin and creatininelevels during nephrotic stage. Statistical analysis using Pearsoncorrelation test was performed to establish the correlation betweenserum albumin and creatinine levels. The type of correlation wasdetermined by regression analysis.Results Subjects were 113 children, consisted of 81 boys (72%)with mean of age 6.8 (SD 3.3) years. Mean of serum albumin andcreatinine levels were 1.4 (SD 0.4) g/dL and 0.7 (SD 0.4) mg/dL, respectively. Analysis using Pearson correlation test showeda moderate (r=-0.478) significant correlation (P<O.Ol) betweenserum albumin and creatinine levels in children with nephroticsyndrome. Regression analysis suggested a negative linearrelationship between serum albumin level as the independentvariable (X) and serum creatinine level as the dependent variable(Y) by using equation Y = 1.328-0.460X.Conclusion In patients with nephrotic syndrome there is amoderate negative correlation between serum albumin andcreatinine levels.

Co-Authors Ade Hafni Andaningrum Setyastuti Danny Hilmanto Fenny Dwiyatnaningrum Gartika Sapartini Herry Garna Nanan Sekarwana Tovan Perinandika

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