Partini Pudjiastuti Trihono
Department of Child Health, University of lndonesia Medical School

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Urinalysis as a diagnostic tool for febrile urinary tract infection in children aged 2 months - 2 years Ayijati Khairina; Partini Pudjiastuti Trihono; Zakiudin Munasir
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.696 KB) | DOI: 10.14238/pi54.2.2014.100-8

Abstract

Background Children aged 2 months to 2 years with febrileurinary tract infection (UTI) need special attention consideringkidney complications, unspecified symptoms, and difficult urinesample collection. Urinalysis was the main supportive examinationfor UTI because of its immediate result and widespreadavailability.Objective To estimate urine nitrite, leukocyte esterase (LE),leucocyturia, bacteriuria, and their combinations as a diagnostictool for febrile UTI in children aged 2 months to 2 years.Methods This is a diagnostic study held in Cipto MangunkusumoHospital, Tangerang General Hospital, Fatmawati Hospital, andBudhi Asih Hospital, involving 7 5 children aged 2 months to 2years. Urine samples for urinalysis and urine culture were collectedusing urine collector in all subjects. Clinical pathologists whoperformed urine culture, did not know the results of urinalysis.Results By parallel test analyses, we found that the best diagnosticvalue was the combination of 3 tests (LE, leucocyturia, andbacteriuria). This combination test showed sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive likelihood ratio (LR+), and negative likelihood ratio(LR-) of 69%, 95%, 85%, 88%, 13.1, and 0.3.Conclusion The combination test of LE, leucocyturia, andbacteriuria shows high specificity, NPV, and LR+ . Therefore, thenegative results of these 3 tests in combination can be used to ruleout UTI.
Prognostic factors and survivals of children with steroid-resistant nephrotic syndrome Partini Pudjiastuti Trihono; Nina Dwi Putri; Aman B Pulungan
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.126 KB) | DOI: 10.14238/pi53.1.2013.42-9

Abstract

Background Children with steroid resistant nephrotic syndrome(SRNS) generally survive, although during the course of diseasetheir kidney function may decrease, leading to end-stage renaldisease (ESRD). There have been few studies reporting on thesurvivals of children with SRNS.Objectives To determine patient and kidney survival rates in childrenwith SRNS at the first, second, third, fourth, and fifth years; and toevaluate the effects of age at onset, initial kidney function, hypertension,and type of resistance, on the survivals of children with SRNS.Methods This retrospective cohort study was performed usingsecondary data obtained from medical records of patients with SRNS inDepartment of Child Health, Cipto Mangunkusumo Hospira~ between2004-2011. The outcomes of kidney survivals were defined in two ways:lack of doubling of base creatinine levels and lack of ESRD.Results There were 45 children with SRNS in our study. Their medianduration ofillness was 24 (range 12-95) months. Twenty percent of thesubjects died, 31.1 % had a doublingofbase creatinine levels, and 13.4%developed ESRD. Life survival rates of subjects at the first, second,third, fourth, and fifth years after diagnosis were 93 %, 84%, 80"/ri, 7 2%,and 61 %, respectively. Kidney survival rates determined by the lackof doubling of base creatinine levels at the first, second, third, fourthand fifth years were 92%, 72%, 56%, 42%, and 34%, respectively, whilekidney survival rates determined by the lack ofESRD were 97%, 88%,81 %, 70"/o, and 58%, respectively. Age at onset, initial kidney function,hypertension at onset, and type of resistance, did not significantly affectthe survivals of children with SRNS.Conclusion Children with SRNS are prone to develop a doublingof base creatinine levels and ESRD. Factors such as age, initialkidney function, hypertension at onset, and type ofresistance, donot significantly affect both, life and kidney survivals of childrenwith SRNS.