I Ketut Suarta
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D+ hemolytic uremic syndrome Ni Made Sumiartini; I Nyoman Lila; I Ketut Suarta
Paediatrica Indonesiana Vol 44 No 2 (2004): March 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi44.2.2004.80-4

Abstract

Hemolytic uremic syndrome (HUS) is characterized by anemia microangiopathy, thrombocytopenia, and acute renalfailure, predominantly occurs in childrenyounger than 4 years of age. It is the most commoncause of acute renal failure in children.1,2 HUS is dividedinto two categories, the epidemic type which isaccompanied by enteritis (D+HUS) and the sporadictype which is not accompanied by enteritis (D-HUS).The pathogenesis is unknown, but available evidencestrongly suggests endothelial cell damage in the organs.
Erythrocyturia and proteinuria conversion in post-streptococcal acute glomerulonephritis I Ketut Suarta
Paediatrica Indonesiana Vol 46 No 2 (2006): March 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.2.2006.71-6

Abstract

Background Acute glomerulonephritis (AGN) is a sudden onsetof macroscopic hematuria and edema. The chronic post-strepto-coccal acute glomerulonephritis (PSAGN) can be predicted if mi-croscopic hematuria, proteinuria, and low serum complement C3level are present for a period exceeding six months after initial onsetof illness. It is prudent to follow the course of PSAGN until proteinurianormalizes and microhematuria disappears in urinalysis.Objective To acquire the time of erythrocyturia and proteinuriaconversion in post-streptococcal acute glomerulonephritis (PSAGN)among children.Methods A retrospective cohort study on children with PSAGNwas conducted in the Pediatric Outpatient Clinic and Ward atSanglah Hospital, Denpasar, Bali from January 2001-December2003. All subjects were recorded for clinical and laboratory signs,including initial symptoms, history of previous streptococcal infec-tions, blood pressure, complete blood count, serum albumin, ASTOtiter, complement C3 level, BUN, and serum creatinin. Erythrocyt-uria and proteinuria follow-ups were done by recording urinalysisfindings for a six-month period after initial onset.Results Thirty subjects 21 boys and 9 girls, mean age 8.7 (SD 2.5)years] with PSAGN were enrolled in the study, 16 had hematuria withedema. Twenty-one subjects had the history of upper respiratory tractinfections and 9 with skin infections. Mean systolic blood pressure was141.3 (SD 21.8) mmHg, mean diastolic blood pressure was 90.8 (SD16.3) mmHg, mean ASTO titer was 1103.3 (SD 686.1) IU/ml, and meancomplement C3 level was 42.2 (SD 15.5) mg/dl. Urinalysis monitoringshowed 2/30, 9/30, 12/30, 22/30, 27/30 subjects had conversion he-maturia at the first, second, third, fourth, and fifth month, respectively.Median duration of erythrocyturia conversion was 4.0 months (95% CI:3.53-4.47). There were 11/30, 18/30, 21/30, 23/30, 25/30, 26/30 sub-jects with proteinuria conversion at the first, second, third, fourth, fifth,and sixth month, respectively. Median duration of proteinuria conver-sion was 2.0 months (95% CI: 1.25-2.75).Conclusion Three out of 30 children remained with persistenthematuria and 4 of 30 remained with persistent proteinuria
Fibrinogen status in relapse and remission of childhood nephrotic syndrome Veronica Lily Limantara; Ida Bagus Mudita; I Ketut Suarta
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.149-53

Abstract

Objective To evaluate fibrinogen concentration of relapsing neph-rotic syndrome (NS) in children, and to investigate relationshipbetween fibrinogen with albumin and cholesterol.Methods A cross-sectional study among NS patients admitted topediatric outpatient clinic and pediatric ward at Sanglah Hospital,Denpasar, from November 1, 2003 to January 31, 2004. All pa-tients were evaluated for clinical and laboratory findings of relapseand remission, including edema, proteinuria, serum albumin, totalcholesterol, as well as total platelet count and fibrinogen concen-tration to evaluate coagulation parameters in nephrotic patients.Results There were 36 patients with the mean age of 7.4 (SD 2.3)years included in this study. Mean fibrinogen concentration in re-lapse state was 671.8 (SD 102.7) mg/dl, while in remission statewas 255.2 (SD 50.5 mg/dl); the mean difference was 416.6 mg/dl(95% CI 362.9;470.4; P<0.001). Fibrinogen was inversely andstrongly correlated with serum albumin concentrations (r=-0.91;P<0.001). Fibrinogen was positively and strongly correlated to to-tal cholesterol (r=0.80; P<0.001). Using multiple regression analy-sis, it was shown that only relapse/remission status was signifi-cantly associated with fibrinogen concentration (P<0.001).Conclusion Fibrinogen status is significantly correlated with re-lapse and remission status of NS in childhood patients.