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All Journal Sari Pediatri Paediatrica Indonesiana Syntax Literate: Jurnal Ilmiah Indonesia AcTion: Aceh Nutrition Journal Journal of Medical Science; Jurnal Ilmu Medis Rumah Sakit Umum Daerah dr. Zainoel Abidin, Banda Aceh Trends in Infection and Global Health
Syafruddin Haris, Syafruddin
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Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health Social Sciences Other

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Neutrophil lymphocyte ratio and severity of acute kidney injury in septic children Kowita, Nurul Huda; Sovira, Nora; Safri, Mulya; Ismy, Jufitriani; Haris, Syafruddin; Herdata, Heru Noviat; Bakhtiar, Bakhtiar
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.492-8

Abstract

Background Acute kidney injury (AKI) in sepsis is associated with an inflammatory process in kidney microcirculation and may increase morbidity and mortality in children. The neutrophil lymphocyte ratio (NLR) is an inflammatory biomarker of the inflammatory process in sepsis. Objective To determine the role of NLR in predicting the severity of AKI and to describe the demographic and laboratory characteristics, as they relate to outcomes of pediatric patients with AKI and sepsis. Methods This cross-sectional study was conducted in the PICU at Dr. Zainoel Abidin General Hospital (RSUDZA), Banda Aceh, Aceh. Medical record data were obtained from critically ill children with sepsis and AKI. Chi-square test was used to compare the proportions of each variable. We also calculated odds ratios to evaluate the AKI severity, PELOD-2 score, and patient outcomes. Spearman's analysis was used to look for a possible correlation between NLR and AKI severity in septic children. Results Seventy-one subjects with sepsis and AKI were included. Subject characteristics were as follows: 63.4% males, 63.4% < 1 year of age, 56.3% with respiratory problems as a primary disease, 38% with AKI injury stage, and 54.9% subjects with PELOD-2 score ?10. There was no significant correlation between AKI severity and mortality (OR 3.04; 95%CI 0.990 to 9.378; P=0.052). Subjects with a PELOD-2 score ?10 had a 47.6 times higher chance of mortality in septic children with AKI compared to those with PELOD-2 scores <10. There was no correlation between NLR and AKI severity (r=0.019; P=0.878). Conclusion There is no correlation between NLR and AKI severity. Sepsis accompanied by AKI may increase the risk of mortality in children. Septic children with more severe AKI tends to be less survive.
Risk factors for acute kidney injury in children with critical illness Chalisah, Lilis; Sovira, Nora; Amna, Eka Yunita; Anidar, Anidar; Haris, Syafruddin; Bakhtiar, Bakhtiar
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.398-404

Abstract

Background Acute kidney injury (AKI) is an acute functional kidney disorder that increases morbidity and mortality in children. The mortality rate for critically ill patients accompanied by AKI is quite high and is influenced by the degree of AKI, the severity of the disease, and organ function disorders. Understanding the risk factors of developing AKI in children with critical illness can help prevent AKI. Objective To determine the risk factors for AKI in children with critical illness. Methods This retrospective cohort study included 255 children aged 1 month to 18 years admitted at the pediatric intensive care unit (PICU) of dr. Zainoel Abidin Regional Public Hospital, Banda Aceh, Aceh, from January to December 2022 using medical record data. Bivariate and multivariate analyses were performed. Results Acute kidney injury occurred in 68 (26.7%) patients. Based on pRIFLE criteria, 34 (50%) patients had AKI in the failure stage. Risk factors for AKI in children with critical illness were in descending order of RR: sepsis (RR 14.3; 95%CI 11.68 to 18.66; P=0.000), mechanical ventilation (RR 12.13; 95%CI 8.75 to 15.98; P=0.000), respiratory disorders (RR 2.51; 95%CI 2.06 to 4.02; P=0.003), congenital heart disease (RR 2.08; 95%CI 2.00 to 3.05; P=0.004), CNS disorders (RR 1.24; 95%CI 1.02 to 2.49; P=0.048), nephrotoxic drug use (RR 1.41; 95%CI 1.24 to 3.08; P=0.000), and age 1 month to 5 years (RR 0.072; 95%CI 0.16 to 0.32; P=0.010). Conclusion Sepsis is a risk factor for AKI in children with critical illness, followed by mechanical ventilation use, respiratory disorders, nephrotoxic drug use. Age <5 years is a protective factor.
Delayed growth rate based on bone age in children with idiopathic nephrotic syndrome at a general hospital in Banda Aceh, Indonesia Haris, Syafruddin; Dimiati, Herlina; Hasballah, Kartini; Pardede, Sudung O.
Trends in Infection and Global Health Vol 4, No 2 (2024): December 2024
Publisher : School of Medicine, Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/tigh.v4i2.42807

Abstract

Paediatric nephrotic syndrome is the most common kidney disease in children, with corticosteroids as the primary treatment. While effective, corticosteroid therapy may decrease bone mineral density. Concurrent vitamin D and calcium supplementation can mitigate bone loss but does not entirely prevent it and may introduce side effects. This study assessed growth delay based on bone age in children with idiopathic nephrotic syndrome receiving long-term steroid therapy at Dr. Zainoel Abidin Public Hospital in Banda Aceh, Indonesia. This observational analytic study used a retrospective cohort design, with data collected from the hospitals Paediatric Polyclinic over one month. Paediatric patients diagnosed with INS who met inclusion criteria were included, and data were extracted from electronic medical records. Statistical analysis was conducted using the Mann-Whitney test. Among the 50 children included, 32 (64%) were male and 18 (36%) were female. The median corticosteroid therapy duration was 24 months (range: 284 months). No significant association was found between corticosteroid therapy duration and growth delay, as measured by BA (p=0.363). INS was more common in boys, particularly in the six to 10-year age group. Most participants had normal nutritional status and stature, with steroid-resistant nephrotic syndrome being the most prevalent type. The findings suggest no relationship between corticosteroid therapy duration and growth delay based on bone age, providing reassurance about the treatments impact on growth outcomes.
Urinary neutrophil gelatinase-associated lipocalin to predict acute kidney injury in children with critical illness Fajri, Rizky; Sovira, Nora; Haris, Syafruddin; Dimiati, Herlina; Bakhtiar, Bakhtiar; Amna, Eka Yunita
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.47-53

Abstract

Background Acute kidney injury (AKI) can increase mortality in children with critical illness. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker for early prediction of AKI in children. Objective To determine the diagnostic value of uNGAL as a predictor of AKI in children with critical illness. Methods This observational cross-sectional study was conducted in the Emergency Room, Pediatric Intensive Care Unit, and Pediatric Ward of Zainoel Abidin Public Hospital, Banda Aceh, Indonesia, between August and December 2023. Subjects were 40 children aged 1 month to 18 years with critical illness. uNGAL levels were measured on the first day of admission. Blood urea and creatinine levels were measured on the first and third days of admission. We calculated the diagnostic sensitivity and specificity of uNGAL to predict AKI. The optimal uNGAL cut-off point for this purpose was determined using receiver operating characteristic (ROC) curve analysis. Result In the majority of patients (29/40; 72.5%) critical illness occurred at the ages of 5 to 18 years. The most common primary diseases were central nervous system disorders in 14/40 (35%) patients, gastrointestinal infection in 6/40 (15%) patients, and malignancy in 5/40 (12.5) patients. Median uNGAL levels were significantly elevated in subjects with renal impairment [17.37 (range 6.13-29.70) ng/mL] compared to those with normal renal function [4.87 (range 0.32-29.49) ng/mL] (P=0.0001). The optimal uNGAL cut-off point was >9.99 ng/mL, with an AUC of 0.842, 81% sensitivity, and 78.9% specificity to predict AKI. The OR of AKI in children with uNGAL levels >9.99 ng/mL was 10.66 (95%CI 2.30 to 49.30; P=0.003). Conclusion Urinary neutrophil gelatinase-associated lipocalin (uNGAL) can be used as a predictor of acute kidney injury in children with critical illness.
Hubungan Hiperbilirubinemia dengan Infeksi Saluran Kemih pada Neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh Utami, Maharani Risiska; Darnifayanti, Darnifayanti; Haris, Syafruddin; Darussalam, Dora; Safri, Mulya; Andid, Rusdi
Sari Pediatri Vol 26, No 5 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.5.2025.272-6

Abstract

Latar belakang. Hiperbilirubinemia sering dijumpai pada neonatus. Beberapa penelitian menunjukkan terdapat hubungan hiperbilirubinemia dengan infeksi bakteri salah satunya infeksi saluran kemih (ISK). Pemeriksaan urinalisis perlu dilakukan untuk mendiagnosis ISK. Komponen urinalisis yang memiliki sensitivitas tinggi untuk diagnosis ISK adalah leukosituria.Tujuan. Mengetahui hubungan hiperbilirubinemia dengan leukosituria pada neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh.Metode. Studi analitik observasional dengan desain penelitian potong lintang. Sampel adalah neonatus dengan hiperbilirubinemia di ruang Neonatal Intensive Care Unit/NICU Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh. Analisis penelitian dengan uji korelasi Spearman.Hasil. Dari 31 neonatus dengan hiperbilirubinemia terdiri dari laki-laki 19(61,3%) dan perempuan 12(38,7%). Leukosituria didapatkan pada 6 laki-laki dan 4 perempuan. Analisis data menunjukkan tidak terdapat hubungan hiperbilirubinemia dengan leukosituria pada neonatus (nilai p=0,071), koefisien korelasi -0,328.Kesimpulan. Tidak terdapat hubungan hiperbilirubinemia dengan infeksi saluran kemih pada neonatus di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh.
Gambaran Anemia Defisiensi Besi Pada Kejang Demam Di Rumah Sakit Umum Daerah dr. Zainoel Abidin Banda Aceh Anidar, Anidar; Haris, Syafruddin; Dimiati, Herlina
Journal of Medical Science Vol 1 No 2 (2020): Journal of Medical Science
Publisher : LITBANG RSUDZA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (284.861 KB) | DOI: 10.55572/jms.v1i2.26

Abstract

Kejang demam adalah bangkitan kejang yang terjadi pada kenaikan suhu tubuh di atas 380C yang disebabkan oleh suatu proses ekstrakranium. Kejang demam merupakan salah satu kejadian bangkitan kejang yang sering dijumpai pada anak balita dan merupakan peristiwa yang mengkhawatirkan bagi orang tua, dan tingginya angka kejadian dimasyarakat. Salah satu faktor yang dapat menyebabkan kejang demam adalah anemia defisiensi besi karena besi memiliki peran penting dalam fungsi penghantaran serabut saraf. Penelitian ini bertujuan untuk mengetahui hubungan anemia defisiensi besi dengan kejang demam. Penelitian ini dilakukan secara potong lintang. Populasi penelitian adalah semua pasien anak umur 1–5 tahun yang didiagnosis kejang demam yang dirawat di RSUD dr. Zainoel Abidin tahun 2019 yang tercatat pada rekam medis. Jumlah sampel dalam penelitian ini ada 40 orang terdiri dari 23 subyek dengan kejang demam sederhana dan 17 subyek dengan kejang demam kompleks. Variabel yang diteliti adalah usia, jenis kelamin, suhu tubuh, faktor genetik dan anemia defisiensi besi. Hasil penelitian didapatkan kejang demam sederhana 23(57.5%) dan kejang demam kompleks 17(42.5%). Jenis kelamin laki-laki didapatkan paling banyak yaitu 25(62.5%) ,suhu tubuh ≥390C 21(52.5%) subyek, faktor genetik yang mempengaruhi terjadinya kejang demam yaitu 17(42.5%). Anemia defisiensi besi didapatkan pada sebagian besar kejang demam yaitu 30(75%). Pada kejang demam kompleks didapatkan persentase anemia defisiensi besi lebih tinggi yaitu 15/17(88.2%). Fokus infeksi penyebab kejang demam adalah sebagian besar infeksi saluran pernafasan atas yaitu 37/40(92.5%). Terdapat gambaran anemia defisiensi besi pada sebagian besar pada subyek kejang demam pada anak balita di RSUD dr. Zainoel Abidin Banda Aceh pada tahun 2019.
Nutritional status and laboratory characteristics of nephrotic syndrome in children undergoing steroid and non-steroid therapy at Dr. Zainoel Abidin Hospital, Banda Aceh Haris, Syafruddin; Riza, Fahrul; Thaib, T. M.; Anidar, Anidar; Thaib, Bakhtiar; Sovira, Nora
AcTion: Aceh Nutrition Journal Vol 10, No 2 (2025): June
Publisher : Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30867/action.v10i2.2478

Abstract

Nephrotic syndrome (NS) is a clinical condition characterized by massive proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. Frequently relapsing NS, steroid-dependent NS, and steroid-resistant NS are categorized as problematic owing to treatment difficulties. These patients require prolonged high-dose steroid therapy or immunosuppressants, resulting in significant side effects. This study evaluated the nutritional status and laboratory characteristics of NS in children undergoing steroid and non-steroid therapies. This study is the first to assess the nutritional status and laboratory characteristics of children with difficult-to-treat NS who received steroid and non-steroid therapy at RSUDZA Banda Aceh. A cross-sectional study was conducted at the outpatient clinic and pediatric ward of Dr. Zainoel Abidin General Hospital, Banda Aceh, in 2019, which was a limitation because it was conducted during the Covid-19 pandemic so that the number of research subjects was limited, which could have caused bias in the study. Statistical analyses included the chi-square test or Fisher’s exact test for categorical variables and the independent sample t-test or Mann-Whitney test for numerical variables, with a 95% significance level (p < 0,05). A total of 60 children aged 2–18 years participated in this study, with 29 receiving steroid therapy and 31 receiving non-steroid therapy. Urine protein levels and relapse incidence differed significantly between the groups (p < 0,001). However, the serum albumin, urea, creatinine, calcium, and total cholesterol levels were not significantly different. No significant differences were observed in the laboratory characteristics between the steroid and non-steroid therapy groups. However, the non-steroid group exhibited a better urine protein status and fewer relapses, indicating potential therapeutic advantages.
Risk factors for progression of chronic kidney disease in children with nephrotic syndrome Adrian, Riki; Sovira, Nora; Haris, Syafruddin; Andid, Rusdi; Darnifayanti, Darnifayanti; Yusuf, Sulaiman
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.291-6

Abstract

Background Nephrotic Syndrome (NS) is a progressive kidney disease in children that can lead to chronic kidney disease (CKD). Understanding the interactions between various risk factors is critical in developing new strategies to prevent the progression of CKD in pediatric patients with NS. Objective To determine the risk factors for the progression of CKD in children with nephrotic syndrome at Dr. Zainoel Abidin Public Hospital, Banda Aceh. Methods This analytical observational study with a cross-sectional approach was conducted from September 2021 to September 2023. Data were obtained from medical records of 52 children aged 2 to 18 years in the inpatient and outpatient wards of Dr. Zainoel Abidin Public Hospital, Banda Aceh who met the inclusion criteria. Bivariate analysis using the Chi-square and Fisher's tests and multivariate analysis using logistic regression test were performed. Results Of 52 subjects, most were male and over ten years of age; 53.8% of subjects had Stage 1 CKD. The majority of stage 3-5 of CKD cases had immunosuppressive toxicity and anemia, while the majority of all subjects had hyperfiltration and proteinuria. Risk factors for CKD progression in children with NS are Hypertension (OR 2.54; 95%CI 0.32 to 20.1; P=0.003), immunosuppressant toxicity with (OR 33.67; 95%CI 2.59 to 437.5; P=0.007) and anemia (OR 33.92; 95%CI 2.77 to 414.5; P=0.006). Conclusion Hypertension, immunosuppressant toxicity and anemia for CKD progression in children with NS.
Hubungan Respiratory Distress Syndrom dengan kejadian Acute Kidney Injury pada Neonatus di Neonatal Intensive Care Unit Rumah Sakit Umum Zainoel Abidin Banda Aceh Arsa, Iwan Sabardi; Haris, Syafruddin; Darnifayanti, Darnifayanti; Yusuf, Sulaiman; Herdata, Heru Noviat; Akbar, Zaki
Sari Pediatri Vol 26, No 1 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.1.2024.36-42

Abstract

Latar belakang. Respiratory Distress Syndrome merupakan penyebab gangguan pernapasan, sering terjadi pada bayi baru lahir dan juga menjadi penyebab paling umum terjadinya morbiditas dan mortalitas pada neonatus. Salah satu komplikasi yang sering terjadi adalah Acute Kidney Injury.Tujuan. Penelitian ini bertujuan untuk menganalisis hubungan antara Respiratory Distress Syndrome dengan kejadian Acute kidney injury pada neonatus di Rumah Sakit dr. Zainoel Abidin Banda Aceh.Metode. Penelitian ini menggunakan pendekatan analitik obervasional dengan desain cross-sectional. Data dikumpulkan dari pasien yang dirawat dalam periode Januari 2021-Desember 2021. Sampel penelitian adalah populasi terjangkau yang memenuhi kriteria inklusi dan eksklusi. Besar sampel penelitian adalah total populasi. Penelitian bersifat retrospektif dengan variabel dependen dan independen yang diamati secara sekaligus.Hasil. Selama penelitian berlangsung didapatkan 50 sampel yang memenuhi kriteria inklusi dan eksklusi penelitian, jumlah neonatus berjenis kelamin laki-laki (50%) sebanding dengan perempuan (50%). Usia neonatus terbanyak pada kelompok 3 hari yakni 36 subjek (72%). Mayoritas jenis persalinan dijumpai pada kelompok sectio caesarea yakni 45 subjek (90%). Kelompok usia gestasi 34-36 minggu (preterm) terbanyak yakni 32 subjek (64%). Subjek kelompok Berat badan lahir 1000-<1500 gram (Bayi Berat Lahir Sangat Rendah) dijumpai terbanyak yakni 43 subjek (86%). Nilai Skor Downes >7 berhubungan dengan kejadian Acute Kidney Injury. Mayoritas subjek penelitian dengan Respiratory Distress Syndrom tidak dijumpai Acute Kidney Injury, sebanyak 39 subjek (78%) dengan hasil normal.Kesimpulan. Pada penelitian ini didapatkan terdapat hubungan antara Respiratory Distress Syndrom dengan kejadian Acute Kidney Injury (p<0,05), Koefisien korelasi 0,668 menunjukkan hubungan yang kuat.
Nilai Rasio Neutrofil Limfosit dan Red Cell Distribution Width pada Neonatus Sepsis Machya, Farish; Darussalam, Dora; Herdata, Heru Noviat; Haris, Syafruddin; Edward, Eka Destianti; Dimiati, Herlina
Sari Pediatri Vol 26, No 3 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.3.2024.146-51

Abstract

Latar belakang. Insiden sepsis pada negara berkembang sampai saat ini masih tinggi. Banyaknya faktor risiko yang memengaruhi, menjadikan sepsis sebagai penyumbang tingginya angka kematian pada bayi. Diagnosis yang seringkali terlambat ditegakkan karena pemeriksaan kultur darah sebagai Gold Standard baru bisa didapatkan hasilnya setelah beberapa hari. Deteksi dini sepsis neonatorum dapat diltegakkan salah satunya dengan pemeriksaan rasio neutrofil limfosit dan red cell distribution width.Tujuan. Menilai rasio neutrofil limfosit, red cell distribution width, dan faktor risiko pada neonatus dengan diagnosis sepsis di neonatal intensive care unit - NICU Rumah Sakit Zainoel Abidin Banda Aceh dengan luaran kematian.Metode. Penelitian desain kohort retrospektif dengan data rekam medis neonatus di NICU Rumah Sakit Umum Daerah Dr. Zainoel Abidin, Banda Aceh, dari Februari hingga Oktober 2023. Sebanyak 43 neonatus dengan diagnosis sepsis yang memenuhi kriteria inklusi dianalisis. Data yang dikumpulkan meliputi karakteristik demografis, hasil laboratorium, serta luaran klinis. Analisis dilakukan menggunakan uji Chi-square dan analisis multivariat dengan SPSS versi 20.0.Hasil. Diperoleh 88,3% neonatus menunjukkan peningkatan NLR, dan 86,05% mengalami peningkatan RDW. Terdapat hubungan signifikan antara metode persalinan sectio caesaria (p<0,03) dengan peningkatan risiko mortalitas. Neonatus dengan berat badan ?2500 gram dan usia gestasi preterm lebih sering mengalami peningkatan NLR dan RDW. Kesimpulan. Peningkatan nilai rasio neutrofil limfosit lebih banyak terjadi pada neonatus sepsis dibandingkan nilai red cell distribution width.
Co-Authors Adrian, Riki Akbar, Zaki Amir, Salsabila Munirah Amna, Eka Yunita Anidar Anidar, Anidar Arsa, Iwan Sabardi Bakhtiar Bakhtiar Chalisah, Lilis Darnifayanti, Darnifayanti Dora Darussalam, Dora Edward, Eka Destianti Fahrul Riza Fajri, Rizky Herlina Dimiati, Herlina Heru Noviat Herdata, Heru Noviat Ismy, Jufitriani Isra Firmansyah, Isra Kartini Hasballah Kowita, Nurul Huda Lubis, Rina Hastuti Machya, Farish Mars Nashrah Abdullah, Mars Nashrah Muliana, Cut Mulya Safri, Mulya Muslim Muslim Nauval, Iflan Nora Sovira, Nora Rahmi, Nurul Maulina Rusdi Andid, Rusdi Safrizal Safrizal Sovira, Sovira Sri Rezeki Sudung O. Pardede, Sudung O. Sulaiman Yusuf Thaib, Bakhtiar Thaib, T. M. Thaib, Teuku Muhammad Utami, Maharani Risiska