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All Journal Sari Pediatri International Archives of Medical Sciences and Public Health
Piprim Basarah Yanuarso, Piprim Basarah
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Religion Environmental Science Health Professions Medicine & Pharmacology Public Health

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Nilai Diagnostik Neutrophil Gelatinase-Associated Lipocalin Urin, Kelainan Urinalisis, dan Kombinasi Keduanya pada Infeksi Saluran Kemih Anak Usia 2–5 Tahun Estetika, Citra; Pardede, Sudung O.; Munasir, Zakiudin; Supriyatno, Bambang; Prawitasari, Titis; Yanuarso, Piprim Basarah
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/sp26.3.2024.137-45

Abstract

Latar belakang. Infeksi saluran kemih (ISK) pada anak memiliki manifestasi klinis yang tidak khas sehingga sulit untuk diagnosis dini. Biakan urin memerlukan waktu hingga lima hari sehingga dapat menyebabkan keterlambatan terapi serta tingginya komplikasi ISK. Kelainan urinalisis yang saat ini digunakan masih memiliki spesifisitas yang rendah. Tujuan. Mengetahui nilai diagnostik Neutrophil gelatinase-associated lipocalin (NGAL) urin, kelainan urinalisis, dan kombinasi keduanya untuk mendiagnosis dini ISK pada anak usia 2-5 tahun.Metode. Uji diagnostik menggunakan biakan urin sebagai baku emas dengan desain potong lintang pada anak berusia 2-5 tahun dengan tersangka ISK dan dirawat di Rumah Sakit Dr. Cipto Mangunkusumo.Hasil. Pemeriksaan NGAL urin diketahui memiliki sensitivitas 85,7% (IK95%: 63,6-96,9%), spesifisitas 74,3% (IK95%: 57,8-86,9%), positive predictive value 64,3% (IK95%: 50,6–75,9%), dan negative predictive value 90,6% (IK95%: 76,9-96,5%) pada anak dengan minimal satu kelainan urinalisis. Pemeriksaan NGAL urin hanya meningkatkan spesifisitas kelainan urinalisis berupa leukosituria saja dan tidak meningkatkan spesifisitas pada yang telah memiliki tiga kelainan urinalisis. Kesimpulan. Neutrophil gelatinase-associated lipocalin urin tidak dianjurkan untuk meningkatkan spesifisitas urinalisis dalam diagnosis ISK pada anak usia 2–5 tahun. Gabungan tiga kelainan urinalisis tanpa NGAL urin sudah memiliki spesifisitas yang baik. Perlu dilakukan penelitian biomarker lain untuk mendiagnosis dini ISK dengan lebih baik.
PRESEPSIN AS A POTENTIAL BIOMARKER OF SEPSIS IN PEDIATRIC PATIENTS UNDERGOING OPEN-HEART SURGERY Fitriany, Julia; Djer, Mulyadi M; Chozie, Novie Amelia; Yanuarso, Piprim Basarah; Putri, Nina Dwi; Yuniar, Irene
International Archives of Medical Sciences and Public Health Vol. 7 No. 1 (2026): International Archives of Medical Sciences and Public Health
Publisher : Pena Cendekia Insani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53806/iamsph.v7i1.1418

Abstract

Sepsis after pediatric open-heart surgery is rare but highly lethal. Diagnosis is challenging because sepsis symptoms often overlap with post operative inflammatory responses. This study assessed presepsin as a biomarker for postoperative sepsis in children with congenital heart disease. In this prospective diagnostic accuracy study at Cipto Mangunkusumo National Central Hospital, Jakarta, 49 children undergoing open-heart surgery were enrolled. Plasma presepsin and procalcitonin (PCT) levels were measured on postoperative day 1 (T1) and day 3 (T3). Diagnostic performance was evaluated using ROC analysis. Presepsin levels were higher in septic than non-septic patients at T1 (415 vs. 141.5 pg/mL) and T3 (624 vs. 75.9 pg/mL), with a significant difference at T3 (p = 0.001). Presepsin was unrelated to surgical complexity but was associated with 7-day mortality (p = 0.013). At T3, presepsin showed better diagnostic accuracy than PCT (AUC 0.945 vs. 0.895). Optimal cutoffs were 404 pg/mL (T1) and 203.5 pg/mL (T3). PCT levels declined over time in septic patients. Presepsin is a promising biomarker for detecting postoperative sepsis in pediatric open-heart surgery patients, demonstrating diagnostic performance comparable to or superior to PCT, particularly on postoperative day 3. Serial monitoring may facilitate earlier identification of septic complications.
Co-Authors Bambang Supriyatno Citra Estetika Irene Yuniar, Irene Julia Fitriany Mulyadi M. Djer Nina Dwi Putri Novie Amelia Chozie Sudung O. Pardede, Sudung O. Titis Prawitasari, Titis Zakiudin Munasir