Dharmanata, Suriya (2015) Analisis Kadar Neutrophil Gelatinase-Associated Lipocalin Urine (Ungal) Dengan Indeks Aktivitas Dan Indeks Kronisitas Nefritis Lupus. Magister thesis, Universitas Brawijaya.
Abstract
Nefrtitis lupus (NL) merupakan manifestasi yang paling serius dari Lupus Eritematosus Sistemik (LES). Biopsi ginjal masih merupakan baku emas untuk diagnosis dan menilai aktivitas dan kronisitas nefritis lupus, tetapi bersifat invasif. Oleh karena itu, diperlukan biomarker lain seperti Neutrophil Gelatinase-Associated Lipocalin urine (uNGAL). Penelitian ini bertujuan untuk mengetahui apakah uNGAL dapat digunakan untuk diagnosis dan menilai indeks aktivitas dan indeks kronisitas NL. Kelompok pasien dibagi menjadi 3 kelompok: pasien NL: 38 pasien, biopsi kelas III/IV, kontrol LES: 12 orang, biopsi kelas I/II, dan kelompok sehat: 20 orang, dan sindroma nefrotik 5 orang. Diagnosis LES menurut kriteria ARA 1997, kriteria NL menurut ISN/RPS 2004 dan nilai indeks aktivitas dan kronisitas menurut NIH. Pemeriksaan NGAL urine menggunakan ELISA, menggunakan urine sewaktu. Terdapat perbedaan bermakna antara kadar uNGAL kelompok pasien NL dengan kontrol sehat (p = 0,000) dan antara kelompok kontrol LES dengan kontrol sehat (p = 0,04). Terdapat korelasi positif antara uNGAL dengan indeks aktivitas histopatologi (p = 0,008; r = 0,437) dan antara uNGAL dengan indeks kronisitas histopatologi (p = 0,001; r = 0,516). Nilai diagnostik uNGAL dengan nilai cut off 692,77 pg/mgKr, sensitivitas sebesar 71,8% dan spesifisitas 88,00%, AUC 83,70%. Nilai AUC uNGAL menunjukkan nilai diagnostik yang baik. Adanya hubungan uNGAL dengan indeks aktivitas dan indeks kronisitas menunjukkan uNGAL berperan dan bisa dipakai untuk menilai indeks aktivitas dan kronisitas NL.
English Abstract
Lupus nephritis (LN) is a serious manifestation of systemic lupus ery matosus (SLE) with renal biopsy as gold standard. Renal biopsy is still gold standard for diagnosis and assess activity and chronicity of lupus nephritis, but are invasive. Since it is an invasive procedure, variety of urinary biomarkers has been investigated, such as neutrophil gelatinase-associated lipocalin (uNGAL). This study was aimed to determine diagnostic performance of uNGAL and assess activity and chronicity indices in LN. Participants in this studied were categorized into 3 groups: LN patient: 38 class III-IV LN patients, SLE: 12 class I-II LN patients, control: 20 healthy volunteers and 5 nephrotic syndrome patients. Diagnosis of SLE was based on 1997 ARA criteria. Lupus nephritis classified according to ISN/RPS 2004, and activity, chronicity indicies scoring classified according to NIH. Urinary uNGAL levels were determined by ELISA, using spot urine. re were significant differences on uNGAL levels between LN patient and healthy controls (p = 0.000) and between LES patient and healty controls (p = 0.04). uNGAL showed significant correlation with activity indices (p = 0,008; r = 0,437) and chronicity indices (p = 0,001; r = 0,516). Diagnostic value uNGAL with cut-off 692.77 pg/mgCr and AUC 83.7% were 71.8% for sensitivity and 88.00% for specificity. AUC of uNGAL has a good diagnostic value in LN. re correlation between uNGAL and activity and chronicity indices showed that uNGAL role in assessing activity and chronicity indices NL.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.772/DHA/a/2015/041503816 |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases > 616.7 Diseases of musculoskeletal system |
| Divisions: | Profesi Kedokteran > Spesialis Patologi Klinik, Fakultas Kedokteran |
| Depositing User: | Sugiantoro |
| Date Deposited: | 13 Aug 2015 09:56 |
| Last Modified: | 13 Aug 2015 09:56 |
| URI: | http://repository.ub.ac.id/id/eprint/158402 |
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