Lie, Shylvia and Dr. dr. Hani Susianti,, Sp.PK(K) and dr. Anik Widijanti,, Sp.PK(K). (2018) Hubungan Rasio IL-6 Urin/Kreatinin Urin dan Eritrosit Dismorfik pada Flow Cytometry Urine Analyzer dengan Kelainan Glomerular pada Pasien Hematuri. Magister thesis, Universitas Brawijaya.
Abstract
Latar Belakang: Kelainan glomerular merupakan penyebab tersering penyakit ginjal tahap akhir. Biopsi ginjal adalah standar baku emas menentukan kelainan glomerular, tetapi invasif dan memerlukan persyaratan khusus. Eritrosit pada kelainan glomerular berbentuk dismorfik. Urinalisis dengan flow cytometry urine analyzer diharapkan dapat menggantikan pemeriksaan mikroskopis dalam membedakan asal hematuri. Rasio IL-6 urin/kreatinin urin diketahui berkorelasi positif dengan skor jejas glomerulus. Penelitian ini bertujuan untuk mengetahui hubungan rasio IL-6 urin/kreatinin urin dan eritrosit dismorfik pada flow cytometry urine analyzer guna mengetahui apakah dapat digunakan untuk membedakan kelainan glomerular dan non glomerular. Metode: Subyek penelitian dibagi menjadi kelompok hematuri glomerular, non glomerular dan kontrol sehat. Penentuan hematuri glomerular menggunakan kriteria klinis. Penghitungan eritrosit dismorfik menggunakan flow cytometry urine analyzer dan mikroskop fase kontras. Kadar IL-6 urin diukur dengan metode ELISA dan kreatinin urin diukur dengan metode enzimatik. Hasil: Kadar IL-6 urin antara kelompok hematuri glomerular dengan non glomerular dan kelompok hematuri non glomerular dengan kontrol berbeda bermakna (p=0,014, p=0,007). Kadar IL-6 urin antara kelompok hematuri glomerular dan kontrol tidak berbeda bermakna. Rasio IL-6 urin/kreatinin urin tidak berbeda bermakna antar ketiga kelompok. Kadar IL-6 urin dan rasio IL-6 urin/kreatinin urin hematuri glomerular berkorelasi negatif dengan persentase eritrosit dismorfik pada flow cytometry urine analyzer dan mikroskop fase kontras. Persentase eritrosit dismorfik pada flow cytometry urine analyzer (cut off 51,24%) memiliki sensitivitas 96,70% dan spesifisitas 90,00%, sedangkan rasio IL-6 urin/kreatinin urin (cut off 0,135 ng/mg) memiliki sensitivitas 80,00% dan spesifisitas 23,30%, dalam membedakan hematuri glomerular dan non glomerular Kesimpulan: Persentase eritrosit dismorfik pada flow cytometry urine analyzer memiliki nilai diagnostik lebih baik dibanding rasio IL-6 urin/kreatinin urin dalam membedakan hematuri glomerular dan non glomerular.
English Abstract
Background: Glomerular abnormalities are the most common cause of endstage renal disease. Renal biopsy is the gold standard to determine glomerular abnormalities, but it is invasive and requires special requirements. Erythrocytes in glomerular disorders are dysmorphic. Urinalysis with flow cytometry urine analyzer is expected to replace microscopic examination in distinguishing the origin of hematuria. Urinary IL-6/urinary creatinine ratio was known to be positively correlated with glomerular lesion score. This study aims to determine the relationship of urinary IL-6/urinary creatinine ratio and dysmorphic erythrocytes in flow cytometry urine analyzer to differentiate glomerular and non glomerular abnormalities. Methods: The subjects were divided into glomerular hematuria, non glomerular hematuria and healthy subjects. Determination of glomerular hematuri is using clinical criteria. Calculation of dysmorphic erythrocyte is using flow cytometry urine analyzer and contrast microscope. Urinary IL-6 levels were measured by ELISA method and urinary creatinine was measured by enzymatic method. Results: Urinary IL-6 levels between glomerular hematuri, non-glomerular hematuri and healthy subjects were significantly different (p = 0.014, p = 0.007). Urinary IL-6 levels between glomerular hematuri and healthy subjects did not differ significantly. Urinary IL-6/urinary creatinine ratio did not differ significantly between the three groups. Urinary IL-6 levels and urinary IL-6/urinary creatinine ratio of glomerular hematuria were negatively correlated with percentage of dysmorphic erythrocytes in flow cytometry urine analyzer and phase contrast microscope. Dysmorphic erythrocytes percentage in flow cytometry urine analyzer (cut off 51.24%) had a sensitivity of 96.70% and specificity of 90.00%, whereas urinary IL-6/urinary creatinine ratio (cut off 0.135 ng/mg) had a sensitivity of 80.00 % and specificity of 23.30% in differentiating glomerular and non glomerular hematuria. Conclusion: Dysmorphic erythrocytes percentage in flow cytometry urine analyzer has better diagnostic value than urinary IL-6/urinary creatinine ratio in differentiating glomerular and non glomerular hematuria.
| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | TES/616.63/LIE/h/2018/041802330 |
| Uncontrolled Keywords: | rasio IL-6 urin/kreatinin urin, eritrosit dismorfik, flow cytometry urine analyzer, kelainan glomerular, hematuri,urinary IL-6/urinary creatinine ratio, dysmorphic erythrocyte, flow cytometry urine analyzer, glomerular disease, hematuria |
| Subjects: | 600 Technology (Applied sciences) > 616 Diseases |
| Divisions: | Profesi Kedokteran > Spesialis Patologi Klinik, Fakultas Kedokteran |
| Depositing User: | soegeng sugeng |
| Date Deposited: | 05 Aug 2022 07:32 |
| Last Modified: | 05 Aug 2022 07:32 |
| URI: | http://repository.ub.ac.id/id/eprint/193013 |
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