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Status Gizi pada Anak dengan Penyakit Ginjal Kronik Stadium 3 – 5 Fase Pradialisis dan Faktor yang Berhubungan = Nutritional Status in Children with Chronic Kidney Disease Stage 3 – 5 Predialysis Phase and Associated Factors.

Latar belakang: Prevalensi penyakit ginjal kronik pada anak setiap tahunnya selalu meningkat. Hal ini perlu dianggap serius karena penyakit ginjal kronik pada anak dapat menyebabkan malnutrisi hingga gagal tumbuh. Namun, belum ada penelitian yang mencari hubungan antara status gizi pada anak dengan penyakit ginjal kronik fase pradialisis dengan faktor-faktor yang berhubungan. Oleh karena itu, penelitian ini bertujuan mengidentifikasi gambaran status gizi dan mencari hubungan antara status gizi dengan faktor yang berhubungan pada anak dengan PGK fase pradialisis. Metode: Desain penelitian ini adalah cross-sectional dengan pengambilan data di Poliklinik Nefrologi Rumah Sakit Cipto Mangunkusumo Jakarta. Data primer berupa berat badan diukur dengan timbangan digital dan tinggi badan dengan stadiometer SECA 703. Data sekunder berupa riwayat sosiodemografis dan laboratorium diperoleh dari rekam medis. Indikator status gizi menggunakan IMT/U dan BB/TB, perawakan dengan TB/U, dan berat badan menggunakan BB/U. Data berat badan dan tinggi badan diolah menjadi z-score menggunakan aplikasi WHO Anthro dan Anthroplus. Analisis data menggunakan metode ANOVA, independent sample t-test, spearman, dan mann-whitney dengan perangkat lunak SPSS Versi 25. Hasil: Terdapat 18 subjek yg diikutsertakan, berusia 3 – 17 tahun. Terdapat 3 subjek berusia di bawah 5 tahun memiliki status gizi baik berdasarkan BB/TB dengan rerata zscore -0,21. Pengukuran status gizi berdasarkan IMT/U didapatkan rerata subjek bergizi baik, yakni -1,02. Rerata perawakan berdasarkan TB/U didapatkan perawakan pendek dengan z-score -2,71. Terdapat 8 subjek yang berusia di bawah 10 tahun dengan median z-score di rentang berat badan kurang berdasarkan indikator BB/U, yakni -2,77. Analisis bivariat antara BB/U, IMT/U, dan TB/U dengan stadium penyakit ginjal kronik, jenis kelamin, faktor etiologi primer, hipertensi, anemia, usia, status ekonomi keluarga, durasi penyakit, dan tingkat pendidikan orangtua tidak menunjukkan hubungan yang signifikan (p > 0,05). Analisis bivariat antara BB/U dan IMT/U dengan gangguan mineral tulang juga tidak berhubungan secara signifikan (p > 0,05). Namun, analisis bivariat TB/U dengan gangguan mineral tulang (p=0,005) memiliki hubungan signifikan. Kesimpulan: Rerata status gizi anak PGK stadium 3—5 fase pradialisis memiliki berat badan kurang, perawakn pendek, tetapi bergizi baik. Tidak ada hubungan signifikan antara status gizi dengan stadium penyakit ginjal kronik, usia, durasi penyakit, faktor etiologi primer, jenis kelamin, hipertensi, anemia, tingkat pendidikan orang tua, dan status ekonomi keluarga. Namun, gangguan mineral tulang berhubungan secara signifikan dengan perawakan anak.
Kata kunci: Penyakit Ginjal Kronik, Anak, Status Gizi, Pradialisis, Faktor yang Berhubungan



Introduction: The prevalence of pediatric chronic kidney disease is increasing annually. This is crucial because pediatric chronic kidney disease can lead to malnutrition. However, there are limited research, especially in Indonesia, that has studied the association between nutritional status in predialysis pediatric chronic kidney disease with related factors. Therefore, this study aims to identify the nutritional status ofchildren with chronic kidney disease and its related factors. Method: This was a cross-sectional study held at Pediatric Nephrology Clinic Cipto Mangunkusumo Hospital, Jakarta. Primary data in the form of weight measured with a digital scale and height with a stadiometer measured with SECA 703. Secondary data in the form of sociodemographic and laboratory history were obtained from medical records. Indicators of nutritional status using BMI-for-age and weight-for-height, stature with height-for-age, and body weight using weight-for-age. The weight and height data were processed into a z-score using the WHO Anthro and Anthroplus applications. Data were analyzed using ANOVA method, independent sample t-test, spearman, and mannwhitney with SPSS Version 25 software. Result: There were 18 subjects in this study, aged 3-17 years old. There were 3 subjects under 5 years old, all of which had good nutritional status based on weight-for-height with a mean z-score of-0.21. Nutritional status based on BMI-for-age showed the subjects had good nutrition with a mean z-score of -1.02. Stature based on height-for-age showed a mean z-score of -2,71, classified as stunted. There were 8 subjects under the age of 10 years old with a median z-score -2,77, classified as underweight based on the weight-forage. Bivariate analysis between weight-for-age, height-for-age, and BMI-for-age with chronic kidney disease stage, gender, primary etiological factor, hypertension, anemia, age, family economic status, duration of illness, and parental education level did not show a significant association (p > 0.05). Bivariate analysis between weight-for-age and BMIfor-age with bone mineral disorders was also not significantly related (p > 0.05). However, bivariate analysis of height-for-age with bone mineral disorders (p=0.005) had a significant association. Conclusion: The average nutritional status of children with CKD stage 3-5 in the predialysis phase were underweight, stunted, but well nourished. There was no significant relationship between nutritional status and stage of chronic kidney disease, age, duration of disease, primary etiologic factors, gender, hypertension, anemia, parental education level, and family economic status. However, bone mineral disturbances were significantly associated with the child's stature.
Keywords: Chronic kidney disease, children, nutritional status, predialysis, related factors