Tesis

Profil dan Faktor Risiko Kelainan Kulit Noninfeksi pada Resipien Transplantasi Ginjal di RSUPN Dr. Cipto Mangunkusumo = The Profile and Risk Factors of Noninfective Skin Manifestation among Kidney Transplant Recipient in Cipto Mangunkusumo General Hospital.

Latar belakang: Transplantasi ginjal merupakan transplantasi organ yang paling sering dilakukan di Indonesia. Resipien transplantasi ginjal (RTG) memerlukan konsumsi obat imunosupresi seumur hidup guna menjaga viabilitas ginjal allograf, sehingga RTG merupakan kelompok individu imunosupresi. Kondisi tersebut menyebabkan kelainan kulit noninfeksi, misalnya kelainan kulit imbas obat, tumor jinak, tumor ganas, kelainan inflamasi, dan kelainan pigmentasi, yang dapat mengganggu secara fungsional maupun estetika. Berbagai faktor risiko memengaruhi kelainan tersebut. Penelitian ini bertujuan untuk menganalisis hubungan antara usia, jenis kelamin, regimen terapi imunosupresi, durasi konsumsi obat imunosupresi pascatransplantasi, jenis kulit Fitzpatrick, kecocokan HLA, dan pajanan matahari terhadap kelainan kulit noninfeksi pada RTG. Metode: Penelitian ini merupakan penelitian potong lintang pada RTG dewasa. Dilakukan pencatatan faktor risiko, pemeriksaan dermatovenereologikus, dokumentasi klinis, dan pemeriksaan penunjang lainnya untuk menegakkan diagnosis. Profil kelainan kulit noninfeksi disajikan sesuai proporsi. Dilakuan analisis bivariat untuk menilai perbedaan proporsi tiap faktor risiko dengan kelainan kulit noninfeksi, dilanjutkan dengan uji regresi logistik. Hasil: Sejumlah 103 RTG di RSUPN dr. Cipto Mangunkusumo menjadi subjek penelitian (SP). Pada 98% SP ditemukan kelainan kulit noninfeksi, termasuk imbas obat (94,20%), tumor jinak (51,50%), kelainan inflamasi (34,0%), kelainan pigmentasi (35,90%), serta kelainan kulit, rambut, dan kuku lainnya (13,60%). Tidak ditemukan tumor ganas kulit. Tidak terdapat hubungan antara usia, jenis kelamin, regimen terapi imunosupresi, durasi konsumsi obat imunosupresi pascatransplantasi, jenis kulit Fitzpatrick, kecocokan HLA, dan pajanan matahari terhadap kelainan kulit noninfeksi pada RTG. Kesimpulan: Hampir seluruh RTG mengalami kelainan kulit noninfeksi. Kelainan kulit noninfeksi yang paling banyak ditemukan adalah kelainan imbas obat. Tidak terdapat hubungan antara usia, jenis kelamin, regimen terapi imunosupresi, durasi konsumsi obat imunosupresi pascatransplantasi, jenis kulit Fitzpatrick, kecocokan HLA, dan pajanan matahari terhadap kelainan kulit noninfeksi pada RTG.
Kata kunci: Dermatologi, imunosupresi, kelainan kulit, resipien transplantasi ginjal, potong lintang


Background: Kidney transplantation is the most frequently performed organ transplantation in Indonesia. Kidney transplant recipients (KTR) require lifelong consumption of immunosuppressive drugs to maintain the viability of the allograft kidney, thus are considered as Immunocompromised. This condition exerts effects on some noninfectious skin disorders, namely drug-induced skin disorders, benign tumors, malignant tumors, inflammatory disorders, and pigmentation disorders, which can be functionally and aesthetically disturbing. There are various risk factors in KTRs that play a role in the formation of this disorders. This study aims to analyze the association between age, gender, immunosuppression therapy regimen, duration of post-transplant immunosuppression drug consumption, Fitzpatrick skin type, HLA-match, and sun exposure on noninfectious skin disorders in KTRs. Methods: This is a descriptive analytical cross-sectional study. Risk factors are recorded, all subjects underwent dermatovenereological examination, clinical documentation and other supporting examinations are carried out to confirm the diagnosis. The profile of noninfectious skin disorders is presented according to proportions. Bivariate analysis was carried out to assess differences in the proportion of each risk factor, followed by multiple logistic regression test. Results: A total of 103 adult KTRs are included in our study. Noninfectious skin disorders were found in 98% of subjects, including drug-induced (94.20%), benign tumors (51.50%), inflammatory disorders (34.0%), pigmentation disorders (35.90%), and other skin, hair and nail disorders (13, 60%). No malignant skin tumors were found. There was no association between age, gender, immunosuppression therapy regimen, duration of post-transplant immunosuppression drug consumption, Fitzpatrick skin type, HLAmatch, and sun exposure with noninfectious skin disorders in KTRs Conclusion: Almost all KTRs experience noninfectious skin disorders. The most common noninfectious skin disorders among RTRs are drug-induced skin disorders. There was no association between age, gender, immunosuppression therapy regimen, duration of post-transplant immunosuppression drug consumption, Fitzpatrick skin type, HLA-match, and sun exposure with noninfectious skin disorders in KTRs
Keywords: Cutaneous disorders, immunosuppression, kidney transplant recipients, cross-sectional