Tesis

Kesesuaian asupan nutrisi anak dengan penyakit ginjal kronik terhadap konsensus Pediatric Renal Nutrition Taskforce oleh International Pediatric Nephrologist Association = Nutritional intake of Indonesian children with chronic kidney disease compared to the Pediatric Renal Nutrition Taskforce Guidelines by the International Pediatric Nephrologist Association.

Latar belakang. Belum ditemukan adanya data yang menggambarkan kesesuaian asupan nutrisi pada anak dengan penyakit ginjal kronik (PGK) di Indonesia. Standar pelayanan kesehatan, kebiasaan makan dan sumber makanan, ketersediaan dan akses formula medis khusus, dan ketersediaan layanan gizi khusus penyakit ginjal pada anak di Indonesia berbeda dengan negara maju. Perbedaan ini bisa menjadi faktor yang kurang baik untuk pertumbuhan anak dengan PGK di Indonesia. Tujuan. Menilai kesesuaian asupan nutrisi baik makronutrien dan mikronutrien pada anak dengan PGK stadium 3–5 mengacu pada konsensus yang telah dibuat oleh Pediatric Renal Nutrition Taskforce. Metode. Penelitian ini merupakan studi observasional analitik dengan desain potong lintang yang bertujuan untuk melihat kesesuaian asupan nutrisi anak dengan penyakit ginjal kronik terhadap panduan Pediatric Renal Nutrition Taskforce di RSUPN Cipto Mangunkusumo (RSCM). Subyek yang diambil data 3-day food records dan data antropometri adalah pasien anak PGK usia 5–18 tahun yang belum menjalani transplantasi ginjal. Variabel yang dinilai secara bivariat dalam memengaruhi kecukupan asupan kalori, makronutrien, dan mikronutrien adalah jenis kelamin, stadium, metode terapi, dan status nutrisi. Hasil. Terdapat 85 subyek yang memenuhi kriteria inklusi dan berhasil melengkapi analisis diet. Total asupan kalori harian anak PGK stadium 3–5 hanya mencapai 88% dari yang sudah direkomendasikan. Asupan protein harian anak PGK stadium 3–5 melebih rekomendasi dengan rerata 187,21%. Terdapat tren meningkatnya asupan kalsium dan vitamin D3 sebanding dengan derajat penyakit pada anak PGK stadium 3–5 akibat dari suplementasi rutin kalsium dan vitamin D3 pada stadium 5. Simpulan. Asupan kalori pasien anak PGK stadium 3–5 masih dibawah rekomendasi PRNT. Diperlukan penurunan asupan protein harian pada anak PGK stadium 3–5 dan pemberian suplementasi kalsium dan vitamin D3 dimulai sejak stadium 3.
Kata kunci: anak, penyakit ginjal kronik, asupan, malnutrisi


Background. There is no data yet found that describes the nutrient intake in children with chronic kidney disease (CKD) in Indonesia. Health care standards, eating habits and food sources, availability and access to special medical formulas, and the availability of nutrition services specifically for kidney disease in children in Indonesia differ from developed countries. These differences could be a disadvantageous factor for the growth of children with CKD in Indonesia. Objectives. Assessing the nutrient intake, both macronutrients and micronutrients, in children with CKD stages 3–5 refers to the consensus established by the Pediatric Renal Nutrition Taskforce. Method. This study is an analytical observational study with a cross-sectional design aimed at assessing the nutrient intake in children with chronic kidney disease against the Pediatric Renal Nutrition Taskforce guidelines at the Cipto Mangunkusumo National General Hospital (RSCM). Subjects whose 3-day food records and anthropometric data were collected were pediatric CKD patients aged 5–18 years who had not undergone kidney transplantation. The variables assessed bivariately for their influence on the adequacy of calorie, macronutrient, and micronutrient intake were gender, stage, therapy method, and nutritional status. Results. There were 85 subjects who met the inclusion criteria and successfully completed the dietary analysis. The total daily calorie intake of children with CKD stages 3–5 only reached 88% of the recommended amount. The daily protein intake of children with CKD stages 3–5 exceeded the recommendation, averaging 187,21%. There was a trend of increased calcium and vitamin D3 intake corresponding to the severity of the disease in children with CKD stages 3–5, due to routine calcium and vitamin D3 supplementation at stage 5. Conclusion. The calorie intake of pediatric CKD patients in stages 3–5 is still below the PRNT recommendations. A reduction in daily protein intake is needed for children with CKD stages 3–5, and calcium and vitamin D3 supplementation should be initiated starting from stage 3.
Keywords: pediatric, chronic kidney disease, nutritional intake, malnutrition