Tesis

Faktor Risiko Kejadian Gangguan Ginjal Akut Pada Pasien COVID-19 di RSUPN Dr. Cipto Mangunkusumo = Risk Factors for Acute Kidney Injury in COVID-19 Patients at Dr. Cipto Mangunkusumo National Central General Hospital.

Latar Belakang: Coronavirus Disease 2019 (COVID-19) tidak hanya menyerang sistem pernapasan, tetapi juga dapat menyebabkan komplikasi sistemik, termasuk gangguan ginjal akut (Acute Kidney Injury/AKI). Kejadian AKI pada pasien COVID-19 dikaitkan dengan peningkatan mortalitas dan morbiditas. Data global menunjukkan bahwa AKI terjadi pada sekitar 4,3–50,6% pasien COVID-19 yang dirawat inap, terutama pada kelompok usia lanjut dan pasien dengan komorbid. Gangguan fungsi ginjal akut ini dapat memperburuk perjalanan penyakit dan meningkatkan beban pelayanan di rumah sakit. Tujuan: Mengetahui proporsi kejadian AKI serta menganalisis faktor-faktor risiko yang berhubungan dengan kejadian AKI pada pasien COVID-19 di RSUPN Dr. Cipto Mangunkusumo. Metode: Penelitian ini merupakan studi observasional analitik dengan desain potong lintang menggunakan data rekam medis pasien dewasa COVID-19 yang dirawat di RSUPN Dr. Cipto Mangunkusumo periode April 2020 hingga Maret 2022. Sampel dipilih dengan metode consecutive sampling. Luaran yang dinilai adalah kejadian gangguan ginjal akut dan hubungannya dengan usia, jenis kelamin, hipertensi, diabetes, penyakit kardiovaskular, obesitas, derajat COVID-19, kadar procalcitonin, kadar CRP, kadar D-dimer. Data dianalisis secara univariat, bivariat, dan multivariat menggunakan regresi logistik. Hasil: Dari 422 subjek yang dianalisis, sebanyak 113 pasien (26,8%) mengalami AKI. Analisis multivariat menunjukkan bahwa usia ≥ 60 tahun (PR = 2,18;IK 95% 1,26-3,77; p=0,005), hipertensi (PR=1,88; IK 95% 1,06-3,37; p=0,03), peningkatan kadar procalcitonin (PR 4,48; IK 95% 2,56-7,84; p < 0,001), penyakit kardiovaskular (PR 4,84; IK 95% 2,57-9,11; p < 0,001), dan obesitas (PR 2,52; IK 95% 1,46-4,33; p=0,001) merupakan faktor yang berhubungan signifikan dengan kejadian AKI. Kesimpulan: Kejadian AKI pada pasien COVID-19 di RSUPN Dr. Cipto Mangunkusumo cukup tinggi. Beberapa faktor risiko seperti usia lanjut, procalcitonin tinggi, hipertensi, penyakit kardiovaskular, dan obesitas berperan penting dalam kejadian AKI.
Kata Kunci: COVID-19, gangguan ginjal akut, faktor risiko


Background: Coronavirus Disease 2019 (COVID-19) affects not only the respiratory system but can also cause systemic complications, including acute kidney injury (AKI). The occurrence of AKI in COVID-19 patients is associated with increased mortality and morbidity. Global data indicate that AKI occurs in approximately 4,3–50,6% of hospitalized COVID-19 patients, particularly among the elderly and those with comorbidities. This acute impairment of kidney function may worsen the course of the disease and increase the burden on hospital services. Objective: To determine the proportion of AKI and analyze the risk factors associated with the occurrence of AKI in COVID-19 patients at Dr. Cipto Mangunkusumo National General Hospital. Methods: This was an analytical observational study with a cross-sectional design using medical records of adult COVID-19 patients admitted to Dr. Cipto Mangunkusumo National General Hospital from April 2020 to March 2022. Samples were selected using a consecutive sampling method. The main outcome assessed was the occurrence of acute kidney injury and its association with age, sex, hypertension, diabetes, cardiovascular disease, obesity, severity of COVID-19, procalcitonin levels, CRP levels, and D-dimer levels. Data were analyzed using univariate, bivariate, and multivariate logistic regression analyses. Results: Out of 422 subjects analyzed, 113 patients (26.8%) developed acute kidney injury (AKI). Multivariate analysis showed that age ≥ 60 years (PR = 2.18; 95% CI: 1.26–3.77; p = 0.005), hypertension (PR = 1.88; 95% CI: 1.06–3.37; p = 0.03), elevated procalcitonin levels (PR = 4.48; 95% CI: 2.56–7.84; p < 0.001), cardiovascular disease (PR = 4.84; 95% CI: 2.57–9.11; p < 0.001), and obesity (PR = 2.52; 95% CI: 1.46–4.33; p = 0.001) were significantly associated with the occurrence of AKI. Conclusion: The incidence of AKI among COVID-19 patients at Dr. Cipto Mangunkusumo National General Hospital was relatively high. Several risk factors, including older age, elevated procalcitonin levels, cardiovascular disease, and obesity, play a significant role in the development of AKI.
Keywords: COVID-19, acute kidney injury, risk factors