FAKTOR RISIKO KEJADIAN NEFROPATI DIABETIKA STADIUM 3-5

Abstract

Nefropati diabetika merupakan penyebab utama kejadian gagal ginjal. Prevalensi di negara-negara Asia sangat tinggi. Sebanyak 20%-40% penderita diabetes akan berkembang menjadi nefropati diabetika, jika tidak dilakukan pencegahan dengan pengelolaan faktor risikonya. Namun penelitian tentang faktor risiko nefropati diabetika di Indonesia masih jarang dilakukan. Penelitian ini bertujuan untuk mengetahui faktor-faktor risiko tersebut. Desain penelitian  ini adalah studi kasus kontrol dengan jumlah sampel 43 kasus dan 43 kontrol. Kasus adalah penderita diabetes dengan komplikasi nefropati diabetika stadium 3-5 dan kontrol adalah  penderita diabetes dengan nilai eGFR>60ml/menit/1,73m² dengan proteinuria negatif. Pengambilan sampel menggunakan teknik consecutive sampling pada pasien diabetes yang dirawat inap. Variabel bebas meliputi riwayat keluarga menderita penyakit vaskuler, lama menderita diabetes, riwayat obesitas, kadar gula darah puasa, kadar kolesterol total, status hipertensi, kebiasaan merokok, status hiperurisemia, kualitas tidur, pola konsumsi obat dan aktifitas fisik. Data diolah secara univariat, bivariat dan multivariat menggunakan regresi logistik berganda. Hasil analisis regresi logistik berganda menunjukkan bahwa yang terbukti merupakan faktor risiko kejadian nefropati diabetika stadium 3-5 adalah hiperurisemia (OR 9,36; 95%CI: 3,035-28,863) dan hipertensi (OR 3,75; 95%CI:1,090-12,934. Hipertensi dan hiperurisemia merupakan faktor yang dapat diperbaiki, sehingga penderita diabetes disarankan untuk  mengendalikan tekanan darah dan kadar asam uratnya sedini mungkin utnuk mencegah komplikasi nefropati diabetika.

Kata kunci: Nefropati diabetika, Faktor risiko

THE RISK FACTORS OF DIABETIC NEPHROPATHY IN STAGE 3-5

ABSTRACT

Diabetic nephropathy is a major cause of kidney failure. The prevalence in Asian countries is very high. As many as 20% -40% of diabetics will develop into diabetic nephropathy, if not prevented by managing risk factors. However, research on the risk factors for diabetic nephropathy in Indonesia is still rare. This study aimed to determined the risk factors for diabetic nephropathy. The study design was a case control study with a total sample of 43 cases and 43 controls. The cases were diabetics with stage 3-5 of diabetic nephropathy and the controls were diabetics with eGFR> 60ml / minute / 1.73m2 with negative proteinuria. Sampling used consecutive sampling technique in hospitalized diabetic patients. Independent variables were family history of vascular disease, duration of diabetes, history of obesity, fasting blood sugar levels, total cholesterol levels, hypertension status, smoking habits, hyperuricemia status, sleep quality, medicines consumption patterns and physical activity. Data was processed in univariate, bivariate and multivariate using multiple logistic regression. The results of multiple logistic regression analysis showed that the significant risk factors for stage 3-5 of diabetic nephropathy were hyperuricemia (OR 9.36; 95% CI: 3.035-28.863) and hypertension (OR 3.75; 95% CI: 1.090-12.934). Hypertension and hyperuricemia are modifiable risk factors, so that diabetic patients are advised to control their blood pressure and uric acid levels as soon as possible to prevented the diabetic nephropathy.

Keywords: Diabetic nephropathy, risk factors.