DOI: https://doi.org/10.14710/jai.v0i0.49464

Injuri Ginjal Akut Akibat Sepsis pada Pasien di ICU

Departemen Anestesiologi and Terapi Intensif, Fakultas Kedokteran, Universitas Padjadjaran, Bandung, Indonesia

Received: 9 Oct 2022; Published: 31 Mar 2023.

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Abstract

Acute kidney injury (AKI) merupakan suatu sindroma klinis akibat penurunan fungsi ginjal. AKI merupakan salah satu komplikasi yang paling sering terjadi pada pasien kritis. 50% pasien di intensive care unit (ICU) bisa mengalami terjadinya AKI dan 13,5% memerlukan terapi pengganti ginjal.

Pasien AKI mempunyai risiko kematian meningkat tiga kali lipat, risiko terjadinya chronic kidney dieseses tujuh kali lipat, dan risiko terjadinya end state renal diseases 22 kali lipat.

Kriteria diagnosis dari risk injury failure lost and end-stage kidney disease (RIFLE), acute kidney injury network (AKIN), dan kidney disease improving global (KDIGO) digunakan untuk mendiagnosis AKI di ICU. Ketiga kriteria ini menggunakan parameter serum kreatinin, dan urine output. Selain itu untuk mendiagnosis AKI di ICU juga digunakan beberapa pencitraan seperti ultrasonografi.

Pengelolaan AKI di ICU meliputi terapi nondialisis dan terapi pengganti ginjal. Terapi non dialisis adalah diuretik, mempertahankan keseimbangan cairan, asam basa, elektrolit dan nutrisi. Terapi pengganti ginjal meliputi beberapa modalitas seperti chronic renal replacement therapy, intermitten hemo dialysis, slow low extended dialysis, and peritoneal dialysis. Pada pasien di ICU, continous renal replacement therapy merupakan modalitas utama.

Pada pasien kritis di ICU dengan AKI mempunyai prognosis yang buruk sehingga merupakan masalah besar. Pemahaman yang lebih baik dalam diagnosis dan pengelolaan secara dini dan tepat merupakan pendekatan utama untuk memperbaiki luaran pasien.

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Keywords: AKI; diagnosis; intensive care unit; prognosis; sepsis

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Section: Literature Reviews
Language : ID
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  1. Hoste EAJ, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI- EPI study. Intensive Care Med. 2015; 41(7): 15p
  2. Melyda. Diagnosis dan Tatalaksana Acute Kidney Injury (AKI) pada Syok Sepsis.CKD259. 2017; 44(17): 907-11
  3. Markum HMS. Gagal Ginjal Akut. Dalam: Buku Ajar Ilmu Penyakit Dalam. Jakarta: Pusat Penerbitan Ilmu Penyakit Dalam FK UI. 2015; 585-9
  4. Bilgili B, Haliloglu M, Cinel I. Sepsis and Acute Kidney Injury. Turk J Anaesth Reanim. 2014; 42: 294-301
  5. Doi K. Role of kidney injury in sepsis. Journal of Intensive Care. 2016; 4:17. 10
  6. Poukkanen M. Acute Kidney Injury in Severe Sepsis and Sepsis Shock. Department of Anaesthesiology and Intensive Care Medicine Helsinki University Central Hospital. 2015: 108 p
  7. Rajapakse S, Rodrigo C, Wijewickrema E. Management of Sepsis-Induced Acute Kidney Injury.SLJCC. 2009; 1(1): 3-14
  8. Zarbock A, Gomez H, Kellum JA. Sepsis-induced acute kidney injury revisited: pathophysiology, prevention and future therapies. Curr Opin Crit Care. 2014; 20(6): 58895
  9. Mohsenin V. Practical approach to detection and management of acute kidney injury in critically ill patient. Journal of Intensive Care. 2017; 5: 57
  10. Rajapakse S, Rodrigo C, Wijewickrema E. Management of Sepsis-Induced Acute Kidney Injury.SLJCC. 2009; 1(1): 3-14
  11. Zarbock A, Gomez H, Kellum JA. Sepsis-induced acute kidney injury revisited: pathophysiology, prevention and future therapies. Curr Opin Crit Care. 2014; 20(6): 58895
  12. Gomez H, Ince C, Backer B, Pickkers P, Payen D, Hotchkiss, Kellum JA. A Unified theory of sepsis-induced acute kidney injury: inflammation, microcirculatory dysfunction, bioenergetics, and the tubular cell adaptation to injury. Shock. 2014; 41(1) : 3-11
  13. Singer, Mervyn et al. 2016.The Third International Consensus Definitionsfor Sepsis and Septic Shock (Sepsis-3). J Am Med Assoc 315(8):801-10
  14. Godin M, Murray P, Mehta R.L. Clinical Approach to the Patient with AKI and Sepsis. SeminNephrol. 2015; 35(1): 12-22
  15. Ostermann M, Joannidis M. Acute kidney injury 2016: diagnosis and diagnostic workup. Critical Care. 2016; 20(299): 1-13
  16. Kidney Disease Improving Global Outcomes. KDIGO Clinical Practice Guideline for Acute Kidney Injury. KDIGO.2012: 132 p
  17. Harty J. Prevention and Management of Acute Kidney Injury. Ulster Med J. 2014; 83(3): 149-157
  18. McCullough PA, Shaw AD, Haase M, et al. Diagnosis of acute kidney injury using functional and injury biomarkers: workgroup statements from the tenth acute dialysis quality initiative consensus conference. Contrib Nephrol 2013;182:13-29
  19. Marik P.E, Taeb A.M. SIRS, qSOFA and new sepsis definition. J Thorac Dis. 2017; 9(4): 943-5
  20. Bellomo R, Ronco C, Mehta RL, Asfar P, Boisramé-Helms J, Darmon M, et al. Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference. Ann Intensive Care. 2017;7:49

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