Dampak Penyakit Ginjal terhadap Pasien COVID-19 di Rumah Sakit Sanglah Denpasar, Bali, Indonesia pada Tahun 2021

Abstract

Pendahuluan. Selain berdampak pada sistem pernapasan, COVID-19 juga berdampak pada organ lain yaitu ginjal. Respons inflamasi sistemik memiliki peranan dalam perburukan klinis pada pasien COVID-19 dengan penyakit ginjal. Penelitian ini bertujuan untuk mengetahui dampak penyakit ginjal terhadap pasien COVID-19. Metode. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross-sectional. Data yang digunakan adalah data sekunder dari rekam medis pasien terkonfirmasi COVID-19 yang dirawat di RSUP Sanglah mulai tanggal 1 Mei 2021 sampai dengan 31 Agustus 2021 dengan menggunakan teknik total sampling.Hasil. Terdapat 248 pasien yang dilibatkan dalam penelitian ini. Mayoritas pasien adalah laki-laki (52,4%) dengan rerata usia keseluruhan pasien adalah 59 (rentang 20-92) tahun. Sebagian besar pasien adalah COVID-19 dengan derajat berat (65,3%). Sebanyak 77 pasien menderita penyakit ginjal (31,0%) dan penyakit ginjal yang paling banyak ditemukan adalah acute on chronic kidney disease (n=33; 42,8%). Terdapat perbedaan bermakna pada kadar hemoglobin (p<0,001), nitrogen urea darah (BUN) (p<0,001), kreatinin serum (p<0,001), dan prokalsitonin (p<0,001) pada pasien yang diklasifikasikan berdasarkan penyakit ginjal. Analisis chi-square menunjukkan bahwa pasien COVID-19 dengan penyakit ginjal berhubungan terhadap sepsis [PR=2,587 (IK 95% 1,750-3,824); p<0,001)], mortalitas [PR=1,696 (IK 95% 1,114-2,583); p=0,018)], dan COVID-19 derajat berat [PR=1,513 (IK 95% 1,077-2,342); p=0,040)]. Analisis regresi logistik menunjukkan pasien COVID-19 dengan penyakit ginjal berhubungan secara signifikan terhadap sepsis [PR=4,318 (IK 95% 1,767-10,553); p<0,001)] dan mortalitas [PR=1,413 (IK 95%= ,664-3,005); p=0,045)]. Kesimpulan. Penyakit ginjal berhubungan secara signifikan dan meningkatkan risiko terhadap kejadian sepsis dan mortalitas pada pasien COVID-19. Kata Kunci: COVID-19, komorbiditas, penyakit ginjalKidney Disease and Its Impact on COVID-19 Patients at Sanglah Hospital Denpasar, Bali, Indonesia in 2021Introduction. Besides having an impact on the respiratory system, COVID-19 also has an impact on other organ such as the kidneys. The systemic inflammatory response thought to be associated with bad prognosis of COVID-19 patients with kidney disease. This study aimed to determine the impact of kidney disease on COVID-19 patients. Methods. This study is an observational analytic study with a cross-sectional approach. The data used is secondary data from the records of confirmed COVID-19 patients who were treated at Sanglah Hospital from 1 May 2021 to 31 August 2021 using total sampling technique.Results. There were 248 patients included in this study. The majority of patients were male (52.4%) with the median overall age of the patients was 59 (range 20–92) years. Most of the patients were severe COVID-19 (65.3%). A total of 77 patients had kidney disease (31.0%) which the most common kidney disease found in patients was acute on chronic kidney disease (n=33; 42.8%). There were significant differences in hemoglobin (p<0.001), blood urea nitrogen (BUN) (p<0,001), serum creatinine (p<0.001), and procalcitonin (p<0.001) in patients classified based on kidney disease. Chi-square analysis showed that COVID-19 patients with kidney disease was correlated with sepsis [PR=2.587 (95%CI 1.750-3.824); p<0.001)], mortality [PR=1.696 (95%CI 1.114-2.583); p=0.018)], and severe COVID-19 [PR=1.513 (95%CI 1.077-2.342); p=0.040)]. Logistic regression analysis showed that COVID-19 patients with kidney disease was correlated with sepsis [PR=4.318 (95%CI 1.767-10.553); p<0,001] and mortality [PR=1.413 (95%CI 1.664-3.005); p=0.045)].Conclusion. Kidney disease increases the risk for sepsis and mortality in COVID-19 patients.