Page 320 - Abstract Book KONIKA 18

Nephrology

P-NEP-003
The Correlation between Hypoalbuminemia and Hypercholesterolemia
in Children with Nephrotic Syndrome and Steroid Resistant Nephrotic Syndrome
in Prof. DR. R.D. Kandou Hospital Manado

Nicholas H. Prawoto, Adrian Umboh, Valentine Umboh
Department of Child Health, Faculty of Medicine Universitas Sam Ratulangi/Prof. Dr. R.D.Kandou Hospital,
Manado, North Sulawesi, Indonesia
Abstract
Background Nephrotic syndrome is glomerulus diseases which is most common in children, characterized
by proteinuria, hypoalbuminemia, edema and hypercholesterolemia. Objective To identify the relationship
between serum cholesterol and serum albumin in childhood nephrotic syndrome and steroid resistant
nephrotic syndrome. Methods This retrospective cross sectional comparative study was performed from
medical record data from all children with the age <18 years diagnosed with nephrotic syndrome and steroid
resistant nephrotic syndrome in Prof. DR. R.D. Kandou Hospital Manado,from January 2019 to December
2020. The relationship between serum cholesterol and serum albumin was measured by Pearson’s correlation.
Results From total 53 samples, 33 patients diagnosed with nephrotic syndrome and 20 patients with steroid
resistant nephrotic syndrome The mean age was 11.7 years old, 75.8% male, 24.3 female. The mean of
albumin level was 1.76 g/dL and cholesterol level was 384.4 mg/dL. Statistical analysis showed that there
is a significant correlation between hypoalbuminemia and hypercholesterolemia in children with nephrotic
syndrome and steroid resistant nephrotic syndrome with a negative correlation and strength of the correlation
(P<0.05; r = -0.619). Conclusion Hypoalbuminemia is negatively correlated to hypercholesterolemia in
children with nephrotic syndrome and steroid resistant nephrotic syndrome. Correlation results may be related
to pathogenesis in nephrotic syndrome, and do not require specific therapy to some extent.
Keywords: nephrotic syndrome; steroid resistant nephrotic syndrome; hypoalbuminemia;
hypercholesterolemia

P-NEP-004
Diagnostic and Management Approach
of HIV-associated Membranoproliferative Glomerulonephritis in Children:
A Case Report

Andini Rizayana, Eka L. Hidayati, Cahyani G. Ambarsari, Dina Muktiarti,
Meilania Saraswati, Henny A. Puspitasari
Departement of Child Health, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Background HIV-positive individuals are at risk for both acute and chronic kidney disease (CKD). In
children living with HIV during the combination antiretroviral therapy (cART) era, approximately 22% of
children experienced proteinuria and/or increase in serum creatinine. Among patients, 50% with nephrotic
range proteinuria died or developed end stage kidney disease (ESKD). Objective To demonstrate diagnostic
and management approach of kidney disease associated with HIV infection. Case A 12-year-old girl with
HIV stage 2 came with acute nephritic syndrome. She had face and lower limb oedema, hypertension,
proteinuria and haematuria in the last 2 weeks. She was diagnosed since 3.5 years of age and received
cART regiments ever since. The cART regiments were Tenofovir, Lopinavir/ Ritonavir and Lamivudine.
Laboratory showed hypoalbuminemia, increased serum creatinine, and hypocomplementemia, with massive
proteinuria. She currently had undetectable viral load with CD4 count of 495 cell/l. Kidney ultrasound
was normal, but histopathology revealed membranoproliferative glomerulonephritis features with diffuse
mesangial and endocapillary proliferation, also negative immunofluorescent results for IgG, IgA, IgM and
C3. The patient was treated with albumin transfusion, diuretics, four antihypertensive agents and antiretroviral
therapy. Corticosteroids are postponed for 2 weeks since the use in immunocompromised conditions is still
controversial. We also monitored clinical symptom and proteinuria regularly after the patient discharged.
Conclusion Kidney disease is not uncommon in children with HIV. Regular kidney function monitoring is
warranted for early detection of HIV-associated kidney disease.
Keywords: Human immunodeficiency virus; membranoproliferative glomerulonephritis; kidney
disease

272 KONIKA XVIII Abstract Book