Page 330 - Abstract Book KONIKA 18

Nephrology

P-NEP-023
Pediatric Nephrotic Syndrome Relapse during COVID-19 Pandemic
in Ulin General Hospital Banjarmasin: A Preliminary Study

Eileen E. Mardiharto, Galih Rahman, Selli Muljanto
Department of Child Health, Faculty of Medicine Universitas Lambung Mangkurat/Ulin General Hospital,
Banjarmasin, South Borneo, Indonesia

Abstract
Background Nephrotic syndrome (NS) is the most common glomerular disease in childhood. Relapse
criteria is proteinuria in consecutive 3 days within 1 week. NS patients are at risk of infections that may
induce relapse. Relapses detected earlier can frequently be managed in an outpatient setting. The pandemic
of coronavirus disease (COVID-19) represents a multi-faceted challenge for health systems across the globe.
The lockdown to contain COVID-19 were implemented resulting in lack of access to health facility and health
care providers which might have affected the disease management. Objective To observe the total of pediatric
nephrotic syndrome and relapse cases in Ulin General Hospital Banjarmasin during COVID-19 pandemic.
Methods The study was conducted at Ulin General Hospital. Subject’s data were obtained retrospectively
from medical records in 2019 until 2020 and data were analyzed. Results We found 112 patients’ nephrotic
syndrome in 2019 with 78 boys and 34 girls. 81 patient’s nephrotic syndrome in 2020, 63 were boys and
18 girls. Our study found relapse cases were 11 in 2019 and 15 in 2020. There were decreased NS cases
followed by increased relapse cases in our study. Data were analyzed using Spearman’s correlation test
with correlation value -0,092. Conclusion There is a weak correlation between decreased of total cases NS
with increased of relapse cases in our study. Further studies needed to determine the effect of COVID-19
pandemic with increasing relapse cases in children with NS.
Keyword: relapse nephrotic syndrome; nephrotic syndrome; COVID-19 pandemic

P-NEP-024
Peritoneal Dialysis is Possible in Bardet-Biedl Syndrome Neonates
with Colostomy

Hardya G. Hikmahrachim , Irene R. Putri , Marcelina P. Kristiono , Anastasia Michelle ,
1,2
1,2
1,2
1,2
Rinawati Rohsiswatmo , Cut N. Hafifah , Gerhard R. Situmorang , Henny A. Puspitasari 1,2
1,2
3
1,2
Neonatal Intensive Care Unit, Pondok Indah Hospital , and Department of Child Health , Department of Urology ,
2
3
1
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Abstract
Background Bardet Biedl Syndrome (BBS) is associated with kidney anomaly and anorectal malformation.
Perinatal events complicating these features pose risk of acute kidney injury (AKI) requiring kidney
replacement therapy (KRT). While considered safe, peritoneal dialysis use sometimes complicated by the
presence of abdominal stoma created to manage anorectal malformation. Objective To demonstrate peritoneal
dialysis in neonate with colostomy. Case A term baby girl was delivered via c-section with multiple congenital
anomalies detected antenatally from increased nuchal translucency at 10 weeks gestational age. Abnormal
features include polydactyly, anal atresia with recto-vestibular fistula, bilateral kidney hypoplasia, and
atrioventricular septal defect. At day 7, she underwent colostomy surgery. Subsequently, she developed severe
respiratory distress and sepsis requiring invasive mechanical ventilation. Laboratory examination indicated
AKI with persistent hyperkalemia and recurrent metabolic acidosis in the presence of normal urine output.
Following conservative management, serum urea level continued to increase, hence peritoneal dialysis was
initiated. Tenckhoff catheter was inserted at day 40 laparoscopically using 30 cm straight-catheter. Exit site
located in upper part of right abdomen, opposite to colostomy. Post-surgical bleeding occurred later requiring
red blood cell transfusion. Manual peritoneal dialysis was started at day 10 post-insertion with 10 mL/kg
1.5% dextrose dialysate per cycle. Inflow problem during initiation was managed by heparinized-dialysate
fluid via syringe pump. No peritonitis sign was found. Patient was discharged following genetic counselling
for BBS type 2, diagnosed using whole exome sequencing. Conclusion Tenckhoff catheter insertion for
peritoneal dialysis access is possible in BBS neonates after colostomy surgery.
Keywords: Bardet-Biedl syndrome; neonatal acute kidney injury; peritoneal dialysis; colostomy

282 KONIKA XVIII Abstract Book