Page 335 - Abstract Book KONIKA 18

Nephrology

P-NEP-033
Clinical Presentation and Outcomes of Rapidly Progressive Glomerulonephritis
in Pediatric Patients

Ireska Tsaniya Afifa, Henny A. Puspitasari
Department of Child Health, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Background Rapidly progressive glomerulonephritis (RPGN) is a clinical syndrome characterized by acute
glomerulonephritis and progressive loss of kidney function over a short period of time. Histologically, it is
characterized by glomeruli crescent formation on kidney biopsy. Despite the rare incidence, renal outcome
of RPGN is usually poor. Early diagnosis and aggressive treatment play a critical role in saving renal
function and preventing permanent glomerular damage. Objective To investigate the clinical presentation,
etiologies, and outcomes of RPGN in pediatric patients at Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Methods A retrospective study conducted in pediatric patients who were diagnosed with clinical RPGN
between 2018 and 2021. Results Total of 7 patients with clinical criteria of RPGN were included in this
study. Majority of them were male, with age ranging from 9 to 17-year-old. Upon presentation, all patients
had hematuria, but only 85% presented with edema and hypertension. All subjects underwent kidney
biopsy. Crescent formations were visible in 57% patients. The most common etiology was post infectious
glomerulonephritis (42%). During three months follow up, hemodialysis was discontinued for two subjects
(28%), one subject developed chronic kidney disease (14%), three had end-stage renal disease (43%), and
one deceased due to complication of acute lung edema and COVID-19. Conclusion Only half of patients
diagnosed with clinical RPGN had crescents formation on kidney biopsy. Post-infectious glomerulonephritis
was the most common etiology. Prognosis of RPGN remains poor despite aggressive treatment given.
Keywords: rapidly progressive glomerulonephritis; chronic kidney disease

P-NEP-034
Vitamin D Profiles, Calcium and Phosphate Level
in Children with Chronic Kidney Disease at Kariadi General Hospital Semarang

Akhmad Fauziannoor, Omega Mellyana, Heru Muryawan
Department of Child Health, Faculty of Medicine Universitas Diponegoro/Dr. Kariadi General Hospital,
Semarang, Central Java, Indonesia

Abstract
Background Children with chronic kidney disease (CKD) have impaired metabolism of vitamin D, parathyroid
hormone (PTH), calcium and phosphate. This condition not only causes bone disease but also increases the
risk of delayed growth. Objective To describe vitamin D profiles, calcium and phosphate level in children
with chronic kidney disease at Kariadi General Hospital. Methods Cross-sectional study, subjects consisted
of children with CKD stage III, IV and V taken by consecutive sampling. We evaluated vitamin D, calcium
and phosphate level. Measurement of Vitamin D level using chemiluminescence immunoassay (CLIA)
method, while calcium and phosphate level were measured by photometer. Results There were 28 research
subjects in 6 months’ study. 75% subjects were aged more than 10 years old. Eight subjects were categorized
as CKD stage III (28.5%), 9 subjects were stage IV (32.1%) and 11 subjects were stage V (39.4%). The
average vitamin D in all subjects was 19.02 + 9.6 ng/dL, 67.9% had insufficiency. Vitamin D insufficiency
in CKD stage III were 17.03 + 8.4 ng/dL, stage IV 19.86 + 9.5 ng/dL and stage V 19.79 + 11.26 ng/dL.
Average calcium level was 2,02 + 0,31 mg/dL, 67.9% had hypocalcemia. Mean phosphate level was 4.26 +
1.79 mg/dL, 42.9% had hyperphosphatemia. The level of phosphate in CKD stage III until V were 3.8 mg/
dL, 4.22 mg/dL and 4.68 mg/dL, respectively. Conclusion All subjects of this study with CKD stage III-V
had low level of Vitamin D. Phosphate increases at lower stages of CKD.
Keywords: Vitamin D; mineral metabolism; chronic kidney disease

KONIKA XVIII Abstract Book 287