Influence of Stressor on Blood Pressure in School Children

INFLUENCE OF STRESSOR ON BLOOD PRESSURE IN SCHOOL CHILDRE

Nutrisi pada Anak dengan Penyakit Ginjal Kronik

Penyakit ginjal kronik (PGK) adalah kerusakan ginjal yang ditandai dengan kelainan patologi anatomi ginjal maupun kelainan fungsi ginjal yang berlangsung selama tiga bulan atau lebih. Anak dengan PGK berisiko mengalami malnutrisi, keterlambatan pertumbuhan, dan gangguan nutrisi. Keadaan ini meningkatkan risiko morbiditas dan mortalitas. Terapi nutrisi pada anak dengan PGK bertujuan mempertahankan status nutrisi optimal; tercukupinya mikronutrien dan makronutrien; menghindari toksisitas uremik, metabolisme abnormal, dan malnutrisi; serta menurunkan risiko morbiditas kronik dan mortalitas pada usia dewasa. Parameter penilaian status nutrisi dan pertumbuhan pada anak dengan PGK meliputi asupan makanan, persentil tinggi/panjang badan terhadap umur, persentil kecepatan pertambahan tinggi/panjang badan terhadap umur, perkiraan berat badan dan persentil berat badan menurut umur, indeks massa tubuh, dan lingkar kepala. Restriksi asupan natrium disarankan pada anak PGK yang menderita prehipertensi atau hipertensi. Restriksi fosfat bermanfaat untuk mencegah dan menangani hiperparatiroidisme dan aman untuk pertumbuhan, nutrisi, dan mineralisasi tulang. Rekomendasi pemberian kalsium adalah 100%-200% kebutuhan sehari sesuai umur. Pasien PGK dengan kekurangan vitamin D disarankan diberi vitamin D dengan monitor kadar vitamin D3 serum. Chronic kidney disease (CKD) is defined as kidney damage characterized by structural, histological and/or functional kidney abnormalities at least for three months. Children with CKD have increased risk for malnutrition, growth retardation, and nutritional disorder, increasing risk of morbidity and mortality. Nutritional therapy for children with CKD is to maintain optimal nutritional status, to achieve adequate micro- and macronutrient intake, to avoid uremic toxicity, abnormal metabolism and malnutrition and also to lower chronic morbidity and mortality risk in adult age. The parameter of nutritional status and growth evaluation in children with CKD are dietary intake, percentile of body height/length for age, percentile of growth for age, estimation of body weight and body weight to age percentile, body mass index, and head circumference. Sodium restriction is suggested for children with CKD with pre-hypertension or hypertension. Phosphate restriction provides the advantages in preventing and managing hyperparathyroidism and is safe for bone growth, nutrition, and mineralization. Calcium intake is recommended at 100%-200% of age-adjusted daily need. Vitamin D supplementation with vitamin D3 serum monitoring is recommended for vitamin D deficient CKD patient. Hendri Tanu Jaya, Sudun

The Effect of Water Intake during Pregnancy on Birth Weight: Pengaruh Asupan Air selama Kehamilan pada Berat Lahir Bayi

AbstractObjective: This systematic review aimed to investigate theeffect of water intake during pregnancy on infant birthweight.Methods: A comprehensive search was conducted usingthe keywords "water intake," "dehydration," "pregnancy,""outcome," "hydration," "birth weight," and "birth outcome"in databases such as "SCOPUS," "EBSCO," "PUBMED,""COCHRANE," and through "Google Search." MeSH headings"pregnancy" and "hydration" were used for the search.Inclusion criteria encompassed pregnant women withoutpathological disorders, birth weight as a studied outcome,prospective cohorts, clinical trial study designs, and Englishlanguagepapers. Out of the 254 articles retrieved, six metthe specifi ed requirements and were included in this review.Results: The fi ndings from the six studies consistentlydemonstrated a positive correlation between higher waterintake, improved hydration, and increased birth weight.All studies measured water consumption or hydrationstatus between 8-37 weeks of gestation. Regardless of theduration of the studies, underhydration or low water intakewas consistently associated with lower birth weight.Conclusion: This review highlights that increasing waterintake among pregnant women positively affects infantbirth weight. Adequate water intake during pregnancy isrecommended to be in the range of 2180 – 3000 mL daily,considering hydration status and the stage of pregnancy.Keywords: birth weight, hydration, pregnancy, water intake.AbstrakTujuan: Untuk mengungkap pengaruh asupan air selamakehamilan terhadap berat lahir bayi.Metode: Menggunakan kata kunci “water intake,""dehydration," "pregnancy," "outcome," "hydration," "birthweight," dan "birth outcome,", artikel dicari. Data diambil daridatabase "SCOPUS," "EBSCO," "PUBMED," "COCHRANE,"dan "Google Search". Kami menggunakan MeSH headingskehamilan dan hidrasi untuk istilah pencarian. Kriteria inklusiadalah perempuan hamil tanpa kelainan patologis, beratbadan lahir adalah salah satu luaran penelitian, desain studiberupa kohort prospektif dan uji klinis, serta artikel dalambahasa Inggris. Dari 254 artikel yang diperoleh, enam artikelmemenuhi persyaratan dan digunakan untuk review ini.Hasil: Dari keenam penelitian menunjukkan bahwa semakintinggi asupan air, semakin baik hidrasi atau asupan airmeningkatkan berat bayi lahir. Semua penelitian mengukurkonsumsi air atau status hidrasi antara 8-37 minggu. Studistudiini secara konsisten memberikan bukti bahwa asupanair yang rendah atau kondisi kekurangan cairan dikaitkandengan berat badan lahir rendah, terlepas dari durasi studi.Kesimpulan: Kajian ini menunjukkan bahwa peningkatanasupan air ibu hamil berpengaruh positif terhadap beratlahir bayi. Asupan air yang cukup pada ibu hamil adalah2180 – 3000 mL setiap hari bergantung pada status hidrasidan usia kehamilan.Kata kunci: asupan air, berat lahir, hidrasi, kehamilan