EVALUASI EFEK TERAPI INISIAL KORTIKOSTEROID DAN FAKTOR - FAKTOR YANG MEMPENGARUHI PADA ANAK DENGAN SINDROM NEFROTIK IDIOPATIK DI RS DR SARDJITO YOGYAKARTA

Abstract

Corticosteroids are the first-line treatment of idiopathic nephrotic syndrome in children. Children with nephrotic syndrome who respond to corticosteroid have 60-90 % chance of having one or more relapses. Initial treatment with a minimum period of 4 weeks is effective but its lead to many side effects. The aims of this study are to determine the effect of initial corticosteroid therapy, identify adverse events that occur in patients and to determine the affect of age, sex, use of albumin, type of corticosteroid and the use of another drug (captopril and furosemide) towards the effect of initial corticosteroid therapy in children with idiopathic nephrotic syndrome in Dr. Sardjito Hospital Yogyakarta. This study is a cross sectional analytic study with retrospective data collection based on the medical records in Dr. Sardjito Hospital Yogyakarta. Evaluation of the effectiveness of initial corticosteroid therapy was done by comparing the concentration of protein in urine and edema before and after therapy. Identify the side effects made descriptively. The evaluation was also conducted on the factors that might impact on the effectiveness of therapies such as age, albumin infusion, gender, type of corticosteroid used and the use of another drug (captopril and furosemide). The number of the subjects of this research were 56 patients. Concentration of protein in urine and edema conditions before and after treatment was significantly different (p <0.05). Initial corticosteroid therapy in children with idiopathic nephrotic syndrome in Dr Sardjito Hospital Yogyakarta can reduce levels of protein in the urine and improve the condition of edema. Based on bivariate analysis age, sex, use of albumin, types of corticosteroids and use of other drug (furosemide) did not affect the therapeutic effects of initial corticosteroid therapy (p> 0.05). Thirty eight children or about 68% of patients experience side effects due to the use of corticosteroids. Side effects due to corticosteroid therapy were moonface, gastritis, hirsuitism, delayed puberty, acne, hypertension, and stomatitis. The most frequent side effects was Moonface (27%)