Korelasi Rasio Albumin Kreatinin Urin dengan Kidney Injury Molecule-1 (KIM-1) sebagai Penanda Cedera Ginjal pada Anak Sakit Kritis

Abstract

Introduction: Inflammatory changes affect the critically ill children, with kidney as one of many organs involved. As a gold standard in diagnosing acute kidney injury, creatinine level has some limitation, including inability to detect early degradation of kidney function, with many determining factors such as gender, body mass and nutritional status. Kidney Injury Molecule-1 (KIM-1) was a biomarker that is proved to be sensitive in early cases of kidney injury, but is not widely available in daily practice and has higher price. Urinary Albumin Creatinine Ratio (ACR), in some studies shows fluctuation in level due to kidney injury following systemic inflammation. This study was aimed to evaluate correlation between urinary ACR and KIM-1 as marker of kidney injury in critically ill children. Method: This was a cross sectional study involving 44 critically ill children in Haji Adam Malik Hospital during November 2021- February 2022. Urine samples were collected by trained professional and sent to laboratory for ACR and KIM-1 assessment. The correlation was then evaluated by using statistical software. Result: The median value of urinary ACR and KIM-1 were 156.66 and 1.55 respectively. The result of Spearman correlation test showed a significant correlation between urinary ACR and KIM-1 (p<0.05) with correlation coefficient R=0.417. Conclusion: There was a significant correlation between the Urinary ACR and KIM-1 in critically ill children. We suggest further study to evaluate applicability of urinary ACR in detecting early kidney injury in critically ill children.