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"ABSTRACTBackground: there is clearly growing population of young adults with potentially important coronary artery disease after Kawasaki disease (KD) during childhood, and cardiologist must be prepared to take care for them. As Kawasaki disease in adolescent and adult is rare and under-recognized, it is important to study data on patient presentations which may permit development of diagnostic criteria and treatment guidelines for this age group.This study aimed to compare the clinical profile of KD between adolescents (>10 years of age) and children ≤10 years. Methods: This is a cross sectional study. A total of 1150 KD cases (age 1-192 months) during the period of January 2003-December 2016 were analyzed. The clinical profile of subjects aged >10 years (adolescents) and ≤10 years (children) at acute phase of KD were compared. Results: we found 17 cases of KD in adolescents among 1150 total cases (1.5%). Incomplete KD was more often seen in adolescents compared to children ≤ 10 years of age (59% vs. 29%). Some clinical features were more frequently seen in children than in adolescents, e.g. conjunctivitis (85% in ≤ 10 years of age vs. 65% in > 10 years), mucosal changes (94% vs. 77%), rash (86% vs. 59%), and hand/foot changes (68% vs. 41%). While other clinical features were more often seen in adolescents, e.g., cervical lymphadenopathy (82% vs. 39%) and coronary dilatation (47% vs. 29%). Laboratory results (hemoglobin, leukocytes, erythrocyte sedimentation rate and C-reactive protein) did not differ much between the two groups. Conclusion: Kawasaki disease in adolescents has some different clinical profile from that of younger age. Majority of adolescent patients have incomplete presentation. Some clinical features such as conjunctivitis, mucosal changes, rash, and hand/foot changes are more often seen in children ≤ 10 years compared to in adolescents, while cervical lymphadenopathy and coronary dilatation are more frequently seen in adolescents. The ratio of male to female is much higher in adolescents."

"Latar belakang: Penyakit Kawasaki (PK) merupakan vaskulitis akut sistemik yang belum diketahui penyebabnya dan mempunyai predileksi pada arteri koroner terutama bayi dan anak balita. Sebanyak 20-40% kasus PK yang tidak diobati akan mengalami kelainan arteri koroner. Masalah PK di Indonesia saat ini adalah masih banyak kasus yang underdiagnosis dan terlambat didiagnosis, serta beberapa kasus overdiagnosis. Sejauh ini belum ada publikasi penelitian tentang PK di Indonesia. Tujuan: Mengetahui profil klinis dan pemeriksaan penunjang PK pada anak di Indonesia. Metode: Penelitian deskriptif potong lintang. Data diperoleh dari rekam medis pasien anak 0-18 tahun dengan diagnosis PK selama periode 1 Agustus 2011 hingga 31 Juli 2012 di 3 rumah sakit di Jakarta dan Tangerang. Hasil: Terdapat 66 subjek yang sesuai dengan diagnosis PK. Sebanyak 77% subjek berusia balita dengan usia tersering 1-2 tahun. Proporsi anak lelaki lebih tinggi dibandingkan perempuan dengan perbandingan 2:1. Seluruh subjek mengalami demam dengan gambaran klinis paling sering adalah perubahan pada bibir dan rongga mulut seperti eritema, bibir pecah-pecah, lidah stroberi, dan eritema difus mukosa orofaring (100%), ruam polimorfik (89%), dan injeksi konjungtiva tanpa eksudat (88%). Gambaran klinis paling jarang adalah limfadenopati servikal unilateral (53%). Anemia dan leukositosis sering terjadi pada fase akut, sedangkan trombositosis mulai terjadi pada minggu kedua. Peningkatan LED dan CRP terjadi pada fase akut, namun pada 15% subjek peningkatan LED tidak disertai oleh peningkatan CRP atau sebaliknya. Hipoalbuminemia terjadi pada 70% subjek. Gambaran infiltrat pada foto toraks didapatkan pada 71% subjek. Aneurisma arteri koroner pada ekokardiografi saat awal diagnosis didapatkan pada 30% subjek. Sebagian besar merupakan aneurisma kecil, 3% aneurisma sedang, dan 1% aneurisma raksasa. Simpulan: Gambaran klinis paling sering selain demam adalah perubahan pada bibir dan rongga mulut, ruam polimorfik, dan injeksi konjungtiva tanpa eksudat, sedangkan yang paling jarang adalah limfadenopati servikal unilateral. Pemeriksaan LED dan CRP sebaiknya dilakukan bersamaan untuk mendukung diagnosis. Hipoalbuminemia dan gambaran infiltrat pada foto toraks mungkin dapat dipertimbangkan sebagai alat bantu diagnosis PK pada anak di Indonesia, namun masih membutuhkan penelitian lebih lanjut untuk membuktikannya.

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Background: Kawasaki disease (KD) is an acute systemic vasculitis with unknown cause. The main predilections are the coronary arteries, especially in infants and children under five. As many as 20-40% of untreated KD will develop coronary problems. Currently, many of the KD cases in Indonesia are still under- or late diagnosed, and some cases are even overdiagnosed. However, there has not been any research publication on KD in Indonesia.

Objective: To describe the clinical and supportive examination profiles of KD in Indonesian children.

Method: A cross-sectional observational study of children under 18 years old with KD diagnosed within August 1st 2011 and July 31st 2012 was performed. Data were obtained from the medical records of patients from 3 hospitals in Jakarta and Tangerang.

Results: Of 66 subjects diagnosed of KD, 77% subjects were children aged 1-2 years old, with male and female ratio was 2:1. All subjects had fever with common clinical profiles were: changes in lips and oral cavity such as erythema, lips cracking, strawberry tongue and diffuse erythema of oropharyngeal mocosae; polymorphic rashes; and non-exudative conjunctival injection (100%, 89%, and 88%, respectively). Unilateral cervical lymphadenopathy was seen in 53% subjects. Anemia and leukocytosis were frequently seen in acute phase, while thrombocytosis developed during the second week. The ESR and CRP also increased during acute phase. However, in 15% subjects with increased ESR, the CRP remained normal, and vice versa. Hypoalbuminemia occured in 70% subjects, and infiltrate on chest xray appeared in 71% subjects. The incidence of coronary artery aneurysm at initial echocardiography was 30%, with small aneurysm were predominant, 3% considered moderate, and 1% was categorized as giant aneurysm.

Conclusion: Changes in lips and oral cavity, polymorphic rashes, and non-exudative conjunctival injection are the most common clinical profiles, besides fever. Unilateral cervical lympadenopathy is the least frequent manifestation. The ESR and CRP examinations should be done to support the diagnosis of KD. Hypoalbuminemia and infiltrate findings on chest xrays might be considered as an aid in diagnosing KD in Indonesian children. However, further study is needed for validation."

"ABSTRAKPenyakit Kawasaki PK merupakan penyakit akut febris yang menyerang anak-anak berusia 5 tahun dengan penyebab yang belum diketahui. Pengalaman merawat anak dengan PK masih terbilang langka. Tujuan penelitian ini adalah untuk menggali pengalaman Ibu yang merawat anak dengan PK pada fase akut. Penelitian ini menggunakan metode kualitatif deskriptif dengan pendekatan fenomenologi. Pemilihan partisipan menggunakan teknik convenience sampling yang melibatkan 15 partisipan melalui wawancara mendalam dengan pertanyaan semi terstruktur. Penelitian ini mengidentifikasi enam tema, yaitu kepastian dalam ketidakpastian, berpacu dengan waktu pengobatan, natur seorang ibu: berjuang demi keselamatan anak, menjalani ketetapan Tuhan, cukup sekali merasakan, dan menumbuhkan kewaspadaan akan PK. Temuan ini selanjutnya memicu semua pihak untuk mulai membangun kewaspadaan akan PK dan bersama-sama mendukung kebijakan strategis untuk memberikan penanganan dan asuhan keperawatan yang holistik tepat pada waktunya.

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ABSTRACTKawasaki Disease KD is an acute febrile disease which attack children under 5 years old with unknown cause. Caring children with KD is still a rare experience. The purpose of this study was to explore mothers rsquo experience of caring children with KD in acute phase, by using a descriptive qualitative method with a phenomenological approach. Convenience sampling was used and 15 participants were involved through semi structured in depth interview technique. The result of the study revealed six main themes certainty in uncertainty, racing against time of treatment, the nature of a mother struggling for the safety of her children, go through God rsquo s will, once is enough, and gaining KD awareness. This findings trigger all parties to gain KD awareness and support KD policies for giving the treatment and the holistic nursing care in time."

"Latar belakang: Penyakit Kawasaki (PK) adalah suatu vaskulitis akut sistemik yang terutama menyerang bayi dan anak balita dan belum diketahui etiologinya. Pada kasus PK yang tidak diobati 15-25 % akan mengalami aneurisme koroner yang dapat berakhir pada infark miokard, penyakit jantung iskemik atau kematian. Berbagai faktor diduga berperan terhadap terjadinya aneurisme koroner. Peran dan kondisi SPE (sel progenitor endotel), suatu subtipe sel punca mulai diteliti dengan tujuan kelak dapat digunakan untuk terapi kelainan koroner pada PK. Tujuan: Mengetahui frekuensi aneurisme koroner pada PK, faktor risiko terjadinya serta perjalanan klinisnya; jumlah dan kualitas SPE pada fase akut maupun lanjut PK dengan atau tanpa aneurisme koroner serta membandingkan jumlah dan kualitas SPE pada kedua fase tersebut. Metode: Subjek adalah pasien PK yang datang berobat selama periode 10½ tahun di 5 RS di Jabotabek. Terdapat 4 desain penelitian yaitu studi potong lintang untuk penelitian faktor risiko aneurisme koroner. Kohort retrospektif untuk perjalanan klinis serta potong lintang untuk masing masing SPE fase akut dan SPE fase lanjut. Subjek diperiksa darah dan ekokardiografi. Hasil: Didapat 667 subjek dengan PK. Frekuensi aneurisme koroner pada fase akut PK 33,3 %, fase konvalesen 7,9 %. Faktor risiko aneurisme koroner adalah lama demam > 7 hari sebelum terapi (p < 0,001; RO 2,02; IK 1,15 sampai 3,53) dan kadar albumin yang rendah (p 0,001; RO 0,53; IK 0,32 sampai 0,87). Mayoritas aneurisme kecil dan sedang kembali normal dengan berlalunya waktu, aneurisme raksasa tidak. Subjek tanpa aneurisme hingga 2 bulan awitan, selanjutnya tetap normal. Tidak ada pebedaan jumlah dan kualitas SPE (CD34+) pada pasien dengan dan tanpa aneurisme koroner pada fase akut dan lanjut. Jumlah SPE (CD34+) lebih tinggi pada fase akut dibanding fase lanjut (p < 0,001). Simpulan dan saran: Lama demam > 7 hari sebelum terapi dan kadar albumin yang rendah merupakan faktor risiko aneurisme koroner. Prognosis aneurisme ditentukan oleh diameternya. Jumlah SPE (CD34+) pada fase akut lebih tinggi secara bermakna dibanding fase lanjut. Pada pasien PK terapi sebaiknya dilakukan sebelum hari ke-8 demam untuk mencegah komplikasi koroner. Pada pasien tanpa aneurisme koroner hingga 2 bulan awitan, ekokardiografi selanjutnya tidak mutlak dilakukan.

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Background: Kawasaki disease (KD) is an acute systemic vasculitis with unknown etiology that mainly affects infants and young children. Coronary aneurysms develop in 15 - 25 % of untreated cases and may lead to myocardial infarction, ischemic heart disease or sudden death. There were some risk factors suspected to play a role in the development of coronary aneurysms. The role of EPC (endothelial progenitor cells) a subtype of stem cell, in KD has been studied lately with the aim that they could be manipulated to treat coronary lesions.

Objective : To investigate the frequency of coronary aneurysms in KD, risk factors for the development of coronary aneurysms and their clinical course; number and quality of EPC in patients with and without aneurysms in acute and late phase of KD, and compare the number and quality of EPC between acute and late phase of KD.

Methods: Subjects were KD patients treated during the period of 10½ years in 5 hospitals in Jabotabek area. There were 4 study designs, namely cross-sectional for coronary risk factors, retrospective cohort for the clinical course and cross sectional for EPC study in acute and late phase. Subjects had blood and echocardiography examinations.

Results: There were 667 KD patients studied. The frequency of coronary aneurysms in acute phase was 33.3 % and 7.9 % in convalescence. Risk factors for coronary aneurysms were duration of fever > 7 days (p< 0.001; OR 2.02; CI 1.15 to 3.53) and low level of albumin (p= 0.001; OR 0.53; CI 0.32 to 0.87). Majority of small and medium sized aneurysms regressed over time but giant aneurysms did not. Subjects without coronary aneurysms till 2 months of onset would remain normal later. No difference was noted in the number and quality of EPC (CD34+) between subjects with and without aneurysms in acute and late phase. The number of EPC (CD34+) in acute phase higher than that of the late phase (p< 0.001).

Conclusion and suggestion: Duration of fever over 7 days before treatment and low level of albumin were the risk factors for the development of coronary aneurysms. Outcome of aneurysms was determined by the size of the diameter. The number of EPC was significantly higher during acute phase compared to that of the late phase. Patients with KD should have been treated before day 8 of fever to prevent coronary complications. For patients without coronary aneurysms till 2 months after onset, further echocardiography is not a necessity."

"Latar belakang: Penyakit Kawasaki adalah penyebab utama penyakit jantung didapat pada anak, yang merupakan suatu vaskulitis sistemik akut. Penyakit ini berhubungan dengan luaran aneurisme arteri koroner, yang dapat dicegah dengan pemberian imunoglobulin intravena (IGIV). Terapi baku emas pada penyakit Kawasaki adalah IGIV dosis tinggi (2 g/kgBB). Namun, IGIV dosis medium (1 g/kgBB) merupakan terapi berbiaya lebih rendah dan mungkin memiliki efikasi yang sama. Melalui penelitian ini, kami mengevaluasi keberhasilan terapi IGIV dosis 1 g/kgBB.Metode: Studi kohort retrospektif multisenter dari data rekam medis dengan total 507 pasien dengan penyakit Kawasaki komplit. Penelitian dilakukan di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dan Kawasaki Center, Indonesia dari Januari 2012 hingga Januari 2022. Pasien yang mendapatkan terapi IGIV dengan dosis 1 g/kgBB didefinisikan sebagai grup A, dan pasien yang mendapatkan terapi IGIV dengan dosis 2 g/kgBB didefinisikan sebagai grup B. Karakteristik dasar subjek dibandingkan antar-kelompok tersebut; demografi, hasil laboratorium, keterlibatan mukokutan, hari demam saat diberikan IGIV, durasi demam pasca-IGIV, lama rawat, dan temuan aneurisme arteri koroner dari ekokardiografi pada periode follow-up.Hasil: Sebanyak 24 pasien (grup A), mendapatkan IGIV dosis medium (1 g/kgBB). Sementara itu, sebanyak 483 pasien (grup B) mendapatkan IGIV dosis tinggi (2 g/kgBB). Distribusi usia dan jenis kelamin, nilai leukosit dan trombosit, hari demam saat diberikan IGIV, durasi demam pasca-IGIV, dan lama rawat tidak berbeda bermakna antar-kelompok (p >0,05). Semua pasien mengalami keterlibatan mukokutan. Berat badan menurut umur (WAZ) dan nilai CRP antar-kelompok bermakna secara statistik (p <0,05). Aneurisme arteri koroner tidak ditemukan pada pasien di grup A dan pada 9 pasien (1,9%) di grup B pada periode follow-up (p >0,05).Simpulan: Terapi dengan dosis inisial IGIV 1 g/kgBB untuk pasien dengan penyakit Kawasaki menunjukkan keberhasilan yang sama dengan IGIV dosis tinggi (2 g/kgBB). Hal ini dapat menjadi opsi terapi bagi negara berkembang.

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Background: Kawasaki disease (KD), the leading cause of acquired heart disease in children, is an acute childhood systemic vasculitis. It is associated with coronary artery aneurysms (CAA), that could be prevented by intravenous immunoglobulin (IVIG) administration. High-dose IVIG (2 g/kg) is usually given in the treatment of Kawasaki disease (KD). However, medium-dose IVIG (1 g/kg) is a low-cost treatment and may have the same efficacy. We aim to determine whether the treatment with IVIG at an initial dose of 1 g/kg is effective for preventing CAA.

Methods: A multicenter retrospective cohort study was conducted. A total of 507 patients with complete KD who were treated with high-dose and medium-dose immunoglobulin at Cipto Mangunkusumo Hospital and Kawasaki Center, Indonesia from January 2012 to January 2022 were enrolled. Patients treated with a single infusion of medium-dose IVIG (1 g/kg) were defined as group A, and patients treated with high-dose IVIG (2 g/kg) were defined as group B. Patient characteristics were compared between the two groups; demographic features, laboratory findings, mucocutaneous involvement, day of fever, duration of fever after treatment, length of stay, and rates of CAA from echocardiography during the follow-up period.

Results: Medium-dose IVIG was given in 24 patients (group A). High-dose IVIG was given in 483 patients (group B). Age and gender distributions, white blood cell and platelet counts, day of fever when IVIG was administered, duration of fever after IVIG treatment, and length of stay did not differ significantly between the two groups (p >0.05). All patients had mucocutaneous involvement. Median of WAZ was higher in group A (+0,35 vs -0,26; p <0.05). Median of concentrations of C-reactive protein was higher in group B (59,5 mg/L vs 81 mg/L; p <0.05). Coronary artery aneurysms were not found in group A and in 9 patients (1.9%) in group B during the follow-up period (p >0.05).

Conclusion: Treatment of KD with IVIG at an initial dose of 1 g/kg could show the same effectiveness as the high-dose IVIG (2 g/kg) and might be an option for low- and middle-income country.

"

"ABSTRACTA cross sectional study on cardiovascular disease risk profile was carried out in North Jakarta, Indonesia. One hundred six Chinese individuals (47 men and 59 women) aged 25 years and over were recruited to collect baseline information related to dietary determinants of cardiovascular risk profile.Result showed high prevalence of overweight /obesity and hypertension, especially in men (43% and 48.8%, respectively). The prevalence of current smoker was 12.2% of men and 3.9% of women. The prevalence of hyperlipidemia was 14.6% of men and 9.6% of women. Mean values of BMI, WHR, and blood pressure were significantly higher in men than in women. Body fatness and blood pressure in women were significantly increased with age. In women, total cholesterol and LDL cholesterol were associated with BMI, while triglyceride was associated with WHR.Intake of fresh fish, crabs/lobster/shrimp, sea weed, tomato and spinach decreased with advancing age of men. No food components that significantly correlated with age of women. There were no significant relationship between food intake and other socio-demographic characteristics. In men, lamb and chocolate intake were significantly associated with BMI while rice vermicelli and sweet bread were significantly correlated with blood pressure. Total cholesterol had significant correlation with pork sausage intake of men. In women, HDL cholesterol were significantly associated with ham and beef sausage, while LDL cholesterol were associated with duck intake.These findings suggested that women had more favorable cardiovascular risk profile than men and age was likely to be an important determinant factor for women. Men were more prevalent smoking habit and poorer attitude to health status than women."

"Background: the risk of Non Alcoholic Fatty Liver Disease (NAFLD) is increasing in patients with type 2 diabetes. Prevalence and factors related to the increased risk of NAFLD in diabetic patients in Indonesia has never been studied before. Data regarding the profile of fibrosis in the population has also been unknown. This study aimed to identify the difference on the profile of diabetic patients with and without NAFLD as well as the degree of fibrosis.Methods: the study was conducted using a cross sectional method in type 2 diabetic patients who were treated at the outpatient clinic of endocrinology and metabolic division in Cipto Mangunkusumo Hospital. Sampling was done consecutively. Collected data comprised of age, duration of diabetes, body mass index (BMI), waist circumference, HDL, triglyceride, and HbA1C levels. Abdominal ultrasonography was conducted for all patients to determine the presence of NAFLD. Patients with NAFLD were subsequently underwent transient elastography in order to assess their degree of liver fibrosis. Chi-square or Fishers Exact tests were used for bivariate analysis and logistic regression was used for multivariate analysis.Results: as many as 186 patients were analyzed in the study and 84 patients (45.2%) were demonstrated to have NAFLD. Transient elastography examinations were carried out in 68 patients and 17 patients (25.0%) were found with severe fibrosis. Univariate analysis showed significant differences on BMI (PR=1.878; 95%CI= 1.296 2.721; p<0.001) and waist circumference (PR=2.368; 95%CI= 1.117 5.017; p=0.018) between patients with and without NAFLD. However, the multivariate test showed that BMI was the only factor that had a significance difference between both groups (OR=2.989; 95%CI=1.625-5.499; p<0.001).Conclusion: prevalence of NAFLD among type 2 diabetic patients in Cipto Mangunkusumo Hospital has reached 45.2% and 25.0% among them had severe fibrosis. BMI is the only factor found to be associated with the occurrence of NAFLD."

"Gangguan tidur umum ditemukan pada pasien end-stage kidney disease (ESKD) anak yang menjalani hemodialisis. Jumlah dan kualitas tidur berperan penting dalam pertumbuhan seorang anak. Penelitian ini bertujuan mengetahui persentase gangguan tidur dan hubungannya dengan usia, jenis kelamin, status gizi, etiologi, dan durasi hemodialisis pada pasien ESKD anak yang menjalani hemodialisis. Desain penelitian ini adalah cross-sectional dengan populasi pasien ESKD anak berusia 4-18 tahun yang menjalani hemodialisis di RSUPN dr. Cipto Mangunkusumo (RSCM). Penilaian gangguan tidur menggunakan kuesioner sleep disturbance scale for children (SDSC) bahasa Indonesia. Pasien yang mengonsumsi obat antikejang, antihistamin, dan antiansietas selama 3 hari sebelum pengambilan data tidak diikutsertakan dalam penelitian. Didapatkan 88,9% dari total 27 pasien ESKD anak yang menjalani hemodialisis di RSCM mengalami gangguan tidur dengan jenis terbanyak (59,3%) gangguan memulai dan mempertahankan tidur. Analisis bivariat menunjukkan tidak ada hubungan signifikan (p>0,05) antara usia, jenis kelamin, status gizi, etiologi, dan durasi hemodialisis dengan gangguan tidur. Sebagai kesimpulan, gangguan tidur banyak ditemukan pada pasien ESKD anak yang menjalani hemodialisis di RSCM. Usia, jenis kelamin, status gizi, etiologi, dan durasi hemodialisis tidak memiliki hubungan yang signifikan dengan gangguan tidur pada pasien ESKD anak yang menjalani hemodialisis di RSCM.

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Sleep disturbances are common in pediatric end-stage kidney disease (ESKD) patients undergoing hemodialysis. Sleep quantity and quality play an important role in child’s growth. This study aims to determine the percentage of sleep disturbances and their association with age, gender, nutritional status, etiology, and duration of hemodialysis in pediatric ESKD patients undergoing hemodialysis. A cross-sectional study was conducted with a population of ESKD patients aged 4-18 years undergoing hemodialysis at RSUPN dr. Cipto Mangunkusumo (RSCM). Sleep disturbances were assessed using the Indonesian language sleep disturbance scale for children (SDSC) questionnaire. Patients who took anticonvulsant, antihistamine, and anti-anxiety drugs for 3 days before data collection were not included. It was found that 88.9% of the total 27 pediatric ESKD patients undergoing hemodialysis at RSCM experienced sleep disturbances with the most frequent type was disturbances in initiating and maintaining sleep (59,3%). Bivariate analysis showed no significant relationship (p>0.05) between age, gender, nutritional status, etiology, and duration of hemodialysis and sleep disturbances. In conclusion, sleep disturbances are commonly found in pediatric ESKD patients undergoing hemodialysis at RSCM. Age, gender, nutritional status, etiology, and duration of hemodialysis had no significant association with sleep disturbances in pediatric ESKD patients undergoing hemodialysis at RSCM."

"Gangguan metabolisme mineral dan tulang pada penyakit ginjal kronik (GMT-PGK) merupakan salah satu komplikasi yang ditemukan pada pasien PGK yang menjalani hemodialisis (PGK-HD). Manifestasi GMT-PGK dapat merupakan kelainan sistemik ataupun hanya ditemukan di tulang yang disebut sebagai renal osteodystrophy(ROD). Risiko kematian akibat GMT-PGK mencapai 17,5%. Di Indonesia, pemeriksaan penanda tulang terkait GMT-PGK belum secara rutin dikerjakan karena belum tercakup dalam pembiayaan Jaminan Kesehatan Nasional (JKN). Tujuan penelitian ini menganalisis profil kalsium, fosfat, PTH, dan vitamin D 25(OH) pada pasien PGK-HD. Penelitian ini merupakan studi potong lintang yang melibatkan 124 pasien hemodialisis rutin di Unit Hemodialisis RS Cipto Mangunkusumo (RSCM) yang berlangsung pada bulan Juni sampai Oktober 2022. Penelitian ini menggunakan data sekunder dari semua pasien hemodialisis yang memiliki data jenis kelamin, usia, durasi HD, fosfat, kalsium total, vitamin D 25(OH), dan PTH. Profil parameter tulang di dominasi turnover tinggi (75,8%), normokalsemia (78%), hiperfosfatemia (57,3%), dan status defisiensi vitamin D (82,3%). Pada penelitian ini didapatkan korelasi hanya pada parameter durasi HD dan PTH. Profil kelainan tulang berdasarkan penelitian ini lebih didominansi kelainan turnover tinggi sehingga dapat menjadi dasar untuk pemberian suplementasi analog vitamin D dan atau kalsimimetik dalam pengendalian peningkatan PTH pada pasien HD. Hiperfosfatemia masih mendominasi proporsi pasien HD sehingga tatalaksana terhadap hiperfosfatemia perlu lebih ditingkatkan dan disarankan untuk pemeriksaan berkala.

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Chronic kidney disease–mineral and bone disorder (CKD-MBD) is one of the complications found in CKD patients undergoing hemodialysis (CKD-HD). Manifestations of CKD-MBD can be a systemic disorder or only found in the bone which is known as renal osteodystrophy (ROD). The risk of death from CKD-MBD reaches 17.5%. In Indonesia, examination of bone markers related to CKD-MBD has not been routinely carried out because it has not been covered by the National Health Insurance financing. The aim of this study was to analyze the profile of calcium, phosphate, PTH, and vitamin D 25(OH) in patients with chronic kidney disease undergoing routine hemodialysis. This research is a cross-sectional study involving 124 routine hemodialysis patients at the Hemodialysis Unit of Cipto Mangunkusumo Hospital (RSCM) which took place from June to October 2022. This study used secondary data from all hemodialysis patients who had data on gender, age, duration of HD, phosphate, total calcium, vitamin D 25(OH), and PTH. Bone parameter profile was dominated by high turnover (75.8%), normocalcemia (78%), hyperphosphatemia (57.3%), and vitamin D deficiency status (82.3%). In this study, correlation was found only on the HD and PTH duration parameters. The profile of bone abnormalities based on this study is more dominated by high turnover disorders so it can be a basis for administering supplementation of vitamin D analogues and or calcimimetics in controlling increased PTH in HD patients. Hyperphosphatemia still dominates the proportion of HD patients so that the management of hyperphosphatemia needs to be further improved and periodic checks are recommended."