Hubungan Kadar Asam Urat dengan Kejadian Gout Arthritis pada Penderita Penyakit Ginjal Kronik
DOI:
https://doi.org/10.29313/bcsms.v6i2.24098Keywords:
Asam Urat, Arthritis Gout, Penyakit Ginjal KronikAbstract
Abstact. Chronic kidney disease (CKD) frequently causes systemic uric acid retention, resulting in hyperuricemia. However, elevated uric acid levels do not always lead to gout arthritis because uremia alters immune responses, including impaired neutrophil chemotaxis. This study aimed to determine the relationship between uric acid levels and the incidence of gout arthritis in patients with chronic kidney disease at Welas Asih Hospital, Bandung Regency. This analytical observational study included 68 patients with chronic kidney disease. The relationship between variables was analyzed using the Fisher Exact Test. Most patients had hyperuricemia (85.3%, 58 patients), whereas only 10.3% (7 patients) developed gout arthritis. Statistical analysis showed an Odds Ratio (OR) of 0.88, indicating no increased risk or significant association between elevated uric acid levels and gout arthritis. These findings suggest that hyperuricemia in patients with chronic kidney disease is predominantly asymptomatic and reflects reduced glomerular filtration rate rather than predicting gout arthritis. Therefore, no significant relationship was found between elevated uric acid levels and the incidence of gout arthritis in patients with chronic kidney disease at Welas Asih Hospital, Bandung Regency.
Abstrak. Penyakit ginjal kronik (PGK) sering menyebabkan retensi asam urat sistemik sehingga terjadi hiperurisemia. Namun, peningkatan kadar asam urat tidak selalu menyebabkan artritis gout karena uremia mengubah respons imun, termasuk menurunkan kemotaksis neutrofil. Penelitian ini bertujuan mengetahui hubungan kadar asam urat dengan kejadian artritis gout pada pasien penyakit ginjal kronik di RSUD Welas Asih Kabupaten Bandung. Penelitian observasional analitik ini melibatkan 68 pasien penyakit ginjal kronik. Hubungan antarvariabel dianalisis menggunakan uji Fisher Exact. Sebagian besar pasien mengalami hiperurisemia (85,3%; 58 pasien), sedangkan hanya 10,3% (7 pasien) yang mengalami artritis gout. Hasil analisis menunjukkan Odds Ratio (OR) sebesar 0,88, yang mengindikasikan tidak adanya peningkatan risiko maupun hubungan yang bermakna antara kadar asam urat tinggi dan kejadian artritis gout. Temuan ini menunjukkan bahwa hiperurisemia pada pasien penyakit ginjal kronik umumnya bersifat asimtomatik dan lebih mencerminkan penurunan laju filtrasi glomerulus dibandingkan sebagai prediktor artritis gout. Oleh karena itu, tidak ditemukan hubungan yang bermakna antara kadar asam urat tinggi dan kejadian artritis gout pada pasien penyakit ginjal kronik di RSUD Welas Asih Kabupaten Bandung.
References
2. Riset Kesehatan Dasar (Riskesdas). Laporan Riskesdas 2018 Nasional.pdf. Lembaga Penerbit Balitbangkes. 2018. p. hal 156.
3. Kielstein JT, Pontremoli R, Burnier M. Management of Hyperuricemia in Patients with Chronic Kidney Disease: a Focus on Renal Protection. Curr Hypertens Rep. 2020;22(12).
4. Perhimpunan Reumatologi Indonesia. Rekomendasi Pedoman Diagnosis dan Pengelolaan Gout. 2020. 1–33 p.
5. Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective – A review. J Adv Res. 2017;8(5):495–511.
6. Perhimpunan Reumatologi Indonesia. Pedoman Diagnosis dan Tatalaksana Hiperurisemia & Artritis Gout. 2024.
7. Cong R, Zhang X, Song Z, Chen S, Liu G, Liu Y, et al. Assessing the Causal Effects of Adipokines on Uric Acid and Gout: A Two-Sample Mendelian Randomization Study. Nutrients. 2022;14(5):1–11.
8. Mohammed E, Browne LD, Kumar AAU, Adeeb F, Fraser AD, Stack AG. Prevalence and treatment of gout among patients with chronic kidney disease in the Irish health system: A national study. PLoS One. 2019;14(1):1–14.
9. Aiumtrakul N, Wiputhanuphongs P, Supasyndh O, Satirapoj B.
Hyperuricemia and Impaired Renal Function: A Prospective Cohort Study. Kidney Dis. 2021;7(3):210–8.
10. Udinsiah APM. Hubungan kadar serum asam urat pada penderita penyakit ginjal kronik dengan kejadian artritis gout di Rumah Sakit Dr. Wahidin Sudirohusodo [Skripsi]. Makassar: Universitas Hasanuddin; 2021
