Hubungan Interleukin 6 dengan Serum Feritin pada Penderita Penyakit Ginjal Kronik yang Anemia dan Menjalani Hemodialisis Reguler

Abstract

Introduction: Anemia is found in most patients with CKD undergoing regular hemodialysis.A variety of invitro invivo studies indicated that the release of proinflammatory cytokines in the blood contribute to the onset of anemia.Interleukin 6 plays a role in iron regulation and metabolism.The anemia of chronic disease is found hypoferemia with normal or increased iron stores.Ferritin serum is still relied to show iron storage in CKD.So researchers are interested in examining the relationship of interleukin 6 and ferritin serum in CKD patients with anemia and undergoing regular hemodialysis . Method : This study is using analytical observation method and cross sectional design that were conducted at H.Adam Malik Hospital in March and April 2016.A total of 35 samples of CKD patients with anemia and undergoing regular hemodialysis who met inclusion criterias were included. All study subjects had their full blood count, feritin serum and interleukin 6 examined. Result : From 35 samples 23 were men (65 %) and 12 were women(35%).Ferritin levels increased in 24 people (68, 6%) and was normal in 11 people (31,4%).Whereas IL-6 level obtained in 9 people were >100 pg/dl and in 16 people were < 100 pg/dl. In the spearman test there was no significant corellation Il-6 with ferritin serum (r= 0,028; p = 0.872). Conclusion: There is no significant correlation between Interleukin 6 with ferritin serum in chronic kidney disease patients with anemia and undergoing regular hemodialysis.

Latar Belakang : Anemia dijumpai pada sebagian besar penderita PGK dengan hemodialisis reguler.Berbagai studi invitro invivo menunjukkan pelepasan sitokin proinflamasi ke dalam darah berkontribusi timbulnya anemia.Interleukin-6 berperan dalam regulasi dan metabolisme besi.Pada anemia penyakit kronik dijumpai hypoferemia, dimana cadangan besi normal atau meningkat .Serum ferritin masih diandalkan menentukan cadangan besi.Sehingga peneliti tertarik meneliti hubungan interleukin 6 dan serum ferritin pada penderita PGK yang anemia dan menjalani hemodialisisreguler. Metode : Penelitian ini menggunakan metode analitik observasional pendekatan potong lintang yang dilakukan di RSUP H. Adam Malik Medan, maret-april 2016. Sebanyak 35 sampel penderita PGK yang anemia dan menjalani hemodialisis reguler yang memenuhi kriteria inklusi.Subjek penelitian diperiksa darah lengkap , serum feritin dan interleukin 6 . Hasil :Subyek berjumlah, 23 orang laki-laki (65 %) ,12orang perempuan (35%) Dijumpai 24 orang (68,6%) kadar feritin meningkat,dan 11 orang (31,4%) yang normal. Sedangkan nilai IL-6 >100 pg/ml diperoleh 9 orang (25,7%) dan nilai IL-6 <100 pg/ml adalah 16 orang . Pada uji spearman tidak didapat hubungan bermakna interleukin 6 dengan serum feritin (r= 0,028; p = 0.872). Simpulan : Tidak terdapat hubungan yang signifikan antara interleukin 6 dengan serum feritin pada penderita PGK yang menjalani hemodialisis reguler. Saran: perlu pengambilan sampel pre,durante, posthemodialisis, kontrol sehat juga pemeriksaan CRP,hepsidin dan eriythropoietin