Proteinuria pada Anak

Abstract

Abstrak Proteinuria merupakan salah satu keadaan yang sering ditemukan pada anak, umumnya sebagai petanda kelainan ginjal dan saluran kemih, meskipun dapat juga terjadi oleh sebab lain. Pada anak sekolah, ditemukan 5 - 15% proteinuria transien dan pada 0,4 - 1% anak sekolah dapat ditemukan proteinuria persisten. Proteinuria dapat dibedakan menjadi proteinuria glomerular, proteinuria tubular, dan proteinuria karena produksi berlebih. Proteinuria glomerular disebabkan peningkatan permeabilitas pada sawar filtrasi glomerulus terhadap protein plasma. Proteinuria tubular terjadi karena kerusakan tubulus primer dengan dominasi protein berat molekul ringan. Proteinuria juga dapat disebabkan produksi protein melebihi kapasitas reabsorbsi tubular. Pemeriksaan proteinuria dilakukan dengan cara uji semikuantitatif atau kuantitatif dengan mengumpulkan urin 24 jam atau urin sewaktu. Proteinuria transien tidak perlu diterapi sedangkan terapi proteinuria persisten tergantung pada penyebabnya. Prognosis proteinuria persisten kurang baik, dan perlu evaluasi berkala meliputi pemeriksaan fisik termasuk tekanan darah, pemeriksaan urinalisis, dan fungsi ginjal.
Kata kunci: proteinuria, glomerular, tubular, anak

Abstract Proteinuria is a condition commonly found in children, usually as a marker of kidney and urinary tract disorder, although it can occur without abnormality of kidney and urinary tract. Transent proteinuria is found in 5 - 15% of school-age children, and persistent proteinuria is found in 0,4 – 1% of school age children. Proteinuria can be categorized as glomerular proteinuria, tubular proteinuria, and proteinuria due to overproduction. Glomerular proteinuria is caused by increased glomerular filtration membrane permeability of plasma protein. Tubular proteinuria is caused by primary tubular damage dominated by low molecular weight protein. Proteinuria can also be caused by overproduction of protein exceeding the tubular reabsorption capacity. Proteinuria test is performed by semi-quantitative or quantitative test by 24-hour urine collection or random urinary excretion. Management of proteinuria is targeted to the underlying causes. Transient proteinuria doesn’t require treatment while persistent proteinuria is treated based on the underlying causes. The prognosis of persistent proteinuria is not so good, so it is important to evaluate physical examination, including, blood pressure, urinalysis, and renal function periodically.
Keywords: proteinuria, glomerular, tubular, children