BAB V. KESIMPULAN DAN SARAN
B. Saran
1. Berdasarkan hasil penelitian peneliti menyarankan formula CG standarisasi yang digunakan dalam estimasi LFG pada laki-laki dewasa sehat
2. Perlu dilakukan penelitian lebih lanjut pada responden di Indonesia dengan menggunakan beberapa formula yang dibandingkan dengan Cystatin C.
46
DAFTAR PUSTAKA
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Ali, Absar., Asif, Naila., and Rais, Zunaira., 2013, Estimation of GFR by MDRD Formula and Its Correlation to Cockcroft-Gault Equation in Five Stages of Chronic Kidney Disease, Journal of Nephrology, 3, 37-40.
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Eastwood, J.B., Kerry, S.M., Rhule, J.P., Micah, F.B., Antwi, Sampson., Boas, F.G., et al., 2010, Assessment of GFR by Four Methods in Adults in Ashanti, Ghana: The Need for an eGFR Equation for Lean African Population, Nephrol Dial Transplant, 25, 2178-2187.
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Penelitian, 13(2), 214-224.
Filho, S.R., Cardoso, C.C., Castro, L.I.A., Oliveira, R.M., and Rodrigues, R., 2011, Comparison of Measured Creatinine Clearence and Clearence Estimated by Cockcroft-Gault and MDRD Formulas in Patient with a Single Kidney, International Journal of Nephrology, 1-4.
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Biochem, 25(4), 380-384.
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General Practice, Kidney Health Australia, Melbourne, p. 5.
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Clinical Research, 2(3), 537-540.
Lee, Jen-Chih., Kang, I-Min., Chou, Che-Yi., Tseng, Yu-Hsiang., Huang, Chiu-Ching., Shih, Chuen-Ming., and Chen, Walter., 2009, Difference
Between Estimated Glomerulofiltration Rate by Modification of Diet in Renal Disease and Cockcroft-Gault Formula in General Population,
Division of Nephrology, 20:148-154.
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Ann Intern Med, 150(9), 604-12.
Lin, Julie., Knight, E.L., Hogan, M.L., and Singh, A.K., 2003, A Comparison of prediction Equations for Estimating Glomerular Filtration Rate in Adults without Kidney Disease, Journal of American Society Nephrol, 14, 2573-2580.
Mahajan, Sandeep., Mukhiya, G.K., Sigh, Rajvir., Tiwan, S.C., Kalra, Vikram, Bhowmik, D.M., et al., 2005, Assessing Glomerular Filtration Rate in healthy Indian Adults: A Comparison of Various Prediction Equations,
JNephrol, 18, 257-261.
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and Krediet, R. T., 2010, Performance of The Cockcroft-Gault, MDRD,
and New CKD-EPI Formulas in Relation to GFR, Age, and Body Size,
Clin J Am Soc Nephrol, 5, 1003-1009.
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Estimates, pp. 5-6.
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Notoatmodjo, Soekidjo., 2010, Metodologi Penelitian Kesehatan, Rineka Cipta, Jakarta, hal. 37-38.
Pearce, Evelyn., 2013, Anatomy and Physiology for Nurse, diterjemahkan oleh Handoyo, Sri Y., hal. 268, PT Gramedia Pustaka Utama, Jakarta.
Ranasinghe, C., Gamage, P., Katulanda, P., Adraweera, N., Thilakarathe, S., et
al., 2013, Relationship between Body Mass Index (BMI) and Body Fat
Percentage; Estimated by Bioelectrical Impedance; in a Group of Sri Langka Adult : A Cross Sectional Study, BMC Public Health, 13, 797.
Rostoker, Guy., Andrivet, Pierre., Pham, Isabelle., Griuncelli, Mireille., and Adnot, Serge., 2007., A Modified Cockcroft-Gault Formula Taking Into Account the Body Surface Area Gives a More Accurate Estimation of the Glomerular Filtration Rate, JNephrol, 20, 576-585.
Ross and Wilson., 2011, Anatomy and Physiology, diterjemahkan oleh Nurachmah, Elly., dan Angriani, Rida., Edisi 10, hal. 225, Salemba Medika, Jakarta.
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diterjemahkan oleh Staf Pengajar Departemen Fisiologi Kedokteran FKUI, Edisi 6, hal. 661, EGC, Jakarta.
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Pembuatan Proposa Penelitian, ANDI, Yogyakarta, hal. 98, 102.
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Umar, H., 2007, Metode Penelitian untuk Skripsi dan Tesis Bisnis, PT. Raja Grafindo Persada, Jakarta, hal. 79.
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Lampiran 4. Leaflet Tampak Depan
Lampiran 6. Informed Consent
PERNYATAAN PERSETUJUAN (INFORMED CONSENT)
Yang bertandatangan dibawah ini:
Nama :_________________________________________ Jenis Kelamin : ________________________________________ Usia/Tanggal Lahir : ________________________________________ Alamat : ________________________________________ No. Telp/HP : ________________________________________ Menyatakan bahwa:
1. Saya telah mendapatkan penjelasan mengenai penelitian yang berjudul: “Perbandingan Laju Filtrasi Glomerulus pada Staf Laki-laki dan Wanita Dewasa Sehat dengan Formula Cockcroft-Gault, Modification of Diet in
Renal Disease, dan Chronic Kidney Disease Epidemiology Collaboration
di Universitas Sanata Dharma Yogyakarta.”
2. Setelah saya memahami penjelasan tersebut, dengan penuh kesadaran dan tanpa paksaan dari siapapun, saya bersedia ikut berpartisipasi dalam penelitian ini dengan kondisi:
a. Secara sukarela bersedia untuk berpuasa 10-12 jam, diambil darahnya, dan melakukan pengukuran antropometri serta digunakan data mediknya untuk kepentingan penelitian.
b. Data yang diperoleh dari penelitian ini akan dijaga kerahasiaanya dan hanya digunakan untuk kepentingan ilmiah.
3. Apabila saya inginkan, saya boleh memutuskan keluar dan tidak berpartisipasi lagi dalam penelitian ini tanpa menyatakan alasan apapun. Demikian pernyataan ini saya buat sejujur-jujurnya tanpa paksaan dari pihak manapun dan penelitian ini dapat memberikan manfaat kepada saya sebagai suatu tindakan deteksi dini untuk kesehatan pribadi saya.
Yogyakarta, ... Saksi Yang membuat pernyataan,
Lampiran 7. Pedoman Wawancara
PEDOMAN WAWANCARA
“Laju Filtrasi Glomerulus pada Staf Laki-laki dan Wanita Dewasa Sehat dengan Formula Cockcroft-Gault, Modification of Diet in Renal Disease, dan Chronic
Kidney Disease Epidemiology Collaboration di Universitas Sanata Dharma
Yogyakarta.”
a. Identitas
1. Nama : ___________________________________________________ 2. Jenis Kelamin : ____________________________________________ 3. Tempat / Tanggal Lahir : _____________________________________ 4. Umur : ______ tahun 5. Pekerjaan : ________________________________________________ b. Kondisi Kesehatan *) 1. Riwayat penyakit a. Tidak ada b. Ada, sebutkan___________________________________________ 2. Status menopause (Untuk perempuan)
a. Sudah b. Belum 3. Menggunakan KB
a. Tidak
b. Ya, sebutkan ____________________________________________ 4. Konsumsi obat-obatan rutin
a. Tidak
b. Ya, sebutkan ____________________________________________ 5. Kondisi hamil (Untuk perempuan)
a. Tidak b. Ya
Lampiran 8. Uji Validitas dan Reliabilitas Intrumen Pengukuran 1. Timbangan merk Nagako
NO Berat Badan (kg) X2 SD CV(%) 1 48 48,14 0,22 0,455 2 48 3 48,5 4 48,2 5 48
2. Alat pengukur tinggi badan merk Height
NO Tinggi Badan (cm) X2 SD CV(%) 1 149,5 149,72 0,26 0,173 2 150 3 149,4 4 149,9 5 149,8 Lampiran 9. Dokumentasi
Gambar 7. Pengukuran Tinggi Badan
Lampiran 12. Deskriptif dan Uji Normalitas Umur
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
umur 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
umur Mean 44.4848 .36081
95% Confidence Interval for Mean Lower Bound 43.7643 Upper Bound 45.2054 5% Trimmed Mean 44.4495 Median 44.0000 Variance 8.592 Std. Deviation 2.93122 Minimum 40.00 Maximum 50.00 Range 10.00 Interquartile Range 5.00 Skewness .097 .295 Kurtosis -.999 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
umur .105 66 .070 .950 66 .010
Lampiran 13. Deskriptif dan Uji Normalitas Tinggi Badan
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
Tinggibadan 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
Tinggibadan Mean 166.1621 .66456
95% Confidence Interval for Mean Lower Bound 164.8349 Upper Bound 167.4893 5% Trimmed Mean 166.1364 Median 167.0000 Variance 29.149 Std. Deviation 5.39894 Minimum 155.00 Maximum 178.50 Range 23.50 Interquartile Range 7.13 Skewness .100 .295 Kurtosis -.390 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
tinggibadan .094 66 .200* .983 66 .478
*. This is a lower bound of the true significance. a. Lilliefors Significance Correction
Lampiran 14. Deskriptif dan Uji Normalitas Berat badan
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
BeratBadan 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
BeratBadan Mean 69.0833 1.36274
95% Confidence Interval for Mean Lower Bound 66.3618 Upper Bound 71.8049 5% Trimmed Mean 68.9764 Median 70.0000 Variance 122.566 Std. Deviation 11.07095 Minimum 44.50 Maximum 100.00 Range 55.50 Interquartile Range 15.25 Skewness .125 .295 Kurtosis .203 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
BeratBadan .067 66 .200* .991 66 .917
*. This is a lower bound of the true significance. a. Lilliefors Significance Correction
Lampiran 15. Deskriptif dan Uji Normalitas Body Surface Area (BSA)
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
BSA 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
BSA Mean 1.7915 .02086
95% Confidence Interval for Mean Lower Bound 1.7499 Upper Bound 1.8332 5% Trimmed Mean 1.7908 Median 1.7995 Variance .029 Std. Deviation .16951 Minimum 1.38 Maximum 2.25 Range .87 Interquartile Range .26 Skewness .032 .295 Kurtosis -.014 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
BSA .078 66 .200* .994 66 .988
*. This is a lower bound of the true significance. a. Lilliefors Significance Correction
Lampiran 16. Deskriptif dan Uji Normalitas Serum Kreatinin
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
kreatininserum 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
kreatininserum Mean .9835 .01708
95% Confidence Interval for Mean Lower Bound .9494 Upper Bound 1.0176 5% Trimmed Mean .9791 Median .9700 Variance .019 Std. Deviation .13879 Minimum .76 Maximum 1.32 Range .56 Interquartile Range .24 Skewness .315 .295 Kurtosis -.734 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
kreatininserum .113 66 .035 .961 66 .037
Lampiran 17. Deskriptif dan Uji Normalitas LFG berdasarkan formula
Cockcroft-Gault (CG)
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
CG 66 100.0% 0 .0% 66 100.0%
Descriptives
Statistic Std. Error
CG Mean 9.48705E1 2.437534
95% Confidence Interval for Mean
Lower Bound 9.00024E1
Upper Bound 9.97386E1
5% Trimmed Mean 9.44209E1
Median 9.39775E1 Variance 392.144 Std. Deviation 1.980262E1 Minimum 57.057 Maximum 139.771 Range 82.714 Interquartile Range 26.534 Skewness .327 .295 Kurtosis -.359 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
CG .053 66 .200* .981 66 .400
Lampiran 18. Deskriptif dan Uji Normalitas LFG berdasarkan formula
Cockcroft-Gault (CG) standarisasi
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
CGstandrisasi 66 100.0% 0 .0% 66 100.0%
Descriptives
Statistic Std. Error
CGstandrisasi Mean 9.11542E1 1.771520
95% Confidence Interval for Mean
Lower Bound 8.76162E1
Upper Bound 9.46922E1
5% Trimmed Mean 9.08506E1
Median 8.84280E1 Variance 207.127 Std. Deviation 1.439189E 1 Minimum 66.588 Maximum 123.598 Range 57.010 Interquartile Range 25.823 Skewness .316 .295 Kurtosis -.802 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
Lampiran 19. Deskriptif dan Uji Normalitas LFG berdasarkan formula
Modification of Diet in Renal Disease (MDRD)
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
MDRD 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
MDRD Mean 89.9588 1.79994
95% Confidence Interval for Mean Lower Bound 86.3640 Upper Bound 93.5535 5% Trimmed Mean 89.8655 Median 88.4355 Variance 213.825 Std. Deviation 14.62276 Minimum 62.06 Maximum 118.98 Range 56.91 Interquartile Range 25.09 Skewness .148 .295 Kurtosis -1.009 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
MDRD .109 66 .051 .963 66 .047
Lampiran 20. Deskriptif dan Uji Normalitas LFG berdasarkan formula Chronic
Kidney Disease Epidemiology Collaboration (CKD-EPI)
Case Processing Summary Cases
Valid Missing Total
N Percent N Percent N Percent
CKDEPI 66 100.0% 0 0.0% 66 100.0%
Descriptives
Statistic Std. Error
CKDEPI Mean 93.1487 2.60944
95% Confidence Interval for Mean Lower Bound 87.9373 Upper Bound 98.3601 5% Trimmed Mean 92.8350 Median 90.2880 Variance 449.404 Std. Deviation 21.19916 Minimum 54.88 Maximum 137.09 Range 82.20 Interquartile Range 36.10 Skewness .244 .295 Kurtosis -.981 .582 Tests of Normality Kolmogorov-Smirnova Shapiro-Wilk
Statistic df Sig. Statistic df Sig.
CKDEPI .118 66 .024 .960 66 .031
Lampiran 21. Hasil uji t berpasangan
Paired Samples Test Paired Differences t df Sig. (2-tailed) Mean Std. Deviation Std. Error Mean 95% Confidence Interval of the Difference Lower Upper Pair 1 CG - CGstandri sasi 3.716333E0 8.942108 1.100697 1.5180 89 5.914578 3.376 65 .001
Lampiran 22. Hasil uji Friedman Ranks Mean Rank CG 2.83 CGstandrisasi 2.39 MDRD 2.21 CKDEPI 2.56 Test Statisticsa N 66 Chi-Square 8.273 df 3 Asymp. Sig. .041 a. Friedman Test
Lampiran 23. Hasil uji Wilcoxon 1. Formula CG standarisasi-CG
Test Statisticsb
CGstandrisasi - CG
Z -2.916a
Asymp. Sig. (2-tailed) .004
a. Based on positive ranks. b. Wilcoxon Signed Ranks Test
2. Formula MDRD-CG
Test Statisticsb
MDRD - CG
Z -2.552a
Asymp. Sig. (2-tailed) .011
a. Based on positive ranks. b. Wilcoxon Signed Ranks Test
3. Formula CKDEPI-CG
Test Statisticsb
CKDEPI - CG
Z -.885a
Asymp. Sig. (2-tailed) .376
a. Based on positive ranks. b. Wilcoxon Signed Ranks Test
4. Formula CG standarisasi-MDRD
Test Statisticsb
CGstandrisasi - MDRD
Z -1.856a
Asymp. Sig. (2-tailed) .063
a. Based on negative ranks. b. Wilcoxon Signed Ranks Test
5. Formula CG standarisasi-CKDEPI
Test Statisticsb
CGstandrisasi - CKDEPI
Z -1.249a
Asymp. Sig. (2-tailed) .212
a. Based on positive ranks. b. Wilcoxon Signed Ranks Test
6. Formula MDRD-CKDEPI
Test Statisticsb
MDRD - CKDEPI
Z -3.009a
Asymp. Sig. (2-tailed) .003
74
BIOGRAFI PENULIS
Penulis bernama lengkap Arfita Anggrayny, lahir di Nabire, Papua pada tanggal 6 April 1994. Penulis merupakan anak ketiga dari empat bersaudara dari pasangan Sungatijo dan Sunarti. Pendidikan penulis dimulai dari TK Aisiyah Bustanul Atfal Legari (1998-1999), SD Negeri Inpres Bumiwonorejo Nabire (1999-2005). SMP Negeri 2 Nabire (2005-2008) dan SMA Negeri 1 Nabire (2008-2011). Pada tahun 2011 penulis melanjutkan pendidikan ke Perguruan Tinggi di Fakultas Farmasi Universitas Sanata Dharma Yogyakarta. Selama masa perkuliahan penulis aktif dalam kegiatan sebagai seksi konsumsi Desa Mitra III Tahun 2013 “Pengobatan dan Jalan Sehat Awali Warak Lor Lebih baik”, sebagai seksi administrasi Sarasehan Spiritualitas Ignasian Tahun 2014 “Aku rapopo” dan sebagai peserta “Program Kreativitas Mahasiswa yang dinyatakan lolos seleksi dan didanai Hibah Direktorat Pendidikan Tinggi (Dikti) tahun 2014” serta sebagai volunteer publikasi Seni Budaya Humaniora Tahun 2015 “Rasa(h) Kuliah”.