The study aimed to identify uric acid level among adult patients

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Third International Seminar on Global Health (3^rd ISGH) Technology Transformation in Healthcare for a Better Life ISGH 3 | Vol 3. No. 1 | Oktober 2019 | ISSN : 2715-1948

School of Health Sciences Jenderal Achmad Yani Page 389

Jenderal Sudirman Canal Road – Cimahi 40533 Phone: +62-22-6631622 – 6631624

DESCRIPTION OF HYPERURISEMIA IN CIPAGERAN DISTRICT AREA CIMAHI CITY

Tria Firza Kumala*, Meihastini [email protected]

Department of Nursing, School of Health Sciences Jenderal Achmad Yani Cimahi, Indonesia ABSTRACT

Hyperuricemia is the most prevalent complained in an adult’s age as manifested by joint swelling and joint pain. Hyperuricemia was earlier detection to gout desease. The hyperuricemia condition was unknown clearly.

The study aimed to identify uric acid level among adult patients.

This study was conducted using analitic descriptive. The total sample included in this study was 20 subjects that selected using purposive sampling techniques. The inclusion criteria were adults aged 36 to 65 years old, not under medication of hyperuricemia. Data were analyzed using mean.

Results: Of total 20 subjects joined in this study, the means level of uric acid was 10.78 (SD=3.81). Conclusion:

Uric acid level has increased mean to adults patients at Cipageran. A promotion such of intervention to all people in the community is essential.

Keywords: Hyperuricemia, uric acid, adults patients

INTRODUCTION

Hyperuricemia is an increase in uric acid levels in the blood which is often known as gout or the medical term is gout arthritis, this disease including degenerative diseases. Hyperuricemia is an early sign that the body will be attacked by gout. At present the exact incidence of hyperuricemia in the community is still unclear. The prevalence of hyperuricemia varies in each age group and increases at 30 years in men and 50 years in women (Liu et al., 2011). The prevalence of hyperuricemia also increases and affects 43,300,000 (21%) adults in the United States (Zhang et al, 2012). The results of the 2012 Riskesdas revealed that the prevalence of hyperuricemia in Indonesia was 11.9% and in East Java was 26.4% (Kemenkes RI, 2013).

Whereas in the world the prevalence of gout has increased the number of sufferers to double between 1990-2010. In adults in the United States gout has increased and affects 8.3 million (4%) Americans.

The prevalence of gouty arthritis is increasing.

Based on the results of Indonesia's Basic Health Research (Riskesdas) in 2013 the prevalence of joint disease based on the diagnosis of health workers or symptoms was highest in East Nusa Tenggara (33.1%), followed by West Java (32.1%), and Bali (30%). In the Cimahi region the prevalence of gout is not known with certainty, but from the results of a preliminary study conducted by researchers in the Cipageran RW 5 on May 31,

2017, 4 out of 10 people experience hyperuricemia or increased levels of uric acid in the blood.

Hyperuricemia condition for a long time will cause gout or gout arthritis which is a disease caused by the accumulation of monosodium urate crystals in the body. Uric acid is the result of the final metabolism of purines, which is a component of nucleic acids found in the body's cell nucleus.

Increased uric acid levels can cause disturbances in the human body such as feelings of pain in the joints and often accompanied by very painful joint pain for the sufferer. In addition to joint pain in gout can also cause a high risk of complications such as urolithiasis and acute gout nephropathy.

Efforts to prevent the occurrence of gout or gout is to monitor uric acid levels regularly, provide clear and applicative information, in order to change the behavior of people, especially adults to the elderly, to undergo healthier activities, in addition to regulating low purine food diets. The Cipageran Kelurahan of Cimahi City has the highest population growth rate in the North Cimahi area of 5.17% in the period of one year, namely 2013 to 2014 (Health Profile of Cimahi City 2014). While the population in the productive age to the elderly in the region reached 4,359 people out of a total of 5,910 people (Cimahi Population Service. 2011).

Seeing the large population in adulthood allows there is a risk of gout that has not been detected and there is no preventive effort against hyperuricemia.

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Description of Hyperurisemia in Cipageran District Area Cimahi City

Third International Seminar on Global Health (3^rd ISGH) Page 390

Vol 3 | No. 1 | October 2019 |

This study aims to determine the description of an increase in uric acid levels in adulthood to the elderly in the working area of Cipageran Village, Cimahi City.

RESEARCH METHODS

This research method uses descriptive analytic research design. This research was conducted on 20 respondents by measuring serum uric acid levels through purposive sampling technique. The respondent's criteria are Age 36 - 65 years, not in the treatment of hyperuricemia. Respondents who met the next criteria were taken serum uric acid samples.

DISCUSSION

In this chapter, we will discuss the results of research on the description of serum uric acid levels in RW 19, Cipageran Village, Cimahi City, which took place during March - April 2018 with a total sample of 20 people.

The data processing results obtained are then analyzed by univariate analysis. For univariate analysis using numerical data with a mean value on uric acid levels.

Table 1. Uric acid mean

Category N Mean Min-Max SD Uric acid 20 10.775 7,3–18,9 3.8051

From the results of the analysis of table 1.1 uric acid levels totaling 20 samples obtained an average of 10,775 with a standard deviation of 3,8051.

Based on table 1 uric acid levels of all respondents above the normal value (> 7 mg / dL) with a mean value of 10,775, with a minimum value of 7.3 mg / dL and a maximum value of 18.9 mg / dL. Under normal conditions, uric acid can accumulate excessively if the production of uric acid is excessive. The average human uric acid production per day is around 600-800 mg. High uric acid levels in the blood are the cause of the accumulation of monosodium urate crystals, which will later settle in the joints and cause an inflammatory response, this condition is also called hyperuresemia. There are several factors that can influence the occurrence of hyperuresemia, namely genetic, food consumption with levels high purines, drinks containing high fructose, blood diseases, alcohol intake, cancer drugs, vit B12, obesity, and hormonal therapy. Of the several factors mentioned above someone who has hyperuresemia can be categorized asymptomatic and symptomatic

hyperuresemia. Most people do not realize that they have increased levels of uric acid in the blood, because the initial increase in uric acid in the blood is not felt clinically by individuals. Someone will only feel a complaint if there is inflammation in the form of swelling in the joints of the toes or hands, but occasionally feel the presence of joint pain or renal colic. Increased levels of uric acid in the blood is rarely detected early by someone and rarely do regular checks on uric acid levels.

From this situation, if there is no attempt to control the level of uric acid in the blood so that an increase in uric acid levels in the blood can cause various kinds of complications, namely decreased kidney function. Excess uric acid produced by the body from purines can occur because the kidneys can not release it through urine, which eventually will eventually form crystals of uric acid that accumulate in the joints. These crystals are hard, so they will erode soft tissue or layers of joint cartilage and cause painful arthritis symptoms due to gout.

Based on research conducted by Giordano et al., 2015 that high uric acid in the blood is strongly associated with the development of chronic kidney disease and can be a poor prognostic factor for the development of acute kidney failure.

Another factor that cannot be changed as a cause of hyperuresemia is age. Based on research conducted by Rini Setyoningsih, 2009 concerning factors related to the occurrence of hyperuricemia in outpatients Dr.Kariadi Hospital Semarang, one of them is the age factor, where age is the subject of the case and control group for most of more than 40 years experiencing hyperuresemia but in bivariate analysis found no significant relationship. At the age above 40 years, there is usually an increase in uric acid levels that occurs due to decreased kidney function in the process of excretion of metabolic waste in the body which is characterized by high levels of urea and creatinine. Whereas in this study respondents in adulthood to the elderly with an age range of 33-76 years who experienced increased levels of uric acid in the blood.

From the above discussion the authors conclude that an increase in uric acid levels in the blood is accompanied by increasing age, especially in the range of adults over 30 years experiencing hyperuresemia. This happens due to increased uric acid metabolism (over production), decreased uric acid expenditure (under excretion) or a combination of both which also affects the decline in kidney function which will inhibit the excretion of uric acid.

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From the explanation above, the researchers concluded that excessive levels of uric acid in the blood that can trigger various pathological conditions can be prevented by doing sports such as ergonomic exercise on a regular basis. This can be seen from the results of this study that the level of uric acid respondents decreased. The minimum value of respondent's uric acid level reaches 3.3 mg / dL and the maximum uric acid level reaches 8.9 mg / dL, this decrease is the process of breaking down the purine buildup in the joints accompanied by an increase in the metabolism of the uric acid combustion system. Although there are still values of uric acid levels of respondents which are more than normal, but these values indicate a decrease from before.

CONCLUSION

This research is a descriptive study about the description of elevated serum uric acid levels in an effort to detect the occurrence of hyperuricemia in the Cipageran Public Health Center in Cimahi City with a sample of 20 adult respondents to the elderly.

Based on the results of the study with the aim of identifying the average level of uric acid, which indicated that the average level of uric acid in the blood reached 3.8051 with SD 3.8051 with a minimum value of uric acid level 7.3 mg / dL and the maximum value of uric acid level was 18.9 mg / dL.

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