Clinical Science Section

Chronic
Kidney
 
Disease
 
Della Sylviani 1940312049
Nugraha Adyan Putra Tarsa 1940312070
 
Preseptor:
 
dr. Drajad Priyono, SpPD-KGH, FINASIM
PENDAHULUAN

LATAR BELAKANG
• Penyakit Ginjal Kronik (PGK) adalah suatu
gangguan pada ginjal ditandai dengan abnormalitas
struktur ataupun fungsi ginjal yang berlangsung
lebih dari 3 bulan.

• Prevalensi PGK meningkat di berbagai wilayah di

seluruh dunia.

• Prevalensi PGK di Sumatera Barat sebesar 0,2%.

•Penyebab tersering terjadinya CKD adalah diabetes

dan tekanan darah tinggi, yaitu sekitar dua pertiga
dari seluruh kasus.
2
 ANATOMI

• Ginjal terletak pada dinding posterior abdomen

(retroperitoneal), terutama didaerah lumbal kanan dan
kiri columna vertebralis.

• Secara umum, ginjal terdiri dari beberapa bagian :

Korteks
Medula
Columna renalis
Processus renalis

3
 Penyakit Ginjal Kronik adalah suatu proses patofisiologis dengan etiologi yang
DEFINISI beragam, mengakibatkan penurunan fungsi ginjal yang progresif, dan pada
umumnya berakhir dengan gagal ginjal

Kriteria penyakit ginjal kronik :

1. Kerusakan ginjal yang terjadi lebih dari 3 bulan, berupa kelainan structural atau
fungsional, dengan atau tanpa manfaat penurunan Laju Filtrasi Glomerulus (LFG),
dengan manifestasi:
- kelainan patologis
- terdapat tanda kelainan ginjal, termasuk kelainan dalam komposisi darah atau urin, atau
kelainan dalam tes pencitraan (imaging test)
2. Laju Filtrasi Glomerulus (LFG) kurang dari 60 ml/menit/1,73m2 selama 3 bulan,
dengan atau tanpa kerusakan ginjal

4
Buku Ajar Ilmu Penyakit Dalam Jilid II edisi V
 Derajat Penjelasan LFG
KLASIFIKASI (ml/mnt/1.73m2 )
1 Kerusakan ginjal ≥ 90
dengan GFR normal
atau meningkat

2 Kerusakan ginjal 60 - 89
dengan GFR
Klasifikasi atas dasar derajat penyakit, dibuat menurun ringan
atas dasar LFG, yang dihitung menggunakan rumus
Kockcroft-Gault sebagai berikut: 3 Kerusakan ginjal 30 - 59
dengan kerusakan
LFG pria (ml/menit/1,73 m2 ) GFR menurun
= (140−𝑢𝑚𝑢𝑟) 𝑋 𝑏𝑒𝑟𝑎𝑡 𝑏𝑎𝑑𝑎𝑛
sedang
72 𝑋 𝑘𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛 𝑝𝑙𝑎𝑠𝑚𝑎 ( 𝑚𝑔 𝑑𝑙 )
4 Kerusakan ginjal 15 - 29
LFG wanita (ml/menit/1,73 m2 ) dengan kerusakan
= (140−𝑢𝑚𝑢𝑟) 𝑋 𝑏𝑒𝑟𝑎𝑡 𝑏𝑎𝑑𝑎𝑛 𝑥 0,85
GFR menurun berat
72 𝑋 𝑘𝑟𝑒𝑎𝑡𝑖𝑛𝑖𝑛 𝑝𝑙𝑎𝑠𝑚𝑎 ( 𝑚𝑔 𝑑𝑙 )
5 Gagal Ginjal < 15 atau dialisis

5
Buku Ajar Ilmu Penyakit Dalam Jilid II edisi V
 EPIDEMIOLOGI

WHO : penyakit ginjal kronis berkontribusi pada

penyakit dunia dengan angka kematian sebesar
850.000 jiwa per tahun.

RISKESDAS 2013
prevalensi penyakit ginjal kronis di Indonesia ≥ 15
tahun berdasarkan diagnosis dokter pada tahun
2013 adalah 0,2% dan terjadi peningkatan pada
tahun 2018 sebesar 0,38%

Prevalensi PGK di Sumatera Barat sebesar 0,2%

kelompok umur 45-54 tahun sebanyak 0,6%.

> 6
 ETIOLOGI Hipertensi

DM

Glomerulonefritis

Penyakit Sistemik

Penyakit Ginjal Polikistik

Obstruksi
7
National Kidney Foundation. 2015. About Chronic Kidney Disease.
 PATOGENESIS

8
National Institute of Diabetes and Digestive and Kidney Disease. 2014
 9
National Institute of Diabetes and Digestive and Kidney Disease. 2014
 Perjalanan Klinis gagal
ginjal

I II III

Penurunan Insufisiensi ginjal

cadangan ginjal Endstage renal
•Kadar BUN dan
disease (ESRD)
•BUN = N kreatinin serum mulai
meningkat

1
0
Patofisiologi: konsep klinis proses-proses penyakit. Edisi ke-6. Jakarta:ECG. hlm. 912–47.
 IDENTIFYING
INFORMATION

Despite being red, Mars is a cold It’s a gas giant and the biggest planet in Saturn is the ringed one. It’s a
place, not hot. It’s full of iron our Solar System. Jupiter is the fourth- gas giant, composed mostly of
oxide dust brightest object in the sky hydrogen and helium

1
2
 PATIENT
MEDICAL
HISTORY

AGE: 25 - 35
GENDER: Female
ALLERGIES: None
LOCATION: Madrid,
Spain

Despite being red, Mars is a Jupiter is a gas giant and the Saturn is the ringed one. It’s a
cold place, not hot. It’s full of biggest planet in our Solar System gas giant, composed mostly of
iron oxide dust hydrogen and helium

2005 2008 2014

1
3
 PHYSICAL
EXAMINATION

SATURN
Saturn is the ringed one. It’s
composed mostly of hydrogen
and helium

MARS
Despite being red, Mars is a cold
place. The planet is full of iron
oxide dust

JUPITER
Jupiter is a gas giant and the
biggest planet in our Solar
System
1
4
 RESULTS

Mercury is the closest planet to the Sun and

the smallest one in the Solar System—it’s
only a bit larger than our Moon. The
planet’s name has nothing to do with the
liquid metal since it was named after the
Roman messenger god, Mercury

1
5
 DR. JENNA JAMES
DISCUSSION “Despite being red, Mars is a
cold place, not hot. It’s full of
iron oxide dust, which gives the
planet its reddish cast”

DR. JOHN DOE

“Jupiter is a gas giant and the
biggest planet in our Solar
System. It’s the fourth-brightest
object in the sky”

DR. DANIEL
PATTERSON
“Mercury is the closest planet to
the Sun and the smallest one in
our Solar System. It’s only a bit
larger than our Moon”

1
7
DISCUSSIO
N
SUMMARY

01
Mercury is the closest planet to the
Sun and the smallest one in the
Solar System—it’s only a bit larger
than our Moon

02
Venus has a beautiful name and is
the second planet from the Sun. It’s
terribly hot—even hotter than
Mercury
COMPARISON

MERCUR
JUPITER VENUS MARS
Y

1
9
DIAGNOSIS
Despite being red, Mars is a cold
place, not hot

Mercury is the closest Jupiter is the biggest planet in our

planet to the Sun Solar System

Venus has a beautiful name, but Neptune is the farthest planet

it’s terribly hot from the Sun

2
0
TREATMENT

VENUS
Venus has a beautiful name
and is the second planet
from the Sun. It’s hotter
than Mercury and its
atmosphere is poisonous

MERCUR
Y
Mercury is the closest
planet to the Sun and the
smallest one in the Solar
System—it’s only a bit
larger than our Moon

2
1
 PATIENT
MONITORIN
G
Mercury is the closest planet to the WEEK 1 WEEK 2 Despite being red, Mars is a cold
Sun and the smallest one place, not hot

MERCU MERCU
RY RY
MARS MARS

SATURN SATURN

MERCU MERCU
RY RY
MARS MARS

SATURN SATURN

Jupiter is the biggest planet in our Saturn is a gas giant, composed

Solar System WEEK 3 WEEK 4 mostly of hydrogen and helium

2
2
CONTRAINDICATI
ONS &
INDICATIONS

1. Here you can describe the reason to 1. Here you can describe the reason to
stop the treatment carry on with the treatment

2. Here you can describe the reason to 2. Here you can describe the reason to
stop the treatment carry on with the treatment

3. Here you can describe the reason to 3. Here you can describe the reason to
stop the treatment carry on with the treatment

4. Here you can describe the reason to 4. Here you can describe the reason to
stop the treatment carry on with the treatment

2
3
 POST-
PREVENTION

Despite being red, Mars is a cold

place, not hot
Mercury is the closest planet to
the Sun

Venus has a beautiful name, but Neptune is the farthest planet

it’s terribly hot from the Sun

2
4
CASE TIMELINE

Jupiter is the biggest The Sun is the star at the

planet in our Solar center of the Solar
System System

1 2 3 4

Mercury is the smallest Despite being red, Mars

planet in our Solar is a cold place, not hot
System

2
5
CONCLUSIONS

CONCLUSIONS
Mercury is the closest planet to the Sun and the smallest
one in the Solar System—it’s only a bit larger than our
Moon. The planet’s name has nothing to do with the
liquid metal since it was named after the Roman
messenger god, Mercury

2
6
REFERENCES

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

2
7
OUR TEAM
JOHN PATTERSON
Here you can talk a bit about
this person

HELENA JAMES
Here you can talk a bit about
this person

JENNA DOE
Here you can talk a bit about
this person

2
8
THANKS
Does anyone have any questions?

addyouremail@freepik.com
+91 620 421 838
yourcompany.com

2
9
CREDITS

This is where you give credit to the ones who are part of this project.
Did you like the resources on this template? Get them for free at our other websites.

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◂ Text & Image slide photo created by Freepik.com

3
0
RESOURCE
LINKS

VECTO
PHOTO
R
Hand-drawn nurse team X-ray human head

Hand-drawn nurse helping patient Close up male doctor examine mri X-ray

Hand-drawn nurse helping patient Tablet X-ray shot

Hand-drawn nurse team

Medicine elements background flat style

Medical infographic assistance

Medical infographic elements

Nice infographic human boy flat design

31
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