Sindrom

Nefritik Akut
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 Definisi
Sindrom Nefritik Akut
(SNA)
Suatu kumpulan gejala klinik
berupa proteinuria, hematuria,
azotemia, red blood cast,
oligouria, dan hipertensi
{PHAROH] yang terjadi secara
akut
Rauf S, Albar H. Konsensus Glomerulonefritis Pasca Streptokokus, Jakarta: UKK Nefrologi IDAI;2012
Glomerulonefritis
Akut (GNA)
Suatu istilah yang lwbih bersifat
umum dan lebih
menggambarkan suatu proses
histopatologi berupa proliferasi
dan inflamasi sel glomeruli
akibat proses imunologik
 Epidemiologi
• SNA mewakili 10 – 15% dari penyakit
glomerular
• Penyebab tersering  Streptococcus β
hemolyticus group A yang nefritogenik
• Terjadi pada semua usia, tetapi paling sering
terjadi pada usia 6-7 tahun
• Laki-laki:wanita = 2:1

Rauf S, Albar H. Konsensus Glomerulonefritis Pasca Streptokokus, Jakarta: UKK Nefrologi IDAI;2012
Lamba P, Nam KH, Contractor J, Kim A. Nephritic Syndrome. Prim Care. 2020 Dec. 47 (4):615-629.
 Penyakit yang digolongkan
ke dalam SNA

Glomerulonefritis Penyakit-penyakit
Glomerulonefritis Penyakit ginjal dengan progresif cepat sistemik
kronik eksaserbasi akut manifestasi hematuria

• Glomerulonefitis
fokal • Purpura Henoch-
• Nefritis herediter Schoenlein (HSP)
(sindrom Alport) • Lupus
• Nefropati IgA-IgG erythematosus
(Maladie de sistemik (LES)
Berger) • Endokarditis
Rauf S, Albar H. Konsensus Glomerulonefritis Pasca • Benign Recurrent bakterial subakut
Streptokokus, Jakarta: UKK Nefrologi IDAI;2012
Kher K. Acute Glomerular Disease in Children. The Open Urology & Nephrology Journal. 2015;8(3):2015.
Etiologi

Barrios EJ, Guerrero GA. Nephritic syndrome associated to skin infection, hepatitis A, and pneumonia: a case report. Colombia Medica. 2010;41(2):171-5
 Patogenesis
Aronson PL, Werner H. Netter’s Pediatrics. Philadelphia: Elsevier; 2011.
 Yang perlu ditanyakan:
• Durasi
• Waktu hematuria: pada awal berkemih,
awal-akhir, atau akhir berkemih
• Warna urin: merah atau pink, teh tua
Anamnesis
Yangatau cola
perlu ditanyakan:
•• Onset
Intermiten atau persisten?
: mendadak atau tidak?
•• Durasi 1. Identitas Pasien: Umur, jenis kelamin,
Gejala yang berhubungan:
dan waktu terjadinya demam, nyeri
edema: alamat
CVA; nyeri atau
kongenital suprapubik,
didapat perineal atau
dari umur 2. Keluhan yang paling sering dikeluhkan
perut; inkontinensia; disuria; frekuensi,
berapa? urin berwarna merah/teh tua/cola.
urgensi,apakah
• Waktu: atau gejala voiding.
bengkak menurun atau
• meningkat 3. Keluhan lain berupa bengkak pada
Faktor presipitasi: trauma?
pada waktu tertentu?
•• Karakter, daerah periorbital, wajah, abdomen atau
Saat in ataulokasi,sebelumnya mengalami
dan progesivitas dari ekstremitas
ISPA atau gastroenteritis
bengkak: lokal atau general?; mulainya 4. RPD: Sedang mengalami infeksi
di daerah mana? Apakah ada tenggorokan atau kulit (±6 minggu
pertambahan BB? sebelumnya), sebelumnya mengalami
• Intermiten atau persisten? episode urin berwarna merah,
• Gejala yang berhubungan: demam, sebelumnya mengalami nyeri dan
nyeri, penurunan BAK, urin berwarna bengkak pada sendi
merah, nyeri CVA, sesak napas. 5. RPK: riwayat penyakit ginjal pada
keluarga
Saadon AQ, Essential Clinical Skills in Pediatrics. Switzerland: Springer International Publishing; 2018
 Pemeriksaan Fisik
Status antropometri
Pemeriksaan BB dan TB

Tekanan darah

Penilaian edema
Biasanya ringan – pada ekstremitas inferior, wajah,
asites, scrotal, efusi pleura
Status kardiovaskular dan perfusi
• Indikator cairan berlebihan: takikardia, hipertensi, respiratory
distress, perifer hangat dan basah, hepatomegali,  JVP
• Indikator hipovolemia: takikardia, hipertensi, perifer dingin, CRT
lambat
Ehidiamhen G. Acute glomerulonephritis. NHS Foundation Trust. 2019;1:1-8
Aronson PL, Werner H. Netter’s Pediatrics. Philadelphia: Elsevier; 2011.
 Pemeriksaan penunjang

Urin Radiologi
Urinalisis, kultur,
Chest X-ray, USG
dipstik

Darah Lain-lain
Darah rutin, darah
Audiogram, biopsi
kimia, ASTO, kadar C3
ginal
dan C4, ANA

Ehidiamhen G. Acute glomerulonephritis. NHS Foundation Trust. 2019;1:1-8

Aronson PL, Werner H. Netter’s Pediatrics. Philadelphia: Elsevier; 2011.
 Symptoms of kidney failure

Rashy skin Muscle cramps Sick stomach

Mars is actually a very cold Neptune is the farthest planet Saturn is the only planet with
place from the Sun rings

Less hungry Swelling Urinating

Mercury is the closest planet Earth is the planet where we Jupiter is the biggest planet
to the Sun all live of them all
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 Table of contents

What is it? Importance

01 You can describe the topic of the
02 You can describe the topic of the
section here section here

Participation Our team

03 04
You can describe the topic of the You can describe the topic of the
section here section here
March 10
 01

What is it?
You can enter a subtitle here if you need it
 The slide title goes here!

Do you know what helps you make your point clear?

Lists like this one:

● They’re simple
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● You’ll never forget to buy milk!

And the most important thing: the audience won’t miss the point of your presentation ever
again
What is World Kidney Day?
World Kidney Day (WKD) is a global health
awareness campaign focusing on the importance of the
kidneys and reducing the frequency and impact of
kidney disease and its associated health problems
worldwide
A picture is worth a
thousand words
 Diagnosis
You can enter a subtitle here if you need it

02
03 Participation
You can enter a subtitle here if you need it
125,000
Big numbers catch your audience’s attention
 10,000
Mercury is the smallest planet

500
Venus has high temperatures

25
Earth is the planet where we all live
 Let’s use some percentages

CREATININE
Venus is the second planet from 25%
the Sun

BLOOD
Jupiter is the biggest planet in 50%
the Solar System

KIDNEY
Despite being red, Mars is a 75%
cold place
 Desktop software
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 Our team
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04
 Our team

Helen dean Carles mad Rose jean

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person here person here person here
 Kidney parts
Vein Cortex
Venus is the second Jupiter is the biggest
planet from the Sun planet of them all

Capsul Piramid
Mercury is the smallest Saturn is the only
planet planet with rings

Pelvis Colum
Earth is the planet Neptune is very far
where we all live from the Sun

Urete Capsul
Despite being red, Mars The Moon is Earth’s
is a cold place only natural satellite
 Events for world kidney day

March 10
Room a Room b Room c
10:00 Chat Meetings Snacks

11:00 Samples Concert Concert

12:00 Meetings Break Samples

13:30 Concert Lunch Meetings

 Most effective treatments
Treatment A
Venus is the second planet
from the Sun

Treatment B
Mercury is the closest planet
to the Sun

Treatment C
Jupiter is the biggest planet
of them all

Follow the link in the graph to modify its data and then paste the new one here. For more info, click here
 Balanced diet
01 02
Vegetables Salads
Venus is the second planet Jupiter is the biggest planet in
from the Sun the Solar System

03 04
Fruits Seeds
Despite being red, Mars is a Saturn is a gas giant and has
cold place several rings
 Improve kidney health
Healthy food Recommendations
● Cook with a spice mix instead of ● Physical activity at least 30
salt minutes a day
● Choose vegetable toppings such ● Keep a healthy weight with a
as spinach good diet
● Try baking or grilling meat, ● No smoking , do not consume
poultry, and fish drugs
● Serve foods without added sauces ● Have a good rest routine and
or fats sleep 8 hours
● Try to choose foods with little or ● Do not drink alcohol or drinks
no added sugar with a lot of sugar and gas
 Recovered patients
Mercury is the closest planet to the Sun and the smallest one in the Solar System—it’s only a
bit larger than the Moon.

Carl Dean Suri Lee

Elena Doe Nataly Do

 Recovered patients

75% 50% 25%

Transplants Medication Habits
Venus is the second planet Despite being red, Mars is a Saturn is a gas giant and has
from the Sun cold place several rings
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