Sherly Yuniarchan, Sherly
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Risk factors for hypertensive crisis in children with acute glomerulonephritis Yuniarchan, Sherly; Prasetyo, Risky Vitria; Soemyarso, Ninik Asmaningsih; Noer, Mohammad Sjaifullah
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.518 KB) | DOI: 10.14238/pi56.2.2016.101-6

Abstract

Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN). Some factors have been suggested to affect blood pressure (BP) in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age); and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years). We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17) years), with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6%) children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5%) and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021). Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.
RISK FACTORS OF MORTALITY IN CHILDREN WITH WILMS’ TUMOR AT SOETOMO HOSPITAL SURABAYA Shanty, Maria Christina; Yuniarchan, Sherly; Andarsini, Mia Ratwita; Ugrasena, I Dewa Gede; Permono, Bambang; Prasetyo, Risky Vitria
Indonesian Journal of Urology Vol 26 No 2 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (7762.046 KB) | DOI: 10.32421/juri.v26i2.469

Abstract

Objective: Wilms? tumor is the most common childhood renal tumor for about 6% of pediatric malignant disease. The 5-year survival rate in United States increased from approximately from 70% (1970-1973) to 92% (1989-1996). This study was aim to analyze the risk factors of mortality in children with Wilms? tumor. Material & Methods: A cross-sectional study was conducted in children with Wilms? tumor at Soetomo Hospital during 2006-2011. The data of demographic, clinical profile, complete blood count, blood urea nitrogen, glomerular filtration rate, histological type, disease stage, metastases and relapse were analyzed as risk factors of mortality using logistic regression. Results: There were 37 Wilms? tumor children and 5 children were excluded because of incomplete data. The mean age was 3.0 (SD 2.6) years, and male-to-female ratio was 2.5 : 1. There were 5/32 children in stage I, 7/32 children in stage II, 8/32 children in stage III, 11/32 children in stage IV, and 1/32 children in stage V. There were 15/32 children underwent operation. Complete remission occurred in 12/32 children and 1/32 children relapsed. There were 20/32 children died, associated with anemia (P=0.033, OR=6.111, 95% CI=1.056-35.352) and advanced stage (P=0.021, OR=8.000, 95% CI=1.575-40.632). The risk of mortality increased 3.284 folds with every increased stage (P=0.007, 95% CI=1.338-7.775). Conclusion: Disease stage is the significant risk factor of mortality in children with Wilms? tumor.