DISTRIBUSI GEOGRAFIS PENYAKIT GINJAL KRONIK DI BALI: KOMPARASI FORMULA COCKCROFT-GAULT DAN FORMULA MODIFICATION OF DIET IN RENAL DISEASE

Abstract

Chronic kidney disease (CKD) is related to the increased of cardiovascular morbidity and mortality. This
study is aiming to identify the prevalence of CKD based on demographical distribution in Bali. A community
based study has been conducted in Bali, 1) height region among indigenous community in a village at northern
part of Bali island using cluster random samples.; 2) in urban area at Denpasar city using stratified random
sampling and 3) in isolated coastal area in Nusa Ceningan island using cluster random sampling. The glomerular
filtration rate was calculated by Cockroft-Gault (C-G) formula and abbriviated Modification of Diet in Renal
Disease ringkas with 4 variables (MDRD-4). The results of GFR using both calculation were compared. CKD
was defined based on KDOQI classification, namely GFR less than 60 ml/mnt. During the study 826 samples
were collected consisted of 219 from height region (males/females 118/101, aged 48±15 years, BW 48.9±10.4
kg, creatinine 0.97±0.64 mg/dL), 302 from urban area (males/females 137/165, aged 43±16 years, BW
56.1±12.1 kg, creatinine 0.81±0/.19 mg/dL) and 305 isolated coastal area (males/females 150/155, aged 42±16
years, BW 53.5±10.3 kg, creatinine 1.00±0.18 mg/dL). Using C-G, mean prevalence of CKD was 56.0%
(95%CI 51.2-60.7%) consisted of 69.9% (95%CI 60.6-77.9%) in height region, 61.9% (95%CI54.5-68.8%) in
urban and 42.3% (95%CI 33.7-51.4%) in isolated coastal area. Using 4-MDRD formula, mean prevalence of
CKD was 6.0% ( 95%CI 1.4-18.2%) consisted of 4.8% (95%CI 0.00-31.2%) in height region, 2,6% (95%CI5
0.3-43.1%) in urban and 9.8% (95%CI 2.5-27.4%) in isolated coastal area. In conclusion, there is a significant
difference of CKD prevalence in Bali if calculated by C-G compared with MDRD-4. Prevalence of CKD in Bali
with MDRD-4 (6.0%) is similar to those in other countries such as USA (4.2%) and Thailand (8.8%). Whether
the calculation of GFR using MDRD-4 is more accurate than C-G in this setting, needs further study.