232 PROCEEDING BOOK
The 2
nd
International Conference on Health Science 2015
Table 6. Frequency Distribution of Respondents’ Creatinine Levels
No. Creatinine Level Mean
± SEM SD
Minimum value
Maximum value
1. Respondents in general
11,04 ± 1,06
5,80 3,80
27,50
2. Age
30-45 tahun
46-59 tahun
60-80 tahun
10,88 ± 1,44
12,61 ± 2,03
7,31 ± 1,16
4,78 6,73
3,06 4,80
7,10 3,80
20,60 27,50
10,6
3. Sex
Male Female
10,25 ± 1,47
12,08 ± 1,52
6,08 5,48
3,80 4,80
27,50 21,50
4. Diabetes Mellitus status
CRF without DM CRF with DM
13,29 ± 1,39
7,16 ± 0,70
6,05 2,33
4,80 3,80
27,50 11,00
Table 7. Difference test on BUN and Creatinine Levels
No. Variables Difference test
p value Interpretation
1. BUN Mann whitney test
0,590 Not signifi cantly different
2. Creatinine Independent t-test
0,003 Signifi cantly different
DISCUSSION
Chronic renal failure CRF is a condition of kidney damage that can be seen bythe results of urination, radiology and histology examination. CRF diagnosis is made when a
patient has a glomerular fi ltration rate GFR of less than 60 mL min 1.73 m² in the same period for more than three months.
8
End-stage renal disease ESDR, or terminal renal failure, is defi ned as kidney damage characterized by decreased GFR 15 mL min 1.73
m², as well as abnormalities examination of serum BUN.
9
Age as A Risk Factor of CRF
Chronic renal failure CRF is a disease that can be suffered by all age ranges, either children, teenagers or the elderly. This is in line with the results listed in Table 1 which point
out that respondents with CRF can be found in young adults 3.30, middle age 36.70, older adults 36.70, and the elderly 23.30.
Kidney failure can occur in all age ranges withvarious causes.
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At a young age, failure can result from chronic dehydration and nephrotoxic substances. Consumption of food or
beverages containing nephrotoxic substances will accelerate the destruction of kidney cells. At the age of older adults and the elderly, the growing ability of kidney cells anatomically
decline and the deterioration of the kidney cell function may also start to occur.
10
Most respondents 96.70 in this study was 40 years old and above. The results correspond Lindeman and Preuss’ theory 1994, which states that the kidney function will
decline progressively from the age of 40 years.
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Kidneys will experience changes in structure and function along withhuman aging proccess. According to Chadijah and Wirawanni 2012,
renal function begins to decline by the age of 40 years and at the age of 60 years old the function remainshalf of the capacity function at the age of 40 years, due to the physiological
“Optimizing The Quality of Life Children Under SDGs” Sustainable Development Goals
233
process in the form of the reduced population of nephrons and the kidney cells’ inability to regenerate.
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The results in this study are in line with Fransiska’s 2007, which states that the majority of CRF patients were 51-60 years old.
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Research conducted by Daryani 2011, states that the average CRF patients had an age range of 40-46 years.
14
According to O’Hare et al. 2007, CRF disease often suffered by the elderly. This is because the elderly begin to
encounter a declining nephron function of the kidneys. CRF patients of the elderly have a higher risk of death due to the lower value of the glomerular fi ltration rate GFR. Theaverage
GFR value ofelderly with CRF is 15 mL min per 1.73 m² while that of adults with CRF is GFR 45 mL min per 1.73 m².
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According to Weinstein and Anderson 2010, aging will progressively lead to a decrease in the value of GFR and renal blood fl ow RBF. GFR decline will cause a decrease in
average plasma fl ow and a decrease in the glomerular capillary coeffi cient. The decreasing afferent arteriolar resistance is associated with the increase in glomerular capillary hydraulic
pressure. The hemodynamic changes occur due to changes in the structure of kidney aging, such as the loss of renal mass, the hyalinisation of the afferent arterioles, the increase of
glomerular sclerotic and tubulointersitial fi brosis. Aging also will disrupt the activity and responsiveness towards vasoactive stimuli, such as the body’s decreased response to perform
vasoconstriction and vasodilation, and also the decreased activity of the renin-angiotensin and nitric oxidemechanism regulations.
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Sex as A Risk Factor of CRF
Table 1 shows that the majority of respondents in this study 56.70 is male. Some theories mention that one of the CRF disease risk factors is sex. This study corresponds the
results of research conducted by Saryono Handoyo 2006, which states that the majority of patients with CRF were males 67.00.
10
This is possible because the male urinary tract is longer which may allow the higher possibility of clogging along the way out from the
bladder. These clogging may include channel narrowing structure or stone blockage within the urinary tract.
A research by Weinstein and Anderson 2010 suggests that sex hormones contribute to CRF. CRF progression in females is slower than in males, both clinically and experimentally
experimental treatment. Gender and age affect changes in the renin-angiotensin system RAS and nitric oxide NO, as well as the activity of metalloproteases. Metalloproteases is
a protease enzyme that perform mechanismof metal catalysis.
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The infl uence of sex on RAS is at the interaction between 17β-estradiol E2 and Angiotensin II. E2,which decreases at the network level, is capable of lowering the activity
of angiotensin II and Angiotensin Converting Enzyme ACE. Conversely, testosterone will increase the activity of RAS. In experimental studies, esterogen therapy and androgen
defi ciency are used as the protection against the progression of CRF.
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Nitric oxide NO is a cytokine that has a protective effect on the kidneys as it prevents decreases in mesangial cells and matrix production. Differences in the levels of NO in sex
due to the interaction between NO and E2, which will stimulate the release of NO synthase. A comparative study between pre-menopausal women and men, showed that the synthesis
and production of NO in women were greater than those in men.
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The incompatibility of metalloproteases levels are also infl uenced by sex, especially its association with renal dysfunction. Metalloprotease is capable of splitting the matrix which
