EFFECT OF GLOMERULOSCLEROSIS INDEX, TUBULAR INDEX, AND MATRIX METALLOPROTEIN AGAINST SERUM CREATININE AND ESTIMATED GLOMERULAR FILTRATION RATE IN OBSTRUCTIVE KIDNEY STONE PATIENTS IN SANGLAH GENERAL HOSPITAL DENPASAR BALI

Abstracs Objective : Kidney stones is one of the many causes of chronic kidney disease (CKD) in clinical and kidney fibrosis in histopathology presentation. Its occurs characterized by the presence of glomerulosderosis (GS), tubulointerstitial fibrosis (TIF)and an tubular atrophy (TA). This research aims to find out that the effect of glomerulosderosis index (GSI), tubular index (TI), andmatrix metalloprotein (MMP-9) againt serum creatinine (SC) and estimated glomerular filtration rate (eGFR) in kidney stone disease. Methode : A total of 62 samples of kidney biobsy patients during kidney stone surgery in Sanglah General Hospital Denpasa-Bali, from February until December 2013 Kidney tissue biopsy stained with Masson’s Trichrome. Determination of GSI was counted GS in 30 glomerular in power field 400, and TI was counted normal tubular in 30 glomerular in power field 400, and MMP-9 was carried out using Kit Methode. Structural Equation Modelling (SEM) program Analysis of Moment Structure (AMOS) was used to analyze the effect of GSI, Tl, and MMP-9 againt SC and eGFR in kidney stone patient. Result : Descrptive analysis were male 43 (69.35), and female 19 (30.65%) Age (years) 50.0* 10.56;SC (mg/dl) 1.71 (0.47 to 6.76); GSl(glomerosclerosis/30glomerular) 11 (0-30);Tl(normal tubular/30 glomerular) 850.24 (118 to 1513); eGFR (ml/min) 65.41 + 20.47: Leukocytes (cells/mm3) 7.82 + 1.89; and MMP-9 (ng/ml) 6.13 (0.05 to 28.37) Direct and total effect (direct and indirect effect) were GS to eGFR = -0.16 and 0.33; Tl to eLFG = 0.28 and 0.36, GS to SC = 0.31; TI to SC = -0.14;MMP -9 to SC = -0.16; SC to eGFR = -0.55. Conclusion : Direct and total effect of GSl to eGFR were negative (-) 16% ; TI to eGFR were positive (+) 36%. Direct effecs (without indirect effect; direct effect as same as a total effect) of GSI, MMP-9, and TI to SC were positive (+) 31%, negative (-) 16%; and negative (-) 14% consecutively. Direct effect or total effect of SC to eGFR were negative (-) 55% The result conduded that the effect measurements of urinary MMP-9 , and GSI, and TI score to SC were negative (-) 16%, positive (+) 31% and negarive (-) 14% consecutively. The effect measurement of urinary MMP-9, and GSI, and TI score to eGFR were negative (-) 0.09%, negative (-) 16%, and positive (+) 28%.