DETEKSI DINI GANGGUAN MINERAL TULANG PADA PENYAKIT GINJAL KRONIK: TINJAUAN SISTEMATIK
EARLY DETECTION OF BONE MINERAL DISORDERS IN CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW
Abstract
Gangguan metabolisme mineral dan tulang merupakan komplikasi penting pada pasien penyakit ginjal kronik yang berdampak pada meningkatnya morbiditas, mortalitas, dan risiko fraktur tulang. Tinjauan sistematik ini bertujuan untuk menganalisis bukti terkini mengenai peran biomarker biokimia dan pemeriksaan radiologis dalam deteksi dini CKD-MBD pada pasien CKD stadium 2–5. Pencarian literatur dilakukan melalui PubMed, Scopus, dan ScienceDirect untuk periode 2015–2025. Empat studi yang memenuhi kriteria inklusi berasal dari India, Italia, Tiongkok, dan Bangladesh, dengan desain potong lintang dan kohort prospektif. Bukti yang kami himpun menunjukkan bahwa peningkatan kadar parathyroid hormone (PTH), fosfat, alkaline phosphatase (ALP), dan fibroblast growth factor-23 (FGF-23) secara konsisten berhubungan dengan penurunan bone mineral density (BMD) serta progresivitas CKD. Kombinasi pemeriksaan biokimia dengan densitometri tulang (DXA) dan pendekatan berbasis machine learning terbukti meningkatkan akurasi diagnosis dini. Oleh karena itu, pemantauan biomarker tersebut dapat menjadi strategi penting dalam deteksi dan pencegahan CKD-MBD secara komprehensif.
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