JAKARTA - The case of acute kidney failure that appears in children has made people panic, because the disease has mysteriously attacked children in a number of areas in Indonesia.
The kidney disease was first revealed in pediatric patients at Professor Dr. Ngoerah Denpasar, Bali, which has been treated since August 2022, but has only been known to experience acute kidney failure since mid-September.
Chairman of the Indonesian Pediatrician Association (IDAI) Bali Province, doctor I Gusti Ngurah Sanjaya Putra, said there was one common case of most cases of mysterious acute kidney failure that attacked children, especially those being treated at Prof. Ngoerah Hospital.
Of the 17 children handled, such cases have links to each other, but they are not considered as the cause. Because there is an MISC (multsystem inflammatory syndrome in children), there are also many cases that are the same outside.
Consultant pediatrician Prof. Dr. dr. Sudung O. Pardede, Sp.A(K) asked the public not to panic in responding to cases of atypical progressive acute kidney disorders that occurred in Indonesia.
Health workers will certainly do their best to treat children with kidney disorders. In addition, the government has also taken a policy regarding the withdrawal of sirop drugs which aims to prevent new cases from appearing again.
Parents can look for alternative drugs other than sirop drugs for a while while while while waiting for the results of an investigation conducted by the Food and Drug Supervisory Agency (BPOM) and the Ministry of Health.
He reminded that it is not certain that all sirop drugs contain substances that are suspected to cause acute kidney disorders so that parents are asked not to panic.
For parents who have already given sirop drugs to children who are included in the list whose circulation is drawn by the government, parents are asked to monitor the condition of their children first, especially to ensure the amount of urine produced.
There is one thing that is easy for the general public to know the condition of children after taking the drug is there or not, the amount of urine decreases. If the child experiences such disorders and the parents are suspicious, immediately check it with the doctor so that it can be followed up, in the form of a blood test in the laboratory
There is a kreatinine or ureum in the blood to be examined, this alone can already know whether there is a decrease in kidney function or not. If for example there is an increase from the creative in children, then there is a decrease in kidney function. If there is no, don't worry," he said, quoted from ANTARA, Saturday, October 29.
Earlier on Friday (21-10), the Ministry of Health had announced as many as 102 brands of sirop drugs consumed by patients with atypical progressive acute kidney failure in Indonesia.
Health Minister Budi Gunadi Sadikin had previously said that the sirop drug product was clinically proven to contain polyethylene glycol. This material is used as a solvent for sirop and harmless drugs as long as its use is on a safe threshold.
Polyethylene glycol is said to trigger contamination if the mixed formula is bad, such as ethylene glycol (EG), diethylene glycol (DEG), and ethylene glycol butyl ether (EGBE).
The acute kidney maladministration of the supervisory body for the implementation of public services of the Ombudsman RI asked the government to take corrective actions related to maladministration in handling cases of atypical progressive acute kidney disorders that befell children in Indonesia.
"Accountability must be shown not always leads to dismissal, it does not always lead to abstractive sanctions, but corrections to policies and implementation steps are very important," said RI Ombudsman member Robert Na Endi Jaweng.
The Ombudsman revealed the potential for maladministration carried out by the Ministry of Health and the Food and Drug Supervisory Agency (BPOM) regarding sirop drug health services that cause atypical progressive acute kidney disorders.
Robert assessed that the Ministry of Health does not yet have basic data related to the spread of diseases starting from the district and city, provincial and central levels, causing negligence in preventing cases of acute kidney disorders.
Due to the absence of data, he continued, the Ministry of Health was not involved in conducting socialization in the form of providing information to the public regarding the causes and anticipation of acute kidney disorders. This can be interpreted as the absence of openness and accountability of valid and trusted information related to the case.
Then, standardization of prevention and handling of cases that do not exist in all health service centers causes public service standards to not be met, including laboratory examination services. "That is potential for maladministration at the Ministry of Health," said Robert.
Meanwhile, the potential for BPOM maladministration is related to pre-market supervision (processes before drugs are distributed and circulated) and post-market control (supervision after products are circulated).
In terms of pre-market supervision, the Ombudsman assesses that BPOM does not optimally supervise products tested by pharmaceutical companies (self-tests). In addition, the Ombudsman also assesses that there is a gap between standardizations regulated by BPOM and implementation in the field. The verification and validation stage before issuance of a distribution permit must be maximized by BPOM.
As for handling the potential for post-market control maladministration, the Ombudsman assessed that in that stage there would be a need for BPOM supervision after the distribution permit. On the point of potential maladministration, the Ombudsman then assessed that BPOM needed to conduct periodic evaluations of the products in circulation. This aims to ensure consistency of the quality of the product content in circulation.
He asked the government to seriously respond to this as a form of their corrective action, at least the right to information is fulfilled, massive explanations and socialization must be carried out, and then there must also be extraordinary steps taken.
Based on data from the Ministry of Health as of Monday (24-10), the number of acute kidney disorders reached 251 cases originating from 26 provinces in Indonesia. About 80 percent of cases occurred in Jakarta, West Java, Aceh, East Java, West Sumatra, Bali, Banten, and North Sumatra. The percentage of mortality rates is around 56 percent or as many as 143 cases. The addition of six cases, including two deaths, reportedly not new cases.
The government has brought in 26 vials and 16 vials, respectively. The drug will be re-imported hundreds of vials from Japan and the United States to be distributed to government referral hospitals. The public can get the bidder for free.
Avoid taking sirop drugs The Chairperson of the Indonesian Pediatrician Association (IDAI) Piprim Basarah Yanuarso advised parents to avoid giving paracetamol sirop drugs to children who have fever as a form of vigilance against acute kidney failure.
Currently, too many antibiotic drug products are circulating in the market, including those containing paracetamol. In fact, these products are often an instant path for parents to reduce child fever. This recommendation is an early warning system that can be applied by parents based on learning from cases of acute kidney failure that attack children in a number of areas in the country.
Parents are invited back to conservative treatment methods to reduce fever in children, one of which is by being given sufficient rest and not using antibiotics.
Facing these problems, parents are asked to remain vigilant but not panic.
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