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Abstrak :
Latar Belakang. Prediksi mortalitas pada kelompok lanjut usia yang semakin meningkat jumlahnya akan memberikan banyak manfaat bagi kesehatan. Cystatin C ditunjukkan memiliki kemampuan sebagai prediktor mortalitas pada beberapa studi. Studi-studi mengenai kemampuan prediksi cystatin c masih sangatlah beragam dan belum ada telaah sistematis untuk menilai kemampuannya dalam memprediksi mortalitas jangka panjang pada kelompok lansia. Tujuan. Penelitian ini bertujuan untuk menilai kemampuan cystatin c sebagai prediktor mortalitas semua sebab dan mortalitas kardiovaskular jangka panjang pada kelompok lanjut usia. Metode. Studi ini merupakan telaah sistematis dan meta-analisis dari studi kohort prospektif observasional. Pencarian studi dilakukan di PubMed, Cochrane, Scopus, EBSCOHost, dan Proquest serta pencarian menual. Kriteria inklusi berupa lansia minimal berusia 65 tahun dengan data cystatin c serum tercantum, kematian semua sebab sebagai luaran. Waktu follow up minimal 5 tahun. Seleksi studi dilakukan berdasarkan alur dari PRISMA. Penilaian kualitas studi dan risiko bias dinilai menggunakan Newcastle Ottawa Scale untuk studi kohort. Hasil studi ditampilkan dalam bentuk deskriptif serta Forest plot. Hasil. Dari 609 studi hasil pencarian, didapatkan 12 studi yang memenuhi kriteria: 5 studi menilai kematian semua sebab, 3 studi menilai kematian kardiovaskular saja, dan 4 studi menilai keduanya. Sebanyak 6 studi dengan kualitas baik dan 6 studi kualitas sedang setelah dilakukan penilaian. Hasil meta-analisis menunjukkan kadar Cystatin C yang tinggi meningkatkan risiko mortalitas jangka panjang akibat semua sebab [HR: 1,74 (95% CI: 1,48 – 2,04); p < 0,00001)] dan mortalitas jangka panjang kardiovaskular [(HR: 2,01 (95% CI: 1,63 – 2,47); p < 0,00001)] pada lansia. Kemampuan prognostik cystatin c tergolong moderat [AUC 0,70 (95% CI: 0,68-0,72); p = 0,02)]. ...... Background. Prediction of mortality in growing aged-population will offer several benefits for health sector. Cystatin C, which has long been known as biomarker to more accurately evaluate glomerular filtration rate in elderly, has also been shown to predict mortality from several studies. Studies regarding its predictive ability were vastly varied and there has not been systematic review to examine its ability in predicting long-term mortality in elderly population. Objectives. This study aimed to evaluate Cystatin C performance as predictor for all-cause and cardiovascular mortality among elderly population. Methods. A systematic review of prospective cohort studies was performed. Literature searching was done in major databases such as PubMed, Cochrane, Scopus, EBSCOhost, and Proquest. Manual searching was also performed. Inclusion criteria were studies involving elderly age 65 or older, cystatin c serum levels available, all-cause mortality as outcome, and 5-years minimum of follow-up. Study selection was performed according to PRISMA algorithm. Newcastle Ottawa Scale for cohort study was used to assess primary studies’ quality and risk of bias. Study results were presented in descriptive tables and Forest plot. Results. Initial searching revealed 609 hits with 12 studies eligible for the review: five studies evaluated all-cause mortality, three studies evaluated cardiovascular mortality, and four studies evaluated both. Meta-analysis showed that high cystatin c levels increasing risk of long-term all-cause mortality [(HR: 1.74 (95% CI: 1.48 – 2.04); p < 0.0001)] and cardiovascular mortality [HR: 2.01 (95% CI: 1,63 – 2,47); p < 0,0001)]. The prognostic ability of cystatin c was considerably moderate [AUC 0.70 (95% CI: 0.68-0,72); p = 0.02]. Conclusion. Cystatin C was able to predict long-term mortality in elderly population.

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[ABSTRAK
Latar belakang : Pekerja yang bekerja di lingkungan panas mempunyai resiko tinggi mengalami gangguan ginjal akibat dehidrasi kronis. Gangguan ginjal dapat dicegah jika kelainan dapat dideteksi dan diterapi sejak awal dimana resiko kesakitan dan kematian juga akan berkurang. Pemeriksaan yang biasa dilakukan dalam praktek sehari-hari pada saat ini adalah dengan kreatinin. Namun pemeriksaan kreatinin baru menunjukkan kelainan pada penurunan LFG lanjut. Cystatin C dikatakan bisa mendeteksi gangguan ginjal lebih awal sebelum kadar kreatinin meningkat sehingga dapat segera dilakukan tindakan pencegahan untuk menghindari kerusakan ginjal lebih lanjut. Metode penelitian:` Penelitian dilakukan dengan desain Cross sectional. Dilakukan pada 94 pekerja laki-laki yang dipilih secara random sampling. Data dikumpulkan dengan wawancara, pemeriksaan fisik, pemeriksaan laboratorium. Kadar cystatin c serum diukur dengan metode Immunonephelometri, kreatinin diukur dengan metode enzymatik, kemudian dihitung estimasi Laju Filtrasi Glomerulus berdasar Cystatin C dan kreatinin dengan metode CKD EPI. Hasil penelitian dilakukan analisa univariate dan bivariate. Hasil: Didapatkan prevalensi Gangguan Fungsi Ginjal dari Pemeriksaan Cystatin C pada Pekerja terpapar panas dengan Laju Filtrasi Glomerulus normal sebesar 17 %. Terdapat hubungan yang bermakna antara usia dan gangguan ginjal (p=0,000) dengan OR 13,22. Terdapat hubungan yang bermakna antara masa kerja dengan gangguan ginjal (p = 0,043) dengan OR 6,67. Kesimpulan: LFG dengan Cystatin C dapat mendeteksi lebih dini gangguan ginjal sebelum kreatininnya meningkat dengan prevalensi 17% sehingga dengan upaya promotif dan preventif yang dilakukan diharapkan dapat mencegah gangguan ginjal lebih lanjut.;

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ABSTRACT
Background: Workers who work in hot environments have a high risk of having renal disorders due to chronic dehydration. Renal disorders can be prevented if the abnormality can be detected and treated early in the beginning where the risk of morbidity and mortality is lower, as well. The common test conducted in daily practice today is the creatinine clearance test. However, creatinine clearance test shows abnormalities only in an advance reduced GFR. Cystatin C is known to be able detecting renal disorders in early stage before the creatinine level increases so that precautions can be taken to prevent a more advance renal damage. Study Method: This study used a cross sectional design. It was conducted to 94 workers whom selected with random sampling. Data was collected by interview, physical examination, and laboratory tests. Serum level of Cystatin C was measured by the method of immunonephelometry. Creatinine was measured by enzymatic method and subsequently, Glomerular Filtration Rate was estimated based on cystatin and creatinine using CKD EPI method. Univariate and bivariate analysis was performed to the results. Result: The study suggest that there is prevalence of renal disorders based on Cystatin C test in heat-exposed workers with normal glomerular filtration rate by 17%. There is a significant association between age and renal disorder (p = 0,000) with OR 13.22. There is a significant relation between period of employment with renal disorder (p = 0,001) with OR 6.57. Conclusion: Cystatin-based GFR is able to detect renal disorder at early stage before the creatinine level increases with prevalence of 17% so that further renal damage is expected to be able prevented with promotion and prevention attempts. ;Background: Workers who work in hot environments have a high risk of having renal disorders due to chronic dehydration. Renal disorders can be prevented if the abnormality can be detected and treated early in the beginning where the risk of morbidity and mortality is lower, as well. The common test conducted in daily practice today is the creatinine clearance test. However, creatinine clearance test shows abnormalities only in an advance reduced GFR. Cystatin C is known to be able detecting renal disorders in early stage before the creatinine level increases so that precautions can be taken to prevent a more advance renal damage. Study Method: This study used a cross sectional design. It was conducted to 94 workers whom selected with random sampling. Data was collected by interview, physical examination, and laboratory tests. Serum level of Cystatin C was measured by the method of immunonephelometry. Creatinine was measured by enzymatic method and subsequently, Glomerular Filtration Rate was estimated based on cystatin and creatinine using CKD EPI method. Univariate and bivariate analysis was performed to the results. Result: The study suggest that there is prevalence of renal disorders based on Cystatin C test in heat-exposed workers with normal glomerular filtration rate by 17%. There is a significant association between age and renal disorder (p = 0,000) with OR 13.22. There is a significant relation between period of employment with renal disorder (p = 0,001) with OR 6.57. Conclusion: Cystatin-based GFR is able to detect renal disorder at early stage before the creatinine level increases with prevalence of 17% so that further renal damage is expected to be able prevented with promotion and prevention attempts. , Background: Workers who work in hot environments have a high risk of having renal disorders due to chronic dehydration. Renal disorders can be prevented if the abnormality can be detected and treated early in the beginning where the risk of morbidity and mortality is lower, as well. The common test conducted in daily practice today is the creatinine clearance test. However, creatinine clearance test shows abnormalities only in an advance reduced GFR. Cystatin C is known to be able detecting renal disorders in early stage before the creatinine level increases so that precautions can be taken to prevent a more advance renal damage. Study Method: This study used a cross sectional design. It was conducted to 94 workers whom selected with random sampling. Data was collected by interview, physical examination, and laboratory tests. Serum level of Cystatin C was measured by the method of immunonephelometry. Creatinine was measured by enzymatic method and subsequently, Glomerular Filtration Rate was estimated based on cystatin and creatinine using CKD EPI method. Univariate and bivariate analysis was performed to the results. Result: The study suggest that there is prevalence of renal disorders based on Cystatin C test in heat-exposed workers with normal glomerular filtration rate by 17%. There is a significant association between age and renal disorder (p = 0,000) with OR 13.22. There is a significant relation between period of employment with renal disorder (p = 0,001) with OR 6.57. Conclusion: Cystatin-based GFR is able to detect renal disorder at early stage before the creatinine level increases with prevalence of 17% so that further renal damage is expected to be able prevented with promotion and prevention attempts. ]

Abstrak :
ABSTRAK
Angka kejadian penderita kanker baik nasional maupun dunia cukup tinggi. Di Indonesia karsinoma nasofaring merupakan jenis tumor ganas terbanyak yang menempati urutan keempat dad seluruh tumor ganas setelah karsinoma serviks, payudara, dan kuiit. Keganasan tersebut sexing terlambat didiagnosis dan mempunyai prognosis yang jelek, meskipun keganasan ini sensitif terhadap penyinaran dan kemoterapi. Namun terapi untuk kanker khususnya kemoterapi mempunyai efek samping yang tidak sedikit terutama obat cisplatin sering menyebabkan nefrotoksis. Pada pasien kanker biasanya sebelum kemoterapi secara nrtin dilakukan pemeriksaan penilaian fungsi ginjal. Penilaian fungsi ginjal dengan bersihan kreatinin (Creatinine Clearance Test= CCT) sering menjadi kendala dalam hal penampungan urin 24 jam. Untuk mengatasinya sering dipakai CCT cara hitung menurut rumus Cockroft dan Gault tetapi dipengaruhi puia banyak faktor yaitu usia, berat badan dan jenis kelamin, Walaupun dikenal uji Baku emas GFR berupa uji bersihan inulin, uji kontras radiologik iohexol atau Cr-ECTA, namun cara-cara tersebut kurang praktis untuk diterapkan secara rutin. Saat ini telah dioerkenalkan parameter uji baru laboratorium untuk LFG yaitu penetapan kadar Cystatin C dalam darah. Cara baru ini mempunyai beberapa keunggulan dibandingkan dengan CCT karena Cystatin C diproduksi oleh sel badan secara tetap, dltras'. babas melalui glomeruli dan tidak disekresi oleh tubulus ginjal. Cystatin C direabsorbsi oleh tubulus proksimal tetapi Iangsung dimetabolisis dalam sel tubulus proksimal tersebut sehingga tidak masuk ke dalam darah. Pengukurarr Cystatin C cukup dengan kadar dalam darah, tanpa penampungan urin 24 jam. Pemeriksaan fungsi ginjal dengan kadar Cystatin C saja tanpa dikonversikan menjadi LFG sulit untuk menentukan penurunan derajat ringan, sedang dan berat. Oleh karena itu pemeriksaan Cystatin C dikonversikan dengan menggunakan rumus Amal dan Hoek, tetapi dengan kedua rumus tersebut belum dapat terlihat penurunan fungsi ginjal yang dini karena jumlah sampel kurang memenuhi syarat.

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ABSTRACT
The incidence of cancer patients nationally and globally is quite high. In Indonesia, nasopharynx carcinoma is in fourth place among commonly found malignant carcinomas,after carcinomas of the cervix, breast and skin. This malignancy is generally diagnosed late and the prognosis is not good, inspite of its sensitivity to radiation and chemotherapy. Chemotherapy has substantial side effects, especially cisplatin which often causes nephrotoxicity. Before starting therapy for cancer patients, evaluation of renal function are routinely carried out. Evaluation of renal function using Creatinine Clearance Test (CCT) often' encounter problems in 24 hour urine collection. To overcome this, CCT count with Cockroft and Gault formula is usually used, however, this test is also influenced by many factors such as age, body weight and sex. Even though there are GFR gold standard tests for GFR such as inulin clearance test, iohexol radiological contrast test or Cr-EDTA, these tests are not practical to be carried out routinely. At present, a new laboratory test parameter for GFR is introduced by establishing Cystatin C levels in the blood. This new procedure has a number of benefits compared to CCT because Cystatin C is produced by body cells continually, freely filtrated through the glomeruli and not secreted by the proximal tubule but is directly metabolized inside the proximal tubule, thus does not enter the blood. Cystatin C level can be measured in the blood without having to conduct a 24 hour urine collection. By carrying out renal function test using solely Cystatin C without conversion to GFR, it is difficult to identify whether the decrease was of mild, medium or severe degree. As the consequence, Cystatin C conversion is done using the Amal and Hoek formulas, however, by using these two formulas early decrease in renal function still could not be detected due to inadequate amount of samples.

Abstrak :
ABSTRAK
Tujuan: Mengevaluasi efek injeksi anti-VEGF intravitreal, bevacizumab, terhadap kadar cystatin C plasma dan VEGF plasma dan meninjau korelasi antara kedua faktor tersebut. Metodologi: Penelitian ini merupakan studi eksperimental satu kelompok dengan sampel dipilih secara konsekutif dari populasi terjangkau. Pemeriksaan oftalmologi lengkap, tekanan darah, laboratorium darah perifer lengkap, dan pemeriksaan kadar cystatin C plasma dan VEGF plasma dilakukan pada subjek sebelum injeksi dan 14 hari pasca injeksi bevacizumab intravitreal dosis 1,25 mg (0,05 cc). Hasil: 33 subjek dilibatkan dalam penelitian ini. Dari seluruh subjek, 63,6% adalah perempuan dan 36,4% adalah laki-laki dengan usia rata-rata 66,4 ± 8,3 tahun. Tidak terdapat perbedaan bermakna secara statistik antara kadar VEGF plasma pre dan pasca injeksi (p=0,339). Tidak terdapat perbedaan bermakna secara statistik antara kadar cystatin C plasma pre dan pasca injeksi (p=0,709). Uji korelasi antara perubahan VEGF plasma dengan perubahan cystatin C plasma pre dan pasca injeksi menunjukkan korelasi yang tidak bermakna (p=0,142). Kesimpulan: Kadar cystatin C plasma tidak berubah secara signifikan pre dan pasca injeksi bevacizumab pada injeksi satu kali. Tidak ditemukan adanya korelasi antara penurunan kadar VEGF plasma dengan peningkatan kadar cystatin C pada pasien AMD neovaskuler pasca injeksi bevacizumab.

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ABSTRACT
Objective: To evaluate the effect of intravitreal bevacizumab injection on plasma cystatin C and plasma VEGF levels and the correlation between the two factors. Methodology: This research was a single arm study with samples selected consecutively from an assigned population. Ophthalmology examinations, blood pressure, complete blood count, and assessments of plasma cystatin C and plasma VEGF levels were carried out on subjects before and 14 days after intravitreal bevacizumab injection of 1.25 mg (0.05 cc). Results: 33 subjects were included in this study. Of all subjects, 63.6% were women and 36.4% were men with an average age of 66.4±8.3 years. There was no statistically significant difference between pre and post injection plasma VEGF and plasma cystatin C levels (p=0.339 and 0.709 respectively). Correlation test between changes in plasma VEGF with changes in plasma cystatin C pre and post injection showed no significant correlations (p=0.142). Conclusion: Plasma cystatin C levels did not change significantly before and after injection of bevacizumab on one-time injection. No correlation was found between decreasing plasma VEGF levels and increasing levels of cystatin C in patients with neovascular AMD after bevacizumab injection.

Abstrak :
Untuk kepentingan klinik, pemeriksaan laju filtrasi glomerulus (LFG) adalah petanda paling penting dalam evaluasi fungsi ginjal pada penderita Penyakit Ginjal Kronik (PGK). Saat ini baku emas pemeriksaan LFG yang paling tepat adalah bersihan inulin tetapi tidak tersedia di Indonesia. Pemeriksaan yang setara dan tersedia di RSCM, adalah pemeriksaan renogram 99 Tc DTPA. Uji bersihan kreatinin yang dianggap mendekati nilai LFG banyak dipengaruhi kesalahan pengumpulan urin. Oleh karena itu untuk pelaksanaan rutin dipakai klasifikasi dan cara estimasi LFG menurut rumus bersihan kreatinin Cockroft & Gault yang direkomendasi oleh K/DOQI, dengan atau tanpa koreksi luas permukaan badan berdasarkan nilai kreatinin serum. Pemeriksaan kadar serum Cystatin C adalah parameter baru yang dikatakan lebih sensitif dibandingkan bersihan kreatinin Cockroft & Gault. Tujuan penelitian adalah mendapatkan pemeriksaan penurunan fungsi ginjal yang lebih baik dibandingkan bersihan kreatinin. Jenis penelitian uji diagnostik. Tiga puluh orang kelompok PGK stage 1,2 dan 3 diperiksa untuk mendeteksi penurunan fungsi ginjal dini. Setiap subyek diperiksa kadar serum Cystatin C dengan cara imunonefelometri, kadar kreatinin serum dengan metode Jaffe kinetik, perhitungan estimasi LFG dengan bersihan kreatinin Cockroft & Gault modifikasi Coresh (CGC), dan 99TcDTPA renogram sebagai baku emas. Hasil penelitian didapatkan hasil uji bersihan kreatinin CGC berada dalam rentang 39- 90 mL/menit/1,73m2 dengan median 72,1 mL/menit/1,73m2, hasil uji kadar Cystatin C serum 0,48 - 3.02 mg/L dengan median 0,81 mg/L dan rentang LFG DTPA 75 -126 Ml/menit/1,73m2 dengan median 118,0 mL/menit/1,73m2. Sensitifitas dan spesifisitas untuk uji Cystatin C adalah 100% dan 57,1% sedangkan untuk bersihan kreatinin CGC adalah 100% dan 38,5%, sehingga kedua uji dapat digunakan sebagai parameter penurunan fungsi ginjal. Berdasarkan hasil nilai-nilai spesifisitas, prediksi negatif, akurasi diagnostik dan Iuas daerah di bawah kurva ROC dari kadar Cystatin C lebih tinggi dari CGC, maka Cystatin C lebih tepat digunakan untuk penetapan adanya kerusakan ginjal dengan penurunan LFG.

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For clinical purpose, glomerular filtration rate (GFR) is the most important marker for evaluation of kidney function in Chronic Kidney Disease (CKD). At present, the gold standard for accurate GFR assessment is inulin clearance which is not available in Indonesia. The alternative examination is renogram 99mTc DTPA. Creatinine clearance test which is assumed to be as close to the GFR value still have many error in urine collection. In clinical practice, GFR estimated from serum creatinine by Cockroft & Gault equation is recommended by KIDOQI and widely accepted as a simple measurement of GFR. Serum Cystatin C is a new parameter which is more sensitive than Cockroft & Gault creatinine clearance. The aim of this study is to get a method to detect early renal dysfunction better than creatinine clearance. Type of study is diagnostic test. We assessed the serum Cystatin C to detect early renal dysfunction in 30 patients with GFR stage 1,2 and 3, classified by KJDOQI staging. Measurements of the following were performed in each subject: serum Cystatin C immunonephelometric assay, serum creatinine by Jaffe kinetic method, GFR estimated from serum creatinine by Cockroft & Gault equation modified by Coresh (CGC), and 99mTcDTPA renogram as gold standard. Results were CGC ranged from 39 to 120 mUmin11.73m2, median 72.1 mL/min/1.73m2. serum Cystatin C ranged from 0.48 to 3.02 mg/L, median 0.81 mg/L and DTPA renogram ranged from 75 to 126 ML/min/1.73m2, median 118.0 mL/min/1.73m2. The sensitivity and specificity of cystatin C in detecting early CKO was calculated to be 100% and 57.1% respectively; compared to CGC were 100% and 38.5%, which allow the tests as a screening test and area under ROC curve of C. Based on the specificity and the negative predictive value, diagnostic accuracy values and area under ROC curve of Cystatin C were superior to CGC, Cystatin C is more reliable measure to determine early renal dysfunction with LFG decr.

Abstrak :
Penderita thalassemia β mayor berisiko mengalarni hemokromatosis yang dapat merusak dan menurunkan fungsi ginjal. Pemeriksaan kadar kreatinin serum secara rutin telah digunakan untuk menilai fungsi ginjal namun cara ini banyak kekurangannya, sedangkan parameter baru cystatin C serum diketahui febih baik dibandingkan kreatinin namun belum pernah diteliti pada penderita thalassemia β mayor dengan hemokromatosis. Dengan mengetahui Iebih dini adanya penurunan fungsi ginjal maka diharapkan dapat menghambat progresititas penurunan fungsi ginjal pada penderita thalassemia β mayor dengan hemokromatosis. Penelitian ini bertujuan menilai fungsi ginjal penderita thalassemia β mayor dengan hemokromatosis. Janis penelitian, potong lintang diiaporkan dalam bentuk deskriptif analitik. Pengambilan darah dan data subyek dilaksanakan di pusat Tfralassemia ilmu Kesehatan Anak dan pengukuran laboratorium dilaksanakan di Departemen Patologi Klinik FKU/RSCM. Semua pasien yang memenuhi kriteria masukan diambil yaitu usia 10-21 tahun, saturasi transferin > 55%, pengobatan desferal < 3 kali per minggu, tidak mendapat obat yang mengganggu sekresi kreatinin. Hasil penelitian didapatkan, kadar kreatinin serum berkisar 0,2-0,7 mg/dL kadar cystatin C serum berkisar 0,69-1,31 mg/L, laju filtrasi glomerulus berdasarkan kadar cystatin C serum dengan menggunakan rumus Hoek (LFG-C) berkisar 57-112,1mL/menit/1,73m2, laju filtrasi glomerulus berdasarkan kadar kreatinin serum menggunakan rumus Counahan-Barrat (LFG-K) berkisar 95,2-288,1 mL/menit/1,73 m2 dan tidak dijumpai perbedaan hasil antara lelaki dan wanita pada parameter tersebut diatas. Dare 62 penderita thalassemia β mayor dengan hemokromatosis didapatkan penurunan fungsi ginjal yaitu laju filtrasi glomerulus < 90 mL/menit/1,73m2 sebesar 75,8% jika ditetapkan dengan LFG-C yang mulai terlihat setelah 96 bulan mendapat transfusi berulang. Namun jika ditetapkan dengan LFG-K semuanya belum menunjukkan adanya penurunan fungsi ginjal. Dijumpai korelasi antara lamanya mendapat transfusi darah dan LFG-C dengan r = - 0,475; sedangkan antara total volum darah transfusi dengan LFG-C dengan r = - 0,467; antara kadar kreatinin dan cystatin C serum dengan r = 0,504. Dijumpai korelasi lemah antara LFG-K dan LFG-C dengan r = 0,37. Tidak djumpai adanya korelasi antara kadar cystatin C serum dengan saturasi transferin. Didapatkan persamaan garis linier regresi pengaruh lamanya mendapat transfusi darah (Y} terhadap rerata LFG-C (X) yaitu Y = 569,1 - 5,06X, sedangkan pengaruh total volum darah transfusi (Y) terhadap LFG-C (X) yaitu Y 107380,7 - 617,414X. Pada penderita thalassemia p mayor dengan hemokromatosis kadar kreatinin serum cenderung rendah oleh karena itu pemantauan fungsi ginjal tidak dianjurkan menggunakan LFG-K, sebaiknya menggunakan LFG-C.

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Patients with j3-thalassemia major are at risk of developing hemochromatosis that will deteriorate and decrease renal function. Routine serum creatinine measurement has utilized to assess renal function, but this method has a lot disadvatages, while cystatin C a new parameter is known to be better than serum creatinine but had never been studied in p-thalassemia major patiens with hemochromatosis. Early detection of decreased renal function cans hopefully, slower the progressivity of renal function decrease in 13-thalassemia major patiens with hemochromatosis. The aim of this study was to access renal function in p-thalassemia major patiens with hemochromatosis. This study was designed as cross-sectional study, and the report was analytic descriptive. Blood and subject data collection was performed in the Thalassemic Center, Departement of Child's Health, FMU1 and laboratory test were performed in the Departement of Clinical Pathology, FMUI, Cipto Mangunkusumo National Hospital. All eligible patiens, i.e aged 10-21 years, with transferrin saturation of > 55%, on desferal with frequency of less than 3 timelweek, not on any medication that affect creatinine secretion, were included in this study. Result of this study showed that serum creatinine level ranged between 0.2-0.7 mg/dL, serum cystatin C level ranged between 0.69-1.31 mg/dL, glomerular filtration rate based on serum cystatin C level calculated with Hoek formula (GFR-C) ranged from 57- 112.1 mUminll.73 m2, glomerular filtration rate base on serum creatinine level calculated with Counahan-Barrat formula (GFR-K) ranged from 95.2-288.1 mL/min/1.73 m2 and there were no significant difference between male and female for all the parameters above. Of 62 subjects, we found decreased renal function, Le. GFR < 90 mL/min/1.73 m2 in 75,8% if GFR-C was used, and decrease was evident approximately 96 months after first administration of repeated transfusion regiment. But, if GFR-K was used, none of the patiens showed decrease renal function. There were negative correlation between the time interval from first transfusion and GFR-C (r = - 0.475) and between total volume of transfused blood (r = -0.467). Positive correlation was observed between serum creatinine and cystatine C level (r = 0.504). Weak correlation was found between serum cystatin C level and transferrin saturation. The equation of linear regression between the length of transfusion (Y) and mean GFR-C (X) was Y = 569.1 - 5.06X, while linear regression line between total volume of transfused blood (Y) and GFR-C (X) was Y = 107380,7 - 617.414X. In p-thalassemia major patiens with hemochromatosis, serum creatinine level tended to be low, thus GFR-K is not recommended for determination of renal function, and instead, GFR-C is a better measure of renal function in those patiens.