Background: Currently, there is limited epidemiology data on acute kidney injury (AKI) in Indonesia. Therefore, we assessed the incidence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods: Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria. Results: Overall incidence of AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5% had stage 1, 33% had stage 2, and 48.5% had stage 3. Primary diagnosis of renal disease and high APACHE II score were the risk factors associated with AKI (OR = 4.53, 95% CI: 1.67-12.33, p = 0.003 and OR = 1.14 per 1 unit increase, 95% CI: 1.09-1.20, p < 0.001, respectively). Chronic kidney disease was the risk factor for severe AKI. Sepsis was the leading cause of AKI. Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (71.7%), followed by slow low-efficiency dialysis (22.8%), continuous renal replacement therapy (4.3%), and peritoneal dialysis (1.1%). Conclusions: This study showed that AKI was a common problem in the Indonesian ICU. We strongly believe that identification of the risk factors associated with AKI will help us develop a predictive score for AKI so we can prevent and improve AKI outcome in the future.

Background : Currently, there is limited epidemiology data on acute kidney injury (AKI) in Indonesia.Therefore, we assessed the incidence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria. Results : Overall incidenceof AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5% had stage 1, 33% had stage 2, and 48.5% had stage 3. Primary diagnosis of renal disease and high APACHE II score were the risk factors associated with AKI (OR = 4.53, 95% CI: 1.67-12.33, p=0.003 and OR = 1.14 per 1 unit increase, 95% CI: 1.09-1.20, p<0.001, respectively).Chronic kidney disease was the risk factor for severe AKI. Sepsis was the leading cause of AKI.Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (71.7%), followed by slow low-efficiency dialysis (22.8%), continuous renal replacement therapy (4.3%), and peritoneal dialysis (1.1%). Conclusions : This study showed that AKI was a common problem in the Indonesian ICU. We strongly believe that identification of the risk factors associated with AKI will help us develop a predictive score for AKI so we can prevent and improve AKI outcome in the future.

Education is one of stages that must be passed in sharping the owned skill. Moreover in the 21st century, where every human is required to have the skill in their field, thus it is must be anticipated started from the childhood namely through primary education level. The main problem of this research how was the teachers’ effort in improving students’ cognitive skill through the basics of 21st century skill and how was the result of students’ cognitive skill improvement after the learning process was done. The purpose of this research was to find out what efforts done by teachers in improving the cognitive understanding skill of grade  V students during teaching and learning process activity and to find out the result of students’ cognitive skill improvement. The method used in this research was qualitative  descriptive where all problems existed would be discussed clearly. The techniques of data collection were observation, interview, and documentation. The subjects of this research were teachers of grade V MI Daarul Hikmah Tangerang. The results of this research showed that the effort done by teacher in overcoming the development occurred was by focusing on the three aspects of learning namely utilization of technology, usage of PAIKEM method in the KBM process and problem based learning. While the result obtained in the students’ cognitive improvement was increased from the previous score namely 1.840 to be 2.070.Keywords: Teacher, Students, Cognitive, The 21st Century

Background : Currently, there is limited epidemiology data on acute kidney injury (AKI) from Southeast Asia, especially from Indonesia which is one of the biggest countries in Southeast Asia. Therefore, we assessed the prevalence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria. We then assessed the Acute Physiology and Chronic Health Evaluation (APACHE) II score of AKI and non-AKI participants. RRT modalities were listed according to the number of times the procedures were carried out. Results : Overall incidence of AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5 % had stage 1, 33% had stage 2, and 48.5 % had stage 3. The use of mechanical ventilation was higher among the participants with AKI compared to the non-AKI participants. Also, AKI participants had higher average APACHE score compared to the non-AKI participants (16.5 vs 9.9). Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (69.4%), followed by slow low-efficiency dialysis (22.1%), continuous renal replacement therapy (4.2%), and peritoneal dialysis (1.1%). Conclusions : This study showed that AKI is a common problem in the Indonesian ICU and had a high mortality rate. We strongly believe that identification of the risk factors associated with AKI will help us to develop a predictability score for AKI so we can prevent and improve AKI outcome in the future.

Background : Currently, there is limited data of large databases of acute kidney injury (AKI) epidemiology from Southeast Asia, especially in Indonesia, the biggest countries in. Therefore, we aimed to provide demographic data of intensive care unit (ICU) patients with AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : We collected demographic and clinical data from 952 ICU patients. Patients were classified into AKI and non-AKI. AKI was classified according to the Kidney Disease Improving Global Outcome (KDIGO) criteria in three stages. We then assess the Acute Physiology and Chronic Health Evaluation (APACHE) II score of AKI and non-AKI patients. RRT modalities were listed down by the number of procedures conducted. Results : Overall incidence of AKI was 43%, distributed among three stages: 18.5 % stage 1, 33% stage 2, 48.5 % stage 3. Patients developing AKI need mechanical ventilation more often in comparison with non-AKI. Patients with AKI have an average APACHE score of 16.5, while non-AKI patients have an average score of 9.9. Among AKI patients, 24.6% requires RRT. The most common RRT modalities were intermittent hemodialysis (69.4%), followed by slow low efficiency dialysis (22.1%), continuous renal replacement therapy (4.2%), and peritoneal dialysis (1.1%). Conclusions: This study showed that AKI is a common problem in Indonesian ICU with containing a high mortality rate. We strongly believe that identification the risk factor of AKI will provide the opportunity to develop the predictability score for AKI prevention and finally improve AKI outcome.