The Case of Mysterious Acute Kidney Injury Increased to 192, Mostly in DKI Jakarta, Jakarta - According to the Indonesian Pediatrician Association or Ikatan Dokter Indonesia (IDAI), as of 18 October 2022, the total case of atypical progressive acute kidney injury increased to 192. This number was the total case reported by 20 provinces in Indonesia.

"There are 192 in total, this does not mean that the new cases are suddenly increasing. But this is the data that has just been reported to us because we know this IDAI data is from member reports. Therefore, sometimes the data is updated a lot," said the Chairman of IDAI Piprim Basarah in a virtual press conference on Tuesday (10/18/2022).

He added that this data was reported from 20 provinces. As of this afternoon (18 October), the provinces that accounted for the most cases were:

- DKI Jakarta with 50 cases

- West Java with 24 cases

- East Java with 24 cases

- West Sumatra with 21 cases

- Aceh with 18 cases

- Bali with 17 cases.

Meanwhile, other provinces accounted for 1 to 2 cases.

Previously, the director general of the Centers for Disease Control and Prevention Ministry of Health Maxi Rein Rondonuwu revealed as of 17 October 2022 there were 156 cases of atypical progressive acute kidney injury also known as the unknown origin. The most reported cases were in DKI Jakarta, followed by West Java. For island data, Java Island accounted for the most cases of mysterious acute kidney injury (AKI) in children.

"There are 156 total cases reported until today (17 October 2022). So, each case which has mysterious acute kidney disease symptoms is tested," he said at the 'Global Handwashing Day 2022' event at Westin Hotel in Jakarta on Monday, 17 October 2022.

"The most reported cases are in DKI Jakarta, then West Java. Basically, most (case reports) are in Java."

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Traced The Cause

To respond to cases of mysterious AKI in children in Indonesia, the Ministry of Health had formed a special team. This special team was conducting an epidemiologist investigation of the findings of the reported cases.

"Our team has been formed. We, the Ministry of Health, will continue to investigate the case to see how the surveillance observation of this disease is," Maxi Rein Rondonuwu added.

"We will find out what causes it by conducting an epidemiological investigation. It has not been known what causes it until now. But we test every case finding."

IDAI together with the Ministry of Health and related parties are currently mitigating the incidence of atypical progressive acute kidney injury in children under five who were healthy and did not have any chronic diseases or previous congenital kidney disorders.

Since mid-September 2022, IDAI has coordinated weekly meetings with the heads of IDAI branches and received reports from the related members about the progressive increase in cases of children with AKI.

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No Specific Bacteria/Viruses Have Been Found

Head of the public service bureau of the Ministry of Health Republic of Indonesia Siti Nadia Tarmizi said that the investigation team to investigate AKI cases in children consists of several parties.

"The Ministry of Health has formed a team consisting of the Indonesian Pediatric Association (IDAI) and Ciptomangunkusumo Hospital (RSCM) to investigate and handle the cases of mysterious acute kidney injury," Nadia said in her statement on Thursday (13/10/2022).

The Directorate General of Health Services of the Ministry of Health (DGHS) has issued a decree of the Directorate General of Health Services of the Ministry of Health number HK 02.92/I/3305/2022 concerning The Clinical Management of atypical progressive acute kidney injury.

Meanwhile, the results of laboratory examination by the Health Development Policy Agency (BKPK) showed that there were no specific bacteria or viruses found from cases of acute kidney injury in children, Nadia continued.

While the result of the discussion with a team from The Gambia, Africa regarding a similar case that led to the alleged consumption of drugs containing ethylene glycol content needed further research.

"More research is needed because it is not detected in the blood," he continued.

Until now, the Ministry of Health was coordinating with World Health Organization (WHO) experts who were conducting case investigations in The Gambia to find out the results.

According to the Secretary of the IDAI Nephrology Coordination Work Unit (UKK) Eka Laksmi Hidayati, there was no clear reason or cause that was complained by the children who are now also patients of AKI before it occurred.

"In interviews with the patient's parents, (the cause) is unclear and (the child) tends to suddenly experience a decrease in the amount of urine. So, we have not found the cause yet," he explained during a press conference on Tuesday (14/10/2022).

Attempts to find or investigate the cause have already been carried out. Still, the IDAI data obtained has led to nothing so far even though the investigation was carried out to the fullest.

"So far we have not obtained consistent data that leads to the cause of these children developing AKI," Laksmi continued.

In general, IDAI data reported, children affected by acute kidney injury / Atypical Progressive AKI are those under-5 years old age group (toddler). There are also cases of 8 years olds kids, especially the ones found in Jakarta.

Writer: Adelina Wahyu Martanti

Fitri Haryanti Harsono contributed to this report.