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All Journal Medical Journal of Indonesia Jurnal Penyakit Dalam Indonesia
Dharmeizar Dharmeizar
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Medicine & Pharmacology

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Journal : Jurnal Penyakit Dalam Indonesia

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Diagnostic Value and the Role of Inferior Vena Cava DiameterCollapsibility Index to Evaluate Dry Weight in HemodialysisPatients Yussac, Muhammad Artisto Adi; Dharmeizar, Dharmeizar; Abdullah, Murdani; Antono, Dono; Muhadi, Muhadi
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 2
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Introduction. In daily clinical practice, fluid status in Hemodialysis (HD) patients is well correlated with dry weight calculation. Dry weight calculation is commonly practiced by clinical observation, which is not accurate. Because of these, few methods has been suggested to calculate the dry weight non-invasively. Bioelectrical Impedance Analysis (BIA) is widely available in overseas but not readily available in all dialysis center in Indonesia, while inferior vena cava diameter is a relatively inexpensive method, and readily available in all dialysis center because it can be performed with ultrasonography (USG) instrument. Methods. A cross-sectional study was performed in a group of regular HD patients at the Haemodialysis Unit, Cipto Mangunkusumo Hospital in Jakarta, June 2011. Dry weight was evaluated with bioelectrical impedance analysis, while the inferior vena cava collapsibility index was evaluated using USG performed by two different observer. Results. We have recruited 30 HD patients, in which 18 (60%) of the subjects were overload according to the bioelectrical impedance analysis, while 21 (70%) were overload according to the inferior vena cava collapsibility index. The mean age of the subjects is 52 years old with the minimum 24 and maximum 69 years. In this research, we found negative correlation (r = -0.957, P<0.0001) between inferior vena cava colapsibility index and BIA. We found a 94.4% sensitivity and 66.7% specificity for inferior vena cava colapsibility index. Both of USG operators showed a κ coefficient value of 0.92, which reflected a very strong agreement between them. Conclusions. The inferior vena cava colapsibility index have a good role as a screening method in determining dry weight in dialysis patients
Estimated Glomerular Filtration Rate (eGFR) as an In-Hospital Mortality Predictor in Acute Coronary Syndrome Patients in ICCU Dewiasty, Esthika; Alwi, Idrus; Dharmeizar, Dharmeizar; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
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Perbedaan Pola Sirkadian Tekanan Darah pada Pasien Penyakit Ginjal Kronik Pra dan PascaTransplantasi Ginjal Di RSCM Tambunan, Marihot; Susalit, Endang; Dharmeizar, Dharmeizar; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
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Pendahuluan: Meningkatnya tekanan darah (TD) 24 jam dan nondipper merupakan faktor risiko morbiditas dan mortalitas kardiovaskular. Prevalensi hipertensi dan nondipper pada Penyakit Ginjal Kronik Stadium 5 dalam Terapi Dialisis (PGK 5D) masih sangat tinggi. Transplantasi ginjal akan memperbaiki TD dan nondipper. Namun demikian, satu bulan pasca transplantasi ginjal, kebutuhan dosis obat imunosupresan masih cukup tinggi yang dapat mengakibatkan hambatan penurunan TD. Perlu dilakukan studi untuk mengetahui seberapa dini perubahan pola sikardian, sehingga dapat dijadikan pertimbangan penatalaksanaan hipertensi yang lebih tepat pada pasien PGK 5D pra dan pasca transplantasi ginjal. Metode: Studi Pre experimental dengan before and after design dilakukan pada 15 pasien PGK 5D/ Pra Transplantasi Ginjal berusia 18–60 tahun di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada Oktober-Desember 2014. Dilakukan pengumpulan urin 24 jam, pemeriksaan LFG dan pengukuran TD 24 jam dengan 24 hrs ABPM pada pra dan satu bulan pasca transplantasi ginjal. Hasil: Terdapat 12 subjek nondipper dan 3 subjek dipper pada pasien PGK Pra Transplantasi Ginjal. Satu bulan pasca transplantasi ginjal, seluruh subjek (15 orang) memperlihatkan keadaan nondipper. Uji McNemar tidak dapat dilakukan karena seluruh subjek PGK satu bulan pasca transplantasi ginjal nondipper (homogen). Penurunan rerata TD sistolik 24 jam pasien PGK satu bulan pasca transplantasi ginjal tidak bermakna (p >0,05), namun demikian penurunan rerata TD diastolik 24 jam bermakna (p <0,05). Simpulan: Berdasarkan hasil studi, dapat disimpulkan bahwa belum terdapat perbaikan nondipper pada pasien satu bulan Pasca Transplantasi Ginjal.
Co-Authors Aida Lydia, Aida Andrijono Andrijono Bambang Sutrisna C. Martin Rumende, C. Martin Cleopas Martin Rumende Dono Antono Em Yunir, Em Endang Susalit Esthika Dewiasty, Esthika Idrus Alwi Ika Prasetya Wijaya Imam Rasjidi Kuntjoro Harimurti Laila Nuranna M. F. Aziz Marihot Tambunan, Marihot Meilania Saraswati Muhadi Muhadi, Muhadi Muhammad Artisto Adi Yussac Murdani Abdullah Nana Supriana Rochani Rochani Saraswati, Mita Hafsah Sigit Purbadi Siti Setiati Wijaya, Indra