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All Journal Medicina journal of internal medicine Jurnal Penyakit Dalam Udayana Cermin Dunia Kedokteran
Wayan Sudhana
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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HUBUNGAN PENYAKIT GINJAL KRONIS PREDIALISIS DENGAN BEBERAPA PARAMETER PENYAKIT ATEROSKLEROSIS ARTERI KAROTIS Sutarka, Nyoma; Suwitra, Ketut; Loekman, Jodi S; Sudhana, Wayan; Kandarini, Yenny; Martadiani, Elysanti Dwi; Margian, Nyoman
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Carotid artery intima media thickness (cIMT) is valid marker of subclinical atherosclerosis because it gives sign of earlyatherosclerosis process. We conduct this study to know the relationship between predialysis chronic kidney disease (CKD) withseveral parameters of carotid arterial atherosclerosis.A cross sectional study was done in patients with predialysis CKD who came to outpatient Clinic of Nephrology inSanglah General Hospital from May 2009. CKD criteria is based on KDQQI 2003. Estimated Glomerular Filtration Rate (eGFR)was calculated with Cockroft-Gault formula. Measurement of cIMT is done by USG B-Mode with USG Logig-5.There were 30 patients (20 with eGFR < 60 ml/mnt and 10 with eGFR 60 ml/mnt). Mean of cIMT in eGFR < 60ml/mnt: right/left cIMT1 0.24445 ± 0.3096/0.3210 ± 0.4006 mm; IMT2 0.2405 ± 0.3138/0.2825 ± 0.3971 mm; IMT3 0.2315 ±0.3026/0.2820 ± 0.3672 mm; bifurkatio IMT 0.3115 ± 0.4069/0.3515 ± 0.4991 mm; total IMT 0.6350 ± 0.1738/0.6938 ± 0.1912mm. For eGFR > 60 ml/mnt: right/left IMT1 0.1120 ± 0.1722/0.1030 ± 0.1398 mm; IMT2 0.0880 ± 0.1103/0.1130 ± 0.1718mm; IMT3 0.1010 ± 0.1408/0.1170 ± 0.1700 mm; bifurcatio IMT 0.1920 ± 0.3545/0.1980 ± 0.3527 mm, total IMT 0.6250 ±0.1269/0.6750 ± 0.1124 mm. There was signiÞ cant difference in eGFR < 60 ml/mnt the left IMT1 (MD: 0.21 CI95% 0.01 ! 0.42;p = 0.038). Five out of 20 patients with eGFR < 60 ml/mnt and 6 among 10 patients of eGFR 60 ml/mnt were found plaques.There are no signiÞ cant difference of plaque location, plaque width, and lumen diameter between carotid arterial with andwithout plaque. As a conclusion we found there is no signiÞ cant difference between predialysis CKD with several parameters ofcarotid arterial atherosclerosis but cIMT tends to be thicker on predialysis CKD patients with eGFR < 60 ml/mnt.
HUBUNGAN ANTARA PERUBAHAN VOLUME DARAH RELATIF DENGAN EPISODE HIPOTENSI INTRADIALITIK SELAMA HEMODIALISIS PADA GAGAL GINJAL KRONIK Agustriadi, Ommy; Suwitra, Ketut; Raka Widiana, Gde; Sudhana, Wayan; Sidharta Loekman, Jodi; Kandarini, Yenny
journal of internal medicine Vol. 10, No. 2 Mei 2009
Publisher : journal of internal medicine

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Intradialytic hypotension (IDH) is a common complication in chronic hemodialysis (HD) patients, in turn would increase morbidity and mortality. Relative blood volume changes during HD play a role in IDH episode. Those changes can be assessed by total plasma protein measurement before and after HD. To determine relationship between relative blood volume changes (assessed by percentage of total plasma protein changes during HD) and IDH episode during HD in chronic renal failure, an analytical cross-sectional study was perferomed in 51 patients (28 males and 23 females, age 47.8 ±11.6 years) underwent chronic HD at Hemodialysis Unit of Sanglah Hospital Denpasar. Data were collected during single HD session. Blood pressure was measured every 30 minutes and relative blood volume changes assessed by measuring percentage of total plasma protein changes during HD. Among them, IDH episode experienced in 10 (19.6%) patients. Logistic regression analysis revealed a strong and significant relationship between relative blood volume changes and IDH episode during HD in chronic renal failure (Beta = 0.29; OR = 1.35; CI 95%: 1.1 - 1.6; p < 0.01) and it was found that every 1% changes in relative blood volume, would increase risk of hypotension episode by 35%. This relationship was still strong and significant (Beta = 0.46; OR = 1.58; CI 95%: 1.11 -2.25; p = 0.01) after adjusted by hemoglobin levels, intradialytic body weight changes, use of antihypertensive medi¬cations and diabetes melitus. Using ROC curve, found that optimal cut of point of intradialytic total plasma protein changes to predict an IDH episode during HD was 5.56% with 90.0% sensitivity and 80.5% specificity (95% CI: 0.83-0.99; p < 0.01). Our data revealed a strong and significant relationship between intradialytic relative blood volume changes assessed by intradialytic total plasma protein changes and IDH episode during HD in chronic renal failure.
KEJADIAN PERITONITIS PADA PASIEN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: IDENTIFIKASI MIKROORGANISME DAN SENSITIFITAS ANTIBIOTIK Haryanti, Elizabeth; Kandarini, Yenny; Widiana, I Gde Raka; Sudhana, Wayan; Loekman, Jod; Suwitra, Ketut
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Patients treated with Continuous Ambulatory Peritoneal Dialysis (CAPD) are constantly exposed to microbial invasionof the peritoneal cavity and rapid microbiological diagnosis of peritonitis is essential due to Hospitalization and imposes asignicant burden of morbidity. The aims of this study were to enumerate the association between microorganisms, sensitity,and resistence of antibiotic on CAPD patients with clinical peritonitis.We collected data through medical records by the number of CAPD patients with clinical peritonitis from June 2004 untilJune 2009. The study was analysis with one-way ANOVA. We found 23 patients clinical peritonitis out of 77 CAPD patients,with insidence was 14% per-year, aged 14 ? 65 y (15M; 8F). The chronic pyelonephritic was a leading (16/23) cause of endstages renal disease. Each patients underwent HD prior (5 ? 60 months) to CAPD, with survival time was 2 ? 51 months. Out of23 patients, 4 were returned to hemodialisis, 15 were died, due to cardiogenic shock 46.7%. Aseptic peritonitis was 31.3%, andthe common microorganism was staphylococcus 18.8%. Peritoneal !uid test showed mean score of sensitivity were tetracycline22.93, cipro!oxacin 19.36, piperacillin-tazobactam 17.36, thrimetropin/sulfamethoxazole 16.5, fosfomycin 15.78, consecutivelyand the rest were resistent. Staphylococus was strongly related to insidence peritonitis, and tetracycline was the most highlysensitive antibiotic in CAPD patients.
seorang penderita tuberkulosis diseminata dengan komplikasi penyakit ginjal kronis Koncoro, Hendra; Kandarini, Yenny; Sudhana, Wayan; Widiana, I Gde Raka
Medicina Vol 47 No 3 (2016): September 2016
Publisher : Medicina

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Abstract

Tuberkulosis diseminata dapat melibatkan berbagai organ dan secara klinis timbul dengan bermacam-macam tanda dan gejala.Penyakit ginjal kronis merupakan salah satu komplikasi yang disebabkan oleh penyebaran hematogenik Mycobacterium tuberculosis ke traktus urogenital. Diagnosis dini dan inisiasi terapi yang tepat merupakan hal penting dalam pencegahan komplikasi lanjut penyakit ini. Dilaporkan sebuah kasus dengan tuberkulosis diseminata yang memperlihatkan keterlibatan paru dan organ ekstra-paru. Kasus ini memperlihatkan tuberkulosis paru, serviks, dan urogenital yang dikonfirmasi dengan pewarnaan sputum basil tahan asam, biopsi serviks, dan biopsi buli buli. Pewarnaan sputum basil tahan asam menunjukkan hasil 3+, sedangkan biopsi serviks dan buli buli menunjukkan radang kronik granulomatosa dengan multinucleated giant cell tipe Langhans. Kadar blood urea nitrogen (BUN) 11 mg/dL dan kreatinin serum 2,58 mg/ dL dengan hidronefrosis ringan kiri pada saat dirawat. Setelah diagnosis ditegakkan, pasien diterapi dengan obat anti-tuberkulosis dan membaik dengan kadar BUN 13,55 mg/ dL dan kreatinin serum 0,9 mg/ dL setelah satu bulan terapi.[MEDICINA.2016;50(3)63-70]
Faktor determinan kesintasan hidup lebih dari lima tahun pada pasien hemodialisis reguler Sudjana, Karismayusa; Ayu, Nyoman Paramita; Kandarini, Yenny; Widiana, Raka; Sudhana, Wayan; Loekman, Jodi Sidharta; Suwitra, Ketut
Jurnal Penyakit Dalam Udayana Vol 2 No 2 (2018): Vol 2 No 2 (2018) July-December 2018
Publisher : PAPDI BALI

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Abstract

Latar Belakang: Pasien hemodialisis regular memiliki risiko mortalitas yang lebih tinggi dibandingkan populasinormal. Angka kesintasam hidup lima tahun pasien hemodialisis regular adalah 35,8% namun angka ini bervariasi di tiap populasi dan dipengaruhi berbagai faktor.Tujuan: Penelitian ini bertujuan untuk mengetahui faktor determinan dari kesintasan hidup lebih dari lima tahun pada pasien hemodialisis regular.Metode: Penelitian ini menggunakan metode kasus-kontrol. Data diambil dari Indonesian Renal Registry Report di Rumah Sakit Umum Pusat Sanglah, Denpasar, Bali. 37 pasien yang menjalani hemodialisis regular selama lebih dari 5 tahun dicocokkan dengan 37 pasien yang menjalani hemodialisis regular selama kurang dari 5 tahun, berdasarkan umur. Data dianalisis dengan uji chi-square.Hasil: Prevalensi pasien yang menjalani hemodialisis regular selama lebih dari 5 tahun didapatkan 9,52%. Kamimenganalisa etiologi penyakit ginjal kronik (PGK), jenis kelamin, tekanan darah, anemia, dan status kecukupanhemodialisis. Perbedaan signifikan kedua kelompok didapatkan pada etiologi PGK (p = 0,021) dan anemia&nbsp; p=0,0). Tidak didapatkan perbedaan signifikan pada jenis kelamin, tekanan darah, dan status kecukupan hemodialisis (p = 0,63, p = 0,64, dan p = 0,34).Simpulan: Penelitian kami menunjukkan bahwa faktor determinan yang berperan signifikan pada kesintasan hidup lebih dari 5 tahun adalah etiologi PGK dan status anemia.
Acute Kidney Injury (AKI) Prerenal pada Dengue Shock Syndrome Nugraha, I.B. Aditya; Sudhana, Wayan
Cermin Dunia Kedokteran Vol 45, No 12 (2018): Farmakologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.026 KB) | DOI: 10.55175/cdk.v45i12.553

Abstract

Dilaporkan satu kasus pasien laki-laki 12 tahun dengan diagnosis awal Severe Dengue Syndrome dengan AKI stadium II pre-renal. Diduga ada kaitan antara DBD dengan kejadian AKI.A case of 12 year-old boy diagnosed as Severe Dengue Syndrome with Acute Kidney Injury (AKI) Pre-Renal stage II was reported. Relationship of Dengue and AKI was discussed. 
Co-Authors Elizabeth Haryanti Elysanti Dwi Martadiani Hendra Koncoro I Gde Raka Widiana Jod Loekman Jodi S Loekman Jodi Sidharta Loekman Ketut Suwitra Loekman, Jodi Sidharta Nugraha, I.B. Aditya Nyoma Sutarka Nyoman Margian Nyoman Paramita Ayu Ommy Agustriadi Sudjana, Karismayusa Yenny Kandarini