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All Journal Jurnal Penyakit Dalam Indonesia
Ratih Tri Kusuma Dewi, Ratih Tri Kusuma
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Medicine & Pharmacology

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Pengaruh Pemberian N-Acetylcysteine Oral terhadap High Sensitivity C Reactive Protein (Hs-CRP) pada Pasien Hemodialisis Kronis Dewi, Ratih Tri Kusuma; Siregar, Parlindungan; Alwi, Idrus; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
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Pendahuluan. Inflamasi dan stres oksidatif merupakan faktor risiko penyakit kardiovaskuler pada pasien penyakit ginjal kronis yang menjalani hemodialisis. Pasien hemodialisis kronis akan mengalami peningkatan kadar Hs-CRP. Hs-CRP merupakan marker inflamasi yang telah terbukti pada beberapa penelitian bermanfaat dalam memprediksi cardiovascular event. Pemberian N-Acetylcysteine (NAC) oral dapat digunakan sebagai strategi untuk menurunkan proses inflamasi yaitu disfungsi endotel dan stress oksidatif yang berperan pada atherosclerosis pada pasien hemodialsis. Pemberian NAC ini diharapkan dapat menurunkan angka morbiditas dan mortalitas karena penyakit kardiovaskuler. Metode. Penelitian eksperimen dengan Randomized Double Blind Controlled Trial pada 65 pasien hemodialisis kronis yang memenuhi kriteria inklusi di unit hemodialisis RS.Cipto Mangunkusumo Jakarta. Penelitian dilakukan pada Agustus sampai Oktober 2013. Hasil. Perlakuan dengan NAC oral selama 60 hari tidak memberikan perbedaan dibandingkan dengan plasebo. Analisis statistik dengan Mann Whitney menunjukkan bahwa tidak ada penurunan kadar Hs-CRP yang signifikan diantara kedua kelompok dengan p value Δ post1-baseline, Δ post2-baseline, and Δ post2-post1 kelompok NAC dibanding kelompok plasebo secara berurutan yaitu 0.796, 0.379 dan 0.712. Sementara itu, hasil uji Wilcoxon Signed Ranks untuk membandingkan penurunan kadar Hs-CRP pada tiap kelompok dalam tiga interval pengukuran Hs-CRP menunjukkan p value dari perbandingan kadar Hs-CRP untuk masing-masing kelompok baseline:Post1, baseline:Post2 dan Post1:Post2 (kelompok NAC Vs kelompok plasebo) secara berurutan 0.821vs0.651; 0.845vs0.358 dan 0.905vs0.789. Simpulan. Pemberian N-Acetylcysteine oral belum terbukti dapat menurunkan kadar Hs-CRP pada pasien hemodialisis kronis.
Relationship between Quality of Life and Nutritional Status on Chronic Kidney Disease Patients with Dialysis Type Dewi, Ratih Tri Kusuma; Putranto, Wachid; Susanto, Agung; Suseno, Aryo; Purwanto, Bambang; Mangesti, Rini Dwi; Giani, Maia Thalia; Septian, Muhammad Raditia
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
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Factor Related to The Incidence of Ascites in Chronic Kidney Disease Patients Undergoing Hemodialysis at RSUD Dr Moewardi Surakarta: A Cross Sectional Study Yusman, Felizia Alika; Dewi, Ratih Tri Kusuma; Mashuri, Yusuf Ari; Nurhayatun, Evi; Giani, Maia Thalia
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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Introduction. Chronic kidney disease (CKD) is a global health issue with continuously rising prevalence. Fluid overload is a frequent systemic complication which occurs in CKD patients undergoing hemodialysis (HD). One of clinical manifestation of fluid overload in HD patients is ascites. This study aimed to determine the factors related to the incidence of ascites in CKD patients undergoing hemodialysis. Methods. An observational analytic study with a cross-sectional approach was conducted at Dr. Moewardi Hospital, Surakarta from September until October 2019. The subjects were end-stage CKD patients undergoing HD. Subjects were selected by total sampling technique. Data were obtained from medical records tracking. Furthermore, each variable was analyzed using Chi Square and Independent T-test analysis. P value less than 0.05 is considered statistically significant. Results. A total of 116 subjects were recruited in this study. Incidence of ascites was documented in 24 (20.7%) patients. The comorbid of chronic heart failure (CHF) was found in 23 (19.8%) subjects, where this condition was associated with the incidence of ascites [p = 0.003; PR 2.888 (95% CI=1.476–5.650)]. In the subjects with hypoalbuminemia was also related to higher incidence of ascites [p < 0.001; PR 7.800 (95% CI=3.153 – 19.293)]. Meanwhile gender, age, diabetes mellitus, the levels of hemoglobin, ureum, creatinine serum, albumin, hematocrit, and leukocyte were not associated with ascites in CKD patients undergoing HD (p > 0.05). Conclusions. Factors related to the incidence of ascites in patients with chronic kidney disease who have undergone hemodialysis is chronic heart failure and hypoalbuminemia.
Co-Authors Bambang Purwanto Cleopas Martin Rumende Giani, Maia Thalia Idrus Alwi Mangesti, Rini Dwi Mashuri, Yusuf Ari Nurhayatun, Evi Parlindungan Siregar Putranto, Wachid Septian, Muhammad Raditia Susanto, Agung Suseno, Aryo Yusman, Felizia Alika