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All Journal Sumatera Medical Journal Indonesian Journal of Kidney and Hypertension Scientific Journal
Wahyudi, Adefri
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Warm Autoimmune Hemolytic Anemia with Chronic Hepatitis B Wahyudi, Adefri; Fadrian; Afriant, Rudy
Sumatera Medical Journal Vol. 7 No. 1 (2024): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v7i1.11836

Abstract

Background: Warm autoimmune hemolytic anemia (wAIHA) is caused by erithrocytes destruction by IgG or IgG plus C3d-mediated autoantibody. Objective: To present a case of warm autoimmune hemolytic anemia (wAIHA) in a patient with chronic hepatitis B infection. Methods: This is a case report that showed a special case. Results: Man, 64 y.o, hospitalized with diagnosis wAIHA and chronic hepatitis B. Diagnosis of wAIHA is built by: severe normocytic normochromic anemia, reticulocytosis 42.29%, increasing lactate dehydrogenase 397 U/L, direct Coombs test (+4), antibody screening IgG (+4). Anothers laboratorium findings: HbsAg (+), albumin 3.5 g/dL, ALT U/L, rapid HIV (-), anti HCV (-). There is no blast found in peripheral blood and bone marrow smear. Patient also diagnosed chronic hepatitis B inactive phase with negative HbeAg, HBV DNA 547 IU/L, normal liver finding in abdominal USG and moderate fibrosis from fibroscan. Washed red cell transfussion was administered, 2 x 125 mg methilprednisolone iv (3 days) tapering off until to 40 mg/day doses. He did not get antiviral prophylaxis and be planned to reevaluate in next 6 months. Conclusion: Steroid is first line therapy in wAIHA. When wAIHA is diagnosed, determination of chronic hepatitis B status should confirmed.  There is a risk of reactivation of chronic hepatitis B infection so monitoring is needed.
Tinjauan Pustakaa Peranan ACEIs. ARB dan ARNI pada Penyakit Ginjal Kronik Wahyudi, Adefri; Wahyudi
Scientific Journal Vol. 5 No. 2 (2026): SCIENA Volume V No 2, March 2026
Publisher : CV. AKBAR PUTRA MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56260/sciena.v5i2.322

Abstract

Latar Belakang: Penyakit ginjal kronik (PGK) dan penyakit kardiovaskular (PKV) merupakan dua kondisi berkaitan dan sering muncul bersamaan. Penggunaan obat yang bekerja di sistem renin angiotensin aldosteron (RAA) eperti golongan ACEIs, ARB, dan ARNI merupakan pilihan utama  pada hipertensi dan bagian pilar utama terapi pada gagal jantung fraksi ejeksi rendah. Efek samping hiperkalemia dan peningkatan kreatinin serum sering menjadi alasan bagi klinisi untuk tidak memberikan ACEIs/ARB pada pasien PGK. Metode: Pendekatan narrative review, sumber literatur dari Pubmed, Google Scholar dan Science Direct dengan kata kunci PGK, PKV, RAAS inhibitor. Kriteria inklusi berupa artikel sesuai tema penelitian, artikel terindeks scopus dan diterbitkan tahun 2016 – 2025. Kriteria eksklusi meliputi artikel yang tidak dapat diakses, tidak menjawab jenis review. Hasil: Penggunaan obat yang bekerja di sistem RAA pada PGK aman dan memberikan outcome yang baik. Penghentian terapi akan meningkatkan risiko progresivitas end stage renal disease (ERSD) 1,29 kali dan insiden PKV 1,38 kali. Kesimpulan: Penggunaan obat yang bekerja di sistem RAA seperti golongan ACEIs, ARB, dan ARNI pada pasien PGK aman, efektif dan memberikan outcome yang lebih baik.
Diagnostic Value of Proenkephalin A 119 – 159 Serum in Early Detection of Sepsis Associated Acute Kidney Injury Wahyudi, Adefri; Priyono, Drajad; Harun, Harnavi; Viotra, Deka; Najirman, Najirman; Kurniati, Roza; Simajuntak, Rohayat Bilmahdi; Murni, Arina Widya
Indonesian Journal of Kidney and Hypertension Vol 3 No 1 (2026): Vol 3 No 1 (2026): Volume 3 No. 1, April 2026
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v3i1.239

Abstract

Background: Sepsis asscociated acute kidney injury (SA-AKI) is common condition that found in sepsis. Due to the lack of creatinine serum, this condition possibly makes therapy delayed. Proenkephalin A 119-159 (PENK) is a breakdown product of the prohormone proenkephalin A which freely filtered at the glomerulus. In other hand, this prohormone and its receptor predominantly expressed in proximal Tubular Epythelial Cells (pTEC) of kidney. Elevated serum PENK levels are an indicator of AKI. However, previous studies have shown varies results. Objectives: This study aims to determine early detection biomarkers for the presence of AKI in sepsis. Methods: This diagnostic test was conducted at Dr. M. Djamil General Hospital Padang in sepsis patients. The diagnosis of AKI was established based on the 2012 KDIGO criteria. Results: The study involved 98 sepsis patients, 58.16% (n=57) of them experienced AKI. Serum creatinine levels at admission and within 48 hours of hospitalization were 1.0 (IQR 0.8–1.5) mg/dl and 1.6 (IQR 0.9–2.1) mg/dl, respectively. A serum PENK level ≥82.6 pmol/L at admission had sensitivity of 98.6%, specificity of 95.1%, positive predictive value of 96.1%, negative predictive value of 97.5%, and accuracy of 96.9% in early detection of AKI in sepsis. Conclusion: Serum PENK level has excellent diagnostic value in early detection of AKI in sepsis.
Co-Authors Arina Widya Murni Deka Viotra Fadrian, Fadrian Harun Harnavi Najirman, Najirman Priyono, Drajad Roza Kurniati Rudy Afriant Simajuntak, Rohayat Bilmahdi WAHYUDI