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All 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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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 Harun Harnavi Najirman, Najirman Priyono, Drajad Roza Kurniati Simajuntak, Rohayat Bilmahdi WAHYUDI