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All Journal e-CliniC Briliant: Jurnal Riset dan Konseptual Jurnal Surya Medika JURNAL CITRA KEPERAWATAN Jurnal Kedokteran Anatomica (Anatomica Medical Journal) Sebatik Indonesian Journal of Medicine Hearty : Jurnal Kesehatan Masyarakat Manuju : Malahayati Nursing Journal Jurnal Kejaora (Kesehatan Jasmani dan Olahraga) Jurnal Ilmiah Kesehatan Abdi Dosen : Jurnal Pengabdian Pada Masyarakat PREPOTIF : Jurnal Kesehatan Masyarakat An-Nadaa: Jurnal Kesehatan Masyarakat Nommensen Journal of Medicine Jurnal Menara Medika Jurnal teknologi Kesehatan Borneo Journal of Holistics and Health Sciences (JHHS) Jurnal Pengabdian Masyarakat: Humanity and Medicine Medical Scope Journal (MSJ) Citius: Jurnal Pendidikan Jasmani, Olahraga, Dan Kesehatan JRKN GALENICAL : Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh Jurnal Pharmacopoeia Jurnal Lentera Prominentia Medical Journal Promotor: Jurnal Mahasiswa Kesehatan Masyarakat JUKEJ: Jurnal Kesehatan Jompa Holistik Jurnal Kesehatan Jurnal Teknokes Preventif : Jurnal Kesehatan Masyarakat Jurnal Kesehatan Primer
Setyawan, Yuswanto
Universitas Ciputra
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Journal : Medical Scope Journal (MSJ)

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Hipernatremia dan Penatalaksanaanya Setyawan, Yuswanto
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32693

Abstract

Abstract: Hypernatremia could be caused by loss of water (increased loss or decreased intake), and although rarely, due to over intake of natrium. Patients who are at risk of hypernatremia are those with disturbance of thirst or limited access of water. Several factors that could cause hypernatremia especially among geriatric patients are, as follows: change of thirst stimuli, decreased ability to concentrate urine, and decreased total body water. Clinical signs of hypernatremia are usually not specific, however, patients tend to become symptomatic if hypernatemia occurs acutely. Hypernatremia clinical signs are mostly neurological related to the severity and the change of serum sodium concentration. Complications of hypernatremia are inter alia shrinkage of brain tissue due to the movement of water from intracellular to extracellular fluid which results in injury of brain vessels, bleeding in the brain, and a variety of neurological signs due to brain involovement which could lead to death. Management of hypernatremia has to be carried out accurately and thoroughly because inaccurate or too-rapid correction could risk the occurrence of cerebral edema.Keywords: hypernatremia, total body water  Abstrak: Hipernatremia dapat disebabkan oleh kehilangan air (peningkatan kehilangan atau penurunan asupan) dan, walaupun jarang, karena kelebihan asupan natrium. Yang berisiko tinggi untuk hipernatremia ialah mereka dengan gangguan mekanisme rasa haus atau keterbatasan akses terhadap air. Berbagai faktor dapat menyebabkan hipernatremia terutama pada geriatri seperti perubahan rangsangan haus, berkurangnya kemampuan pemekatan urin, dan berkurangnya total body water. Gejala klinis hipernatremia biasanya tidak spesifik namun pasien cenderung menjadi simtomatik saat hipernatremia terjadi secara akut. Gejala hipernatremia terutama bersifat neurologik terkait dengan tingkat keparahan dan kecepatan perubahan konsentrasi natrium serum. Komplikasi hipernatremia ialah antara lain penyusutan otak akibat perpindahan cairan intrasel ke ekstrasel yang dapat merobek pembuluh darah otak, pendarahan otak, dan berbagai gejala neurologik akibat keterlibatan otak, yang dapat berakhir fatal. Penatalaksanaan hipernatremia perlu dilakukan dengan cermat karena penanganan yang tidak tepat atau koreksi yang terlalu cepat dapat berisiko terjadinya edema serebri.Kata kunci: hipernatremia, total body water
Acute Kidney Injury in Critically Ill Patients Setyawan, Yuswanto
Medical Scope Journal Vol 3, No 1 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.3.1.2021.32694

Abstract

Abstrak: Gagal ginjal akut (GGA) sering ditemukan dalam praktek klinik namun diagnosisnya dapat tertunda oleh karena keterbatasan alat diagnostik. Dewasa ini, kriteria diagnostik RIFLE, AKIN, dan KDIGO untuk menilai adanya GGA dan keparahannya dianggap tidak cukup untuk menggambarkan kompleksitas sindrom GGA. Proteinuria dan mikroalbuminuria yang merupa-kan marker klasik progresi cedera ginjal kronik, telah dipergunakan dan divalidasi untuk progresi GGA ke CKD. Kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), dan urinary cystatin C dapat berperan dalam memrediksi pemulihan ginjal. Indikasi biopsi ginjal pada pasien kritis ialah gangguan ginjal yang tidak jelas atau progresi CKD dengan hematuria glomerulus dan proteinuria lebih dari 1 gram per hari, manifestasi ginjal dari penyakit sistemik yang mengancam nyawa, kecurigaan penolakan akut atau kronik dari ginjal transplan. Mempertahankan hemodinamik yang adekuat seharusnya bermanfaat dalam pence-gahan onset atau perburukan GGA, namun kelebihan cairan harus dihindari. Sampau saat ini penentuan saat inisiasi acute renal replacement therapy (ARRT) masih kontroversial, demikian pula nilai ambang spesifik untuk memulainya belum sepenuhnya disepakati. Kata kunci: gagal ginjal akut; penyakit kritis' laju filtrasi glomerulus (LFG)  Abstract: Acute kidney injury (AKI) is a common problem in clinical practice, but its diagnosis could be delayed due to the inherent limitation of current diagnostic tools. Current practice suggests that RIFLE, AKIN, and KDIGO diagnostic criteria used to assess the presence of AKI and its severity are insufficient to illustrate the complexity of the AKI syndrome. Proteinuria and micro-albuminuria, classical markers of chronic kidney disease (CKD) progression, have been used and validated for the progression of AKI to CKD. Kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and urinary cystatin C could play a role in prediction of renal recovery. Indication of renal biopsy in critically ill patients are unexplained renal impairment or progression of CKD with both glomerular hematuria and proteinuria more than 1 gr per day, renal manifestations of life threathening systemic disease, suspected acute or chronic rejection of a transplanted kidney. The maintenance of adequate hemodynamics should be beneficial in preventing the onset or the worsening of AKI, but fluid overload should be avoided. Timing of acute renal replacement therapy (ARRT) initiation is still controversial, moreover, specific thresholds for starting are still unclear.Keywords: acute kidney injury (AKI); critically ill; glomerular filtration rate (GFR)
Co-Authors Abdillah , Winda Adisyahputra, Vega Alfia, Nur Laili Areta Idarto Banjarnahor, Dharma PP Basudewa, I Nyoman Arhi Billy Daniel Messakh Christian Kutanggas, Rivo Deddi, Rhandy Bane Umbu Dongu Dharma PP Banjarnahor Erik Jaya Gunawan Gisela Tania Irwanto Harsa Sekarputri, Cempaka Hebert Adrianto Imelda Ritunga Indratiawati, Indratiawati Irwin Priyatna Kusumah Kusumah, Irwin Priyatna Kutanggas, Rivo Christian Kwando, Felicia Kwando, Feliciana Laurensia Budi, Stephanie Ledo, Naldi Lukas, Dwi Lily Ronald Pratama Adiwinoto Safira, Vita Sholihah, Puput Mar'atus Siahaan, Salmon Charles Siahaan, Salmon Charles P. T. Suharna, Anik Sulistio, Timothy Sultan, Dharma Sunur, Vincentius William Tannus, Ferdinand Aprianto Vincentia Maria Iriane Wargiati, Wargiati Wijaya , Wilson Gani Wijaya, Wilson Gani Wiyono, Mohamad