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All Journal RETORIKA: Jurnal Ilmu Bahasa Primary: Jurnal Pendidikan Guru Sekolah Dasar EKONOBIS (JURNAL EKONOMI DAN BISNIS) Jurnal Aplikasi Bisnis dan Manajemen (JABM) E-Journal Jurnal PAJAR (Pendidikan dan Pengajaran) Pendas : Jurnah Ilmiah Pendidikan Dasar Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) Jurnal Pengabdian Magister Pendidikan IPA Bioscientia Medicina : Journal of Biomedicine and Translational Research Pendidikan Bahasa Indonesia dan Sastra Jurnal Penelitian Tarbawi: Pendidikan Islam dan Isu-Isu Sosial Al-Tamimi Kesmas: Jurnal Ilmu Kesehatan Masyarakat (Journal of Public Health Sciences) JURNAL MUTIARA PENDIDIKAN INDONESIA JURNAL MAHAJANA INFORMASI Jurnal Kesehatan Ilmiah Indonesia / Indonesian Health Scientific Journal PROJECT (Professional Journal of English Education) Dinasti International Journal of Management Science Jurnal Psikiatri Surabaya (Surabaya Psychiatry Journal) Journal Informatic, Education and Management (JIEM) Jurnal Abdimas Pariwisata Pendidikan Bahasa Indonesia dan Sastra (Pendistra) Jurnal Fakultas Ilmu Keislaman UNISA Kuningan Jurnal Kewarganegaraan Ilomata International Journal of Social Science Jurnal Penelitian Keperawatan Kontemporer (JPKK) Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Language Education, Linguistics, and Culture Journal of Mathematics and Scientific Computing With Applications Jurnal Kolaboratif Sains Jurnal Pengabdian Masyarakat Aufa (JPMA) Shautuna: Jurnal Ilmiah Mahasiswa Perbandingan Mazhab Universitas Muhammadiyah Yogyakarta Undergraduate Conference Proceeding Jurnal Ilmu Pendidikan (SOKO GURU) Jurnal Masyarakat Indonesia Research Review: Jurnal Ilmiah Multidisiplin Maternity and Neonatal : Jurnal Kebidanan ADIBA: Journal of Education PENDALAS: Jurnal Penelitian Tindakan Kelas dan Pengabdian Masyarakat Frasa: English Education and Literature Journal Journal of Islamic Economics and Business Jurnal Administrasi Perkantoran Jurnal Indonesia Sosial Sains Islamic Social Finance Aceh Sanitation Journal (ASjo) Epistemik: Indonesian Journal of Social and Political Sciences JS (Jurnal Sekolah) Amal Ilmiah: Jurnal Pengabdian Kepada Masyarakat JRIIN :Jurnal Riset Informatika dan Inovasi Journal of Indonesia Vascular Access Jurnal Pengabdian Masyarakat dan Riset Pendidikan Cross-Border Journal of Business Management Journal of Computer Science Contributions (Jucosco) JMT (Jurnal Matematika dan Terapan) Al-Qalam: Jurnal Kajian Islam Dan Pendidikan Jurnal Teologi Rahmat Jannatul Makwa Health : Jurnal Ilmiah Kesehatan (Scientific Journal of Health) Tepak Sirih : Jurnal Pengabdian Kepada Masyarakat Madani Jurnal Pendidikan IPA Indonesia JIS Ahsan: Jurnal Ilmiah Keislaman dan Kemasyarakatan International Journal of Islamic Business and Economics (IJIBEC) JPEMAS: Jurnal Pengabdian Kepada Masyarakat JoDENS: Journal of Digital Ecosystem for Natural Sustainability NAWASENA: Journal of Community Service Jurnal Wicara Desa Indonesian Journal of Social Sciences, Policy and Politics (IJSSPP) Jurnal Pendidikan: Media, Strategi, dan Metode PENDIMAS Jurnal Ilmiah Mahasiswa & Penelitian Keperawatan IZZI: Jurnal Ekonomi Islam
Juliana
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Optimizing the Surgical Field via Multimodal Controlled Hypotension during Posterior Spinal Fixation for a T11 Burst Fracture: An Anesthetic Case Study Juliana; Heri Dwi Purnomo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1455

Abstract

Background: Significant intraoperative blood loss is a major challenge in complex spinal surgeries, impairing surgical field visibility and increasing patient morbidity. Controlled hypotension is an established anesthetic technique to mitigate this challenge, yet the optimal combination of agents to ensure efficacy and safety remains an area of active investigation. This case study details the successful application of a multimodal anesthetic regimen, centered on the synergistic effects of dexmedetomidine and isoflurane, to achieve deliberate hypotension during posterior stabilization of a thoracic burst fracture. Case presentation: A 39-year-old male, classified as American Society of Anesthesiologists (ASA) physical status II, presented with a traumatic, unstable burst fracture of the eleventh thoracic vertebra (T11) following a high-energy fall. He was scheduled for a posterior decompressive laminectomy and T10-T12 pedicle screw fixation. Anesthetic management was initiated with a multimodal approach utilizing intravenous infusions of dexmedetomidine and morphine, supplemented by maintenance with isoflurane. This strategy was employed to maintain a target mean arterial pressure (MAP) of 60-65 mmHg. Throughout the 135-minute procedure, the patient’s hemodynamics remained exceptionally stable within the target range. The estimated blood loss was minimal (approximately 350 mL), providing the surgical team with an excellent, clear operative field. The patient emerged smoothly from anesthesia with no neurological deficits and experienced a favorable postoperative recovery. Conclusion: This case demonstrates that a multimodal anesthetic strategy incorporating dexmedetomidine, a volatile agent, and opioid infusions is a highly effective and safe method for inducing and maintaining controlled hypotension in major spinal surgery. This approach successfully optimized the surgical conditions by minimizing blood loss and enhancing visibility, without compromising hemodynamic stability or vital organ perfusion, thereby contributing to a positive patient outcome.
Optimizing the Surgical Field via Multimodal Controlled Hypotension during Posterior Spinal Fixation for a T11 Burst Fracture: An Anesthetic Case Study Juliana; Heri Dwi Purnomo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1455

Abstract

Background: Significant intraoperative blood loss is a major challenge in complex spinal surgeries, impairing surgical field visibility and increasing patient morbidity. Controlled hypotension is an established anesthetic technique to mitigate this challenge, yet the optimal combination of agents to ensure efficacy and safety remains an area of active investigation. This case study details the successful application of a multimodal anesthetic regimen, centered on the synergistic effects of dexmedetomidine and isoflurane, to achieve deliberate hypotension during posterior stabilization of a thoracic burst fracture. Case presentation: A 39-year-old male, classified as American Society of Anesthesiologists (ASA) physical status II, presented with a traumatic, unstable burst fracture of the eleventh thoracic vertebra (T11) following a high-energy fall. He was scheduled for a posterior decompressive laminectomy and T10-T12 pedicle screw fixation. Anesthetic management was initiated with a multimodal approach utilizing intravenous infusions of dexmedetomidine and morphine, supplemented by maintenance with isoflurane. This strategy was employed to maintain a target mean arterial pressure (MAP) of 60-65 mmHg. Throughout the 135-minute procedure, the patient’s hemodynamics remained exceptionally stable within the target range. The estimated blood loss was minimal (approximately 350 mL), providing the surgical team with an excellent, clear operative field. The patient emerged smoothly from anesthesia with no neurological deficits and experienced a favorable postoperative recovery. Conclusion: This case demonstrates that a multimodal anesthetic strategy incorporating dexmedetomidine, a volatile agent, and opioid infusions is a highly effective and safe method for inducing and maintaining controlled hypotension in major spinal surgery. This approach successfully optimized the surgical conditions by minimizing blood loss and enhancing visibility, without compromising hemodynamic stability or vital organ perfusion, thereby contributing to a positive patient outcome.
Penerapan Pencatatan Keuangan Sederhana Menggunakan Aplikasi Digital Google Spreadsheet Dalam Meningkatkan Efisiensi Administrasi Keuangan Pada UMKM Pembuatan Tahu 5 Bersaudara Di Desa Bakaran Batu: Penerapan Pencatatan Keuangan Sederhana Menggunakan Google Spreadsheet Juliana; Deva Kaila Ardianti; Mita Ananda Aulia; Andini Indah Pratiwi; Siti Nia Ramadhani
Jurnal Administrasi Perkantoran Vol 14 No 1 (2025): Jurnal Administrasi Perkantoran
Publisher : Prodi Pendidikan Administrasi Perkantoran UNIMED

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24114/judika.v14i1.69704

Abstract

This study aims to determine the financial administration conditions of the 5 Brothers Tofu Making MSME before using digital recording, describe the implementation of simple financial recording with Google Sheets, and analyze its impact on financial administration efficiency. The study used a qualitative descriptive method with a case study approach through observation, interviews, and documentation. The results showed that before the implementation, financial recording was unstructured, making it difficult for the owner to control cash flow and business profits. After using Google Sheets, recording became more systematic, transparent, and efficient with the automatic calculation feature and cloud-based storage. The conclusion of the study shows that Google Sheets is an effective and affordable solution for MSMEs in improving financial administration efficiency.
Faktor-Faktor Yang Mempengaruhi Pengetahuan Ibu Dalam Melakukan Deteksi Dini Stunting Di UPTD Puskesmas Suro Kecamatan Suro Makmur Kabupaten Aceh Singkil: Factors Influencing Mother's Knowledge In Carrying Out Early Stunting Detection At Suro Public Health Center, Suro Makmur District, Aceh Singkil Regency Arlis; Dameria Br Ginting; Maita Sarah; Mazly Astuty; Juliana
Jurnal Kolaboratif Sains Vol. 8 No. 10: Oktober 2025
Publisher : Universitas Muhammadiyah Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56338/jks.v8i10.8758

Abstract

Latar Belakang: Stunting merupakan kondisi gagal tumbuh akibat kekurangan gizi dalam waktu lama sehingga balita menjadi pendek dari standar tinggi badan usianya. Prevalensi stunting di Indonesia mengalami peningkatan di tahun 2020 menjadi 33,2%. Pengetahuan ibu dapat dipengaruhi oleh berbagai faktor diantaranya umur, pendidikan, pekerjaan, pengalaman dan sumber informasi. Penelitian ini bertujuan mengetahui Faktor•Fafaktor yang mempengaruhi pengetahuan ibu dalam melakukan deteksi dini stunting di UPTD Puskesmas Suro Kecamatan Suro Makmur Kabupaten Aceh Singkil Metode : Penelitian ini menggunakan metode analitik kuantitatif dengan rancangan cross sectional dengan populasi yaitu ibu yang memiliki balita usia 0-5 tahun, teknik pengambilan sampel dengan pusposive sampling dengan jumlah sampel sebanyak 65 orang. Analisa bivariat menggunakan uji paired t test dengan tingkat kemaknaan 95%. Hasil : Hasil penelitian menunjukkan Faktor umur mempengaruhi pengetahuan ibu tentang deteksi dini stunting, nilai P value 0,000. Faktor pendidikan mempengaruhi pengetahuan ibu tentang deteksi dini stunting, nilai P value 0,001. Faktor pekerjaan mempengaruhi pengetahuan ibu tentang deteksi dini stunting, nilai P value 0,001. Dan Faktor sumber informasi mempengaruhi pengetahuan ibu tentang deteksi dini stunting dengan nilai p value sebesar 0,006. Faktor pengalaman tidak mempengaruhi pengetahuan ibu tentang deteksi dini stunting, nilai P value 0,074. Saran : Dari hasil penelitian diatas disimpulkan bahwa faktor umur, pendidikan, pekerjaan, dan sumber informasi berpengaruh terhadap pengetahuan ibu.
Pelatihan Digitalized Assesment berbasis Kahoot dan Quizizz di SD Inpress 10/73 Arallae syarifuddin; Juliana
PENDIMAS: Jurnal Pengabdian Masyarakat Vol 2 No 1 (2023): PENDIMAS: Jurnal Pengabdian Masyarakat
Publisher : Fakultas Tarbiyah dan Ilmu Keguruan (FTIK) IAIM Sinjai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47435/pendimas.v2i1.2177

Abstract

Era revolusi industri 4.0 sebagai era perkembangan Teknologi, Informasi dan Komunikasi (TIK) membuat perubahan di berbagai sektor termasuk dunia pendidikan juga merasakan dampaknya. Seorang guru dituntut untuk mampu menciptakan pembelajaran yang inovatif, efektif dan efisien yang terintegrasi dengan teknologi. Namun realita yang terjadi, masih banyak guru yang belum menguasai media pembelajaran terutama media penilaian yang berbasis digital. Hal serupa juga dialami oleh guru SD Inpres 10/73 Arallae yang masih menggunakan cara konvensional yaitu berbasis kertas (paper based test). Oleh sebab itu, pelatihan digitalized assement berbasis kahoot dan quizizz penting untuk dilakukan agar guru-guru SD Inpres 10/73 Arallae mampu menggunakan fitur-fitur kahoot dan quizizz dalam membuat instrumen penilaian hasil belajar siswa dan dapat memanfaatkan media tersebut dalam pembelajaran di era digital tanpa batas dan tanpa kertas. Adapun metode yang digunakan dalam pengabdian masyarakat ini adalah perencanaan, pelaksanaan dan refleksi. Hasil dari kegiatan pengabdian masyarakat ini adalah berupa implementasi penggunaan kahoot dan quizizz dalam membuat instrumen penilaian hasil belajar siswa. Kecakapan guru dalam menggunakan kahoot dan quizizz menjadikan kegiatan pembelajaran menjadi lebih menarik dan partisipasi siswa dapat pula meningkat.
PENGARUH TRANSISI MODEL PEMBELAJARAN TERHADAP KETAHANAN AKADEMIK MAHASISWA S1 KEPERAWATAN PASCA PANDEMI Juliana; Azniah, Azniah; Sastika Sumi, Susi
Jurnal Ilmiah Mahasiswa & Penelitian Keperawatan Vol 2 No 3 (2022): Jurnal Ilmiah Mahasiswa & Penelitian Keperawatan
Publisher : STIKES Nani Hasanuddin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35892/jimpk.v2i3.970

Abstract

Pandemi penyakit COVID-19 yang sedang berlangsung telah menginfeksi ratusan juta orang karena penularan yang begitu cepat sehingga menyebabkan banyak kematian secara global dan masih menjadi perhatian utama di semua negara karena belum ditemukan obatnya. Adanya virus COVID-19 pada tahun 2020 memberikan dampak yang luar biasa hampir pada semua bidang, salah satunya pada bidang pendidikan. Tujuan penelitian adalah untuk mengetahui pengaruh transisi model pembelajaran terhadap ketahanan akademik mahasiswa S1 Keperawatan pasca pandemi di STIKES Nani Hasanuddin Makassar. Penelitian ini menggunakan metode penelitian survei analitik dengan rancangan penelitian cross sectional study. Pengambilan sampel menggunakan purposive sampling dengan jumlah sampel sebanyak 74 mahasiswa. Pengumpulan data menggunakan kuesioner dan dianalisa menggunakan analisis regresi linear sederhana. Hasil penelitian menunjukkan bahwa responden yang mengatakan transisi model pembelajaran efektif berjumlah 66 responden (89,2%), dimana terdapat 59 responden (79,7%) yang ketahanan akademiknya baik dan 7 responden (9,5%) yang ketahanan akademiknya kurang, sedangkan responden yang mengatakan transisi model pembelajaran tidak efektif berjumlah 8 responden (10,8%), dimana terdapat 3 responden (4,1%) yang ketahanan akademiknya baik dan 5 responden (6,8%) yang ketahanan akademiknya kurang. Hasil uji statistik dengan Chi-square diperoleh nilai ρ=0,002. Kesimpulan dalam penelitian ini adalah ada pengaruh transisi model pembelajaran terhadap ketahanan akademik mahasiswa S1 Keperawatan pasca pandemi di STIKES Nani Hasanuddin Makassar.
Pengembangan Desa Wisata Dengan Konsep Green Economy Sebagai Upaya Meningkatkan Pendapatan Masyarakat (Studi Pada Desa Kembang Kuning Kec Sikur) Juliana; Sutanto, Himawan
Journal of Economics and Business Vol 11 No 2 (2025): Ekonobis, September 2025
Publisher : Fakultas Ekonomi dan Bisnis Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/ekonobis.v11i2.243

Abstract

Pariwisata merupakan sektor penting dalam perekonomian Indonesia, dengan desa wisata menjadi salah satu daya tarik utama yang semakin diminati. Penelitian ini bertujuan untuk menganalisis strategi pengembangan desa wisata berbasis green economy di Desa Kembang Kuning serta dampaknya terhadap masyarakat setempat dari aspek ekonomi, sosial, dan lingkungan. Metode penelitian yang digunakan adalah kualitatif deskriptif, melibatkan observasi, wawancara, dan dokumentasi. Hasil penelitian menunjukkan bahwa strategi pengembangan Desa Wisata Kembang Kuning melibatkan pembangunan infrastuktur seperti homestay serta pengembangan usaha mikro kecil dan menengah (UMKM), pemberdayaan masyarakat melalui pelibatan aktif dalam pengelolaan pariwisata, dan pengembangan sumber daya manusia (SDM). Sedangkan dampak pengembangan ini membawa dampak positif yang besar bagi komunitas lokal, terutama dalam aspek ekonomi. Munculnya peluang kerja dan usaha baru di sekitar objek wisata meningkatkan pendapatan masyarakat serta mengurangi tingkat pengangguran. Di samping itu, pengembangan ini juga memperkuat identitas budaya setempat dan meningkatkan kesadaran masyarakat akan pentingnya menjaga kebersihan lingkungan.
HUBUNGAN KUNJUNGAN ANC DENGAN KEBERHASILAN BOUNDING ATTACHMENT MELALUI INISIASI MENYUSU DINI DI KLINIK BIDAN MURNIATI Tambunan, Lili Yuliana; Juliana; JAHRIANI, NANI
Jannatul Makwa Health : Jurnal Ilmiah Kesehatan (Scientific Journal of Health) Vol 3 No 02 (2025): Jannatul Makwa Health : Jurnal Ilmiah Kesehatan (Scientific Journal of Health)
Publisher : AHM Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69886/jmh.v3i02.25

Abstract

Inisiasi menyusu dini sangat berpengaruh terhadap bayi yaitu menjadikan bayi lebih tenang, tidak stress, pernafasan dan detak jantung lebih stabil, hal ini dikarenakan oleh kontak antara kulit ibu dan bayi dapat mempererat hubungan ikatan rasa kasih sayang antara ibu dan anaknya. Prevalensi pelaksanaan Inisiasi Menyusui Dini (IMD) di dunia menurut perkiraan global WHO adalah kurang dari setengah (42%) dari semua bayi baru lahir. Hasil penelitian ini menghubungkan teori dengan kenyataan di lapangan mengenai hubungan IMD dengan bounding attachment di Klinik bidan MUrniati. Penelitian ini menunjukkan bahwa hampir secara keseluruhan ibu bersalin dilakukan Inisiasi Menyusu Dini (IMD) minimal 1 jam pertama setelah persalinan. Hal ini menunjukkan bahwa semua ibu yang bersalin normal dan operasi SC dapat atau tidak dapat melakukan IMD tergantung kondisi ibu dan bayinya.Hasil penelitian yang didapatkan berdasarkan berdasarkan hubungan Kunjungan Ante Natal Care (ANC) dengan keberhasilan bounding attachment terdapat mayoritas ibu berhasil melakukan bounding attachment kepada bayinya dengan kunjungan ANC yang sangat rutin yaitu sebanyak 17 orang (56,6%), dan minoritas ibu cukup berhasil dalam melakukan bounding attachment kepada bayinya dengan kunjungan ANC yang rutin yaitu sebanyak 13 orang (43,4%).Hasil uji chi-square diperoleh nilai p = 0,031 (p < 0,005
PENGARUH AKTUALISASI DIRI DAN PENGHARGAAN TERHADAP PRESTASI KERJA KARYAWAN PADA PERUSAHAAN UMUM DAERAH AIR MINUM TIRTA MUARE ULAKAN KABUPATEN SAMBAS DALAM PERSPEKTIF BISNIS ISLAM Juliana; Gustina; maskupah
Cross-Border Journal of Business Management Vol. 4 No. 2 (2024): Cross-Border Journal of Business Management
Publisher : Institut Agama Islam Sultan Muhammaad Syafiuddin Sambas

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The potential of human resources must be managed as well as possible in order to provide optimal output. Therefore, a company must think about ways it can develop the potential of its employees. One of them is improving employee work performance, good work performance will provide benefits for employees and the company. Work performance is influenced by various factors, including self-actualization and appreciation. Employees who have the opportunity to actualize themselves and receive appropriate rewards tend to have high motivation to participate. This research aims to determine the effect of Self-Actualization and Reward on Employee Work Performance at the Tirta Muare Ulakan Regional Public Water Company, Sambas Regency, both partially and simultaneously. This research method uses quantitative research with causal associative research. The data used is primary data and secondary data. Primary data sources were obtained through distributing questionnaires to all employees in the company and then tested using the SPSS version 22 application with validity tests, reliability tests, normality tests, multicollinearity tests, heteroscedasticity tests, multiple regression tests, hypothesis tests and coefficient of determination tests. Meanwhile, secondary data was obtained from documents from offices related to this research. These results show that the self-actualization variable has a positive and significant effect on employee work performance at the Tirta Muare Ulakan Regional Public Water Company, Sambas Regency with a value of Tcount>Ttable (6.431>3.315) or can be seen from Siga (0.000<0.005). Apart from that, the reward variable also shows a positive and significant influence on employee work performance at the Tirta Muare Ulakan Regional Public Water Company, Sambas Regency with a Tcount value of Ttable (3.947>3.315) or can be seen from Sig<a (0.000<0.005). Simultaneously, self-actualization and appreciation have a positive effect on employee work performance at the Tirta Muare Ulakan Regional Public Water Company, Sambas Regency with a Tcount Ttable value (200.142>3.315) and a Sig value <0.05 (0.000<0.05)
Beyond Glycemia: Independent Hemodynamic and Metabolic Drivers of Incident Diabetic Kidney Disease in a 5-Year Prospective Indonesian Primary Care Cohort Juliana; Nelly
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1490

Abstract

Background: The relative contributions of hyperglycemia, hypertension, and metabolic adiposity to the progression of diabetic kidney disease (DKD) are debated, particularly in Southeast Asian populations and in the context of modern polypharmacy. We aimed to prospectively quantify the independent impact of glycemic burden, hemodynamic stress, and central adiposity on the 5-year incidence of DKD in an Indonesian primary care cohort. Methods: We conducted a 5-year, multi-center, prospective cohort study at 25 primary care clinics in Indonesia. We randomly sampled and enrolled 1,250 T2DM patients without pre-existing DKD (eGFR > 60 mL/min/1.73m² and normoalbuminuria). The primary composite outcome was incident DKD, defined as persistent albuminuria (ACR ≥ 30 mg/g on 2 of 3 occasions) or a sustained eGFR decline of ≥ 30%. Baseline predictors included HbA1c, Systolic Blood Pressure (SBP), and Waist-to-Height Ratio (WHtR). Multivariable Cox proportional-hazards models were used to estimate Hazard Ratios (HRs), adjusting for demographics, baseline eGFR, and baseline use of RAAS inhibitors (RAASi) and SGLT2 inhibitors. Results: Of 1,250 participants, 980 (78.4%) completed the 5-year follow-up. Over a median 4.9 years, 215 participants (21.9%) developed the composite DKD outcome. In the fully-adjusted multivariable Cox model, all three pathways were strong, independent predictors of incident DKD. The standardized HR for SBP (per 1-SD increase) was 1.68 (95% CI: 1.40–2.01; p<0.001), for HbA1c (per 1-SD increase) was 1.45 (95% CI: 1.22–1.73; p<0.001), and for WHtR (per 1-SD increase) was 1.39 (95% CI: 1.18–1.65; p<0.001). Conclusion: In this prospective primary care cohort, hemodynamic stress (SBP), glycemic burden (HbA1c), and metabolic adiposity (WHtR) were all independent, potent drivers of incident DKD, even after controlling for the use of protective cardio-renal medications. These findings confirm that a multi-pillar strategy, aggressively targeting blood pressure, glucose, and weight/metabolic health simultaneously, is essential for DKD prevention.
Co-Authors ABDUL HAMID Abi, Antonius Remigius Ade Putra Pulungan Adelia, Ririn Adriansyah, Agung Adristi Hanun Naziliah Afriana Agung Jiwana Ajie Gunawan, Indra Akbar, Dimas Akhiriyah Ramadhani Al Hafez Husein Al Yuda Alam, El-Islam Purnama Aldo Aditya Suprijadi Alfenny, Verellyn Alviolina, Desi Ambarita, Gabrielli Amelda Pramezwary Amelia, Witra Ananda Shafira Dwiyanti Anandha Budiantoro Andini Indah Pratiwi Andreas Sihombing angelina, lidwina Angelina, Vera Anglia Banda Sutomo, Woro Anjelina Sagala Ann John, Jeena Anton Sitepu Antonio, Ferdi Antonius Remigius Abi Anugerah Agungputranto Arafik Lamadi Arlis Arya Fadlilah Pradana As'ad Naufal Avianita Dewi Kusumawardhani Azniah Syam Balqis , Putri Baqdal Bogor Lumbanraja Br Sinaga, Fitriani Br. Perangin-angin, Almaria Br. Tarigan, Jesikapna Ita Bunga Aditi Chania, Santika Cindy Cindy Septa Sari Br. Sitanggang Citra Kristina D. Simbolon Clarisa Christina Gabriella Dalimunthe, Nur'aini Damailia, Eva Damanik, Hanna Cintia Dameria Br Ginting Danang Himawan Limanto Darinda Sofia Tanjung Data Fitri Deandra Asthyn Pakasi Derryl Rasad Texaga Desideria Lumongga Dwihadiah Deva Kaila Ardianti Dewantara, Jagad Aditya Dewi Driyani, Dewi Diah Trismi Harjanti Dian Hartanti Dian Parwati Dicky Fauzi Firdaus Diena Mutiara Lemy Dinda Natalia Marbun Djakasaputra, Arifin Dr. Adolf J.N. Parhusip Dwi Sabrina Ummaya Dyan Wulan Sari Hs Eka Kartika Silalahi Eka Margareta Sinaga Elia Azani Elisabeth Siallagan Ester Julinda Simarmata, Ester Julinda Euis Bandawaty Fachrurazi Fadhillah, Zaki Fanny Gunawan Faradinah Farhan Farhan Zacky, M. FAUZI Febrianty, Wita Firda Fauziah Hidayat Firda Islamaya Farhan Florentina Ambarawati, Nova Frentika, Diena Frida Simorangkir Frikson Jony Purba Gading Yudha Pratama Gaol, Rumiris Lumban Gustina Hadisantoso, Erwin Halim, Mohd Hamsir, Widianto Harahap, Olivia Harahap, Olivia Feby Hasibuan, Ampuan Lidyawati Hassan, Rayyani Haziq, Juan Syakir Heka Maya Sari Sembiring Helpi Suryani Manurung Heny Herawati Heri Dwi Purnomo Himawan Sutanto, Himawan Hubah Asyiroh Hubner, Ira B. Hulu, Meitolo Husain, Putri Zulvia Suleman Icham , Maulana Iim Suryahim Ika Kartika Inar Innocentius Bernarto, Innocentius Irmina Pinem Irwan Jani Tarigan ISKANDAR Islamiah, Dina Ismi Zatya Ismiati iswanto Jahriani, Nani Jamaluddin Jamaluddin Jatiman, Thomas Jhonas Dongoran Johan Johan Joni Ribowo Jose Andre Juliana Siregar, Santi Juliani Juliannes Cadith Julinda Simarmata, Ester Jun Suhardi Junjungan Nimasratu Rahmatsani Jurnal Wicara Khafi Khairiah, Rahayu Khairunnisa Khoirudin Kristina Sianturi, Nelli Leny Nurdiyaningsih Lestari Lia Muniar Lumbantoruan Lili Yuliana Tambunan Liu, Jasmine Patricia M. Adji Yudha M. Farhan Zacky Maita Sarah Malena Manalu, Evelina Asyera Manika Putri Kunigara Manurung, Sri Yuni maskupah Mas’ad, Muhammad Aunurrochim Maya Dita Anggraini Maya Sari Sembiring, Heka Mazly Astuty Mega Puan Sidabariba, Christifani MEIKARDO SAMUEL PRAYUDA Mhd Hidayattullah Mila Febrina Rindayani Milala, Marcelinus Mita Ananda Aulia Mitra Wati Ndruru Mohamad Sattar Rasul Muchsin Idrus Muhammad Anis, Muhammad Muhammad Hafizh Muhammad Rifqo Hafidzudin Farid Mulia, Sri Mulis MULYADI Nabila Rosalina Putri Nadila Aprianingsih Nadya Wulandari Alshanti Nanda Amalia Ramadhanti Nani Jahriani Nelly Nia puspita Ningrum, Widya Nitri Mirosea Noevandi Nova Bernedeta Sitorus Nova Bernedetta Sitorus Nova Florentina Ambarwati Novena Desrianta Teresia Sitanggang Nur Handayani Nur, Makmur Jaya Nuraini Astriati Nurhayati Nurhayati, R. Nusi, Mardian Octovianus, Johanes P, Sudirman Pakasi, Deandra Asthyn Pane, Aina Ristanti Pani Akhiruddin Siregar Panjaitan, Susi Septiani Angelina Pebrijah Nasution Pramawati, Anita Pramono, Rudy Pregita, Sesylia Purnaman, Si Made Ngurah Putri Huzaifah Putri Tipa Anasi Putri Wardani Putu Laksmi Febriyani Rafid Rabbani Rizkiawan Ramadhan, Andi Muhammad Fuad Ramadhani, Akhiriyah Ranti Sihombing Rantika Wulandari Ratna Dwi Ramdhani Razita Aulia Azkia Reflina Sinaga Regina Sipayung Remigius Abi, Antonius Revantoro Artha Dwiprawira Ribka Kariani Br Sembiring Risa Anggraini Rivaldhi Batubara, Reza Rizka Pahmawati Regina Br Sitanggang Rizki, Heru Tri Novi Rosdayanti Rosida, Rida Rudy Candra Rully Tuiyo Rumahorbo, Elisabet Jojor Rumiris Lumbangaol Ruslan Sabrina O Sihombing Saeniah Saepudin Safaruddin Sahratullah Salma Fadila Salsabilla, Anggina Zahra Sandra Maleachi Santosa, Gladys Nasya Reviva Saputra, Rizka Donny Agung Sarah Nur Suhaila Siregar Sembiring, Andini Br Sembiring, Randy Seprianingsih, Dewi Setia Hartaty Saragih Sheily Triratnasari Tanzil Shella widari Sianipar, Rosianna Sianturi, Nadya Fransiska Sihite, Jernyta Sihombing, Kartini Sihombing, Rismawati Silaban, Patri Simamora, Sarimauli Simanjuntak, Sinta Dameria Simbolon, Riskianmo Sinaga, Masriani Sinaga, Mikael Siprianus Jewarut Siregar, Nela Suriani Sitanggang, Yuniarta Tiofani Siti Nia Ramadhani siti rahmah Situmorang, Tioro Sola Grasia Purba Sri Lestari Sri Rohmuliaty Stefany Sudiro Alexander Xaverius Simamora Suhayni Sulastri Sulastri Supardin Surya Kartini Indah Sari Siregar Syahputra, Andrian Syahrial Syaiah Syaiful Bahri, Amelia Ramdhani Syaiyuti Syarifuddin Tamara Aulia Fakhrinnisa Tamba, Nurlela Tamba, Venantia Tambunan, Lili Yuliana Theresia Magdalena Br Tungkir Three Angel Grace Silitonga Tia Fahira Putri Army Tomas Marcelino Adistika Martin Tongam E Panggabean Triratnasari Tanzil, Sheily Triwibowo, Cecep Triwibowo Tuti Vina Winata Br. Simanungkalit Umi Kalsum Urva, Magfira Vera Angelina Wibowo Wahyuhadi Putro, Wisnuadji widya, Ade Wiguna, William Wisnuadji Wibowo Wahyuhadi Putro Wiwi Uswatiyah Wulan Sari HS, Dyan Yanti Elnida Purba Yaparno Famahato Daeli Yara Yulia Yayan Hendayana Yeni Utamin Yuliana Indriani Yuliana Tambunan, Lili Zebua, Sherli Rahmadani