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All Journal Indonesian Journal of Kidney and Hypertension Medika Kartika : Jurnal Kedokteran dan Kesehatan
Najirman, Najirman
Unknown Affiliation
Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary

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PERANAN IL-6 PADA PATOFISIOLOGI DAN TATA LAKSANA ARTRITIS REUMATOID Rozak, Hasbi Abdul; Najirman, Najirman
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 7 No 2 (2024): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Abstract

Artritis Reumatoid (AR) merupakan penyakit autoimun progresif yang disebabkan oleh inflamasi kronik pada berbagai macam sistem dan organ di seluruh tubuh. Tujuan tinjauan Pustaka ini untuk mengetahui peran IL-6 dalam tata laksana dan patofisiologi dalam AR. Penyakit autoimun ini mampu meningkatkan tingkat mortalitas hingga 3 kali lebih tinggi daripada populasi umum. Patofisiologi terjadinya progresifitas penyakit melibatkan berbagai macam sitokin diantaranya yaitu IL-1, IL-6, dan TNF-α memiliki peran utama untuk memicu sel pannus yang dapat merusak tulang rawan secara lokal dan menghambat pembentukan molekul matrik baru melalui zat kolagen dan enzim proteolitik. Kerusakan sendi berkaitan dengan adanya IL-6 yang dihasilkan secara berlebihan pada serum dan fibroblas sinovium. IL-6 juga meningkatkan produksi ligand (RANKL), receptor activator of nuclear factor-kB (RANK) yang menginduksi ekspresi mRNA, dan meningkatkan resorpsi melalui interaksi RANK/RANKL/osteoprotegerin. Tinjauan pustaka yang ada membuktikan bahwa tocilizumab yang berperan sebagai anti IL-6R memiliki efektivitas yang paling tinggi, serta memiliki risiko efek samping yang paling rendah dibandingkan DMRAD biologi yang lain. Kata kunci : artritis reumatoid, tata laksana, patofisiologi DOI : 10.35990/mk.v7n2.p209-218
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 Priyono, Drajad Roza Kurniati Rozak, Hasbi Abdul Simajuntak, Rohayat Bilmahdi Wahyudi, Adefri