Rubin Surachno Gondodiputro
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung

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Uji Validitas Neutrophil Gelatinase Associated Lipocalin sebagai Penanda Diagnosis Gangguan Ginjal Akut pada Sepsis Hidayat, -; Parwati, Ida; Gondodiputro, Rubin Surachno; Rita, Coriejati
Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gangguan ginjal akut (GgGA) merupakan penurunan fungsi ginjal secara mendadak yang ditandai dengan peningkatan kreatinin serum ≥0,3 mg/dL atau meningkat >1,5 kali dari kadar sebelumnya atau penurunan urine output (UO) <0,5 mL per jam selama >6 jam. Sepsis merupakan penyebab tersering GgGA dengan angka kejadian berkisar 20–50% dan angka kematian mendekati 70%. Kadar neutrophil gelatinase associated lipocalin (NGAL) urine penderita GgGA dapat meningkat secara cepat dan lebih awal dibandingkan dengan kadar kreatinin serum sehingga NGAL dapat dijadikan penanda diagnosis GgGA. Penelitian bertujuan mengetahui validitas NGAL urine sebagai penanda diagnosis GgGA pada penderita sepsis. Sebanyak 50 sampel urine diambil dari penderita sepsis di Unit Gawat Darurat (UGD), Intensive Care Unit (ICU), dan Medical Intermediate Care (MIC) di Rumah Sakit Dr. Hasan Sadikin Bandung selama Februari sampai Mei 2010 dan dilakukan pemeriksaan kadar NGAL urine dengan metode enzyme linked immunosorbent assay (ELISA). Data yang diperoleh dianalisis dengan uji nonparametrik Mann-Whitney, kurva receiver operating characteristic (ROC), dan uji validitas. Hasil penelitian didapatkan kadar NGAL urine penderita sepsis dengan GgGA lebih tinggi secara bermakna dibandingkan dengan penderita sepsis tanpa GgGA (3.380 ng/mL berbanding 116 ng/mL; p<0,001). Pada cut-off point 107 ng/mL, NGAL urine memiliki sensitivitas 100%, spesifisitas 36%, positive predictive value (PPV) 60,9%, negative predictive value (NPV) 100%, dan akurasi 68%. Simpulan, kadar NGAL urine memiliki validitas yang baik dan dapat dijadikan sebagai penanda diagnosis terjadinya GgGA pada penderita sepsis. [MKB. 2012;44(2):121–6]. Validity Test of Neutrophil Gelatinase Associated Lipocalin as Diagnostic Marker forAcute Kidney Injury on SepsisAcute kidney injury (AKI) is an abrupt decrease of renal function which marked by increase of serum creatinine ≥0.3 mg/dL or ≥1.5 times of previous level or decrease urine output <0.5 mL/hour in >6 hours. Sepsis is the most common cause of AKI with incidence rate is about 20–50% and mortality nearly 70%. Urine neutrophil gelatinaseassociated lipocalin (NGAL) level in AKI patients can increase quickly and earlier compared with serum creatinine and could be as a marker for AKI. The purpose of this study was to assess the validity of urine NGAL as diagnostic marker of AKI on sepsis patients. Subjects were 50 urine samples of sepsis patients from Emergency Department (ED), Intensive Care Unit (ICU) and Medical Intermediate Care (MIC) in Dr. Hasan Sadikin Hospital Bandung between February and May 2010 and were examined with enzyme linked immunosorbent assay (ELISA) method. Data analysis was performed by non parametric Mann-Whitney test, receiver operating characteristic (ROC) analysis and validity test.The results found that urine NGAL of AKI patients were significantly higher compared with non AKI patients (3,380 ng/mL vs 116 ng/mL, p<0.001). A cut-off point >107 ng/mL for urine NGAL had a sensitivity of 100%, specificity of 36%, positive predictive value (PPV) of 60.9%, negative predictive value (NPV) of 100% and accuracy of 68%. In conclusions, urinary NGAL level has good validity and could be used as a screening test for AKI on sepsis patients. [MKB. 2012;44(2):121–6]. DOI: http://dx.doi.org/10.15395/mkb.v44n2.131
Validitas Kidney Injury Molecule-1 Urin Metode Mikro Enzyme-Linked Immunosorbent Assay Sebagai Penanda Dini Gangguan Ginjal Akut pada Sepsis Balqis, Lulu Fahrizah; Noormartany, Noormartany; Gondodiputro, Rubin Surachno; Rita, Coriejati
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v48n1.729

Abstract

Gangguan ginjal akut (GgGA) adalah penurunan fungsi ginjal ditandai peningkatan kreatinin serum ≥0,3 mg/dL atau >1,5 kali dibanding dengan kadar sebelumnya atau penurunan urine output <0,5 mL/jam lebih dari 6 jam. Sepsis merupakan penyebab tersering GgGA (20–50%). Kidney injury molecule-1 (KIM-1) adalah glikoprotein transmembran tipe-1. Kadar KIM-1 urin penderita GgGA akibat sepsis meningkat lebih awal dibanding dengan kreatinin serum. Penelitian bertujuan mengetahui validitas KIM-1 urin sebagai penanda dini GgGA pada sepsis, dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung periode Februari–Mei 2013. Bentuk penelitian observasional analitik khusus dengan rancangan potong lintang. Subjek penelitian adalah penderita sepsis yang didiagnosis klinisi sesuai kriteria The American College of Chest Physician/The Society of Critical Care Medicine 2001, berdasarkan consecutive admission sampling. Metode yang digunakan mikro enzyme-linked immunosorbent assay. Analisis dengan chi-kuadrat, Mann-Whitney, tabel 2x2, dan kurva receiver operating curve untuk menghitung validitas. Subjek terdiri atas 25 penderita sepsis dengan GgGA dan 25 penderita sepsis tanpa GgGA. Kadar KIM-1 urin penderita sepsis dengan GgGA meningkat dibanding dengan tanpa GgGA. Kadar KIM-1 urine cut-off >0,8 ng/mL memiliki sensitivitas 96%, spesifisitas 60%, nilai duga positif 70,6%, nilai duga negatif 93,8%, dan akurasi 78%. Simpulan, sensitivitas KIM-1 urin tinggi, spesifisitas sedang sehingga dapat digunakan sebagai skrining GgGA pada penderita sepsis. [MKB. 2016;48(1):19–25]Kata kunci: GgGA, KIM-1, sepsis, validitas Validity of Urinary Kidney Injury Molecule-1 Using Micro Enzyme-Linked Immunosorbent Assay Method as an Early Marker of Acute Kidney Injury in Sepsis PatientsAAcute kidney injury (AKI) is a rapid decline in renal function marked by increased serum creatinine of ≥0.3 mg/dL or >1.5 times higher than the previous levels or decreased urine output of <0.5 mL/hour for more than 6 hours. Sepsis is the most common cause of AKI (20–50%). Kidney injury molecule-1 (KIM-1) is a type-1 transmembrane glycoprotein. Urinary KIM-1 levels of sepsis patients due to AKI increases earlier than the serum creatinine levels; thus KIM-1 may serve as an AKI marker. This study aimed to determine the validity of urinary KIM-1 as the early marker in sepsis patients with AKI. The study was a specific observational analytical study with cross-sectional design, conducted in Dr. Hasan Sadikin General Hospital Bandung in February–May 2013. Subjects were patients diagnosed with sepsis by clinicians according to the criteria of the The American College of Chest Physician/The Society of Critical Care Medicine 2001 and were selected by consecutive sampling admissions. Urinary KIM-1 levels were measured by micro enzyme-linked immunosorbent assay. The data were analyzed by chi-square, Mann-Whitney, 2x2 tables, and receiver operating curve to measure validity. Subjects consisted of 25 sepsis patients with AKI and 25 sepsis patients without AKI. Urinary KIM-1 level of sepsis patient with AKI increased compared to patients without AKI. Level of urinary KIM-1 with a cut-off of >0.8 ng/mL presented 96% sensitivity, 60% specificity, 70.6% positive predictive value, 93.8% negative predictive value and 78% accuracy. In conclusion, the level of urinary KIM-1 has high sensitivity and moderate specificity thus can be used for AKI screening in sepsis patients. [MKB. 2016;48(1):19–25]Key words: AKI, KIM-1, sepsis, validity
Elevated Endothelin-1 in Intradialytic Hypertension Rubin Surachno Gondodiputro; Andika Wiratama; Stefanie Yuliana Usman; Erma Arnika Dewi; Evan Susandi; Afiatin Afiatin; Ria Bandiara
International Journal of Integrated Health Sciences Vol 7, No 2 (2019)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v7n2.1737

Abstract

Objective: To determine the relative change in endothelin-1 (ET-1) during hemodialysis procedure in Stage Five Dialysis-Dependent Chronic Kidney Disease (CKD-5D)patients with and without intradialytic hypertension (IDH).Methods: This was a cross-sectional, observational study involving 40 CKD-5D patients who received two hemodialysis per week for at least three months at the dialysis unit of Dr. Hasan Sadikin Hospital General Bandung, Indonesia during September 2016. Subjects were divided two groups: with IDH (n=20) and without IDH (n=20). Plasma ET-1 level was examined before and after hemodialysis.Results: There was a significant elevation of ET-1 level (mean±SD pg/mL) between pre- and post-dialysis state in patients with IDH (3.33±1.28 vs. 3.84±1.75; relative changes: 15.32%, p=0.013). No change was observed in patients without IDH (3.99±2.30 vs. 4.38±1.81; relative changes: 9.77% p=0.083). The post-dialysis absolute ET-1 level was significantly lower in CKD-5D patients with IDH (3.84±1.75 vs. 4.38±1.81; p=0.024).Conclusion: There was a significant elevation of ET-1 level in CKD-5D patients with IDH during hemodialysis procedure at the dialysis unit of Dr. Hasan Sadikin General Hospital Bandung.
KADAR HEMOGLOBIN RETIKULOSIT DI ANEMIA DAN NONANEMIA AKIBAT DEFISIENSI BESI ABSOLUT DI GAGAL GINJAL TERMINAL TERKAIT HEMODIALISIS (Reticulocyte Hemoglobin Level of Absolute Iron Deficiency Anemia and NonAbsolute Iron Deficiency Anemia In End State Renal Disease Undergoing Maintenance Hemodialysis) Amelia Rachmiwatie; Noormartany Noormartany; Rubin Surachno Gondodiputro; Delita Prihatni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1256

Abstract

Absolute Iron Deficiency Anemia (IDA) is one of the complications in the End State Renal Disease (ESRD) patients undergoingmaintenance hemodalysis, with an incidence of 76.4%. If this condition is not properly addressed, it can lead to impaired cardiac functionand increased mortality. The incidence of this case is between 30−45%. The determination of the iron status in ESRD patients wqs setby the Perhimpunan Nefrologi Indonesia 2011 using serum ferritin and transferrin saturation, but they do not provide a meaningfulchange in the value of the initial state of the iron deficiency. This condition should be examined with other parameters combination aswell as those influenced by diurnal variation and infection-inflammation condition. Reticulocyte hemoglobin (Ret-He) parameter canbe used as a marker of bone marrow iron availability because these reticulocytes are young erythrocytes released from the bone marrowinto the circulation. These conditions were circulated only within a short time about 1-2 days before becoming mature erythrocytes. Theaim of this study was to determine the Ret-He level diferentiation between absolute IDA and non absolute IDA states in ESRD patientswhom underwent maintenance hemodialysis. This research was conducted in the Laboratory of Clinical Pathology-RSHS-Bandung fromSeptember 2012 to June 2013. The study design was cross-sectional. All subjects were ESRD patients undergoing hemodialysis maintenancefor at least three (3) months and consisted of absolute IDA and non-absolute IDA based on the results of the ferritin and transferrinsaturation calculations according to the criteria of Pernefri 2011 Reticulocyte hemoglobin levels were checked using a fluorescenceflowcitometry principle in the automated hematology analyzer. In this study it was found that the Ret-He mean in the absolute IDA was26.1 pg/cell and 35.9 pg/cell in non absolute IDA. Statistical analysis was performed using Independent T-test. A total of 61 undergoingmaintenance hemodialysis subjects participating in this study comprised patients with absolute IDA and non-absolute IDA who met theinclusion and exclusion criteria. It can be concluded that the Ret-He level in statistical analysis showed absolute IDA which was meaningfullower than nonabsolute IDA in ESRD patients undergoing maintenance hemodialysis (p<0.001).
PENGARUH PEMBERIAN OBAT ANTIHIPERTENSI TERHADAP KUALITAS HIDUP PASIEN HIPERTENSI DENGAN GANGGUAN GINJAL KRONIK DI INSTALASI HEMODIALISA RSUP DR. HASAN SADIKIN BANDUNG Anggun Hari Kusumawati; Lia Amalia; Rubin Surachno Gondodiputro; Cherry Rahayu
Pharma Xplore : Jurnal Sains dan Ilmu Farmasi Vol 1 No 2 (2016): Pharma Xplore : Jurnal Sains dan Ilmu Farmasi
Publisher : Fakultas Farmasi Universitas Buana Perjuangan Karawang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36805/farmasi.v1i2.114

Abstract

ABSTRAK Hipertensi merupakan penyebab gangguan ginjal kronik melalui suatu proses yang mengakibatkan hilangnya sejumlah besar nefron fungsional yang progresif dan irreversible. The Kidney Disease Outcome Quality Initiative (K/DOQI) of the national kidney foundation (NKF) merekomendasikan target tekanan darah pada pasien gangguan ginjal kronik < 140/90 mmHg sehingga dapat mengurangi risiko terjadinya penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian obat antihipertensi terhadap kualitas hidup pasien GGK yang menjalani hemodialisis di RSUP DR.Hasan Sadikin Bandung. Penelitian menggunakan desain cross sectional observational konkuren dengan mengkaji data rekam medis dan status harian pasien selama periode Desember 2015-Febuari 2016 dan hasil pengisian kuisioner Kidney Disease and Quality of Life (KDQOLTM-36). Subyek penelitian merupakan pasien GGK yang menjalani hemodialisis dan mendapatkan terapi obat antihipertensi (OAH), laki-laki dan perempuan, usia lebih dari 18 tahun. Terdapat perbedaan bermakna penurunan tekanan darah sistolik(p=0,011) dan diastolik (p=0,023) untuk setiap terapi OAH, kombinasi 2 OAH memberikan efek penurunan tekanan darah sistolik dan diastolik yang paling baik dan berbeda bermakna (p=0,001). Pengobatan tunggal dan kombinasi dua obat antihipertensi memberikan efek penurunan tekanan darah yang paling baik.Setiap jenis terapi obat antihipertensi tidak memberikan perbedaan bermakna terhadap kualitas hidup kecuali domain aspek efek penyakit (p=0,041). Kata kunci : Hipertensi, gagal ginjal kronik, hemodialisis, antihipertensi, KDQOL, kualitas hidup. 40 ABSTRACT Background: Hypertension is the leading cause of chronic kidney disease (CKD) through a process that resulted in loss of a large number of functional nephron on progressive and irreversible. The Kidney Disease Outcome Quality Initiative (K/DOQI) of The National Kidney Foundation (NKF) recommends a target blood pressure values of < 130/80 mmHg in CKD patients, it can reduce the risk of cardiovascular disease. Objective : The purpose of this study is to understand the antihypertension medication effects to the quality of life of hemodialysis patients in RSUP DR.Hasan Sadikin Bandung. Methods : The design of study is cross sectional observational with concurrent medical record with patients daily status analyses during December 2015 - February 2016 with questionnaire by the Kidney Disease and Quality of Life (KDQOL-36. Results : The analysis result shows significant differences in the reduction of systolic (p=0, 011) and diastolic (p=0, 023) blood pressure in each group of antihypertension therapy. Furthermore, 2 combination of antihypertension therapy gives the most significant different in reduction of systolic and diastolic blood pressure (p=0, 001). Conclusions : Second combination of antihypertension therapy can be reduce of blood pressure better than other therapy. Second combinations of antihypertension therapy is best for decrease of blood pressure and creatinin serum. In all domain of quality of lifes, symptom/problems have a highest score, and burden of kidney disease have a lowest score of quality of life. Keywords : chronic kidney disease, hemodialysis, antihypertension, KDQOL, quality of life.