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All Journal Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Jurnal Kedokteran Brawijaya Indonesian Journal of Urology Research Journal of Life Science Jurnal Farmasi Klinik Indonesia INDONESIAN JOURNAL OF MEDICAL LABORATORY SCIENCE AND TECHNOLOGY Ina Kidney Heart Science Journal Journal of Indonesia Vascular Access Deka in Medicine
Atma Gunawan
Laboratorium Ilmu Penyakit Dalam Rumah Sakit Umum Dr. Saiful Anwar Malang
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Hubungan antara Obesitas, Konsumsi Tinggi Purin, dan Pengobatan terhadap Kadar Asam Urat dengan Penggunaan Allopurinol pada Pasien Hiperurisemia Yunita, Ema P.; Fitriana, Dinar I.; Gunawan, Atma
Indonesian Journal of Clinical Pharmacy Vol 7, No 1 (2018)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.325 KB) | DOI: 10.15416/ijcp.2018.7.1.1

Abstract

Hiperurisemia adalah kondisi ketika kadar asam urat dalam darah melebihi nilai normal. Terdapat banyak faktor yang memengaruhi peningkatan kadar asam urat, seperti obesitas, konsumsi tinggi purin, dan pengobatan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara obesitas, konsumsi tinggi purin, dan pengobatan terhadap kadar asam urat dengan penggunaan allopurinol pada pasien hiperurisemia. Data diperoleh melalui rekam medis dan kuesioner dari RSUD Dr. Saiful Anwar, Malang, dan dengan studi potong melintang. Pengambilan sampel dilakukan selama satu bulan (April–Mei 2014). Data dianalisis secara deskriptif dan diuji hipotesis. Sampel penelitian ini adalah 45 pasien hiperurisemia yang memperoleh allopurinol sebagai terapinya selama satu bulan dan pasien dipilih dengan metode pengambilan sampel konsekutif. Hasil dari penelitian ini menunjukkan bahwa tidak terdapat hubungan komparasi yang bermakna secara statistik antara kadar asam urat terhadap obesitas (0,193), konsumsi tinggi purin yaitu makanan laut (0,420), daging (0,469), jerohan (0,054), dan polong-polongan (0,398) juga pengobatan yaitu furosemid (0,631), aspirin dosis rendah (0,773), hidroklorotiazid (0,216), dan spironolakton (0,246). Selain itu, tidak pula terdapat korelasi yang bermakna secara statistik antara kadar asam urat terhadap obesitas (0,197), konsumsi tinggi purin yaitu makanan laut (0,426), daging (0,476), jerohan (0,053), dan polong-polongan (0,404) juga pengobatan yaitu furosemid (0,637), aspirin dosis rendah (0,776), hidroklorotiazid (0,220), dan spironolakton (0,250).Kata kunci: Allopurinol, asam urat, penghambat xantin oksidase Associations between Obesity, High Purine Consumptions, and Medications on Uric Acid Level with the Use of Allopurinol in Hyperuricemia PatientsHyperuricemia is a condition when the blood uric acid level exceeds the normal amount. There are many factors that can increase the uric acid level, such as obesity, high purine consumptions, and medications. The aim of this study was to determine the associations between obesity, high purine consumptions, and medications on uric acid level with the use of allopurinol in hyperuricemia patients. Data were collected through medical records and questionnaires from General Hospital of Dr. Saiful Anwar, Malang, and delivered within a cross-sectional study. Sampling was conducted for one month (April–May 2014). Data were analyzed descriptively and tested hypothetically. The samples of this study were 45 hyperuricemia patients who had gotten allopurinol as their therapy for a month and they were choosen by the consecutive sampling method. The results of this study showed that there were no statistically significant comparative association between uric acid level on obesity (0.193), high purine consumptions i.e. seafoods (0.420), meats (0.469), organ meats (0.054), and pods (0.398) also medications i.e. furosemide (0.631), low dose aspirin (0.773), hydrochlorotiazide (0.216), and spironolactone (0.246). In particular, there were no statistically significant correlations between uric acid level on obesity (0.197), high purine consumptions i.e. seafoods (0.426), meats (0.476), organ meats (0.053), and pods (0.404) also medicines i.e. furosemide (0.637), low dose aspirin (0.776), hydrochlorotiazide (0.220), and spironolactone (0.250).Keywords: Allopurinol, uric acid, xanthin oxidase inhibitor
Proteinuria Severity in Lupus Nephritis is Associated with Anti-dsDNA Level and Immune Complex Deposit Location in Kidney Engli, Katherina; Handono, Kusworini; Eko, Mudjiwijono Handaru; Susianti, Hani; Gunawan, Atma; Kalim, Handono
Journal of Tropical Life Science Vol 8, No 3 (2018)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.08.03.03

Abstract

Lupus nephritis (LN) is one of the manifestations of Systemic Lupus Erythematosus (SLE), with proteinuria being one of the clinical manifestations. The proteinuria pathogenesis is associated with anti-dsDNA antibody and the location of immune complex deposits within the kidney. This study aims to investigate the correlation of the severity of proteinuria with the location of immune complex deposits and the level of anti-dsDNA antibody in LN. Data were collected in cross-section. Fifty-three patients with LN in Saiful Anwar Hospital Malang, who underwent renal biopsy, were included. Hematoxylin-eosin staining and immunofluorescence analysis were used to assign subjects to different histopathological classes and determine the immune complex deposits. The spot urine samples were evaluated using the dipstick method for semi-quantitative proteinuria. The anti-dsDNA antibody levels were evaluated using the enzyme-linked immunosorbent assay (ELISA). Turbidity and enzymatic tests were conducted to elucidate urine protein and creatinine content, respectively. The level of proteinuria is significantly different among the different locations of immune complex based on the dipstick and protein/creatinine methods (p = 0.021 and p = 0.005, respectively). There was a significant correlation between anti-dsDNA antibody level and the severity of proteinuria (r = 0.326 based on dipstick and r = 0.28 based on protein/creatinine method). Thus, proteinuria in LN is determined by anti-dsDNA level and the location of immune complex deposits in the kidney.
Kadar Antibodi Anti-dsDNA dan Urine Monocyte Chemoattractant Protein-1 pada Nefritis Lupus Susianti, Hani; Salman, Yuliana; Gunawan, Atma; Handono, Kusworini
Jurnal Kedokteran Brawijaya Vol 27, No 2 (2012)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (879.079 KB) | DOI: 10.21776/ub.jkb.2012.027.02.8

Abstract

ABSTRAKKata Kunci: Lupus  eritematosus  sistemik  (LES) merupakan  penyakit  autoimun  yang  ditandai  oleh  peradangan  kronis  dan  akut. Biomarker klasik untuk mendeteksi adanya penyakit LES adalah antibody anti-double stranded DNA (anti-dsDNA) dan urine Monocyte Chemoattractant Protein-1   (uMCP-1).   Penelitian ini dilakukan untuk mengkaji hubungan antara kedua biomarker tersebut dengan klasifikasi histopatologis nefritis lupus untuk mengganti biopsi ginjal dalam penentuan kelas histopatologi nefritis lupus.   Penelitian ini dilakukan selama 11 bulan   berupa studi observasional dengan pengambilan sampel darah dan urin untuk mengetahui kadar antibodi anti-dsDNA dan MCP-1, serta biopsi ginjal untuk menentukan kelas nefritis lupus berdasarkan klasifikasi WHO tahun 1982.   Data hasil penelitian menunjukkan tidak ada perbedaan yang signifikan (p=0,208>α) antara mean rank kadar anti-dsDNA pada kelompok kontrol dan kelompok kasus,begitu pula dengan hasil perbandingan mean rank kadar uMCP-1 (p=0,247>α).   Uji korelasi Spearman's rho,menunjukkan hubungan signifikan kadar anti-dsDNA dan kadar uMCP-1 (r = 0,861; p<0,001). Dapat disimpulkan bahwa tidak terdapat perbedaan kadar biomarker antibodi anti-dsDNA dan urine MCP1 pada kejadian nefritis lupus dan klasifikasi histopatologi nefritis lupus, namun terdapat hubungan yang sangat erat antara kadar biomarker antibodi anti-dsDNA dengan kadar urine MCP-1. Nilai sensitifitas kadar anti-dsDNA dan uMCP-1  lebih rendah yaitu 20% – 40% dibandingkan dengan nilai spesifisitasnya, yaitu 50% – 83,33%.Kata Kunci: Anti-dsDNA, uMCP-1, klasifikasi histopatologi, nefritis  lupus
PREVALENCE OF URINARY TRACT STONES IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA (BPH) UNDERGOING TRANS URETHRAL RESECTION OF THE PROSTATE (TURP) OPERATION Cahayani, Putu Ayu Evie; Daryanto, Besut; Gunawan, Atma
Indonesian Journal of Urology Vol 31 No 2 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i2.959

Abstract

Objective: This study aims to determine the prevalence of urinary tract stones in BPH patients undergoing TURP surgery. Material & Methods: This research is a descriptive study using secondary data with medical records of BPH patients who underwent TURP at Saiful Anwar General Hospital (RSSA) for the period of 2018 – 2022. Results: From the results of the 169 patient samples BPH undergoing TURP, there were 35 samples, who experienced urinary tract stones. The most frequent incidence of urinary tract stones in patients with BPH at the age of 60 – 70 years of 15 samples (42.90 %), with the highest prostate volume being >50 mL, there are 15 samples (42.90 %), and the location of the most urinary tract stone were in the lower urinary tract with the bladder stone type being 30 samples (85.7%). Conclusion: From the results, it can be concluded that the prevalence of urinary tract stones in BPH patients undergoing TURP surgery is 20.7%, which is an absolute indication for TURP. Keywords: Benign prostatic hyperplasia, urinary tract stone, age, prostate volume.
THE CORRELATION OF NOCTURIA INCIDENCE AND ANXIETY LEVELS DURING THE COVID-19 PANDEMIC Maharani, Revina; Daryanto, Besut; Gunawan, Atma
Indonesian Journal of Urology Vol 31 No 3 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i3.1007

Abstract

Objective: This study aims to examine the relationship between nocturia and anxiety levels as precipitating factors in related study population. Material & Methods: This study used a survey facilitated via Google Form, using the International Consultation on Incontinence Questionnaire Nocturia, Zung Self-Rating Anxiety Scale, and a Demographic Data Questionnaire to obtain corresponding data. The descriptive-analytic method was applied, and Chi-square statistical analysis was performed. Results: From 270 participants, 240 exhibited normal anxiety levels, 28 demonstrated mild to moderate anxiety levels, and two presented severe anxiety levels. Furthermore, 148 participants reported experiencing nocturia, while 122 participants did not exhibit nocturia. Conclusion: This study showed no correlation between anxiety levels and nocturia in students from the Nutritional Science and Nursing Science Programs at Universitas Brawijaya, batches 2019, 2020, and 2021. Keywords: Anxiety level, nocturia, covid-19.
Neutrophil Gelatinase-Associated Lipocalin (NGAL) in Urine as a Potential Non-Invasive Method for Determine Kidney Damage in Predialysis Patients Titisari, Nurina; Hernowati, Tinny Endang; Ratnawati, Retty; Fauzi, Ahmad; Gunawan, Atma; Jaya, Wiwi
Research Journal of Life Science Vol 8, No 3 (2021)
Publisher : Direktorat Riset dan Pengabdian Masyarakat, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.rjls.2021.008.03.1

Abstract

NGAL expression in acute kidney failure is well known. It is approved that NGAL expression occurs earlier than the level of BUN and creatinine in acute kidney failure. NGAL is not only expressed in the blood but also in the urine, where urine collection has many advantages over blood collection. This study aims to observed the expression of NGAL in predialysis patients and to determine the correlation between NGAL serum and NGAL urine of patients. The sample was taken from healthy persons as control and predialysis patients. The examination of BUN, creatinine, and urinalysis were done to approve the diagnose in predialysis patients. While NGAL in serum and urine were analyzed using the Enzyme-Linked Immunoabsorbent Assay (ELISA). The results showed that the concentration of NGAL in serum was higher in the predialysis patients compared to the healthy subjects (p<0.05). There was a strong positive correlation between the NGAL in the serum and the NGAL in the urine (r= 0.98 and p<0.000). It is concluded that the non-invasive examination of NGAL in urine can be choose rather than using serum NGAL. However, it must be noted that NGAL could be used for chronic renal failure in predialysis patients as long as other biomarkers have been proven.
Observational Study on How the Frequency of Dialyzer Reuse Impacts Hemodialysis Effectiveness Wicaksono, Ramadi Satryo; Gunawan, Atma; Samsu, Nur; Rifai, Achmad
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.152

Abstract

Background: The increasing practice of dialyzer reuse in hemodialysis raises critical concerns regarding its impact on efficacy, infection risks, and essential metrics such as Urea Reduction Ratio (URR) and Kt/V values. Addressing these concerns is paramount to establishing safe and optimal reuse limits through comprehensive performance assessments. Objective: To evaluate the feasibility of dialyzer reuse by assessing Kt/V and URR measurements. Methods: A prospective cohort study was conducted at RSUD Dr. Saiful Anwar's Hemodialysis Unit from November 2021 to January 2022. Data collection employed a standardized pilot form designed to collate Kt/V and URR data from all participants. Statistical analyses included repeated measures ANOVA to detect temporal changes in average Kt/V and URR, alongside Spearman correlation analysis to explore variable relationships. Results: The study encompassed 15 participants, revealing a statistically significant decline in both Kt/V and URR values across each reuse group (p < 0.05). Specifically, each subsequent reuse of the dialyzer corresponded to a decrement of 0.0469 units in Kt/V and 1.003 units in URR. Notably, by the 7th reuse, hemodialysis adequacy remained satisfactory, achieving an average Kt/V of 1.61. Furthermore, the study indicated that even up to 11 reuses could achieve a Kt/V > 1.4. Similarly, the average URR value for the 7th reuse was 70.207%, with the potential to maintain URR > 65% even after up to 13 reuses. Conclusion: This study unequivocally affirms that hemodialysis adequacy remains satisfactory up to the 7th reuse of dialyzers, despite observed declines in Kt/V and URR values over successive reuses.
Prevalence and comorbid for late-stage chronic kidney disease (CKD) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) due to urinary obstruction Hanafi, Hafidz; Daryanto, Besut; Gunawan, Atma
JURNAL INDONESIA DARI ILMU LABORATORIUM MEDIS DAN TEKNOLOGI Vol 6 No 2 (2024): Promising and valuable research towards diagnosis, prognosis and treatment of dis
Publisher : Universitas Nahdlatul Ulama Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/ijmlst.v6i2.5821

Abstract

Chronic Kidney Disease (CKD) is a condition of gradual or chronic decline in kidney function, which is quite severe and caused by various kidney diseases, including urinary obstruction. This disease is progressive and generally irreversible. CKD requires kidney replacement therapy, one of which is continuous ambulatory peritoneal dialysis (CAPD). To determine the prevalence and risk factors for End Stage Renal Disease (ESRD) in patients undergoing CAPD due to urinary obstruction. We performed a retrospective cohort with a cross-sectional study was conducted using secondary data from medical record data of ESRD patients with CAPD accompanied by urinary obstruction at Dr. Saiful Anwar General Hospital, Malang, Indonesia. The prevalence of CKD in patients with CAPD accompanied by urinary obstruction was 6,50% and dominated by males (57,8%) with an age range of 41-50 years (26%). The majority of comorbidities are severely high the Body Mass Index (BMI) (89,0%) and hypertension (80,8%). The location of obstruction is mostly unilateral (5,64%) with mild levels (4,06%). Urinary obstruction is a frequent clinical finding in CKD patients with CAPD. The most common risk factor in this study was hypertension. The prevalence and comorbidities among CAPD patients with Urinary obstruction (UO) are better understood because to this study. It is necessary to recognise its limitations, particularly the small sample size and single-centre design. Future studies should involve more centres and larger patient groups in order to provide a more thorough knowledge of the mechanisms behind the high survival rates among CAPD patients.
The association between albumin levels, platelet-to-albumin ratio, and the likelihood of peritonitis occurrence in individuals undergoing peritoneal dialysis Mazen, Mazen; Rifai, Achmad; Gunawan, Atma
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.4

Abstract

BACKGROUND: Since albumin and platelet had been reported to govern the risk of infection, their impact in the case of peritoneal dialysis (PD) – related peritonitis should be investigated. OBJECTIVES: To assess the association between albumin levels and platelet – to – albumin ratio and the risk of PD-related peritonitis. METHODS: We conducted a retrospective study in Saiful Anwar General Hospital, Malang, Indonesia during July 2019 and July 2021. Data related to albumin levels and platelet – to – albumin ratio as well as the incidence of PD-related peritonitis were collected from medical record using a standardized pilot form. The association between the albumin levels and platelet – to – albumin ratio and the risk of PD-related peritonitis was analyzed using multiple logistic regression. RESULTS: We included 123 PD patients during study period. Of them, 20 patients were PD-related peritonitis. Our study found that lower albumin levels were associated with increased risk of PD-related peritonitis with the mean difference was -0.30 (MD: -0.30; 95%CI: [-0.55], [-0.05]). We also found that platelet – to – albumin ratio was observed higher in PD-related to peritonitis compared to control (MD: 14420.10; 95%CI: 832.08, 28008.12). However, the role of albumin levels and platelet – to – albumin ratio had weak association to the risk of PD-related peritonitis with the area under curve were 61% and 59%, respectively. CONCLUSION: Our study provides the preliminary data regarding the potential role of albumin and platelet – to – albumin ratio for predicting the risk of PD-related peritonitis. However, further large – scale study should be performed to reclarify our findings.
Investigating the connection between age progression and erectile dysfunction incidence in chronic kidney disease patients undergoing hemodialysis Widiaputro, Dandi; Suwito, Heru; Eldatarina, Helsa; Firmansah, Wahyu; Akbar, Muhamad; Wattimury, Rosmince; Rahardja, Ketut; Haryanto, Dheni; Gunawan, Atma
Deka in Medicine Vol. 1 No. 2 (2024): August 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e210

Abstract

BACKGROUND: Erectile dysfunction is frequently observed in patients with chronic kidney disease (CKD), especially in the elderly population. However, studies have presented diverse outcomes on this matter. OBJECTIVES: To assess the correlation between age progression and the prevalence of erectile dysfunction in chronic kidney disease patients receiving hemodialysis. METHODS: The study employed a retrospective design and was conducted at RSUD Dr. Saiful Anwar, Malang, during June-July 2022. Data collection involved retrieving age, the erection hardness score (EHS), and baseline characteristics from medical records. Statistical analysis focused on assessing the correlation between age and erectile dysfunction using linear regression. RESULTS: The study population consisted of 59 patients with erectile dysfunction and 61 patients without erectile dysfunction. The primary findings highlighted a substantial and moderately negative association between age and the EHS score, which serves as a key indicator of erectile function. The results suggested that as individuals aged, there was a noticeable trend towards a decrease in the EHS score, implying a decrease in erectile capacity. CONCLUSION: Our findings emphasize the crucial importance of age as a determining factor in the development of erectile dysfunction.
Co-Authors ACHMAD RIFAI Anjarwani, Setyasih Cahayani, Putu Ayu Evie Eko, Mudjiwijono Handaru Eldatarina, Helsa Engli, Katherina Etik Sulistyowati Fauzi Ahmad Muda Firmansah, Wahyu Fitriana, Dinar I. Hamam Hadi Hanafi, Hafidz Handono Kalim Hani Susianti Haryanto, Ahmad Farid Haryanto, Dheni Indra Prasetya Kurnianingsih, Novi Kusworini Handono Maharani, Revina Mazen, Mazen Nur Samsu Nurudinulloh, Akhmad Isna Rahardja, Ketut Retty Ratnawati Susetyowati Suwito, Heru Tamaulina Br Sembiring Tinny Endang Hernowati Titisari, Nurina Wattimury, Rosmince Wicaksono, Ramadi Satryo Widiaputro, Dandi Widito, Sasmojo Wiwi Jaya Yuliana Salman Yunita, Ema P.