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HUBUNGAN ANTARA BEBERAPA PARAMETER ANEMIA DAN LAJU FILTRASI GLOMERULUS PADA PENYAKIT GINJAL KRONIK PRADIALISIS Paramita Ayu, Nyoman; Suega, Ketut; Raka Widiana, Gede
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Anemia is one of chronic kidney disease (CKD) complication and it affects many organs including cardiovascular. Earlydetection and evaluation are important to prevent more serious complications. There is scarce data with regard about correlationbetween anemia and glomerulus ltration rate (GFR) in pradialysis CKD.Aim of this study is to determine correlation between anemia parameters and GFR, also prevalence of anemia in pradialysisCKD in Sanglah Hospital, Denpasar-Bali. An analytical cross sectional study was carried out in Sanglah Hospital. Samples wereselected through simple random sampling.Eighty samples (58 males and 22 females, aged 54 ± 10 years) were included. Prevalence of anemia, serum iron belowthan 50 ug/dl, transferrin saturation below than 20% and erythropoietin below than 5 mIU/ml was 41.3%, 25%, 20%, and 25%respectively. Using Pearson?s analysis, there were signicant correlation between haemoglobin (r = 0.76, p = 0.00) and serumiron (r = 0.29, p = 0.01) with LFG. Using linier regression entering those variables into model, it found formula haemoglobin= 7.63 + 0.13GFR (R-square = 0.58, p = 0.00) and serum iron = 54.71 + 0.48GFR (R-square = 0.08, p = 0.01). There wassignicant correlation between haemoglobin and serum iron with LFG. Forty one percent pradialysis CKD patients had anemiacomplication.
PENGARUH SPIRONOLAKTON SEBAGAI TERAPI TAMBAHAN ACE INHIBITOR DAN/ATAU ANGIOTENSIN RECEPTOR BLOCKERS TERHADAP ALBUMINURIA PADA PENYAKIT GINJAL KRONIK PRADIALITIK STUDI KLINIS ACAK TERKONTROL BUTA GANDA -, Yuriawantini; Suwitra, Ketu; Raka Widiana, I Gde; Sidharta Loekman, Jodi; Sudhan, Wayan; Kandarini, Yenny
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Abstract

Recently studies suggest that aldosterone contributes to progressive kidney disease. This has raised the possibility ofusing aldosterone antagonist in CKD. To evaluate effects of spironolactone 25 mg/day on albuminuria in CKD patients, thirtyCKD patients were enrolled in randomized double blind placebo controlled study. Permutted block randomization was done toreceive spironolactone 25 mg/day or placebo as control in addition to ACE inhibitors and/or ARBs. Albuminuria and bloodpressure were examined at baseline and 12 weeks. Albuminuria was measured as urinary albumin:creatinine ration and comparedas primary out come. During this study 15 patient were received conventional therapy and spironolactone 25 mg/day and 15patient were received placebo. One of patient dropped-out after 4 weeks due to hiperkalemia in spironolactone group and one ofpatient in the control group lost to follow-up. After 12 weeks of therapy, in spironolactone group albuminuria was decreased from510 (180.0 ? 798.0) to 254.0 (40.3 ? 491.8) mg/g, MD, 187.0 (29.0 ? 332.3) mg/g, p= 0.035 and in control group from 804.0 (52.0? 1126.0) to 637.0 (99.0 ? 1098.8) mg/g MD -10.5 (-186.5-86.0) mg/g, p= 0.490. There was significant difference of decreamentof albuminuria in both groups (Z=-0.69, p=0.046). There were no statistically different of serum potassium levels and bloodpressure in both groups after treatment. Baseline aldosterone levels were not significantly correlated with albuminuria (r = -0.128,p = 0.499). As Conclusion in this study is spironolactone reduces albuminuria in pradialytic CKD patients
THE ROLE OF NEOPTERIN AS A NOVEL BIOMARKER FOR REDUCED KIDNEY FUNCTION: A COMMUNITY BASED STUDY Widiana, G Raka; Suwitra, K; Effendi, Imam
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Cardiovascular disease is a major complication for patents with reduced kidney function. Neopterin is well known as abiomarker for cardiovascular disease, however it is not clear whether it is associated with reduced kidney function. Study wascarried out in a Legian Kuta village a tourist town in Bali. Samples were underwent a series of interview, physical examinationand were taken blood samples for neoperin and creatinine tests. Neoptein concentrations were tested for its normal distributionand associated with C-G formula for estimated glomerular filtration rate. Cut-off value for prediction of reduced renal functionwas rested using ROC curve, and calculated for sensitivity, specificity.Seventy nine samples were selected through cluster random sampling from 284 residents (177 males and 107 females)with age 46 ± 10 years, body weight 67 ± 13 kg and height 162 ± 9 cm. It was shown that neopterin concentration was normallydistributed (K-S Z = 1.175, p = 0.126), with mean 6.66 ± 3.35 ng/ml and e-GFR was 89 ± 25 ml/mnt. There was significantnegatively correlation between neopterin concentrations and e-GFR (R = -0.26, Rsq = 0.068, p = 0.021), using regressionequation it was revealed that every 1 unit increased of neopterin concentrations produce 1.42 decrease of e-GFR. Using ROCcurve, neopterin was accurately detect reduced kidney function defined as e-GFR of 60 ml/mnt or less (AUC = 0.88; 95%CI0.74 to 1.00; SE = 0.07; p = 0.02). Using 7.46 ng/ml as cut-off value for normal neopterin concentrations, it was showed thatsensitivity and specificity were 100% and 72% to detect the presence of reduced kidney function, consecutively. Neopterin maybe used as a novel biomarker for reduced kidney function, for its role in the pathogenesis of cardiorenal syndrome in generalpopulation.
EFFECT OF POLYETHERSULFONE COMPARED TO CELULLOSE DIACETATE DIALYZER MEMBRANE ON SERUM INTERLEUKIN-6 AND C-REACTIVE PROTEIN LEVES IN HEMODIALYSIS Raka Widiana, I Gde
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Abstract

Synthetic dialyzer membrane is considered to have greater biocompatibility properties than cellulose based dialyzermembrane. This study is aiming to determine whether the use of polyethersulfone synthetic dialyzer (PES) membrane producelower inflammatory (IL-6 and CRP) response compared to celullose diacetate (CDA).Study samples were selected consecutively from all kidney failure patients who were undergoing routine HD at HDcenters in Denpasar Mayoralty. Thirty HD patients consisted of 15 with PES (11 males and 4 females, aged 45 ±10 years) and 15patients with CDA (8 males and 7 females, aged 48 ±13 years) were included in this study.A significant increase of plasma IL-6 per 1000 monocytes (Z=-4.103, p=0.003), from18.56±21.00 pg/dl before HD to56.00±105.41 pg/dl after HD among two groups was found. When the increase of plasma IL-6 per 1000 monocytes duringhemodialysis was compared bewteen the two groups, a significant higher increase of plasma IL-6 per 1000 monocytes in CDAgroup compared to PES group (71.47±142.51 pg/dl versus 3.38±4.46 pg/dl, Z=-2.883, p=0.003). There was no significant increaseof plasma hs-CRP levels before-after HD among both groups. Also, there was no significant difference of plasma hs-CRPchanges during HD between the two groups. Using multivariate ANCOVA, a consistent effect between the two membrane (F=18.401,p=0.000) on logistic transformed of plasma IL-6 per 1000 monocytes changes. However, this effect was not significant (F=1.937,p=0.176) on logistic transformed of plasma hs-CRP changes. It was found that plasma levels of pre HD albumin related to logistictransformed of plasma IL-6 per1000 monocytes (F=5.610, p=0.026), however, there were no relationship between HD factor(KT/V) and HD age (months), with logistic transformed of plasma IL-6 per 1000 monocytes changes.Increament of plasma IL-6 levels per 1000 monocytes during HD is smaller, however, changes of plasma hs-CRP levelsduring HD is similar among HD patients with PES than CDA membrane. In addition, plasma levels of pre HD albumin may affectplasma IL-6 changes during HD.
DISTRIBUSI GEOGRAFIS PENYAKIT GINJAL KRONIK DI BALI: KOMPARASI FORMULA COCKCROFT-GAULT DAN FORMULA MODIFICATION OF DIET IN RENAL DISEASE Raka Widiana, I Gde
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Abstract

Chronic kidney disease (CKD) is related to the increased of cardiovascular morbidity and mortality. Thisstudy is aiming to identify the prevalence of CKD based on demographical distribution in Bali. A communitybased study has been conducted in Bali, 1) height region among indigenous community in a village at northernpart of Bali island using cluster random samples.; 2) in urban area at Denpasar city using stratified randomsampling and 3) in isolated coastal area in Nusa Ceningan island using cluster random sampling. The glomerularfiltration rate was calculated by Cockroft-Gault (C-G) formula and abbriviated Modification of Diet in RenalDisease ringkas with 4 variables (MDRD-4). The results of GFR using both calculation were compared. CKDwas defined based on KDOQI classification, namely GFR less than 60 ml/mnt. During the study 826 sampleswere collected consisted of 219 from height region (males/females 118/101, aged 48±15 years, BW 48.9±10.4kg, creatinine 0.97±0.64 mg/dL), 302 from urban area (males/females 137/165, aged 43±16 years, BW56.1±12.1 kg, creatinine 0.81±0/.19 mg/dL) and 305 isolated coastal area (males/females 150/155, aged 42±16years, BW 53.5±10.3 kg, creatinine 1.00±0.18 mg/dL). Using C-G, mean prevalence of CKD was 56.0%(95%CI 51.2-60.7%) consisted of 69.9% (95%CI 60.6-77.9%) in height region, 61.9% (95%CI54.5-68.8%) inurban and 42.3% (95%CI 33.7-51.4%) in isolated coastal area. Using 4-MDRD formula, mean prevalence ofCKD was 6.0% ( 95%CI 1.4-18.2%) consisted of 4.8% (95%CI 0.00-31.2%) in height region, 2,6% (95%CI50.3-43.1%) in urban and 9.8% (95%CI 2.5-27.4%) in isolated coastal area. In conclusion, there is a significantdifference of CKD prevalence in Bali if calculated by C-G compared with MDRD-4. Prevalence of CKD in Baliwith MDRD-4 (6.0%) is similar to those in other countries such as USA (4.2%) and Thailand (8.8%). Whetherthe calculation of GFR using MDRD-4 is more accurate than C-G in this setting, needs further study.
Correlation between Head Computed Tomography Scan Examination and Cranial Index Measurement in Pediatric Hydrocephalus Zulfariska, Nony; Anandasari, Pande Putu Yuli; Margiani, Ni Nyoman; Sitanggang, Firman Parulian; Patriawan, Putu; Widiana, I Gde Raka
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 22, No 1 (2022): January
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v22i1.12464

Abstract

Hydrocephalus in children can inhibit child growth. However, if treated immediately, the patient will develop normal intelligence. In radiology, the most important problem is to detect hydrocephalus early. Currently, radiology examinations can detect hydrocephalus accurately with a CT scan to identify the presence of blockages and assess the degree. Skull radiography is used to assess the presence of advanced hydrocephalus. A comparison is carried out and assesses the relationship between hydrocephalus measurement on the ventricular and cranial index by scanogram. The study used a cross-sectional analytics design, using Picture Archiving and Communication System (PACS) data. There were 68 samples taken using consecutive sampling, obtaining ventricular index measurement results above 0.30, and patients under 12 years old. Spearman rank test showed a correlation between the ventricular index measurements and cranial index, with Spearman’s Rho (r) = 0.856 and p0.001 with linear equation Y= 2.973 + 0.005X. It revealed that the constant 2.973 indicated that if there is no B coefficient value, the participation value will be 2.973. Furthermore, regression coefficient X of 0.005 indicated that the participation value grows by 0.005 for every 1 addition of the B coefficient value with R2= 0.340.
Ekspresi P16INK4a pada Squamous Cell Carcinoma Serviks Uteri dan Cervical Intraepithelial Neoplasia 1, 2, 3 Luh Yeni Laksmini; Moestikaningsih .; Gede Raka Widiana; Ni Putu Sriwidyani; Ketut Mulyadi
Majalah Patologi Indonesia Vol 23 No 3 (2014): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Abstract

Background Cervical cancer is the second most common cancer in female in the world. In Bali, in 2008, cervical cancer is the second most common malignancy after breast cancer. This cancer has known to develop from precancerous lesions, cervical intraepithelial neoplasia (CIN).There is difficulty to determine grade of dysplasia of the uterine cervix and to predict wheather the lesion has potency of progression. The expression of P16INK4a has correlation with degree of cervical dysplasia and carcinoma. The aim of this study is to evaluate expression of P16INK4a in squamous cell carcinoma (SCC) of cervix uteri and CIN1, CIN2, CIN3. Methods A cross sectional analytic study was performed on 60 samples that divided into 10 CIN1, 10 CIN2, 10 CIN3, and 30 SCC. Samples were tooken from block paraffin archive from Private Laboratory in Denpasar and Anatomical Pathology Laboratory Sanglah Hospital, during January 1st 2011 until Juny 30th 2013. Immunostaining was performed to determine the expression score of P16INK4a. Expression of P16INK4a was determined by for scoring system base on staining grade and intensity. The result was analyzed by Kruskal Wallis test with level of significance α at p
VARIABILITAS TEKANAN DARAH PENDERITA HIPERTENSI BERDASARKAN DERAJAT HIPERTENSI: STUDI POTONG -LINTANG PADA PASIEN RAWAT JALAN POLIKLINIK PENYAKIT DALAM RSUP SANGLAH Desak Putu Puteri Diah Rahtini; I Gde Raka Widiana
E-Jurnal Medika Udayana Vol 9 No 5 (2020): Vol 9 No 05(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.675 KB) | DOI: 10.24843/MU.2020.V09.i5.P07

Abstract

Derajat hipertensi merupakan salah satu faktor penting yang telah umum diketahui berhubungan dengan kerusakan organ pada penderita hipertensi. Namun berbagai penelitian terkini menunjukkan bahwa variabilitas tekanan darah (VTD) memberikan stres tambahan secara independen dan memiliki korelasi yang lebih tinggi terhadap kerusakan organ. Penelitian ini dilakukan untuk mengetahui gambaran hubungan VTD dan derajat hipertensi. Penelitian dilakukan dengan metode observasional deskriptif menggunakan data primer melalui anamnesis dan pengukuran tekanan darah sebanyak 3 kali (interval 2 menit), serta data sekunder diperoleh dari rekam medis. Derajat hipertensi ditentukan melalui rerata tekanan darah yang kemudian diklasifikasikan menjadi hipertensi terkontrol (H0), hipertensi tidak terkontrol ringan (H1), dan hipertensi tidak terkontrol sedang-berat (H2). VTD digambarkan melalui median perbedaan tekanan darah dan koefisien cronbach’s alpha. Dari 37 sampel, sebagian besar adalah laki-laki (65%), berusia 51-60 tahun (54%), dengan riwayat hipertensi dalam keluarga (62%), aktivitas fisik rendah (81%) dan tidak bekerja (38%); sedangkan konsumsi rokok (16%), konsumsi garam berlebih (43%), konsumsi kopi (46%), dan konsumsi alkohol (11%) tergolong rendah. Sebagian besar menderita penyakit ginjal kronis (78%), H1 (49%), dan mengonsumsi ?2 obat antihipertensi (81%), sebagian besar golongan ACEI/ARB (84%). VTD sistolik diperoleh: 4mmHg (0,97), VTD diastolik: 3mmHg (0,97), dan variabilitas mean arterial pressure: 2mmHg (0,97). VTD terbesar terjadi pada VTD sistolik H0: 9mmHg (0,75). Hasil penelitian menunjukkan bahwa nampaknya tidak ada hubungan antara VTD dengan derajat hipertensi. Kata kunci: Variabilitas tekanan darah, derajat hipertensi
Pendekatan rasional terapi infeksi saluran kemih pada USILA (usia lanjut) I Gde Raka Widiana I Gde Raka Widiana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 28, No 01 (1996)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Aging may affect functional and structural changes of the urinary tract which modify the response against infection. Sructural changes in elderly such as prostate hypertrophy, urinary tract stone, the use of catheter, and the presence of cystoceles should be treated properly. Attention should be paid on functional abnormalities in elderly including bladder atonia, neurologic defects, and prolonged bed rest. Inadequate immune response in elderly may also play a role in the changes. Those factors make the treatment of urinary tract infections in elderly have to be carried out more radically.Complicated urinary tract infections, infection in males with prostate hypertrophy, and pyelonephritis need prolonged treatment. Recurrent urinary tract infections in female elderly patients need early prophylactic treatment. Doing a culture of the causative microorganisms and a sensitivity test for the appropriate antibiotics should be taken into consideration in the selection of the antibiotics. Flouroquinolones and cephalosporins seem to be drugs of choice in multiresistant and severe casesKey words: urinary tract infections - elderly - functional changes - structural changes - treatment
Conservative therapy in chronic renal failure I Gde Raka Widiana I Gde Raka Widiana
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 27, No 02 (1995)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Chronic renal failure is still a major health problem in medicine world. An adequate treatment could only retard the progress of renal failure and delay the course toward end-stage renal disease, a condition that requires maintenance dialysis or kidney transplantation.Managable factors should always be identified and promptly treated. Dietary therapy may be able to cope with uremic symptoms, perhaps retards the progress of renal failure and improves nutritional status. All above mentioned will improve morbidity and mortality of the patients. A proper antihypertensive regiment not only protect the kidneys through blood pressure reduction but also gives independent renoprotective effects by improvement of renal hffect and electrolyte balance.emodynamics without negative metabolic effect and electrolyte balance.Key Words: end-stage renal disease -- predialytic phase -- conservative treatment -- dietary management -- hypertension
Co-Authors A. A. G. Oka, A. A. G. Ade Sinyo Aristantrisna Adnyani, Ni Made Dwi Agrasidi, Putu Anindya Ake, Anselmus Anak Agung Chris Tedy Pramana Anak Agung Gde Oka Anak Agung Wiradewi Lestari and N. Sutarka Anwar Santoso Ari Andayani Arlene Elizabeth Padang Aslesa Wangpathi Pagehgiri Ayu, Nyoman Paramita Bagus Ngurah Putu Arhana Bambang Purwanto Barimbing, Morris Lintong Budi Suprapti Christopher Ryalino Cokorda Bagus Jaya Lesmana Dedi Silakarma Desak Putu Puteri Diah Rahtini Desy Permatasari Dewa Nyoman Putra Adiwinata Dewi Catur Wulandari Dharmi Lestari, Ni Putu Djodi Sidartha E. Elyshanti Elizabeth Haryanti Elysanti Dwi Martadiani Erawan, I Gusti Ngurah Agung Tresna Feliciano Pinto, Feliciano Firman Parulian Sitanggang Firman Sitanggang Gede Andi Aditya Gede Sukma Pranata Darma Gede Wira Mahadita Gede Wirya Kusuma Duarsa Handayani, Putu Novi Hendra Koncoro Hendra S Hendra Salim Hizkia Robinson Junsen Lumban Gaol I Dewa Agung Sutanjaya Giri Nugraha I Dewa Nyoman Wibawa I G. N. Anom-Supradnya I G. N. M. Sugiana I Gede Aditya Krishna Santhi I Gede Hendra Sucipta I Gusti Agung Trisna Windiani I Gusti Ayu Made Juliari I Gusti Kamasan Arijana I Gusti Ngurah Ketut Budiarsa I Gusti Ngurah Made Suwarba I Gusti Rai Putra Wiguna I K. Sudartana I Kadek Agus Setiawan I Ketut Suwiyoga I Ketut Wiargitha I Ketut Widiana I Made Adi Satria Darma I Made Agus Endra Permana I Made Arimbawa I Made Ayusta I Made Gede Widnyana I Made Kardana I Nengah Wiadnyana Steven Christian I Nyoman Adi Putra I Nyoman Semadi I Nyoman Wiryawan I Putu Budhiastra, I Putu I Putu Gede Budiana, I Putu Gede I Putu Gede Eka Ariawan Suyasa, I Putu Gede Eka Ariawan I Wayan Eka Sutyawan I Wayan Gede Jayanegara I Wayan Juli Sumadi I Wayan Putu Sutirta Yasa I Wayan Sudhana I Wayan Wita I Wayan Yudiana IBN Mahendra Ida Bagus Gede Suparyatha Ida Bagus Putra Pramana Ida Safitri IKG Suandi Imam Effendi Indira Prawita Martani Inez Kartika Jetty Kalembang Jod Loekman Jodhi S Loekman Jodi Sidharta Loekman Jodi SL Juliari, IGAM K Suwitra K. Suwitra Kadek Budi Santosa Ketu Suwitra Ketut Mulyadi Ketut Putu Yasa Ketut Rina, Ketut Ketut Suarta Ketut Suega Ketut Suwitra Ketut Tuti Parwati Merati Komang Ayu Witarini Kumbara, Cokorde Istri Yuliandari Krisnawardani Luh Gede Yuliadewi NS Luh Yeni Laksmi Luh Yeni Laksmini Made Agus Dwianthara Sueta Made Agus Kusumadjaja Made Asih MADE RATNA SARASWATI . Made Satria Yudha Dewangga Made Widhi Asih Mahadita, Gede Wira Mahardani, Putu Nandika Tungga Yudanti Mahautama, I Gusti Agung Putra Maria, Dessy Marleen MOCHAMMAD THAHA Moestikaningsih ** Moestikaningsih . Monica Sampurna Ngakan Gede Dwija Hermawan Ni Ketut Putri Ariani Ni Kompyang Rahayu Ni Made Amelia R. Dewi Ni Made Ari Suryathi Ni Made Dharma Laksmi Ni Made Putri Suastari Ni Nyoman Margiani Ni Putu Sriwidyani Ni Wayan Anantika Riani Ni Wayan Winarti NP Veny Kartika Yantie Nyoman Maharmaya Nyoman Paramita Ayu Nyoman Srie Laksminingsih Nyoman Sutarka, Nyoman Oka Udrayana Ommy Agustriadi Pande Made Wisnu Tirtayasa Pande Putu Yuli Anandasari Pantjawati, Ni Luh Diah Patriawan, Putu Paulus Wiyono Pemayun, Cok Istri Dewiyani PITIKA ASPR Poerwono Rahardjo Pradnyana DS, Bagus Ari Prayuda, Prayuda Purnama Purnama Putra, I Made Rama Putu Astri Novianti Putu Ayu Saraswati Putu Junara Putra Putu Yuliawati Raka-Sudewi A. A. Reny Setya Pratiwi Duarsa Rully Roesli Sanyoto, Arundina Satrio Ryandi Semadhi, Putu Gitanjani Mahadewi Setiawan, I Gede Budhi Sianny Herawati Silvester Kristian Taopan Siska Sitanggang, Firman Parulian Soetjiningsih Soetjiningsih Sudaryat S Sudjana, Karismayusa Sukmawati, Nurindah Sutyawan, I Wayan Eka Tianing - Trianto Trianto W Sudhana W. G. Jayanegara Wahyuningrum, Stefany Adi Wayan Aryadana Wayan Aryadana Wayan Sudana Wayan Sudhan Wayan Sudhana Wiradharma, Ketut Gede Y. Saskia-Javi Yenny Kandarini Yoga Putra Yuliawati, Putu Yuriawantini - Zulfariska, Nony