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Mochammad Sja'bani Mochammad Sja'bani
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Calcitriol infra venous therapy in routinely hemodialyzed patients with secondary hyperparatyroidism Mochammad Sja'bani Mochammad Sja'bani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 31, No 02 (1999)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Secondary hyperparathyroidism is common in patients with chronic renal failure. Secondary hyperparathyroidism with vitamin D deficiency may increase renal osteodystrophy.Objective: To determine the blood intact parathormone (iPTH) level in routinely hemodialyzed patients with secondary hyperparathyroidism undertaking calcitriol intravenous therapy once in two weeks. Methods: a double blind randomized clinical trial had been done in 32 chronic renal failure patients from 41 secondary hyperparathyroidism who underwent regular hemodialysis in Dr. Sardjito Hospital Yogyakarta. All patients received intravenous calcitriol 11.1.g or placebo twice a week after dialysis for 2 weeks. The proportion of the decrease of iPTH level at least 30%; calcium, and phosphate levels in calcitriol (16 patients) and in placebo (16 patients) group were measured.Results: The decrease of iPTH at least 30% in calcitriol group were 12 patients (75%) and in placebo group 6 patients (37.5%) (p> 0.05). In calcitriol group there were 4 patients (25%) with hypercalcemia and 6 patients (37.5%) with hyperphosphatemia, whereas in placebo group 5 patients (31.3%) with hypercalcemia and 5 patients (31.3%) with hyperphosphatemia (p>0.05).Conclusion: Calcitriol intravenous therapy for 2 weeks might decrease iPTH at least 30%.Key words: secondary hyperparathyroidism - chronic renal failure - osteodystrophy - intact parathormone -calcitriol
Effect of erytropoietin therapy on left ventricle mass and end stage small disease underwent hemodyalisis Mochammad Sja'bani Mochammad Sja'bani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 29, No 04 (1997)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Cardiovascular disease is the most common cause of death in patients maintained on hemodialysis (HD) of end stage renal disease (ESRD). This study was aimed at evaluating the regression of left ventricular mass (LV mass) and blood pressure among ESRD patients underwent HD. A randomized double-blind placebo controlled clinical trial had been done on 32 patients who underwent HD with acetate. Left ventricular mass was examined with Echocardiography interdialitic time. Fifteen patients (11 males and 4 females) with r-HuEpo therapy (group I) and 16 patients (9 males and 7 females) with placebo (group II) were recruited in the study. The mean age group I was 52.27 ± 14.69 years and Group II: 46.25 ± 9.01 years (95% CI:-2.82 - 14.86; p = 0.117. There was no significant difference in hemoglobin concentration (Hb), hematocrit (Hct), systolic and diastolic blood pressure; LVM at baseline between two groups. After 5 weeks of therapy with r-HuEpo 2000 Unit 2 times/week, the change of mean in hemoglobin concentration in Group I increased: 8.05 ± 1.62 mg/dl to 8.39 ± 2.160 mg/dl and in Group II decreased 7.38 ± 1.2 to 7.13 ± 1.75 mg/dl (p = 0.083,NS), Hct: group I increased 22.54 ± 7.83% to 25.71 ± 6.66%; group II decreased 23.99 ± 4.69 to 21.51 ± 5.29 (p = 0.061,NS) where as systolic blood pressure in Group I increased from 134.615 ± 21.454 mmHg to 140.67 ± 27.12 mmHg, group II increased 144.37 ± 18.24 mmHg to 146,88 ± 26,01 mmHg (p = 0.520, NS); diastolic blood pressure in Group I decreased from 83.076 ± 11.821 mmHg to 79.67 ± 13.43 mmHg, group II 91.25 ± 10.87 mmHg to 90.63 ± 15.69 mmHg (p = 0.046, SI; and the LV mass in Group I reduced from 359.15 ± 107.49 g to 316.32 ± 67.43 g, group II 345.21 ± 89.27 to 340.65 ± 97.84 g (p = 0.434, NS) respectively. In conclusion, after 5 weeks of therapy r-HuEPO tended to reduce left ventricular mass in ESRD patients with maintenance hemodialysis. Left ventricular mass reduction in this patients may be associated with diastolic blood pressure reduction, increase of hemoglobin concentration and increase of hematocrit decrease of end diastolic diameter.Key words: r-HuEPO - left ventricular mass - hemodialysis - echocardiography - end stage renal disease
Renoprotective effects of calcium antagonists on kidney disease Mochammad Sja'bani Mochammad Sja'bani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 27, No 03 (1995)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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There has been a growing number of evidence that calcium antagonists provide a salutary effects in preserving kidneys against acute renal ischemia in patients at increasing risk. Their beneficial effects on cellular and mitochondrial calcium may explain the effects on renal hemodynamics and metabolics. It seems, that they do not directly vasodilate kidney vessels but alter the response towards vasoconstrictor agents. This effect may mediate diuretic and natriuretic effect of calcium antagonists. Effects on tubuloglomerular feedback and autoregulation mechanism in the kidneys play an important role in this regards. The above mentioned effects may provide a significant kidney protection and retard the progress of kidney disease.The results of recent studies show that calcium antagonists exert potentially. beneficial effects on several clinical settings including radiocontrast-induced nephrotoxicity and transplant-associated renal insufficiency, particularly cyclosporine A nephrotoxicity and ischemia during harvesting of kidneys.Key words: kidney disease - calcium antagonists renoprotective - hemodynamics - kidney function
Hepatitis C seoconversion and risk factors in hemodialyzed patients: a follow-up study Mochammad Sja'bani Mochammad Sja'bani
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

Telah dilakukan studi follow-up untuk menentukan serokonversi (SK) anti hepatitis C dan taktor risiko potensial pada penderita gagal ginjal terminal dengan hemodialisis (HD) rutin di Unit Renal RSUP DR. Sardjito antara Oktober 1992 sampai April 1993.Penderita yang diikutsertakan dalam penelitian adalah penderita dengan gagal ginjal terminal yang menjalani HD rutin 2 kali seminggu dengan dialisat asetat. Tidak seorangpun dari penderita yang mempunyai riwayat penyalahgunaan obat intravena. Lama HD dan riwayat transtusi darah juga dicatat. Pada awal penelitian dan 6 bulan sesudahnya dilakukan pemeriksaan darah serial, meliputi anti-HCV, titer AST, ALT dan ALP. Penderita yang meninggal dalam 6 bulan follow-up dikeluarkan dari penelitian.Selama penelitian dijumpai 26 penderita dengan anti-HCV negatif (18 laki-laki dan 8 perempuan dengan umur rerata 48,84± 11,34 tahun, lama HD rerata 14.63± 12,98 bulan dan trekuensi transtusi darah rerata 2,30 ± 1,37 kali) dan 32 dengan anti-HCV positit (24 laki-laki dan 8 perempuan dengan umur rerata 48,40 ± 15,30 tahun, lama HD rerata 13,38 ± 16,62 bulan dan trekuensi transtusi darah rerata 3,86 ± 3,36 kali). Penderita dengan anti-HCV positit memiliki trekuensi titer AST abnormal (Iebih dari 1,5 nilai normal) tidak berbeda bermakna (15,6% vs 11,5%, p>0.05), trekuensi titer ALT abnormal (lebih dari 1,5 nilai normal) tak berbeda bermakna (40,6% vs 50,0%, p>0,05) dibandingkan penderita dengan anti-HCV negatif pada awal penelitian. Sebelas penderita dengan anti-HCV negatit drop-out selama 6 bulan follow-up. Di antara 21 penderita dengan anti-HCV negatit yang dianalisis dijumpai SK hepatitis C sebanyak 12 (57,1%) kasus. Penderita dengan SK menunjukkan trekuensi titer AST abnormal Iebih tinggi (75% vs 22,22%, p0,05) dibandingkan dengan penderita tanpa mengalami SK.Disimpulkan bahwa penderita dengan SK memiliki trekuensi titer AST dan ALT abnormal yang Iebih tinggi dibandingkan dengan penderita tanpa mengalami SK.Key words: hepatitis C -- seroconversion -- hemodialysis -- liver function -- risk factor
Renoprotective effects of ACE inhibitors on the progression of diabetic kidney disease Mochammad Sja'bani Mochammad Sja'bani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 27, No 01 (1995)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Functional and structural abnormalities in diabetic kidney disease lead to intraglomerular hypertension and albuminuria. Systemic hypertension and genetically inherited defect on autoregulation in preglomerular arterioles will enhance kidney injury in those patients. ACE inhibitors could reduce albuminuria In patients with diabetic nephropathy and animal models. Hemodynamic improvement manifested by the reduction of albuminuria by ACE inhibitors is only seen in the experimental studies. However, recent studies have shown that ACE inhibitors, especially captopril, could give protective effects on kidneys in insulin-dependent diabetics with nephropathy. Captopril also reduces the risk of death, dialysis, and kidney transplantation in those patients.Key words: diabetes mellitus -- kidney disease -- ACE inhibitors -- albuminuria -- kidney preservation
Liver Function Test in Chronic Hemodialyzed Patients with Anti Hepatitis C Virus Antibody Mochammad Sja'bani Mochammad Sja'bani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 26, No 02 (1994)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Untuk mengetahui fungsi hepar pada penderita gagal ginjal terminal dengan antibodi terhadap virus hepatitis C (anti HCV) positif yang menjalani hemodialisis, suatu penelitian potohOlintang telah dilakukan di Unit Hemodialisis. Rurnah Sakit Umum Pusat Dr: Sardjito, Yogyakarta.Selama penelitian ditemukan 58 penderita (42 laki-laki. 16 perempuan) dengan 32 (55%).anti HCV positif. Tidak ditemukan perbedaan yang bermakna antara kelompok dengan anti HCV positif dan kelompok dengan anti HCV negatif dalam kadar aspartate amino transferase (AST) (46,22 ± 20,85 UI/1 vs 40,15 ± 20,37 U1/1, p > 0,05), kadar alanine amino transferase (ALT) (45,44 ± 26,26 IU/1 vs 37,04 ± 23,03 U1/1, p > 0,05), kadar alkaline phosphatase (ALP) (156, 31 ± 141,141U/1 vs 144,57 ± 82,15.1y/l, p > 0,05),. dan jumlah hemodialisis (8 sampai dengan 733 kali). Kadar AST yang rneningkat di afas 1,5 kali nilai normal cenderung ditemukan lebih besar tapi secara statistik tidak signifikan pada kelompok dengan anti HCV positif dibanding dengan kelompok dengan anti HCV negatif (56.0% vs 30,7%, p > 0,05) yang mungkin akibat jumlah sampel yang kecil. Frekuensi transfusi ditemukan lebih tinggi secara bermakna pada kelompok dengan anti HCV positif dibanding kelompok dengan anti HCV negatif (3,53 ± 3,47 vs 2,23 ± 1,47 kali, p < 0,05).Key Words : hepatitis C virus-anti HCV antibodies -end stage renal disease-blood transfusion- hemodialysis
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