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All Journal Indonesian Journal of Urology Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease Paediatrica Indonesiana Biomolecular and Health Science Journal JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Anesthesiology and Reanimation (IJAR) Majalah Biomorfologi (Biomorphology Journal) Green Medical Journal Indian Journal of Forensic Medicine & Toxicology

Ninik Asmaningsih Soemyarso

Department Of Child Health, Airlangga University Medical School/Dr. Soetomo Hospital Surabaya, East Java

Author-ID : 3298359

Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Management of childhood Gitelman syndrome: a case study Risky Vitria Prasetyo; Putu Dian Saraswati; Ninik Asmaningsih Soemyarso; Mohammad Sjaifullah Noer
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Gitelman syndrome is a rare, autosomal recessive, renal tubular salt wasting disorder characterized by hypokalemia, and metabolic alkalosis in combination with significant hypomagnesemia and hypocalciuria.1,2 The prevalence is estimated to be 1 in 40,000 individuals. The condition affects both males and females of all ethnic backgrounds. The prevalence of heterozygotes is approximately 1% in Caucasian populations.2,3In the majority of cases, symptoms do not appear before the age of six years and the disease is usually diagnosed during adolescence or adulthood. Symptoms, such as transient episodes of muscle weakness and tetany, sometimes accompanied by abdominal pain, vomiting and fever, are often seen in Gitelman syndrome patients. Paresthesias, especially in the face, frequently occur. Remarkably, some patients are completely asymptomatic except for the appearance of chondrocalcinosis at adult age that causes swelling, local heat, and tenderness over the affected joints. Blood pressure is lower than that in the general population. Sudden cardiac arrest has been reported occasionally. In general, growth is normal but can be delayed in those Gitelman syndrome patients with severe hypokalemia and hypomagnesemia.2,4

Repeat urine cultures in children with urinary tract infection Risky Vitria Prasetyo; Ninik Asmaningsih Soemyarso; Mohammad Sjaifullah Noer
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Background Urinary tract infections (UTIs) are the secondleading cause of infection in children, following respiratorytract infections. Repeat urine cultures after antibiotic treatmentare routinely obtained in clinical practice to verify proof ofbacteriologic cure. The American Academy of Pediatrics doesnot recommended repeat cultures, due to increased cost anddiscomfort to patients.Objective To determine the frequency of positive repeat urinecultures after 3 days of antibiotics in children 'With UTIs.Methods We conducted a retrospective study on childrenwith UTIs who visited the Division of Pediatric Nephrology,Department of Child Health at Dr. Soetomo Hospital, Surabayafrom January 2006 to December 2011. Results of repeat urinecultures were obtained after 3 days of antibiotic treatment.Descriptive statistics were used to analyze the data.Results Of the 779 pediatric UTI cases, repeat urine cultureswere performed in 264 (33.9%) cases. Of the 264 patients whocomprised our study, there were similar numbers of girls and boys(50.4% vs. 49.6%, respectively). The mean age of patients was43.9 (SD 1.59) months and 35.5% of subjects were aged under 1year. In the initial urine cultures of our subjects, Escherichia coliwas the most common organism found, v,ith 92 cases (34.8%),compared to 58 cases (21.9%) of Klebsiella pneumoniae and 29cases (10.9%) of Pseudom.onas aeruginosa. Repeat urine culturesshowed no bacterial growth in 168 cases (63.6%).Conclusion Mostly negative repeat urine cultures v,ill probablyobviate the need of this test in daily routine practice. [PaediatrIndanes.2012,52:170Â·4].

Neutrophil gelatinase-associated lipocalin as a biomarker for acute kidney injury in children after cardiac surgery Meta Herdiana Hanindita; Riskky Vitria Prasetyo; Ninik Asmaningsih Soemyarso; I Ketut Alit Utamayasa; Paul Tahalele
Paediatrica Indonesiana Vol 56 No 4 (2016): July 2016
Publisher : Indonesian Pediatric Society

Background Acute kidney injury (AKI) is still diagnosed by measuring the estimated creatinine clearance (eCCl), despite the fact that it may not change until 50% or more of kidney function has been lost. AKI after cardiac surgery is related to prolonged intensive care, decreased quality of life, and increased long term mortality. Neutrophil gelatinase-associated lipocalin (NGAL) represents an early biomarker of AKI, which may be useful for assessing AKI in cardiac patients.Objective To determine the validity of urinary and plasma NGAL as biomarkers for AKI in children after cardiac surgery.Methods Subjects were children who underwent cardiac surgery in Dr. Soetomo Hospital, Surabaya, Indonesia from August 2013 to January 2014. Serial urine and blood samples were analyzed for NGAL before surgery, as well as at 2h, 4h, 12h, and 24h after surgery. The AKI was established based on pRIFLE criteria. Estimated creatinine clearance (eCCl) was calculated from the estimated glomerular filtration rate (eGFR), according to age by the traditional Schwartz formula. Serum creatinine was assayed by the Jaffe method before surgery, as well as at 12h, 24h, 48h, and 72h after surgery.Results Of 20 subjects, 5 developed AKI. Urinary and plasma NGAL increased markedly at 2h postoperatively, as compared to eGFR which showed a rise at 12-48 h after cardiac surgery. Analysis of 2h post-operative urinary NGAL at a cut off value of 11.270ng/mL yielded an area under the curve (AUC) of 1.00 (95%CI 2.63 to 12.13), with sensitivity and specificity of 100% each for AKI. In addition, 2h post-operative plasma NGAL at a cut off value of 8.385 ng/mL yielded an AUC of 1.00 (95%CI 3.71 to 12.15) with sensitivity and specificity of 100% each for AKI.Conclusion Urinary and plasma NGAL are valid as early biomarkers for AKI in children after cardiac surgery.

Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome Ninik Asmaningsih; Windhu Poernomo; M Sjaifullah Noer
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Background Children with idiopathic nephrotic syndrome (INS)have been known to have T-cell dysfunction and an impairment ofthe cytokine network that may alter glomerular permeability andthe glomerular filtration barrier. This disorder may contribute to thepresence of urinary protein loss in children with INS. The elevationof serum IgE levels has been noted in some cases, but its associa-tion with steroid-responsive nephrotic syndrome has not been fullyelucidated.Objective This study was done to investigate the association be-tween serum IgE levels prior to prednisone treatment in childrenwith INS and the outcome of treatment.Methods A prospective observational study has been conductedon 22 children with INS. Prednisone therapy was given with a doseof 60 mg/m 2 body surface area (BSA) for four weeks followed by asingle dose of 40 mg/m 2 BSA every other day for another fourweeks. This protocol was applied for steroid-responsive INS chil-dren. Children with steroid resistance were given oral cyclophos-phamide 2 mg/kg for eight weeks. IgE level measurements wereperformed prior to prednisone therapy and at remission. Data wereanalyzed using one-way ANOVA and multiple regression.Results Twenty-two children were enrolled in this study. High lev-els of serum IgE were found in 95.5% of children, with a mean of2002.5 (SD 2172.1) IU/ml. The serum IgE levels of INS childrenwith history of allergy were significantly higher than those of neph-rotic children without history of allergy (P<0.05). However, therewas no significant correlation between the serum IgE levels andthe outcome of treatment in children with INS.Conclusion The high serum IgE levels in children with INS seemto be associated with humoral immune disorder and did not haveany association with the outcome of therapy. Even though the se-rum IgE levels were significantly higher in INS children with historyof allergy, other factors that may influence serum IgE levels mustbe considered

Predictors of mortality in children with lupus nephritis Lukman Oktadianto; Risky Vitria Prasetyo; Ninik Asmaningsih Soemyarso; Mohammad Sjaifullah Noer
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Background Renal involvement during the clinical course ofsystemic lupus erythematosus (SLE) is generally considered to bethe most important factor influencing disease prognosis in termsof morbidity and mortality. Various factors have been reported toinfluence the prognosis of lupus nephritis (LN).Objective To analyze clinical signs and laboratory parameters thatmight serve as predictors associated with mortality in pediatricLN.Methods Retrospectively, medical records of children with LNat Soetomo Hospital from 1998 to 2011 were studied. Diagnosisof SLE was based on Revised American Rheumatism Associationcritera, while patients with clinical manifestations of hypertension,abnormal urinalysis, and serum creatinin > 1 mg/dL wereconsidered as lupus nephritis. Cox proportional hazard modelingwas used to assess for associations of clinical signs and laboratoryparameters with mortality. Kaplan-Meier survival analysis wasused to assess the cumulative survival from the time of diagnosisto the outcome.Results There were 57 children with LN of whom 43 (75%) weregirls. The female-to-male ratio was 3:1. Subjectsâ€™ mean age was 10.6(SD 6.87) years. The mean time of observation was 51 (SD 74.54)months and 23 (40%) children died. Age, gender, hypertension,hematuria, proteinuria, and anemia were not significant aspredictors for mortality. However, hypertensive crisis (HR=2.79;95%CI 1.16 to 6.75; P=0.02) and initial glomerular filtration rate(GFR) of <75 mL/min/1.73m2 (HR=3.01; 95%CI 1.23 to 7.34;P=0.01) were significant predictors of mortality in children with LN.The mean survival time of LN with hypertensive crisis and initialGFR <75 mL/min/1.73m2 was 36.9 (SD 12.17) months.Conclusion Hypertensive crisis and GFR <75 mL/min/1.73m2 aresignificant predictors of mortality in children with LN.

ASSOCIATION BETWEEN NUTRITIONAL STATUS AND THE OUTCOME OF PEDIATRIC PATIENT WITH DENGUE SHOCK SYNDROME Shidi Laras Pramudito; Dewi Ratna Sari; Ninik Asmaningsih Soemyarso
Majalah Biomorfologi Vol. 30 No. 1 (2020): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Background: The association between nutritional status and dengue infection is still considered controversial. Researches that study obesity and shock in pediatric patients with dengue hemorrhagic fever (DHF) has been widely carried out. However, researches that study the association between obesity and the outcome of patients with dengue shock syndrome (DSS) are still rarely done. Objective: The objective was to study the association of obesity in body mass index-for-age (BMI-for-age), gender, and age to the outcome of patients with dengue shock syndrome (recurrent shock or death). Materials and Methods: The research was analytical retrospective observational research with a case-control design using secondary data from the medical records of pediatric patients with DSS in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia during 2015. The analyses used to test the association of obesity (BMI-for-age), gender, age and the outcome of patients with dengue shock syndrome (recurrent shock or death) were the Chi-Square or Fisher Exact test. Results: The sample acquired was 60 data, consisting of 46 patients with DSS without recurrent shock or death and 14 pediatric patients with DSS experiencing recurrent shock or mortality. The frequency of boys and girls were found in equal numbers. Age group >5-10 years was found more common (45%). The results of the analyses test found no association between gender (p=0.542), age (p=0.314), and obesity (p=1.000) and the outcome of pediatric patients with dengue shock syndrome. Conclusion: There were no association found between obesity, age, and gender to the outcomes of pediatric patients with DSS at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Evaluation of the Progressivity Parameters of Chronic Kidney Disease after Branched-Chain Amino Acid Supplementation in Children Esthy Poespitaningtyas; Roedi Irawan; Ninik Asmaningsih Soemyarso; Jusak Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1467

Chronic Kidney Disease (CKD) is not an uncommon issuein children. Chronic kidney disease is the abnormality ofstructure or function of the kidney that occurs for more than three months. The presence of a longitudinal decline inGlomerulus Filtration Rate (GFR), proteinuria, and hypertension Are the characteristics of CKD. One of the recommendationsof nutritional supplementation as the prevention of CKD is by the administration of oral Branched-Chain Amino Acid (BCAA).To date, there has been no research to analyze the effects of the BCAA on children with stage 2-4CKD. This study aimed toanalyze the effect of BCAA in inhibiting the progressivity of stage 2-4 CKD in children and improving nutritional status.Astudy with randomized pre-post test controlled trial design was performed in the Outpatient Clinic of Pediatric Nephrologyin Dr. Soetomo Hospital with stage 2-4CKD. The subjects were divided into two groups, such as the BCAA and placebo, andwere monitored for eight weeks to be evaluated the GFR, albumin, proteinuria, blood pressure, and nutritional status.Sixteen children with stage 2-4 CKD dominated by 71.4% of male patients were enrolled in this study. The mean age was 12.5(SD 2.90) years. Approximately 50% (p=0.767) stage 2 chronic kidney, 50% (p=1.000) moderate malnutrition, and 64.28%(p=1.000) short stature were found, with nephrotic syndrome as the most common underlying cause of CKD (p=0.149). InBCAA group, decrease of GFR -5.08±7.13 (p=0.055), increase of serum albumin 0.20±0.23 (p=0.062), decrease of deltasystole -11.57±15.08 (p=0.565) and diastole -4.85±16.25 (p=0.708), weight loss -0.07±1.01 (p=0.828), an increase of height0.14±0.24 (p=0.771), and a decrease in BMI -0.03±0.74 (p=0.389) were reported. It was concluded that branched-chainamino acid (leucine, isoleucine, and valine) supplementation did not provide a significant effect to inhibit progressivity ofstage 2-4CKD in children and improvement of nutritional status.

Clinical Profile of Children with Pyelonephritis and Cystitis in Dr. Soetomo General Academic Hospital, Surabaya Lutifta Hilwana; Ninik Asmaningsih Soemyarso; Atika Atika
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 14 No. 1 (2023): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V14I12023.1-5

Highlights:1. In patients younger than one year old, cystitis was more frequent in boys. Meanwhile, in patients aged 1-5, girls were more frequent in pyelonephritis and cystitis.2. In pyelonephritis, all patients had fever, followed by diarrhea and lethargy.3. Urinary symptoms, such as dysuria and hematuria, were more frequent in cystitis than in pyelonephritis. AbstractIntroduction: Urinary tract infection (UTI) is a common infection in children. Prompt diagnosis and treatment of this infection are important to prevent further damage to the kidney. This study aimed to examine the clinical profile of children with pyelonephritis and cystitis in Dr. Soetomo General Academic Hospital, Surabaya.Methods: This was a descriptive study conducted in Dr. Soetomo General Academic Hospital, Surabaya, from June 2013 until December 2015, using secondary data and presented by percentage. Samples included in this study were children aged two months to five years old with UTI as a primary or secondary diagnosis of diarrhea and had urine culture results ≥ 105 CFU/ml.Results: There were 30 patients with pyelonephritis and 27 patients with cystitis. The prevalence of pyelonephritis was 0.285% and of cystitis was 0.247%. In pyelonephritis patients younger than one-year-old, boys and girls were equal. However, boys (60%) were more frequent in cystitis patients. In both pyelonephritis and cystitis patients aged 1-5, girls were more frequent (56.3%; 64.7%). In pyelonephritis patients, all patients were found with fever, followed by diarrhea (60%) and lethargy (56.7%) as the two most common symptoms. The two most common symptoms in cystitis patients were lethargy (44.4%) and irritability (33.3%). Urinary symptoms, such as dysuria and hematuria, were more frequent in cystitis (11.1%; 7.4%) patients than in pyelonephritis patients.Conclusion: Boys were more frequent to suffer urinary tract infections. Systemic symptoms were frequently found in pyelonephritis patients, while urinary symptoms were more frequent in cystitis patients.

Evaluation of the Progressivity Parameters of Chronic Kidney Disease after Branched-Chain Amino Acid Supplementation in Children Esthy Poespitaningtyas; Roedi Irawan; Ninik Asmaningsih Soemyarso; Jusak Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1467

Chronic Kidney Disease (CKD) is not an uncommon issuein children. Chronic kidney disease is the abnormality of structure or function of the kidney that occurs for more than three months. The presence of a longitudinal decline in Glomerulus Filtration Rate (GFR), proteinuria, and hypertension Are the characteristics of CKD. One of the recommendations of nutritional supplementation as the prevention of CKD is by the administration of oral Branched-Chain Amino Acid (BCAA). To date, there has been no research to analyze the effects of the BCAA on children with stage 2-4CKD. This study aimed to analyze the effect of BCAA in inhibiting the progressivity of stage 2-4 CKD in children and improving nutritional status. A study with randomized pre-post test controlled trial design was performed in the Outpatient Clinic of Pediatric Nephrology in Dr. Soetomo Hospital with stage 2-4CKD. The subjects were divided into two groups, such as the BCAA and placebo, and were monitored for eight weeks to be evaluated the GFR, albumin, proteinuria, blood pressure, and nutritional status.Sixteen children with stage 2-4 CKD dominated by 71.4% of male patients were enrolled in this study. The mean age was 12.5 (SD 2.90) years. Approximately 50% (p=0.767) stage 2 chronic kidney, 50% (p=1.000) moderate malnutrition, and 64.28% (p=1.000) short stature were found, with nephrotic syndrome as the most common underlying cause of CKD (p=0.149). In BCAA group, decrease of GFR -5.08±7.13 (p=0.055), increase of serum albumin 0.20±0.23 (p=0.062), decrease of delta systole -11.57±15.08 (p=0.565) and diastole -4.85±16.25 (p=0.708), weight loss -0.07±1.01 (p=0.828), an increase of height 0.14±0.24 (p=0.771), and a decrease in BMI -0.03±0.74 (p=0.389) were reported. It was concluded that branched-chain amino acid (leucine, isoleucine, and valine) supplementation did not provide a significant effect to inhibit progressivity of stage 2-4CKD in children and improvement of nutritional status.

Increased Interleukin-6 as Inï¬‚ ammatory Response and Magnesium Deï¬ ciency in Pre-dialysis Chronic Kidney Disease of Indonesian Children Kardani, Astrid Kristina; Soemyarso, Ninik Asmaningsih; Aras, Jusli Aras; Prasetyo, Risky Vitria; Noer, Mohammad Sjaifullah
Indonesian Journal of Tropical and Infectious Disease Vol. 9 No. 2 (2021)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v9i2.21479

Chronic kidney disease (CKD) is a serious health problem in children, with increasing morbidity and mortality rates throughout the world. Children with CKD tend to experience magnesium (Mg) deï¬ ciency that can stimulate an inï¬‚ ammatory response in the body. One of the inï¬‚ ammatory responses is an increase of Interleukin-6 (IL-6). Study to analyze the correlation between Mg and IL-6 in pre-dialysis CKD children. The methods a cross sectional study was conducted in Dr Soetomo General Academic Hospital from November 2018 to April 2019. Children with pre-dialyis CKD were included in this study. Variables of serum Mg level (mg/dL) and inï¬‚ ammatory marker (IL-6) were measured from the blood and analyzed by ELISA method. The correlation between Mg and IL-6 was analyzed with Spearman's correlation test with p <0.05. Result a total of 47 children (27 boys vs 20 girls) between 3 months to 18 years old, with pre-dialysis CKD and no history of magnesium supplementation were included. The primary disease that causes of CKD were lupus nephritis (38.3%), nephrotic syndrome (23.4%), urologic disorder (23.4%), tubulopathy (10.6%) and others (4.3%). The average IL-6 level was 55.42±43.04 pg/dL and Mg level was 2.06±1.54 mg/dL. There were no signiï¬ cant correlation between IL-6 level and Mg level with staging of CKD and duration of illness (p>0.05), but there was a signiï¬ cant correlation between serum Mg level and IL-6 level (r=-0.748; p<0.001). Magnesium levels have a signiï¬ cant inverse correlation with IL-6 levels in pre-dialysis CKD children. The lower the Mg levels in the blood, the higher IL-6 levels and vice versa.

Co-Authors Aras, Jusli Aras, Jusli Aras Atika Atika Chairunnisa Dessy Surya Setyani Dewi Ratna Sari Dwi Susanti Dwiyanti Puspitasari, Dwiyanti Esthy Poespitaningtyas Hanindita, Meta Herdiana Heru Setiawan I Dewa Gede Ugrasena Irwanto, Irwanto Ismoedijanto Jusak Nugraha Kardani, Astrid Kristina Lucky Andriyanto Lukman Oktadianto Lutifta Hilwana Mariyatul Qibtiyah Mohammad Sjaifullah Noer Muhammad Riza Kurniawan Ni Wayan Tirthaningsih Noershanti Ramadhani Nugroho Setia Budi Nur Annisa Nugraheningtyasari Paul L Tahalele Prastiya Indra Gunawan Putu Dian Saraswati Riskky Vitria Prasetyo Risky Vitria Prasetyo Roedi Irawan Rozalina Loebis Semedi, Bambang Pujo Sherly Yuniarchan Shidi Laras Pramudito Sri Andreani Utomo Utariani, Arie Windhu Poernomo Yulistiani Yulistiani Yuni Hisbiiyah

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