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All Journal Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Majalah Kedokteran Sriwijaya Biomedical Journal of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) Indonesian Journal of Kidney and Hypertension Jurnal Menara Medika Open Access Indonesian Journal of Medical Reviews Bioscientia Medicina : Journal of Biomedicine and Translational Research PHARMACOLOGY, MEDICAL REPORTS, ORTHOPEDIC, AND ILLNESS DETAILS (COMORBID) Journal Of World Science Jurnal Penyakit Dalam Indonesia
Zulkhair Ali
Department Of Internal Medicine, Dr. Mohammad Hoesin Hospital, Palembang, Indonesia / Department Of Internal Medicine, Faculty Of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Economics, Econometrics & Finance Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Chronic Renal Failure in a Post-Kidney Transplant Patient with Kidney Graft Hydronephrosis and Renal Anemia Elfiani Elfiani; Zulkhair Ali; Fadil Pramudya; Muhammad Yusri; Huntari Harahap
Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Vol. 11 No. 4 (2023): JAMBI MEDICAL JOURNAL Jurnal Kedokteran dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22437/jmj.v11i4.28890

Abstract

ABSTRACT   A kidney transplant is the ideal option for End Stage Renal Disease (ESRD). A successful kidney transplant will improve the excretory function of the kidney so that it can return the quality of life for patients with Chronic Kidney Disease (CKD) to normal. However, in some cases of transplant recipients, the grafted kidney does not function optimally due to several complications. Post-kidney transplant complications may occur, which are classified into two groups, namely surgical and medical complications. Cases of obstruction characterized by hydronephrosis of the graft kidney, a post-transplant surgical complication. The most common location is where the ureter implants into the bladder, namely the distal 1/3 ureter. The most important medical or non-surgical complications are rejection or rejection reactions ranging from acute, hyperacute and chronic. Chronic rejection is the gradual loss of function of the transplanted organ over several months to years after the organ is functioning normally. Chronic rejection is difficult to treat where the use of immunosuppression is of little use because the damage has already occurred, so the patient again needs another renal replacement therapy, namely hemodialysis. The following is a case report of a patient after a kidney transplant six years ago, experienced decreased kidney function again and had to receive hemodialysis therapy due to a kidney graft/hydronephrosis graft.
Nephrogenic Ascites in End-Stage Renal Disease Patients Undergoing Hemodyalisis: Case Series Mulia, Deddy Primadona; Irawan, Rico; Kartika, Herleni; Wangsa, Syahpri Putra; Akbar, Kgs. M. Yusuf Arief; Effendi, Ian; Suhaimi, Novadian; Slamet, Suprapti; Ali, Zulkhair
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.121

Abstract

Ascites occurring in individuals with chronic kidney disease (CKD) undergoing hemodialysis (HD) are referred to as nephrogenic ascites (NA). The pathogenesis of NA remains uncertain but involves many interrelated factors. These factors include inadequate dialysis, low ultrafiltration, poor nutrition, increased peritoneal membrane permeability, and impaired peritoneal lymphatic reabsorption. Frequent accompanying complaints are leg edema, nausea, decreased appetite, weakness, and complaints due to hypotension during HD. NA generally carries a poor long-term prognosis, likewise, with complex therapeutic options, both medical and surgical. Management of NA includes education regarding fluid restrictions, a high protein diet, intensive HD, as well as therapeutic modalities with continuous ambulatory peritoneal dialysis (CAPD) and kidney transplantation. CAPD has been proven to improve quality of life and recovery from ascites. The NA in this case report was all related to the patient's low level of compliance against fluid intake restrictions, particularly while experiencing oliguria or anuria. In this case, intensive education regarding limiting fluid intake and high-protein nutrition seems essential for better patient outcomes. On the other hand, the presence of infectious complications gives poor outcomes. Two patients presented with umbilical hernia, which could be an obstacle for CAPD.
Angiotensin-Converting Enzyme Genetic Polymorphism rs4343 as Risk of Diabetic Nephropathy in Jambi-Malay Population Elfiani, Elfiani; Puspasari, Anggelia; Arif, Cut Wulan; Maharani, Citra; Ali, Zulkhair; Suhaimi, Novadian; Effendi, Ian; Suprapti, Suprapti; Shafira, Nyimas Natasha Ayu
Molecular and Cellular Biomedical Sciences Vol 8, No 1 (2024)
Publisher : Cell and BioPharmaceutical Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21705/mcbs.v8i1.410

Abstract

Background: Diabetic nephropathy (DN) is one of the frequent complications of type II diabetes mellitus (T2DM) in Jambi province. Controlling blood glucose and blood pressure does not guarantee DN prevention, since genetic factors may also contribute to this disease. Multi-ethnic studies showed that one of the strongest genetic factors associated with DN was single nucleotide polymorphism rs4343 of angiotensin-converting enzyme (ACE) gene. Study regarding phenotype-genotype association of ACE rs4343 and DN has not yet been performed in Jambi Province, which is dominated by Malay ethnicity. This study was conducted to reveal the association between ACE rs4343 and the risk of DN in the Jambi-Malay population.Materials and methods: This was a cross-sectional study involving 75 subjects (44 with DN and 31 without DN) who suffered from T2DM and hypertension. DN was defined as albumin to creatinine ratio (ACR) ≥30 mg/g. Genotyping was performed with one-step tetra amplification refractory mutation system-polymerase chain reaction (PCR) using specific primer for ACE rs4343. Bivariate and multivariate analyses were performed to analyze the genetic risk for DN.Results: The bivariate analysis showed the proportion of DN subjects was higher than non-DN within the AG genotype (11:1) than within the AA (33:30) genotype. This difference was statistically significant (p=0.012; OR (95% CI): 10.00 (1.22-82.15)). Multivariate analysis showed that AG genotype (p=0.047; OR (95% CI): 10.04 (1.03-97.31)) and uncontrolled blood pressure (p=0.001; OR (95% CI): 6.72 (2.08-21.71)) were the risk factors of DN in the Jambi-Malay population.Conclusion: Polymorphism of ACE rs4343 is a risk factor of DN in the Jambi-Malay Population.Keywords: rs4343, angiotensin-converting enzyme gene, diabetic nephropathy, Malay, Jambi
OVERVIEW OF PERIPHERAL NEUROPATHY IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS AT DR. MOHAMMAD HOESIN HOSPITAL PALEMBANG Christin, Theresia; Ali, Zulkhair; Legiran, Legiran; Ferawaty, Ferawaty
PHARMACOLOGY, MEDICAL REPORTS, ORTHOPEDIC, AND ILLNESS DETAILS Vol. 2 No. 3 (2023): JULY
Publisher : Transpublika Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55047/comorbid.v2i3.890

Abstract

Neurological complications occur in almost 60% of patients with advanced CKD and affect the nervous system at all levels, both central and peripheral. Peripheral neuropathy in CKD is usually asymptomatic until renal function is below 15%, and glomerular filtration is less than 10-12 ml/min. This study seeks to identify and characterize peripheral neuropathy in patients with chronic kidney disease undergoing hemodialysis at Dr. Mohammad Hoesin Hospital Palembang. This is a descriptive cross-sectional study with the research sample comprising chronic kidney disease patients undergoing hemodialysis at Dr. Mohommad Hoesin Palembang Hospital. The distribution of research subjects based on the Neuropathy Symptom Score (NSS) revealed that 65.7% fell into the mild neuropathy category, based on an NSS of 3-4. According to the electrophysiology results, 82.9% of patients exhibited peripheral neuropathy, while 17.1% showed normal NCS results. Sensory motor neuropathy accounted for 51.4%, including 71.5% with axonal neuropathy, 11.4% with axonal-demyelinating lesions, and no demyelinating lesions. The high prevalence of peripheral neuropathy in CKD patients identified through electrophysiological examination (ENMG) emphasizes the importance of nerve conduction examination as a diagnostic tool for peripheral neuropathy in CKD patients. This can aid in determining the progression of peripheral neuropathy in CKD patients, allowing for appropriate management and prevention of disability complications to enhance the quality of life for these individuals.
Impact of Etelcalcetide on Cardiovascular Outcomes and Mortality in Hemodialysis Patients with Secondary Hyperparathyroidism: A Meta-Analysis Nurul Ramadhani Umareta; Fitri Rahmariani; Zulkhair Ali
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i1.701

Abstract

Secondary hyperparathyroidism (SHPT) is a common complication in hemodialysis patients, contributing to cardiovascular disease and mortality. Etelcalcetide, a novel calcimimetic agent, has shown promise in managing SHPT. This meta-analysis aimed to evaluate the impact of etelcalcetide on cardiovascular outcomes and mortality in hemodialysis patients with SHPT. A systematic search of electronic databases (PubMed, Scopus, Web of Science) was conducted to identify randomized controlled trials (RCTs) comparing etelcalcetide with placebo or other active treatments in hemodialysis patients with SHPT. The primary outcomes were cardiovascular events (composite of myocardial infarction, stroke, heart failure, and cardiovascular death) and all-cause mortality. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Seven RCTs (n=4,520 patients) were included in the meta-analysis. Etelcalcetide was associated with a significant reduction in cardiovascular events (RR 0.85, 95% CI 0.75-0.96, p=0.01) and all-cause mortality (RR 0.88, 95% CI 0.79-0.98, p=0.02) compared to placebo. No significant difference in cardiovascular events or mortality was observed between etelcalcetide and cinacalcet. In conclusion, etelcalcetide appears to be effective in reducing cardiovascular events and mortality in hemodialysis patients with SHPT. Further studies are needed to confirm these findings and to assess the long-term impact of etelcalcetide on cardiovascular health in this population.
THE EFFECT OF TAHAJUD PRAYER ON STRESS Pranata, Lilik; Irfannuddin, Irfannuddin; Ali, Zulkhair; Andraini, Trinovita
Menara Medika Vol 7, No 2 (2025): VOL 7 NO 2 MARET 2025
Publisher : Fakultas Kesehatan Universitas Muhammadiyah Sumatera Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31869/mm.v7i2.6951

Abstract

Introduction: Stress is a physical and emotional reaction that occurs when a person faces pressure or environmental changes that require them to adapt. If stress is left unchecked, it can lead to many disorders. One thing that can be done is to perform tahajud prayers. The purpose of this study is to determine the benefits of tahajud prayer on stress. Method: The research design uses a literature review method by analysing articles from databases such as PubMed, Science Direct, ProQuest, and Google Scholar, focusing on articles published between 2020 and 2025, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart approach. After selection, six articles were found to meet the inclusion criteria. Results: Tahajud prayer therapy can reduce stress levels. Discussion: Every individual experiences different levels of stress, so the process of performing tahajud prayer must be adapted to the stress level. The activity of tahajud prayer should be performed regularly without coercion and with sincerity.
Effect of Garlic (Allium Sativum) Extract on Hemoglobin Levels in Chronic Hemodialysis Patients Ramadhan, Philosophia; Alif Fathur Rachman, Muhammad; Ali, Zulkhair; Effendi, Ian; Novadian, Novadian; Suprapti, Suprapti; Saleh, Irsan
Journal of World Science Vol. 2 No. 1 (2023): Journal of World Science
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jws.v2i1.129

Abstract

CKD patients undergoing hemodialysis have increased inflammatory biomarkers. Anemia in CKD is associated with an advanced degree of inflammation while undergoing chronic hemodialysis. Garlic (Allium sativum) has anti-inflammatory and antioxidant effects, which are expected to improve the degree of inflammation in CKD patients. This study aims to assess the effect of garlic extract on hemoglobin levels in patients undergoing chronic hemodialysis. This study was an experimental study with a double-blind, randomized clinical trial design. This study was a crossover, randomized, placebo-controlled, double-blind trial. The study subjects were 40 stages 5 CKD patients undergoing chronic hemodialysis, randomly divided into two groups, namely the group that received 1000 mg of garlic extract per day (2x500 mg) for six weeks and the group that received a placebo, then a 2-week wash-out period. And after that, the two groups were given alternate treatment. Statistical analysis was carried out using the SPSS version 25.0 program. A total of 40 subjects participated in the study, 57.5% male. The mean age of the subjects was 48.6 (26-59) years. The results showed that there was a significant difference in Hb levels in the garlic group (p = 0.047), where the increase in Hb was from 10.2 (9.2–11.8) mg/dl to 10.23 (8.9–11.6) mg/dl while in the placebo group, there was a decrease in Hb from 10.18 (9.6 – 11.2) mg/dl to 10.05 ± 0.52 mg/dl. Garlic extract can reduce levels of inflammation which can then increase hemoglobin levels.
Effectiveness of Renal Denervation Therapy in Persistent Hypertension: A Meta-Analysis Mulia, Deddy Primadona; Syahpri Putra Wangsa; Kgs. M. Yusuf Arief Akbar; Edy Nur Rachman; Chairil Makky; Eva Julita; Zulkhair Ali; Novadian Suhaimi; Suprapti Slamet; Ian Effendi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1049

Abstract

Background: Persistent hypertension is a global health problem that requires effective therapy. Renal denervation (RDN) therapy is emerging as a promising new option. This meta-analysis aims to evaluate the effectiveness of RDN in patients with persistent hypertension. Methods: We performed a systematic search in PubMed, Scopus, and the Cochrane Library for studies evaluating the effectiveness of RDN in patients with persistent hypertension. Data were extracted and analyzed using a random effects model. Results: A total of 12 studies with a total of 1,024 patients were included in this meta-analysis. RDN demonstrated significant reductions in systolic and diastolic blood pressure compared with controls (MD -12.3 mmHg [95% CI -15.8 to -8.8] for systolic blood pressure and MD -6.1 mmHg [95% CI -8.2 to -4.0] for blood pressure diastolic). The effectiveness of RDN is higher in patients with more severe hypertension and in patients who are unresponsive to antihypertensive drugs. Conclusion: RDN is an effective therapy for persistent hypertension, especially in patients with more severe hypertension and in patients who are unresponsive to antihypertensive drugs.
Is It a Tumor or Not? A Case of Focal Segmental Glomerulosclerosis Secondary to Type 2 Diabetes with a Concomitant Renal Pseudotumor Rery TF Yuniarti; Ian Effendi; Zulkhair Ali; Novadian; Suprapti; Elfiani; Novandra AP; Dila Siti Hamidah; Fadil Pramudhya Husein; Ika Kartika Edi P
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1154

Abstract

Background: Focal segmental glomerulosclerosis (FSGS) is a histologic pattern of glomerular injury that can be primary or secondary to various conditions, including obesity, diabetes, and hypertension. Renal masses, often detected incidentally, can be benign or malignant, with renal cell carcinoma (RCC) being the most common. This case report presents a patient with FSGS secondary to type 2 diabetes and a concomitant renal pseudotumor, initially suspected to be RCC. Case presentation: A 60-year-old woman presented with weakness, fever, and weight loss. Imaging revealed a renal mass, initially suspected to be RCC. A kidney biopsy revealed FSGS, and further evaluation confirmed type 2 diabetes. After controlling her diabetes and hypertension, the renal mass regressed, suggesting a pseudotumor. Conclusion: This case highlights the importance of considering pseudotumors in the differential diagnosis of renal masses, especially in patients with comorbidities such as diabetes. A kidney biopsy can help avoid unnecessary invasive procedures like nephrectomy.
Bridging the Therapeutic Gap: A Systematic Review and Meta-Analysis on the Efficacy, Safety, and Pathophysiological Impact of Sodium Zirconium Cyclosilicate in Enabling Guideline-Directed Medical Therapy Edy Nur Rachman; Ian Effendi; Zulkhair Ali; Novadian; Suprapti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1489

Abstract

Background: Hyperkalemia is a life-threatening complication of chronic kidney disease (CKD) and heart failure (HF), primarily impeding the use of life-saving renin-angiotensin-aldosterone system inhibitors (RAASi). This systematic review and meta-analysis evaluate the evidence for sodium zirconium cyclosilicate (SZC) in managing hyperkalemia and enabling RAASi therapy. Methods: This systematic review searched Medline, Embase, and Cochrane CENTRAL to September 2025. Dual reviewers independently screened, extracted data, and assessed bias (Cochrane RoB 2, Newcastle-Ottawa Scale). We included RCTs and observational studies of SZC in adults with hyperkalemia. A random-effects meta-analysis was performed on RCTs reporting maintenance-phase efficacy and safety. Results: The search yielded 1,254 citations, with 6 pivotal studies included. The meta-analysis of 3 RCTs found that SZC (5-10g daily) was significantly more effective than placebo at maintaining normokalemia over 12-28 days. The pooled mean difference in serum K+ was -0.58 mEq/L (95% CI: -0.65 to -0.51; I2 = 0%). SZC did increase the risk of edema (pooled Risk Ratio: 2.95; 95% CI: 1.51 to 5.76; I2 = 0%). The narrative synthesis of observational data confirmed that SZC use was associated with a >2.5-fold increase in the likelihood of continuing RAASi therapy. Conclusion: Sodium zirconium cyclosilicate is a highly effective and rapidly acting agent for both acute correction and chronic management of hyperkalemia. Our meta-analysis provides a precise estimate of its high maintenance-phase efficacy. Its primary clinical benefit lies in providing a renal-independent pathway for potassium excretion, thereby "uncoupling" potassium levels from RAASi use and bridging a critical treatment gap.
Co-Authors Abdul Hakim R Ade Yonata Ade Yonata, Ade Agustina H Akbar, Kgs. M. Yusuf Arief Akbar, M Yusuf Arief Ali Ghanie Alif Fathur Rachman, Muhammad Alwi Shahab Alwi Shahab Amir, Teguh Setiadi Anggelia Puspasari Arief Akbar, Kgs M Yusuf Arif, Cut Wulan Chairil Makky Christin, Theresia Citra Maharani Deddy Primadona Mulia Devi, SNA Ratnasari Dila Siti Hamidah Eddy Mart Salim Edy Nur Rachman Effendi, Ian Elfiani Elfiani Elfiani Emilia Emilia Erial Bahar Erial Bahar Erial Bahar, Erial Erwin Sukandi Eva Julita Fadil Pramudhya Hoesain Fadil Pramudhya Husein Fadil Pramudya Fauzan Azhari, Fauzan Ferawaty, Ferawaty Ferry Usnizar Ferry Yusrizal Fitri Rahmariani Fitria Koeshardani Harahap, Huntari Harun Hudari Ian Effendi Ian Effendi Ian Effendi Ika Kartika Ika Kartika Edi P Indrajaya, Taufik Irawan, Rico Irfannuddin Irfannuddin Istiqomah, Amelia Junaidi A Kartika, Herleni Kendenan, Margaretha Kgs M Yusuf Arief Akbar Kgs. M. Yusuf Arief Akbar kurniati, nova Kusrini, Ida Legiran Legiran Lidiawati Handayani Lilik Pranata M Yusuf Arief Akbar Mediarty Mediarty Syahrir Muhammad Irsan Saleh Muhammad Yusri Mulia, Deddy Primadona Nova Kurniati Novadian Novadian Novadian Novadian, Novadian Novadian Suhaimi Novadian Suhaimi Novadian Suhaimi Novandra AP Nurul Ramadhani Umareta Nyimas Natasha Ayu Shafira R.M. Suryadi Tjekyan Radiyati Umi Partan Ramadhan, Philosophia Ratna Maila Dewi Anggraini Reinanda Marizki R Rery TF Yuniarti RM Suryadi Tjekyan Rostika Dewi Shahab, Alwi Slamet, Suprapti SNA Ratnasari Devi Suhaimi, Novadian Suprapti Suprapti Slamet Suprapti Suprapti Suprapti Suprapti Syahpri Putra Wangsa Taufik Indrajaya Taufik Indrajaya Trinovita Andraini Wangsa, Syahpri Putra Yudhie Tanta Yulianto kusnadi