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Six-Minute Walk Test Performance in Non-Dialysis Chronic Kidney Disease: An Observational Study from a Tertiary Hospital Setting Irena Fathin Amelia; Harun, Harnavi; Miftah Irramah; Selfi Renita Rusjdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1324

Abstract

Background: Functional capacity dramatically declines in non-dialysis chronic kidney disease (CKD-ND), impacting patient prognosis and quality of life. Accurate, practical assessment is crucial for timely intervention. This study evaluated functional capacity using Six-Minute Walk Test (6MWT) and explored associated clinical factors in Indonesian CKD-ND patients. Methods: We conducted a cross-sectional study at RSUP Dr. M. Djamil Padang, enrolling 44 patients with CKD stages 3-5 not on dialysis. Using purposive sampling, we collected 6MWT distance (6MWD) following ATS guidelines and extracted demographic/clinical data (age, gender, BMI, eGFR, etiology) from medical records. Functional capacity, expressed as Metabolic Equivalents (METs), was estimated from 6MWD and patient data using the Nury formula. Descriptive statistics summarized the findings. Results: The cohort (54.5% male, mean age 56-65 years) predominantly had advanced CKD (43.2% Stage 5) and hypertension etiology (45.4%). Functional capacity was severely impaired: mean 6MWD was low (Men: 291m, Women: 255m), and a striking 70.5% of patients exhibited low functional capacity (<3.0 METs). No participants achieved high capacity (>6.0 METs). Lower mean 6MWD and a higher prevalence of low METs were distinctly observed in patients with lower eGFR and advanced age. Conclusion: This study reveals profound functional limitations in Indonesian CKD-ND patients well before dialysis initiation. Lower eGFR and older age were strongly associated with poorer performance. The 6MWT effectively quantifies this impairment, highlighting its utility for routine screening and emphasizing the urgent need for functional assessment and rehabilitation strategies in CKD-ND management.
Peran Angiotensin 1-7 pada Penyakit Ginjal Kronik Sofiani, Dinda Putri; Harun, Harnavi
Jurnal Ilmu Kesehatan Indonesia Vol. 6 No. 3 (2025): September 2025
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jikesi.v6i3.1521

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Latar Belakang:  Penyakit ginjal kronik (PGK) ditandai penurunan progresif fungsi ginjal. Pada patogenesisnya, sistem renin–angiotensin–aldosteron (RAAS) berperan sentral. Angiotensin-(1–7) [Ang(1–7)], metabolit angiotensin II yang berikatan dengan reseptor Mas, memiliki efek vasodilatasi, anti-inflamasi, dan anti-fibrosis yang berpotensi protektif. Objektif:  Mengevaluasi bukti preklinik dan klinik terkait peran Ang(1–7) terhadap tekanan darah, inflamasi/fibrosis, dan luaran ginjal pada PGK. Metode:  Tinjauan naratif atas studi 2010–2025 yang ditelusuri di PubMed/Scopus dengan kata kunci “chronic kidney disease”, “angiotensin-(1–7)”, “Mas receptor”. Inklusi: model hewan atau uji klinik yang melaporkan tekanan darah, albuminuria, eGFR, atau penanda inflamasi/fibrosis. Ekstraksi berfokus pada arah efek dan keselamatan. Hasil:  Studi preklinik konsisten menunjukkan penurunan tekanan darah, hambatan aktivasi TGF-β/SMAD dan NF-κB, serta penurunan kolagen interstisial. Pada manusia, uji awal bersampel kecil melaporkan penurunan albuminuria dan tekanan darah, perbaikan biomarker inflamasi, serta perlambatan penurunan eGFR pada sebagian kohort; profil keamanan umumnya baik. Namun, heterogenitas populasi, variasi dosis/route (peptida vs analog), dan durasi intervensi yang singkat membatasi kepastian efek kausal. Kesimpulan:  Ang(1–7) menjanjikan sebagai adjuvan penatalaksanaan PGK melalui modulasi RAAS non-klasik dengan efek anti-inflamasi dan anti-fibrotik. Meski sinyal manfaat awal ada, bukti klinik masih terbatas. Uji acak terkontrol berskala besar dengan penetapan dosis, durasi, dan luaran keras (penurunan eGFR jangka panjang, dialisis, kematian) diperlukan sebelum implementasi rutin
Lactococcus lactis D4 Decreases NF-κB and α-SMA in Rat Models of Obstructive Jaundice Suchitra, Avit; Alvarino, Alvarino; Darwin, Eryati; Harun, Harnavi; Rivai, Muhammad Iqbal; Sukma, Ade
The Indonesian Biomedical Journal Vol 16, No 6 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i6.3384

Abstract

BACKGROUND: Obstructive jaundice, often due to choledocholithiasis or malignancies, leads to immune suppression, intestinal damage, and bacterial translocation, worsening outcomes. Some inflammatory mediators like nuclear factor kappa B (NF-κB), alpha-smooth muscle actin (α-SMA), and interleukin-6 (IL-6) are important in this process. Current treatments remain inadequate, highlighting the need for novel approaches. Probiotics, such as Lactococcus lactis D4 (LLD4), may help reduce inflammation and bacterial translocation, thus offering a potential therapeutic option. This study was conducted to evaluate the effects of LLD4 on NF-κB, α-SMA, and IL-6 in obstructive jaundice rat models.METHODS: This post-test randomized controlled study involved 15 male Wistar rats divided into three groups: sham, bile duct ligation (BDL), and BDL+LLD4 groups. The rats were maintained for 7–10 days, with the rats in BDL+LLD4 group received fermented milk containing LLD4 via gavage at a dose of 112 mg/20 gBW per day for 7 days. The expression levels of NF-κB, α-SMA, and IL-6 were analyzed using immunohistochemistry.RESULTS: Administration of LLD4 were able to significantly reduced NF-κB expression compared to the BDL group (40.20±21.276 vs. 53.60 ± 20.403) in obstructive jaundice rat models. Though not significant, BDL+LLD4 group showed lower α-SMA expression compared to BDL group (58.40±14.271 vs. 63.20±9.16). However, administration of LLD4 did not give any significant effect on IL-6 expression.CONCLUSION: LLD4 reduces inflammation in models of obstructive jaundice by lowering the NF-κB and α-SMA expression. This indicates that LLD4 might be potential as an adjunct therapy for reducing morbidity in obstructive jaundice cases.KEYWORDS: obstructive jaundice, bile duct ligation, Lactococcus lactis D4, NF-κB, α-SMA, IL-6
Efficacy, Safety, and Metabolic Effects of Low-Molecular-Weight Heparin versus Unfractionated Heparin in Chronic Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Studies Evelin Veronike; Harnavi Harun; Drajad Priyono; Deka Viotra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1494

Abstract

Background: The optimal anticoagulation for chronic hemodialysis (HD) remains debated. Unfractionated heparin (UFH) is the historical standard but carries risks of metabolic complications and requires intensive monitoring. Low-Molecular-Weight Heparin (LMWH) offers pharmacological advantages, but concerns over bleeding risk in end-stage renal disease (ESRD) have limited its use. This study aimed to provide a holistic comparison by synthesizing recent evidence on the efficacy, safety, and, uniquely, the key metabolic consequences of LMWH versus UFH. Methods: This systematic review followed PRISMA 2020 guidelines. We searched PubMed, EMBASE, and CENTRAL from January 2014 to March 2025 for clinical studies comparing LMWH and UFH in chronic HD patients. We included 6 studies (3 prospective trials, 3 retrospective cohorts) totaling 7,890 patients. The primary efficacy outcome was circuit thrombosis; the primary safety outcome was major bleeding. Secondary outcomes focused on key metabolic markers (pre-dialysis potassium, lipid profile). Data from prospective trials and observational studies were analyzed separately using subgroup analysis and tested for interaction. Metabolic data were pooled using a random-effects model. Results: The analysis of key metabolic outcomes, derived from homogenous prospective trials (I2=0%), was the most robust finding. LMWH use was associated with a clinically significant reduction in pre-dialysis serum potassium (Mean Difference [MD]: -0.30 mEq/L; 95% CI: -0.50 to -0.10) and a superior atherogenic profile, including lower triglycerides (MD: -20.10 mg/dL) and higher HDL (MD: +4.50 mg/dL). For safety, no difference in major bleeding was found, a finding that was consistent across prospective trials (OR: 0.78; 95% CI: 0.33-1.85) and large retrospective cohorts (OR: 0.87; 95% CI: 0.69-1.09), with no subgroup interaction (p=0.75). Efficacy for preventing circuit thrombosis was also similar. Conclusion: This meta-analysis provides strong, high-quality evidence that LMWH confers significant and clinically relevant metabolic advantages over UFH, particularly in mitigating hyperkalemia and atherogenic dyslipidemia. Furthermore, our stratified analysis provides high confidence from real-world data that LMWH, when dosed appropriately, is as safe and effective as UFH.
Stunting Management Education with the Application of Yodiwa Innovation Products in Padang Panjang City, West Sumatra, Indonesia Amelia, Rinita; Suryanis, Ira; Siana, Yusti; Ruhsyahadati, Ruhsyahadati; Harun, Harnavi; Pratama, Yudha Endra
Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) Vol 7, No 6 (2024): Volume 7 No 6 2024
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkpm.v7i6.14974

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ABSTRAK Pemerintah telah meluncurkan program Rencana Aksi Nasional Penanganan stunting pada tingkat nasional, daerah terutama desa. Salah satu bagian dari program tersebut adalah pencegahan stunting yang terjadi di masyarakat. Karena sebagian besar masyarakat belum paham dengan benar menganai stunting, dan beranggapan bahwa stunting atau kerdil sebutan yang biasa digunakan di masyarakat adalah faktor keturunan. Penanganan bagi pasien stunting dilakukan dengan memberikan makanan yang bergizi tinggi, salah satu dengan pemanfaatan susu kambing sebagai sumber pretein hewani. Penerapan produk inovasi YODIWA (Yogurt dadiah Etawa) sebagai salah satu olahan susu kambing menjadi yogur dengan menggunakan starter dari dadiah. Metode yang dilakukan dalam pengabdian ini yaitu edukasi tentang manfaat dari susu kambing, dadiah dan probiotik; pelatihan pembuatan Yodiwa serta launching Pojok Yodiwa. Peserta pelatihan terdiri dari anggota TP-PKK Kota Padang Panjang yang berasal dari perakilan tiap kelurahan. Dengan diadakan pelatihan tentang pengolahan makanan tinggi protein berbahan dasar susu kambing in diharapkan mampu mengurangi prevalensi stunting di Kota Padang Panjang serta launching pojok Yodiwa ini sebagai centre pengolahan Yodiwa di Kota Padang Panjang yang berpusat di Kelurahan ganting. Kata Kunci: Dadiah, Stunting, Susu Kambing, Yodiwa, Padang Panjang  ABSTRACT The government has launched the National Action Plan program for handling stunting at the national, regional, and village levels. One part of the program is preventing stunting that occurs in the community. Most people do not understand properly about stunting and think that stunting or dwarfism, the term commonly used in society, is a hereditary factor. Treatment for stunting patients is carried out by providing highly nutritious food, one of which is using goat's milk as a source of animal protein. Application of the innovative YODIWA (Etawa dadiah yoghurt) as a form of processing goat's milk into yoghurt using a starter from dadiah. The method used in this service is education about the benefits of goat's milk, dadiah, and probiotics, as well as training on making Yodiwa and launching Pojok Yodiwa. The training participants comprised the Padang Panjang City TP-PKK members who came from each sub-district. By holding training on processing high protein foods made from goat's milk, it is hoped that it will be able to reduce the prevalence of stunting in Padang Panjang City and launch this Yodiwa corner as a Yodiwa processing centre in Padang Panjang City, which is based in Ganting Village. Keywords: Dadiah, Stunting, Goat's Milk, Yodiwa, Padang Panjang
Correlation Between Oxidative Stress, SIRT1 Serum Level, and eGFR on Elderly Harun, Harnavi; Veronike, Evelin; Kam, Alexander; Amelia, Rinita
Jurnal Penelitian Pendidikan IPA Vol 9 No 8 (2023): August
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v9i8.4916

Abstract

The aging network kidney causes Oxidative Stress (OS) and damages the kidney. Studies of aging kidneys keep going growing by developing sirtuin as an antiaging. Sirtuin 1 (SIRT1) is a protein implicated in several disorders including diabetes functions as an anti-aging protein. Decreased eGFR in the elderly caused by his height prevalence factor risk disease kidney at an older age. The study aims to study the correlation between oxidative stress, SIRT1 serum levels, and eGFR in the elderly.  The method used in this research is observational with the cross-sectional method. The sample in this study was the whole elderly who met the inclusion and exclusion criteria, totaling 30 people. Exclusion criteria are patients with glomerulonephritis, nephropathy obstruction, nephropathy sour veins, and obesity. All patients complied requirements asked to fill informed consent form. The inspection was carried out by urinalysis ultrasound kidney and assessing serum MDA levels which were found to be higher in this study. This study showed SIRT1 and eGFR levels decreased in the elderly. There was a negative correlation with moderate correlation strength between serum MDA levels and serum SIRT1 levels and a strong correlation between serum MDA levels and eGFR in the elderly. There was a positive correlation with a moderate correlation between serum SIRT1 levels and eGFR in the elderly. SIRT1 is suggested to be examined in elderly patients with decreased eGFR, even without comorbidity.
The correlation between pentraxin-3, matrix metalloproteinase-9, and estimated glomerular filtration rate in patients with chronic kidney disease Harun, Harnavi; Dewi, Amelia Fitria; Amelia, Rinita
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 1, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss1.art8

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Background: Chronic kidney disease (CKD) is diagnosed when there is a sustained decrease in the estimated glomerular filtration rate (EGFR) over a period of more than 3 months. While Pentraxin-3 (PTX-3) and Matrix Metalloproteinase-9 (MMP-9) levels increase during the acute phase of the kidney injury, chronic conditions often exhibit alteration in the epithelial mesenchymal transition (EMT).Objectives: This study aimed to elucidate the correlation between serum PTX-3, MMP-9, and eGFR in patients with CKD. Method: Thirty hypertensive patients with CKD stages 3, 4, and 5, aged between 16 and 65 years, were enrolled in the study (15 males and 15 females). Diagnosis of CKD was based on the 2012 Kidney Disease Improving Global Outcomes (KDIGO) criteria, utilizing serum creatinine, and CKD-epidemiology Collaboration (CKD-EPI) estimates. Subsequently, serum MMP-9 and PTX-3 levels were quantified. Result: Patients with CKD exhibited significantly higher serum levels of PTX3 and MMP9. Furthermore. a significant negative connection between PTX-3, MMP-9, and EGFR was observed. Additionally, CKD patients displayed a correlation between PTX-3 and MMP-9 concentrations.Conclusion: Plasma levels of PTX-3 and MMP-9 serve as unique, promising, and important markers that contribute to the pathogenesis of CKD.
β2-Microglobulin: A Powerful Biomarker for Chronic Kidney Disease Progression Yanuar Surya Saputra Poedjijo; Drajad Priyono; Deka Viotra; Harun, Harnavi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1219

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Background: Chronic kidney disease (CKD) is a global health concern with increasing prevalence. Early detection and accurate prognosis are crucial for effective management. β2-microglobulin (β2M) has emerged as a promising biomarker in CKD, but its prognostic value requires further evaluation. This meta-analysis aimed to comprehensively assess the association between β2M and CKD progression. Methods: A systematic search of PubMed, Embase, and Cochrane Library was conducted for studies published between 2013 and 2024 investigating the relationship between β2M and CKD progression. Studies were included if they reported hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between β2M levels and renal endpoints (e.g., end-stage renal disease [ESRD], doubling of serum creatinine, or a decline in estimated glomerular filtration rate [eGFR]). A random-effects model was used to pool the HRs. Results: Six eligible studies involving 5,420 participants were included. The pooled analysis demonstrated a significant association between elevated β2M levels and increased risk of CKD progression (HR = 2.15; 95% CI: 1.78-2.59; p < 0.001). Subgroup analyses revealed that this association remained consistent across different CKD stages and underlying etiologies. Conclusion: Elevated β2M is a strong and independent predictor of CKD progression. Its incorporation into clinical practice may improve risk stratification and guide therapeutic interventions in CKD patients.
The Role of Superoxide Dismutase in Kidney Aging: A Meta-Analysis of Oxidative Stress, Inflammation, and Renal Function Hannie Qalbina Syaiful; Harnavi Harun
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1234

Abstract

Background: Kidney aging is an inevitable physiological process characterized by a progressive decline in renal function, increased oxidative stress, and chronic low-grade inflammation. Superoxide dismutase (SOD), a key antioxidant enzyme, plays a crucial role in mitigating oxidative damage. This meta-analysis aimed to comprehensively evaluate the association between SOD levels/activity and markers of oxidative stress, inflammation, and renal function in the context of kidney aging. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted for relevant studies published between 2013 and 2024. Studies investigating the relationship between SOD (SOD1, SOD2, SOD3) and kidney aging in humans were included. Data on SOD levels/activity, oxidative stress markers, inflammatory markers, and renal function parameters were extracted. Random-effects models were used to pool the standardized mean differences (SMD) and 95% confidence intervals (CI). Results: Nine studies with a total of 1,245 participants were included in the meta-analysis. Pooled analysis revealed a significant negative association between SOD activity and markers of oxidative stress (SMD = -0.85, 95% CI: -1.20 to -0.50, p < 0.001). Similarly, SOD activity was inversely associated with inflammatory markers (SMD = -0.62, 95% CI: -0.95 to -0.29, p < 0.001). Furthermore, a significant positive association was observed between SOD activity and eGFR (SMD = 0.78, 95% CI: 0.41 to 1.15, p < 0.001). Conclusion: This meta-analysis provides compelling evidence that SOD plays a critical role in mitigating oxidative stress and inflammation in kidney aging, contributing to the preservation of renal function. These findings highlight the potential of SOD as a therapeutic target for age-related kidney diseases.
Clinical and Demographic Profile of Chronic Kidney Disease Patients Undergoing Kidney Transplantation at a Tertiary Hospital in Indonesia Khairil Faiz Amir; Ade Asyari; Harun, Harnavi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i4.1243

Abstract

Background: Chronic kidney disease (CKD) is a global health problem, and kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). This study aimed to describe the clinical and demographic profile of CKD patients undergoing kidney transplantation at Dr. M. Djamil General Hospital, Padang, Indonesia. Methods: A descriptive retrospective study was conducted using medical records of CKD patients who underwent kidney transplantation between 2015 and 2023. Data on age, gender, duration of hemodialysis, donor-recipient relationship, blood pressure, blood type, crossmatch results, serum urea and creatinine levels, and etiology of CKD were collected and analyzed. Results: The study included 18 patients, all aged 19 to 59 years. The majority of patients were male (55.6%) and had undergone hemodialysis for less than 3 years (55.6%). Prehypertension and hypertension were the most prevalent blood pressure categories (44.4% each). Blood types A and O were most common (27.8% each), with consistent crossmatch results across groups. High levels of serum urea and creatinine were predominant, and hypertension was the most frequent etiology of CKD (66.7%). Conclusion: This study provides valuable insights into the characteristics of CKD patients undergoing kidney transplantation in Indonesia. The findings highlight the importance of early detection and management of CKD, particularly hypertension, to reduce the burden of ESRD and the need for transplantation.
Co-Authors Abdul Alim Rahimi Abdul Alim Rahimi Ade Asyari Ade Sukma Ade Teti Vani Afdhol Falah Ajat Sudrajat Alexander Kam Alexander Kam Alexander Kam Alvarino Alvarino Amelia, Rinita Anandia Putriyuni Andikha Putra Annesa Fadella Arief Rinaldy Arina Widya Murni Asir, Taufik Rizkian Athif Abyaz Khalil Putra ayu pathya Dasman, Hardisman Deddy Canceria Suka Rahmatsyah Deka Viotra Deka Viotra Deka Viotra Deka Viotra Deka Viotra Deka Viotra Deka Viotra Dela Hangri Jalmas Dessy Abdullah Dewi, Amelia Fitria Dian Puspita Diana Melida Dional Setiawan Drajad Priyono Drajad Priyono Drajad Priyono Eryati Darwin Evelin Veronike Fadrian, Fadrian Fauzar Fauzar Fauzar Fauzar Fauzar, Fauzar Febrianti Ika Kurnia Finny Fitry Yani Genta Pradana gina ariani Hannie Qalbina Syaiful Hardisman Dasman Husna Yetti Ilmiawati Ilmiawati, Ilmiawati Indra, Syarif Indrapriyatna, Ahmad Syafruddin Irena Fathin Amelia Jalmas, Dela Hangri Jersivindo Ranazeri Jersivindo Ranazeri Kam Alexander Kam, Alexander Khairat AS Khairil Faiz Amir Miftah Irramah Nadia Purnama D Nur Indrawaty Lipoeto Pratama, Yudha Endra Putri Lisna Radias Zasra Radias Zasra Rangga Lunesia Rapida Saragih RAVEINAL RAVEINAL Restu Susanti Rezki Sadeli Rini Yulia Rinita Amelia Rinita Amelia Rivai, Muhammad Iqbal Rizkianto Imannual Rose Dinda Martini Roslaini Roslaini Roza Kurniati Roza Kurniati Roza Kurniati Roza Kurniati Roza Mulyana Ruhsyahadati Ruhsyahadati Ruhsyahadati, Ruhsyahadati Selfi Renita Rusjdi Siana, Yusti Sjaaf Fidiariani Sofiani, Dinda Putri Sri Puji Rahayuningsih Suchitra, Avit Syaiful Azmi Syaiful Azmi Syaiful Azmi Syaiful Azmi Veronike, Evelin Vesri Yoga Viotra, Deka Yanuar Surya Saputra Poedjijo Yerizal Karani Yoga, Vesri Yudha E. Pratama Yugo Berri Putra Rio Yuliarni Syafrita Yulistia Asmi Yusti Siana Zaki Mahmudi Dasril Zaki Mahmudi Dasril Zaki Mahmudi Dasril