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All Journal Jurnal Kesehatan Andalas Global Medical and Health Communication The Indonesian Biomedical Journal Jurnal Penelitian Pendidikan IPA (JPPIPA) Jurnal Kreativitas PKM Majalah Kedokteran Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Human Care Journal Contagion: Scientific Periodical Journal of Public Health and Coastal Health Nusantara Hasana Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Indonesian Journal of Multidisciplinary Science Jurnal Ilmu Kesehatan Indonesia (JIKSI) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Eduvest - Journal of Universal Studies Oshada Media Penelitian dan Pengembangan Kesehatan Proceeding International Health Conference
Harun Harnavi
Fakultas Kedokteran Universitas Andalas
Aerospace Engineering Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Library & Information Science Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Neuroscience Nursing Physics Public Health Social Sciences

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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.
THE DIFFERENCE IN TOTAL IMMUNOGLOBULIN E LEVELS AND EOSINOPHIL COUNTS AMONG ELDERLY INDIVIDUALS WITH AND WITHOUT ALLERGIC DISEASES Mulyana, Roza; Rio, Yugo Berri Putra; Raveinal, Raveinal; Martini, Rose Dinda; Harun, Harnavi; Asir, Taufik Rizkian; Fadrian, Fadrian; Murni, Arina Widya
Media Penelitian dan Pengembangan Kesehatan Vol. 35 No. 4 (2025): MEDIA PENELITIAN DAN PENGEMBANGAN KESEHATAN
Publisher : Poltekkes Kemenkes Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34011/jmp2k.v35i4.3114

Abstract

Penyakit alergi dapat terjadi pada lansia dengan gejala yang dapat memburuk akibat adanya proses imunosenesens. Kadar IgE total dan jumlah eosinofil dapat digunakan sebagai pemeriksaan tambahan untuk penyakit alergi. Penelitian ini bertujuan untuk mengetahui perbedaan kadar IgE total dan jumlah eosinofil pada lansia dengan dan tanpa penyakit alergi. Penelitian observational analitik ini dilakukan pada lansia usia 60-80 tahun di RSUP DR. M. Djamil Padang selama Januari–Juni 2024. Sampel dikelompokkan menjadi kelompok lansia dengan penyakit alergi dan kelompok lansia tanpa penyakit alergi. Pengambilan sampel dilakukan secara consecutive sampling, melibatkan 52 partisipan (masing-masing 26 dengan dan tanpa penyakit alergi).  Kadar IgE total dan jumlah eosinofil diperiksa dengan menggunakan sampel darah vena. Analisis data menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan median kadar IgE total pada kelompok alergi sebesar 1.741,1 kIU/L (minimum 517,7 kIU/L; maksimum 4843 kIU/L), sedangkan kelompok non-alergi 177,1 kIU/L (minimum 14 kIU/L; maksimum 800 kIU/L). Median jumlah eosinofil pada kelompok alergi sebesar 378 sel/µL (min: 100; maks: 950), sedangkan kelompok non-alergi 61,5 sel/µL (min: 17; maks: 189). Terdapat perbedaan signifikan kadar IgE total dan jumlah eosinofil antara lansia dengan dan tanpa penyakit alergi (p<0,001). Lansia yang mengalami Alergi menunjukkan kadar IgE  dan jumlah eosinofil lebih tinggi dibandingkan lansia yang tidak  alergi.  
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