K. Heri Nugroho HS, K. Heri
Department Of Internal Medicine, Faculty Of Medicine, Universitas Diponegoro/RSUP Dr. Kariadi, Semarang

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FAKTOR RISIKO KEJADIAN NEFROPATI DIABETIKA STADIUM 3-5 Roesipin, Sri Wahyuningsih; Seno, Heri Nugroho Hario; Suhartono, Suhartono; Hadisaputro, Suharyo; Sakundarno, Mateus
Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal Vol 8 No 2 (2018): Oktober
Publisher : LPPM STIKES KENDAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.347 KB) | DOI: 10.32583/pskm.8.2.2018.135-143

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Nefropati diabetika merupakan penyebab utama kejadian gagal ginjal. Prevalensi di negara-negara Asia sangat tinggi. Sebanyak 20%-40% penderita diabetes akan berkembang menjadi nefropati diabetika, jika tidak dilakukan pencegahan dengan pengelolaan faktor risikonya. Namun penelitian tentang faktor risiko nefropati diabetika di Indonesia masih jarang dilakukan. Penelitian ini bertujuan untuk mengetahui faktor-faktor risiko tersebut. Desain penelitian  ini adalah studi kasus kontrol dengan jumlah sampel 43 kasus dan 43 kontrol. Kasus adalah penderita diabetes dengan komplikasi nefropati diabetika stadium 3-5 dan kontrol adalah  penderita diabetes dengan nilai eGFR>60ml/menit/1,73m2 dengan proteinuria negatif. Pengambilan sampel menggunakan teknik consecutive sampling pada pasien diabetes yang dirawat inap. Variabel bebas meliputi riwayat keluarga menderita penyakit vaskuler, lama menderita diabetes, riwayat obesitas, kadar gula darah puasa, kadar kolesterol total, status hipertensi, kebiasaan merokok, status hiperurisemia, kualitas tidur, pola konsumsi obat dan aktifitas fisik. Data diolah secara univariat, bivariat dan multivariat menggunakan regresi logistik berganda. Hasil analisis regresi logistik berganda menunjukkan bahwa yang terbukti merupakan faktor risiko kejadian nefropati diabetika stadium 3-5 adalah hiperurisemia (OR 9,36; 95%CI: 3,035-28,863) dan hipertensi (OR 3,75; 95%CI:1,090-12,934. Hipertensi dan hiperurisemia merupakan faktor yang dapat diperbaiki, sehingga penderita diabetes disarankan untuk  mengendalikan tekanan darah dan kadar asam uratnya sedini mungkin utnuk mencegah komplikasi nefropati diabetika.   Kata kunci: Nefropati diabetika, Faktor risiko   THE RISK FACTORS OF DIABETIC NEPHROPATHY IN STAGE 3-5   ABSTRACT Diabetic nephropathy is a major cause of kidney failure. The prevalence in Asian countries is very high. As many as 20% -40% of diabetics will develop into diabetic nephropathy, if not prevented by managing risk factors. However, research on the risk factors for diabetic nephropathy in Indonesia is still rare. This study aimed to determined the risk factors for diabetic nephropathy. The study design was a case control study with a total sample of 43 cases and 43 controls. The cases were diabetics with stage 3-5 of diabetic nephropathy and the controls were diabetics with eGFR> 60ml / minute / 1.73m2 with negative proteinuria. Sampling used consecutive sampling technique in hospitalized diabetic patients. Independent variables were family history of vascular disease, duration of diabetes, history of obesity, fasting blood sugar levels, total cholesterol levels, hypertension status, smoking habits, hyperuricemia status, sleep quality, medicines consumption patterns and physical activity. Data was processed in univariate, bivariate and multivariate using multiple logistic regression. The results of multiple logistic regression analysis showed that the significant risk factors for stage 3-5 of diabetic nephropathy were hyperuricemia (OR 9.36; 95% CI: 3.035-28.863) and hypertension (OR 3.75; 95% CI: 1.090-12.934). Hypertension and hyperuricemia are modifiable risk factors, so that diabetic patients are advised to control their blood pressure and uric acid levels as soon as possible to prevented the diabetic nephropathy.   Keywords: Diabetic nephropathy, risk factors.
Pengaruh pemberian minuman lidah buaya terhadap kadar antioksidan total dan persentase lemak tubuh pada sindrom metabolik Silitonga, Marisi Elizabeth R.; Nugroho HS, K. Heri; Tjahjono, Kusmiyati; Widyastiti, Nyoman Suci; Afifah, Diana Nur
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 7, No 1 (2018)
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (478.798 KB) | DOI: 10.14710/jgi.7.1.1-8

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Background: Metabolic syndrome is related to glucose metabolism disturbance (hyperglycemia), lipid (dyslipidemia), high blood pressure, and central obesity. Metabolic syndrome implicates to heart attack, diabetes mellitus, hypertension, and death. Aloe vera, well known rich of polyphenol and vitamin, has a pharmacological effect to improve insulin resistance, chronic inflammation, and oxidative stress.Objective: To prove the effect of Aloe vera-based drink toward total antioxidant concentration improvement and body fat percentage reduction in metabolic syndrome subjects.Methods: Thus study was pre-post randomized true experimental study with control group design. The subjects were divided by 2 groups, treatment group (n=19) and control group (n=19). Treatment group was given 165 g/d Aloe vera-based drink for 30 days. Both of groups were given nutrition education about metabolic syndrome management. Total antioxidant concentration and body fat percentage were assessed pre-post-test by ABTS and BIA respectively, while food intake and activity were assessed by 24-h recall and GPAQ respectively. Independent t-test and Mann Whitney test were used to compare before and after treatment between control and treatment group.Results: Total antioxidant concentration significantly improved (p=0.00) in treatment group from 1.2 to 2.0 mmol/L, while total antioxidant concentration decreased from 1.4 to 1.3 mmol/L (p=0.074) in this control group. Moreover, there was significant difference of total antioxidant between treatment and control groups in the end of study (p=0.00). Furthermore, body fat percentage was reduced significantly from 32.8 to 32,4 mmol/L (p=0.005) in treatment group, while the reduction of body fat percentage in control group was not significant from 33.1 to 33,4 mmol/L (p=0.100). There was no difference of body fat percentage between two groups after intervention (p=0.358).Conclusion: Aloe vera-based drink improved total antioxidant concentration in metabolic syndrome subjects.
Acute COVID-19 cardiovascular syndrome: A case report Agus Layanto; Sofyan Rais Addin; Friska Anggraini Helena Silitonga; Ayudyah Nurani; Rakhma Yanti Hellmi; Charles Limantoro; K Heri Nugroho Hario Seno; Fathur Nur Kholis
JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL) Vol 10, No 6 (2021): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v10i6.30323

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A man 44 years old with metabolic syndrome and chronic kidney disease was presenting acute COVID-19 cardiovascular syndrome. The condition was aggravated by presence of ureterolithiasis and gout. After treatment, hemodialysis and ureteroscopic lithotripsy-double J ureteral stent, the patient was recovered from his condition
Artemisia annua Leaf Extract Increases GLUT-4 Expression in Type 2 Diabetes Mellitus Rat Arum Kartikadewi; Awal Prasetyo; Lisyani Budipradigdo; Heri Nugroho; Kusmiyati Tjahjono; Arthur Lelono
The Indonesian Biomedical Journal Vol 11, No 1 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i1.531

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BACKGROUND: The depletion of glucose transporter 4 (GLUT-4) affects blood glucose level in the type 2 diabetes mellitus (T2DM) patient. Herbals supplementation such as Artemisia annua is known to posses an antidiabetic potency, but its effect on long term glucose control marker, glicated hemoglobin (HbA1C) and muscle GLUT-4 expression still has not been investigated.METHODS: Twenty Wistar rats were divided into four groups (five rats per group). The C1 group was consist of healthy control rats and C2 group was consist of diabetic control rats. Diabetic condition was induced by giving high lard fat diet for 28 days, followed with 30 mg/kgBW of Streptozotocin injection at the 29th day. Meanwhile, T1 and T2 group were consist of diabetic rats, which were supplemented with 50 mg/kgBW and 100 mg/kgBW of Artemisia annua leaf extract, respectively. GLUT-4 expression and HbA1C level were measured at the 14th day post-treatment.RESULTS: The GLUT-4 was expressed 1.8 and two times higher in T1 and T2 group, respectively, compared to C2 group. Meanwhile, HbA1C level in C2 group was two times higher than C1 group (11.95±2.52 compared to 5.61±2.69, p<0.01). Further, the administration of 100 mg/ kgBW Artemisia annua extract caused a slight reduction of HbA1C (11.95±2.52 compared to 8.18±3.53, p>0.05)CONCLUSION: Muscle cell’s GLUT-4 in T1 and T2 group was expressed increasingly and significantly different compared to the C2 group. HbA1C level in T2 was slightly reduced although no significant different compared to C2 group.KEYWORDS: Artemisia annua, GLUT-4, HbA1C, type 2 diabetes mellitus
A Rare Case of 18-year-old female with Primary Sclerosing Cholangitis, Mixed Connective Tissue Disease, Short Stature Fransisca Yustika Dewi Siahaan; Hery Djagat Purnomo; Khristophorus Heri Nugroho Hario Seno; Rakhma Yanti Hellmi
Journal of Biomedicine and Translational Research Vol 6, No 2 (2020): Augusts 2020
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v6i2.6299

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Background: Primary sclerosing cholangitis (PSC) is a rare chronic immune-mediated liver disease affecting intra and extrahepatic bile ducts, in which inflammation and fibrosis are the main factors that lead to biliary stricture. The pathogenesis of this disease is still unclear. It happens approximately 0.5 to 1.3 cases per 100,000 person-years in Northern Europe. PSC is difficult to diagnose until complications arise. PSC can also be a manifestation of mixed connective tissue disease (MCTD) in the liver. A chronic immune disease that has occurred since childhood may result in delayed development and short stature. Case Presentation:   A 18-year-old female presented with icteric, anemia, short stature, and absence of menstruation. Laboratory and radiological findings suggested obstruction of intra and extrahepatic biliary duct (conjugated bilirubin 11,80 mg/dL), severe anemia, normal sex hormone levels, increased RNP/SM antibodies. Histopathology showed liver cirrhosis suggestive for primary sclerosing cholangitis. The patient then was given biliary stenting, transfusion of packed red cell, immunosuppresive, corticosteroid, ursodeoxycholic acid. Within a year of treatment, there was a significant decrease of direct bilirubin and improvement in symptoms.Conclusion: Patient with PSC, MCTD, and short stature is a very rare case. This is the first case that has been found in dr. Kariadi Hospital, Semarang. It has high mortality rate and difficult to diagnose and treat. According to multiple guidelines, this patient should have liver transplantation , but in this case, biliary stenting and oral treatments have resulted in an excellent outcome.
RISK FACTORS OF TYPE 2 DIABETES MELLITUS DURATION AND NON-COMPLIANCE WITH MEDICATION TO POOR GLYCEMIC STATUS Marisa Gita Putri; K. Heri Nugroho HS; Mateus Sakundarno Adi; Suhartono Suhartono; Bagoes Widjanarko
Jurnal Berkala Epidemiologi Vol. 8 No. 3 (2020): Jurnal Berkala Epidemiologi (Periodic Epidemiology Journal)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbe.V8I32020.256-264

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Background: Type 2 diabetes mellitus is a chronic disease that is still a global health problem. Uncontrolled diabetes mellitus (DM) can result in poor glycemic status, with factors that affect patients including long-term DM and medication compliance. Purpose: This study aimed to determine the risk factors of long-term DM and non-compliance with medication on the poor glycemic control status of patients with type 2 DM. Methods: This type of research used observational analysis with a case–control design. Samples were taken from patients with type 2 DM, with 40 cases and 40 controls. The criteria for sample inclusion were that the patients had a glycosylated hemoglobin level check, were willing to be research respondents, and could communicate well. The exclusion criterion was patients experiencing a drastic decline in health status during the study. The sampling technique used was consecutive sampling. This research was conducted at the Panti Wilasa Citarum Hospital in Semarang City from July to September 2019. The relationship and the risk of long-term DM and adherence to taking medication with glycemic status were tested using the chi-square test. Results: This study showed that a duration of DM >5 years (p = 0.01; Odss Ratio (OR) = 3.46; 95% confidence interval [CI] = 1.37 < OR < 8.69) and non-compliance with taking medication (p = 0.02; OR = 3.15; 95% CI = 1.25 < OR < 7.93) are risk factors for poor glycemic status. Conclusion: Duration of DM >5 years and non-compliance with taking medication are risk factors for poor glycemic status in patients with type 2 DM.
Obesity as Risk Factor of Type 2 Diabetes Mellitus in Women of Reproductive Age Hanifah Ardiani; Soeharyo Hadisaputro; Djoko Trihadi Lukmono; Heri Nugroho; Antono Suryoputro
Global Medical & Health Communication (GMHC) Vol 6, No 2 (2018)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1839.548 KB) | DOI: 10.29313/gmhc.v6i2.2708

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Women of childbearing age with type 2 diabetes mellitus (DM) are more at risk of having pregnancy complication (in both the mother and the baby) at twice the risk for sexual dysfunction and three times more likely to die than women of childbearing age without DM. The purpose of this study was to prove obesity as the risk factor of type 2 DM in women of childbearing age. The study design was a case-control and a qualitative analysis using the in-depth interview. This study conducted in Internal Medicine Polyclinic and Eye Polyclinic in Regional General Hospital Madiun, June–July 2017. The population in this study was women of childbearing age 20–49 years old and married who check blood sugar in Regional General Hospital Madiun. The samples of this study were 54 cases and 54 controls using consecutive sampling. Data analyzed by chi-square and logistic regression. The results showed that obese women of childbearing age had risk 2.63 times greater for type 2 DM than non-obese (p=0.016, 95% CI=1.06–6.53). In conclusion, obesity was a risk factor of type 2 DM in the women of reproductive age. OBESITAS SEBAGAI FAKTOR RISIKO DIABETES MELITUS TIPE 2 PADA WANITA USIA SUBURWanita usia subur (WUS) dengan diabetes melitus (DM) tipe 2 lebih berisiko mengalami komplikasi kehamilan (baik pada ibu maupun bayinya), berisiko 2 kali lebih besar untuk menderita gangguan fungsi seksual, dan 3 kali lebih besar untuk mengalami kematian dibanding dengan WUS tanpa DM. Tujuan penelitian ini membuktikan obesitas sebagai faktor risiko DM tipe 2 pada WUS. Desain studi dalam penelitian ini adalah kasus kontrol yang diperdalam dengan analisis kualitatif menggunakan wawancara mendalam. Penelitian ini dilakukan di poliklinik penyakit dalam dan poliklinik mata RSUD Kota Madiun Juni–Juli 2017. Populasi dalam penelitian ini adalah WUS berusia 20–49 tahun dan sudah menikah yang diperiksa gula darah di RSUD Kota Madiun. Sebanyak 54 kasus dan 54 kontrol dipilih menggunakan consecutive sampling. Data dianalisis dengan chi square dan regresi logistik. Hasil penelitian menunjukkan bahwa WUS yang obesitas memiliki risiko 2,63 kali lebih besar untuk mengalami DM tipe 2 dibanding dengan yang tidak obesitas (p=0,016; 95% IK=1,06−6,53). Simpulan, obesitas merupakan faktor risiko DM tipe 2 pada WUS.
Faktor Risiko Penyakit Ginjal Kronik Diabetes (PGK-DM) pada Diabetes Mellitus Tipe-2 (Studi di RSUD DR Soedarso Kota Pontianak Provinsi Kalimantan Barat) Sulistio Rini; Suharyo Hadisaputro; Lestariningsih Lestariningsih; Heri Nugroho; Selamat Budijitno
Jurnal Epidemiologi Kesehatan Komunitas Vol 3, No 2: Agustus 2018
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2159.764 KB) | DOI: 10.14710/jekk.v3i2.4029

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Background: Prevalence of type-2 diabetes mellitus have increased significantly. The increasing number of people with diabetes has a major impact on the development of chronic diabetic kidney disease. The research was aimed to clarify several risk factors of chronic diabetic kidney disease on type-2 diabetes mellitus (CDK-DM).Method: The research was based on case control study design. The number of respondents was 140 respondents consisting 70 cases and 70 controls that met the criteria of inclusion and exclusion. The cases were patients with type-2 chronic diabetic kidney disease stadium 2-5. The controls were patients with type-2 chronic diabetic kidney disease with blood sugar levels ≥ 200 mg / dL. The data were then analyzed using logistic regression.Results: The result shows that risk factors of chronic diabetic kidney disease in type-2 diabetes mellitus are diabetes in family (OR = 6,732; 95% CI = 2,623- 17,276), high blood pressure (OR = 6,760; 95% CI = 2,190- 20,867), lack of physical activities (OR = 4,367 95% CI = 1,823-10,462) and lack of family support (OR = 4,203; 95% CI = 1,437-12,295). The probability of chronic diabetic kidney disease occurrence in type-2 diabetes mellitus when four risk factors exist are 96,71%.Conclusion: The host factors have important role of chronic diabetic kidney disease in type 2 diabetes mellitus . The factors proven to be risk factors for occurrence of chronic diabetic kidney disease in type 2 diabetes mellitus were diabetic in the family, Hipertension, poor physical exercise and family Support. 
Faktor Risiko Kejadian Nefropati Diabetika pada Wanita Sri Wahyuningsih; Heri Nugroho; Suhartono Suhartono; Suharyo Hadisaputro; Mateus Sakundarno Adi
Jurnal Epidemiologi Kesehatan Komunitas Vol 4, No 1: Februari 2019
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (257.799 KB) | DOI: 10.14710/jekk.v4i1.4426

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Background: Diabetic nephropathy was the most frequent complication in diabetics. The prevalence in women at South East Asia country was higher than men, that different than in Europe, American and African. It's a controversial thing. There was no research about the risk factors for diabetic nephropathy in women in Indonesia.Methods: The purpose of this study was to determine the risk factors for stage 3-5 diabetic nephropathy in women. This research used case-control study design. The cases were women with stage 3-5 diabetic nephropathy. Sampling by consecutive sampling technique by comparing the age of the case. Data were analyzed statistically by univariate, bivariate and multivariate using multiple logistic regression analysis.Results: The results of the analysis showed that the risk factors for stage 3-5 diabetic nephropathy were hyperuricemia (OR:9.6; 95%CI:1.870-45.799), lack of physical activity (OR:9.5; 95%CI:1.693-53,287), blood sugar level ≥126 mg/dl (OR:14.7; 95% CI:1.487-145.846), history of oral contraceptive use (OR:7.3; 95%CI:1.254-42.716) and history of obesity (OR:8.9; 95%CI:1.195-65.766).Conclusion: It is recommended for diabetics people to control uric acid levels, fasting blood glucose, body weight and does enough physical activity. For oral contraceptives users it is recommended to consult with a doctor during consumption.
Faktor Risiko yang Berpengaruh Terhadap Status Kontrol Glikemik pada Kehamilan dengan Diabetes Melitus (Studi Kasus Kontrol Pasien di Beberapa RS di Kota Semarang) Resna Meiwarnis; Ariawan Soejoenoes; Heri Nugroho; Suharyo Hadisaputro; Henry Setyawan
Jurnal Epidemiologi Kesehatan Komunitas Vol 1, No 2: Agustus 2016
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (231.292 KB) | DOI: 10.14710/j.e.k.k.v1i2.3947

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Background : The number of diabetes patients was higher in women than men. The high prevalence in women occurs in pregnant women because of the increasing age of childbearing. Commonly, pregnancy in women with diabetes was associated with morbidity and mortality.  Data obtained from Diabetic  Department  King’s  College  Hospital mentioned that  during  pregnancy, a good control of maternal diabetes cause a progressive decline in blood glucose control. The purpose of this research is to explain some risk factors related to glycaemic control status in pregnancy with diabetes mellitus. Methods : This research was an observational study using case control design by using retrospective approach. The population of this study is all cases of pregnancy with diabetes with  the number of sample was 62 people, consist of 31 cases and 31 control with consecutive  sampling. In this research, cases sample selection was chosed from pregnant women with diabetes who come to Tugurejo Hospital, Semarang City Hospital and Roemani Hospital during 2015. Control sample selection was chosed from non pregnant women with diabetes who come to Tugurejo Hospital, Semarang City Hospital and Roemani Hospital during 2015. Results : The pattern of taking medications that was not good (p= 0,002; aOR= 7,2; 95%CI= 1,9-17,2) was risk factors of poor glycaemic control status with probability event amounted was 70,0%. Conclusion : The risk factors to glycaemic control status in pregnancy with diabetes was the pattern of taking medications that was not good. Background  :Thenumber  ofdiabetes  patients  washigher  inwomen  thanmen.Thehigh prevalence   in   women   occurs   in   pregnant   women   because   of   the   increasing   age   of childbearing.  Commonly,  pregnancy  inwomen  withdiabetes  wasassociated  withmorbidity andmortality.  Dataobtained  fromDiabetic  Department  King’s  College  Hospital  mentioned that  during  pregnancy,  agood  control  ofmaternal  diabetes  cause  aprogressive  decline  in bloodglucosecontrol.Thepurposeof thisresearchisto explainsomeriskfactorsrelatedto glycaemiccontrolstatusinpregnancywithdiabetesmellitus.Methods  :Thisresearch  wasanobservational  studyusingcasecontrol  design  by  using  a retrospective  approach.  Thepopulation  ofthisstudyisallcasesofpregnancy  withdiabetes with  the  number  of  sample  was  62  people,  consist  of  31  cases  and  31  control  with consecutive  sampling.  In  this  research,  cases  sample  selection  was  chosed  from  pregnant women   with   diabetes   who   come   to  Tugurejo   Hospital,   Semarang   City   Hospital   and Roemani  Hospital  during  2015.  Control  sample  selection  was  chosed  from  non  pregnant women   with   diabetes   who   come   to  Tugurejo   Hospital,   Semarang   City   Hospital   and RoemaniHospitalduring2015.Results:Thepatternoftakingmedications  thatwasnotgood(p=0,002;aOR=7,2;95% CI=1,9-17,2)was   risk  factors   of  poor  glycaemic   control   status  with  probability   event amountedwas70,0%.Conclusion  :Theriskfactorstoglycaemiccontrolstatusinpregnancywithdiabeteswasthe patternoftakingmedicationsthatwasnotgood.