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Effectivity of Erythropoietin Alpha Compared to Erythropoietin Beta in Patients with Chronic Kidney Disease-Anemia on Hemodialysis Prasetya, Anak Agung Ngurah Putra Riana; Suprapti, Budi; Shanti, Bayu Dharma
Folia Medica Indonesiana Vol. 55, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

Anemia in patient with chronic kidney disease could cause a lot of complication. The first line therapy of this condition is by treating with erythropoiesis-stimulating agents (ESA) or called erythropoietin. The erythropoietin alpha and beta were two types of the human recombinant erythropoietin that are usually used in Indonesia. The aim of this study was to determine the effectivity of erythropoietin alpha compared to erythropoietin beta especially in haemoglobin and haematocrit level. This prospective observational study was conducted in March – September 2016. The inclusion criteria were CKD stage 5 patients with a minimum of 3 months of regular hemodialysis, Hb <10 g/dL with enough iron status ST > 20% and FS > 200ng/mL. The methology of this study had been approved by the Health Research Ethics Committee of the Bhayangkara H.S. Samsoeri Mertojoso Hospital, Surabaya. Patients received 2000 IU subcutaneous erythropoietin twice a week on both groups. Blood sample was withdrawn in pre-treatment and after 4 weeks of post erythropoietin therapy treatment for measurement of haemoglobin and haematocrit. Target for this erythropoietin therapy are increase of Hb 0.5 – 1.5 g/dL (not to exceed 12 g/dL) and increase of Hct level 2 – 4 % in 4 weeks. Based on the inclusion criteria, there were 20 patients in this study (10 patient each of both erythropoietin alpha either beta group) that consist of 7 women and 13 men. After the treatment, the mean of increased haemoglobin level for erythropoietin alpha group was 1.28 ± 0.80 g/dL (p=0.001) and erythropoietin beta was 0.37 ± 0.95 g/dL (p=0.254). The mean of increased haematocrit level for erytropoietin alpha group was 3.56 ± 3.46 % (p=0.010) and erythropoietin beta was 1.34 ± 2.71 % (p=0.152). In comparison of haemoglobin and haematocrit achievement in both groups showed that erythropoietin alpha gave better achievement in haemoglobin parameter (p=0.033), but there were no differences in both groups on haematocrit parameters (p=0.127).
The use of hydroxyethyl starch 200/0,5 as plasma subtitutes is safe in hypovolemic patients as indicated in changes of n-acetyl--glucosaminidase and creatinin serum parameters Shinta, Dewi Wara; Khotib, Junaidi; Rahardjo, Eddy; Rahmadi, Mahardian; Suprapti, Budi
Folia Medica Indonesiana Vol. 51, No. 4
Publisher : Folia Medica Indonesiana

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Abstract

Hydroxyethyl Starch (HES) is a compound that improves intravascular volume effectively and rapidly without causing tissue edema. However, HES also has renal safety profile which is still being debated. Based on clinical experience in Dr. Soetomo Hospital, the frequency of acute renal failure following HES 200/0.5 administration at a dose of less than 20 ml/kg (maximum dose) is very rare. The purpose of this study was to evaluate the effect of HES 200/0.5 at a dose of less than 20 ml/kg in patients undergoing surgery. N-acetyl-b-D-Glucosaminidase (NAG) per urine creatinine ratio and creatinine serum were used as main parameter to assess renal injury. This research was observational and prospective design in patients undergoing elective surgery at Gedung Bedah Pusat Terpadu, Dr. Soetomo Hospital, who requiring resuscitation therapy with HES 200/0.5 and met the inclusion and exclusion criteria. NAG was measured prior to surgery and 12 hours after administration of fluid therapy, while creatinine serum was observed before surgery and 48 hours after resuscitation. This study was conducted for three months, and obtained 50 subjects divided into 2 groups, crystalloid group and HES 200/0.5 group. Demographic and baseline characteristics did not differ between groups, except the total bleeding volume. Total bleeding in HES 200/0.5group was higher than crystalloid group (p <0.0001). The mean volume of fluid received in HES 200/0.5 group was 2042.0 ± 673.9 mL, higher when compared with that of crystalloid group (910.0 ± 592.0 ml). Doses of HES 200/0.5 received was 8.31 ± 4.86 ml/kg. Measurement of the of NAG/creatinine ratio and creatinine serum showed significant increase in both groups, but still within the normal range. In addition, the value of these two parameters did not differ between groups. In conclusion, HES 200/0.5 in a dose of less than 20 ml/kg is safe to use in patients who suffered from hypovolemic hemorrhage, without prior history of renal impairment.
Comparison of the antiemetic effectiveness between granisetron and dexamethasone with ondansetron and dexamethasone in acute-phase chemotherapy patients Arfiani, Ria Fitrah; Susilo, Dwi Hari; Suprapti, Budi
Folia Medica Indonesiana Vol. 52, No. 3
Publisher : Folia Medica Indonesiana

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Nausea and vomiting may occur in patients receiving chemotherapy, a condition referred to as chemotherapy-induced nausea and vomiting. The provision of combined dexamethasone and ondansetron or granisetron is the therapeutic management of acute phase nausea and vomiting in cytostatics with a high risk of nausea and vomiting. Granisetron has been known to have better pharmacokinetics and pharmacodynamics compared to ondansetron, so it is possible to have nausea and vomiting suppressing effect higher than that of ondansetron. This study aimed to compare antiemetic effectiveness of granisetron and dexamethasone with ondansetron and dexamethasone in acute-phase chemotherapy patients. This study was conducted in patients who received the combination of cisplatin-paclitaxel and cisplatin-fluorouracil, double-blind, with samples comprised new head and neck surgical oncology patients. Measurement of nausea and vomiting during the acute phase of chemotherapy was conducted using Index of Nausea, Vomiting, and Retching (INVR). Observation of nausea and vomiting in the patients was done during the first 12 hours after administration of cisplatin and interviews were conducted on h 12. Results showed that there was no difference in the effectiveness of nausea and vomiting suppression in the administration of granisetron and dexamethasone compared to ondanstron and dexamethasone in acute phase chemotherapy patients (p = 0.076).
Co-Authors Abdul Rahman Bahmid Aditiawardana Aditiawardana, Aditiawardana Alsagaff, M. Yusuf Andarsari, Mareta R. Aniek S. Budiatin Ardiana, Shafira muti Arfiani, Ria Fitrah Arief Bachtiar Arina Deri Puspita Sari Arina Dery Puspitasari Ayunda Nur Hidayatiningsih Azril O. Ardhiansyah Bella Donna Perdana Putra Budiatin, Aniek S. Bulqiah, Andi Cahyo Wibisono Cahyo Wibisono Nugroho Chrysnanda Maryska Dewi Damayanti Dewi W. Shinta Dewi W. Shinta Dewi Wara Shinta Didik Hasmono Dinda Monika Nusantara Ratri Dinda Monika Nusantara Ratri Eddy Rahardjo Enda Mora Enok Nurliawati Fathia Ramadiani FITRIANI, VICTORIA YULITA Hapsari, Pharmasinta P. Hartono, Frenky Hidayati, Movita I Gde Raka Widiana Idha, Arofa Idha, Arofa Junaidi Khotib Khusnul Fitri Hamidah Kusmiati, Tutik M. Yusuf M. Yusuf Assegaf Mahardian Rahmadi Makmuroh Nurul Qomar Purnamawati, Dewi Mansur, Mifta Marcha Debby Saraswati Marcha Debby Saraswati Marcha Debby Saraswati Mareta R. Andarsari Mareta Rindang Andarsari Meyta Sari, Cinantya Muhammad Amin Mulya Sundari Ni Made Amelia R. Dewi Ni Made Mertaniasih Nia Widyasari Novan Y. I. Pratama Nurmainah Nurmainah Pharmasinta P. Hapsari Pharmasinta Putri Hapsari Prasetya, Anak Agung Ngurah Putra Riana Prasetya, Anak Agung Ngurah Putra Riana Prastuti Asta Wulaningrum Purwiningtyas, Mida Putranto, J.Nugroho Eko Putri Nilamsari, Wenny R.R. Endang Lukitaningsih Raden Mohamad Herdian Bhakti Rahmawati Raising Ramadiani, Fathia Retna Dwi Puspitarini Ritonga, Fany Devita S. Soedarsono Santi, Bayu Dharma Santoso, Agustinus Santoso, Agustinus Sarah Puspita Atmaja Sari, Cinantya Meyta Selvia Febriana Astuti Sensusiati, Anggraini Dwi Shafira Muti Ardiana Shanti, Bayu Dharma Shanti, Bayu Dharma Shinta, Dewi W. Sjamsiah, Siti Sjamsiah, Siti Sofiati Diah Baisuni Subakti Zulkarnain, Bambang Suharjono Suharjono, Suharjono Susilo, Dwi Hari Thomas Erwin Christian Junus Huwae Toetik Aryani UMI FATMAWATI Wahyuni, Diyah WENNY PUTRI NILAMSARI Yosiyanita Safari Yudistira Nurrizky Grahitaning Putra Rohmaana Yulistiani Yulistiani Yulistiani Yulistiani, Yulistiani Yusuf Alsagaff, Mochamad Zahra Oviary Satryo, Fatimatuz Zamrotul Izzah Zedny Norachuriya Zuhri, Muhammad Isnaini