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All Journal Medula Biomedical Journal of Indonesia JOURNAL LA MEDIHEALTICO Healthy Tadulako Journal (Jurnal Kesehatan Tadulako)
Ade Yonata, Ade
Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Lampung
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Journal : Medula

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Literature Review: Gagal Ginjal Akut Akibat Nefrotoksisitas Gentamisin Akbar, Dafa Rafiqi; Yonata, Ade; Ratna, Maya Ganda; Darwis, Iswandi
Medula Vol 14 No 9 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i9.1312

Abstract

Acute kidney failure or Acute Kidney Injury (AKI) is a sudden decline in kidney function that is often caused by various factors such as sepsis, ischemia, and nephrotoxicity. One of the significant causes of nephrotoxicity is gentamicin, an aminoglycoside antibiotic commonly used to treat Gram-negative bacterial infections. Although effective, gentamicin has nephrotoxic side effects, especially at high doses or long-term use, which can cause damage to the renal tubular epithelium and trigger AKI. This literature review aims to describe and study more deeply the relationship between gentamicin consumption and the incidence of acute kidney failure. Gentamicin works by inhibiting bacterial protein synthesis on the 30S ribosome. Still, its mechanism of action also has the potential to cause nephrotoxicity through drug accumulation in kidney cells, impaired mitochondrial function, increased production of reactive oxygen species (ROS), and mesangial contractions that reduce the glomerular filtration rate. Signs of gentamicin nephrotoxicity include increased serum creatinine levels, blood urea nitrogen, albuminuria, and decreased glomerular filtration rate, accompanied by structural damage such as tubular necrosis and edema in the proximal tubular epithelium. Previous studies have shown that high doses of gentamicin can increase the number of necrotic cells in the kidney and cause renal fibrosis in test animals. In humans, the incidence of gentamicin-induced nephrotoxicity has been reported to reach 10-25% of therapeutic use, with an estimated incidence of AKI of around 15% of total AKI cases. The importance of proper monitoring and management for patients using gentamicin to reduce the risk of nephrotoxicity. Prevention strategies include monitoring kidney function, dose adjustment, adequate hydration, and considering various alternative antibiotic therapies for patients at high risk of nephrotoxicity.
Faktor Gangguan Ginjal dan Diabetes Melitus yang Mempengaruhi Mortalitas Penderita Sindrom Koroner Akut di RSUD Dr. H. Abdul Moeloek Tahun 2020–2021 Fadhlurrahman, Fadhlurrahman; Yonata, Ade; Karima, Nisa; Kurniati, Intanri
Medula Vol 15 No 3 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i3.1676

Abstract

Acute Coronary Syndrome (ACS) is one of the leading causes of cardiovascular mortality worldwide and in Indonesia. Various risk factors have been investigated, yet two important comorbidities that frequently worsen the prognosis are diabetes mellitus and kidney disorders. Diabetes mellitus accelerates atherosclerosis and promotes plaque instability, whereas kidney disorders exacerbate cardiovascular metabolism and restrict therapeutic options due to impaired drug elimination. This study aimed to analyze the influence of diabetes mellitus and kidney disorders on the mortality of ACS patients at Dr. H. Abdul Moeloek General Hospital. An analytic observational study with a cross-sectional design was conducted involving 71 patients diagnosed with ACS during the 2020–2021 period. The main independent variables were diabetes mellitus and kidney disorders, while mortality served as the dependent variable. Data were analyzed using the Chi-Square test, Fisher’s Exact Test, and Odds Ratio (OR) calculations, with a significance level of p < 0.05. The study found an overall mortality rate of 25.3% among ACS patients. A significant relationship was observed between diabetes mellitus and mortality (p = 0.012; OR = 3.1) as well as between kidney disorders and mortality (p = 0.019; OR = 4.0). This indicates that ACS patients with diabetes mellitus have approximately three times higher risk of death, and those with kidney disorders have about four times higher risk compared to those without these comorbidities. In conclusion, diabetes mellitus and kidney disorders are significant predictors of mortality among ACS patients, highlighting the importance of comprehensive management for patients with these conditions in clinical cardiovascular care.
Co-Authors Akbar, Dafa Rafiqi Aziz, M. Alamsyah Effendi, Ian Fadhlurrahman, Fadhlurrahman Indrajaya, Taufik Intanri Kurniati Iswandi Darwis Karima, Nisa Khaerunnisa P, Maya Lumentut, Anastasia M. Maelissa, Merlin M. Nurul Islamy Ratna, Maya Ganda Suhaimi, Novadian Wirawan, Wahyudi Zulkhair Ali