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All Journal Medula Biomedical Journal of Indonesia JOURNAL LA MEDIHEALTICO Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) JPM (Jurnal Pengabdian Masyarakat) Ruwa Jurai
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 Social Sciences 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.
HUBUNGAN USIA, ULTRAFILTRATION RATE (UFR), INTERDIALYTIC WEIGHT GAIN (IDWG), DAN DIABETES MELITUS DENGAN KEJADIAN HIPOTENSI INTRADIALITIK PADA PASIEN GAGAL GINJAK KRONIK DI RSUD DR. H. ABDUL MOELOEK PROVINSI LAMPUNG Nurfatin, Ghina Nisrina; Yonata, Ade
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1731

Abstract

Chronic kidney disease is a clinical syndrome due to changes in kidney’s function or structure with management by hemodialysis. The complication of hemodialysis is intradialytic hypotension, whose incidence is influenced by several factors. The study aims to determine the correlation between age, Ultrafiltration Rate (UFR), Interdialytic Weight Gain (IDWG), and diabetes mellitus with the incidence of intradialytic hypotension. The study is an analytic observational study with cross-sectional design at the hemodialysis installation of RSUD Dr. H. Abdul Moeloek in December 2022 - January 2023 using primary data from 72 patients. Data analysis using the Chi-Square test and multiple logistic regression. Most of the respondents were female (56.9%), ≤65 years old (83.3%), had UFR >10 ml/KgBB/H (59.7%), IDWG of >3 kg (37.5%), history of diabetes mellitus (55.6%) , intradialytic hypotension (58.3%), and the most blood pressure reduction occurred in the 1st hour. There was no correlation between patient’s age (p=0.200) and intradialytic hypotension but there were a correlation between UFR (ml) (p=0.000), IDWG (kg) (p=0.000), and a history of diabetes mellitus (p=0.000) with intradialytic hypotension. Ultrafiltration Rate has an effect of 20.744 times on intradialytic hypotension. There was a correlation between UFR (ml), IDWG (kg), and diabetes mellitus with the incidence of intradialytic hypotension in patients with chronic renal failure. Ultrafiltration Rate (UFR) has the most impact on the incidence of intradialytic hypotension at RSUD dr. H. Abdul Moeloek Lampung.
HUBUNGAN GANGGUAN GINJAL DENGAN ANGKA KEMATIAN PADA PASIEN RAWAT INAP COVID-19 DI RSUD DR. H. ABDUL MOELOEK PROVINSI LAMPUNG Gerizha, M. Rakha; Yonata, Ade
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1734

Abstract

Coronavirus Disease 2019 (Covid-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The risk of death from Covid-19 is reported to be higher due to kidney damage which causes various complications in patients. The background of this research was to determine the relationship between kidney disorders and the mortality rate of inpatients with Covid-19 at RSUD Dr. H. Abdul Moeloek, Lampung. This type of research is a retrospective analytic descriptive with a cross sectional approach, conducted from November to December 2022 at the Abdul Moeloek Hospital in Bandar Lampung. The population in this study were patients diagnosed with Covid-19 who were recorded as inpatients at RSUD Dr. H. Abdul Moeloek with a total of 361 samples selected according to the inclusion and exclusion criteria. The analytical test in this study used the Chi square test. Based on research, the majority of Covid-19 patients were female, aged 19- 59 years, with length of stay <14 days. The mortality rate for Covid-19 patients with comorbid kidney disorders is 54%. The results of the Chi Square test for the relationship between kidney impairment and mortality in Covid-19 hospitalized patients showed a p-value of 0.000. There is a relationship between kidney disorders and the death rate of Covid-19 inpatients at Dr. H. Abdul Moeloek Lampung Province. Hospitalized patients with comorbid CKD are more at risk of dying compared to Covid-19 patients without CKD.
Faktor Risiko dan Komplikasi Hipertensi Tidak Terkontrol di Indonesia: Literature Review Puspitasari, Nabila; Yonata, Ade; Islami, Suryadi
Medula Vol 16 No 3 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i3.1822

Abstract

Uncontrolled hypertension is one of the major public health problems in Indonesia and contributes substantially to increased morbidity and mortality related to cardiovascular disease and target organ damage. This condition occurs when blood pressure remains above the recommended target despite the use of antihypertensive therapy. This article aims to review and analyze risk factors and complications associated with uncontrolled hypertension in the Indonesian population. The study applied a literature review design with article searches conducted through the Google Scholar and Garuda databases in accordance with the PRISMA 2020 guidelines. Following the selection process, twelve articles met the inclusion criteria and were analyzed descriptively. The review results indicate that the dominant risk factors for uncontrolled hypertension include older age, obesity, diabetes mellitus, dyslipidemia, employment status, low educational level, poor medication adherence, excessive salt intake, physical inactivity, smoking, and psychological stress. The most frequently reported complications were stroke, chronic kidney disease, heart failure, myocardial infarction, and hypertensive retinopathy. These findings demonstrate that uncontrolled hypertension in Indonesia remains a serious challenge that requires integrated control strategies through early detection, optimization of therapy, improvement of patient adherence, and strengthening of promotive and preventive interventions based on primary health care services and community involvement.
Co-Authors Akbar, Dafa Rafiqi Aziz, M. Alamsyah Betta Kurniawan, Betta Effendi, Ian Fadhlurrahman, Fadhlurrahman Gerizha, M. Rakha Hadibrata, Exsa Indrajaya, Taufik Intanri Kurniati Iswandi Darwis Karima, Nisa Khaerunnisa P, Maya Lukman Pura Lumentut, Anastasia M. Maelissa, Merlin M. Muhartono Muhartono Nurfatin, Ghina Nisrina Nurul Islamy Puspitasari, Nabila Ratna, Maya Ganda Risal Wintoko Risti Graharti Sayuti, Marzuqi Sofyan Musyabiq Wijaya Suhaimi, Novadian Suharmanto Suryadi Islami Syahrul Hamidi Nasution Taruna, Achmad Wirawan, Wahyudi Zulkhair Ali