Artaria Tjempakasari, Artaria
Nephrology Division, Department Of Internal Medicine, Faculty Of Medicine Universitas Airlangga, Surabaya, Indonesia - Dr. Soetomo General Hospital Surabaya

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BACTERIA CAUSED SEPSIS BIOMARKERS Tjempakasari, Artaria; Nasronudin, Nasronudin
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 3 (2014)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Sepsis is a clinical condition of patients with serious infections that show a systemic inflammatory response, with or without a positive blood culture. sepsis is one of the most frequent causes of death in patients in intensive care units. We are at urgent need for biomarkers and reliable measurements that can be applied to risk stratification of septic patients and that would easily identify those patients at the highest risk of a poor outcome. Such markers would be of fundamental importance to decision making for early intervention therapy. Pro-inflammatory cytokines such as tumor necrosis factor- (TNF- ), interleukins-1,-6,-8 (IL-1, IL-6, IL-8) are postulated to play a major role in the pathogenesis of the syndrome. C-reactive protein (CRP) and procalcitonin (PCT) are among a few biomarkers thatincorporated into clinical practice although their precise role in the pathopysiology of sepsis and organ dysfunction still unclear.
Risk Factors for Urinary Tract Infection in Hospitalized Patients Hadiati Setyorini; Nunuk Mardiana; Artaria Tjempakasari
Biomolecular and Health Science Journal Vol. 2 No. 1 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (785.728 KB) | DOI: 10.20473/bhsj.v2i1.11549

Abstract

Introduction: Urinary tract infection (UTI) is the most common infection that can be fatal and has higher rate mortality especially in some patient. This study is aim to analyze risk factors for urinary tract infection in hospitalized patients for prevention and more aggressive approach can be taken.Methods: Consecutively, medical records of 285 patients with urinary analysis was recorded for risk factors and urine culture results if suspected UTI. Risk factors for sex, age, urinary catheter, urolithiasis, DM, and immobilization was analyzed with bivariate analysis and multivariate analysis.Results: From 285 patients, 92 patients had UTI with average age was 52.45 years old, 48 (56.49%) were female. Most common pathogen were E. coli (41.3%), Enterobacter sp. (8.8%) and Enterococcus faecalis (7.6 %). From bivariate analysis, geriatric age (>60 years) has RR 1.421 (95% CI 1.015-1.989, p=0.046) and immobilization has RR 1.861 (95% CI 1.266-2.738, p=0.007), whereas sex (RR 1.190 95% CI 0.851 – 1.664, p=0.310), diabetes (RR 1.171 95% CI 0.833 – 1.645, p=0.367), insulin usage (RR 0.900 95% CI 0.519 – 1.561, p= 0.703), glycosuria (RR 1.152 95% CI 0.741 – 1.791, p=0.522), and CKD (RR 1.475 95% CI 0.896 – 2.430, p= 0.126) give insignificant result. From multivariate analysis, urinary catheter has OR 4.506 (95% CI 2.312-8.872, p=0.000), urolithiasis with OR 4.970 (95% CI 1.931-12.787, p=0.001), and hyperglycemia has OR 2.871 (95% CI 1.485-5.551, p=0.002).Conclusion: Geriatric age and immobilization are risk factors for urinary tract infection, and urinary catheter, urolithiasis, and hyperglycemia are independent risk factors for urinary tract infection.
A Female Patient With Clinical Symptoms as Recurrent Urinary Tract Infection Caused By Urinary Tract Tuberculosis Rastita Widyasari; Artaria Tjempakasari; Chandra Irwanadi Mohani
Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v1i1.16829

Abstract

Background : Urinary tract tuberculosis (TB)  is one type of extrapulmonary TB. The prevalence in developed countries is around 15-20% of all cases of extrapulmonary TB.1 The insidious onset and non-specific constitutional symptoms of urinary tuberculosis often lead  to delayed diagnosis and  rapid progression to a non-functioning kidney.2-3 The only way to limit renal function loss and destruction  is by early diagnosis and therapy.4Case: 34-year-old woman, came with complaints of urinary pain accompanied by right flank pain 10 months prior. Patient also had  complaint of weight loss but ignoring complaints of night sweats. Patient repeatedly diagnosed as a urinary tract infection and received many kinds of antibiotic therapy but her complaints were not getting better. Urine production was about 1700 cc/24 hours. From general physical examination, there was a lack of nutritional status with BMI 17.1 kg/m2. Vesicular lung sound without rhonchi heard in both lung fields. From the urinalysis examination there were pyuria and haematuria without bacteriuri. Laboratory examination showed value of BUN was 17 mg/dl and creatinine 0.9 mg/dl. From aerob urine culture we found sterile urine. But we found positive result of Mycobacterium tuberculosis (MTB) urine cultures which was sensitive to isoniazid, rifampicin, pyrazinamide, and ethambutol. Abdominal ultrasound showed severe ecstasis of right pelviocalyceal system without stones,mass, nor cyst. We had additional data from intravenous pyelogram (IVP) which showed a non-visualized dextra pelviocalyceal system and delayed bladder emptying function at 120th minutes. From computed tomography stonographic, we found severe right hydronephrosis, proximal to distal right hydroureter, and thickening of bladder wall (± 1.61 cm) on the right antero-lateral side. To find out the cause of thickening of bladder wall, we did bladder biopsy which showed the mononuclear inflammatory cell stroma. Patients were diagnosed with urinary tract TB and received category 1 of oral anti tuberculosis therapy (Rifampicin, Isoniazid, Pyrazinamid, and Ethambutol) for 12 months and underwent right DJ stent implantation  to manage the ectasys.Conclusion : Urinary tract TB often showed unspecified complaints and can be suggested as recurrent urinary tract infections. Early diagnosis and optimal management were needed to prevent anatomical and functional complications.
AUTOIMMUNE OPTIC NEUROPATHY (AON) PROFILE AT OPHTHALMOLOGY OUTPATIENT CLINIC OF A TERTIARY HOSPITAL IN SURABAYA, INDONESIA Devanty Dwi Santosa; Lukisiari Agustini; Artaria Tjempakasari
Majalah Biomorfologi Vol. 34 No. 1 (2024): MAJALAH BIOMORFOLOGI
Publisher : Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mbiom.v34i1.2024.19-25

Abstract

Highlights Autoimmune optic neuropathy (AON) is one of the diseases that involve the central nervous system (CNS) and can result in disability if not treated quickly and appropriately. The autoimmune optic neuropathy (AON) patient's profile, including disease etiology and therapy, is essential to minimize the incidence of AON.   Abstract Background: Autoimmune optic neuropathy (AON) is a kind of optic neuritis that causes progressive and severe vision loss. The presence of an autoimmune disease usually characterizes the diagnosis of this disease. Several autoimmune processes that can cause AON are Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD), Myelin Oligodendrocyte Glycoprotein Immunoglobulin (MOG-IgG), and other disorders, specifically systemic autoimmune disease, such as Systemic Lupus Erythematous (SLE), Sjogren's Syndrome, and Sarcoidosis. Risk factors for AON involve young adults and women. Most of the patients received therapy according to the ONTT protocol and underwent outpatient treatment with oral methylprednisolone or prednisone. Objective: The study aimed to obtain the autoimmune optic neuropathy (AON) profile in patients at the Ophthalmology Outpatient Installation of Dr. Soetomo General Academic Hospital Surabaya, Indonesia, in the 2017-2022 Period. Material and Method: This retrospective descriptive study used medical records; 70 subjects were included. Result: Most subjects suffered from SLE (55.7%) as the cause of AON and received therapy according to the ONTT protocol, namely oral methylprednisolone or prednisone (67.1%) with outpatient therapy. Some patients were given other therapies (25.7%), such as mecobalamin and other B complex vitamins. Conclusion: AON is an uncommon condition. However, if not treated promptly and effectively, it can result in handicaps. This study may serve as a reference for future relevant research and as an attempt to prevent the disease.
The Administration of Intradialytic Parenteral Nutrition Does Not Affect the Anemia Status of Chronic Kidney Disease Patients Undergoing Hemodialysis Hertanto, Decsa Medika; Nurwidda, Arvi Dian Prasetia; Tjempakasari, Artaria; Widodo, Widodo; Pranawa, Pranawa
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.115

Abstract

Background: Hemodialysis (HD) patients are susceptible to malnutrition, and there is a close relationship between malnutrition and the incidence of anemia. Parenteral nutrition plays a role in treating malnutrition. Objective: This study aims to determine the effect of parenteral nutrition on anemia in HD patients. Methods: Quasi-experimental research which is part of the nutritional research tree at the Hemodialysis Unit of RSUP Dr. Soetomo Surabaya for 3 months. A total of 45 malnourished CKD patients (SGA B & C) undergoing routine HD were included in this study (n=26 received regular diet & education, n=17 received regular diet, education and intradialytic parenteral nutrition, and n=2 dropped out of school due to blood transfusion). Measurements of body mass index (BMI), hemoglobin (Hb), serum iron (SI), and total iron binding capacity (TIBC) were carried out before and 8 weeks after therapy. Between groups used the Mann-Whitney test, while pre and post used the Wilcoxon matched-pairs sign rank test. Results: The treatment group was older than the control group. There was no difference in duration of HD between groups. Intradialytic parenteral nutrition had no effect on BMI (24.71±3.939 vs 24.71±4.026; p=0.3802), Hb (9.746±1.309 vs 9.162±1.960; p= 0.3525), SI (62.33±34.74 vs. 53.78±24.89; p=0.3594), and TIBC (242.8±119.0 vs. 197.3±43, 65; p=0.4258). Conclusion: In HD patients, intradialytic parenteral nutrition for 8 weeks did not affect Hb, SI and TIBC levels. Long-term observations with larger samples are needed to confirm these findings.
Providing Intradialytic Parenteral Nutrition Therapy Does Not Improve Anthropometric Status in Hemodialysis Patients with Malnutrition Suryantoro, Satriyo Dwi; Tjempakasari, Artaria; Nurwidda, Arvi Dian Prasetia; Widodo, Widodo; Thaha, Mochammad; Mardiana, Nunuk
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.123

Abstract

Background: Malnutrition is prevalent in hemodialysis patients and significantly impacts prognosis. It can result from reduced food intake and protein loss during hemodialysis. Nutritional status is determined through anthropometric examinations, which include upper arm circumference (UAC), body mass index (BMI), hand grip strength, bicep, and tricep fold thickness. Laboratory examinations like total cholesterol and Malnutrition Inflammation Score (MIS) or Subjective Global Assessment (SGA) are also used. Intradialytic Parenteral Nutrition (IDPN) is expected to maintain or improve the nutritional status of hemodialysis patients. Objective: This research examines the impact of parenteral nutrition therapy on the anthropometric status of malnourished hemodialysis patients. Methods: This cross-sectional study, a sub-analysis of a larger nutritional therapy study, involved 24 hemodialysis patients experiencing malnutrition based on SGA B and C criteria with 1-10 years of hemodialysis. IDPN therapy was provided, and anthropometric measurements and total cholesterol were taken at baseline and three months after nutritional therapy. Data processing used comparative statistical analysis. Results: The mean age was 45.33 years, with 14 males and 10 females. After 3 months, there were no significant differences in UAC (mean difference = 0.13; p = 0.69), BMI (mean difference = 0.13; p = 0.50), hand grip strength (mean difference = -0.96; p = 0.282), biceps skinfold thickness (mean difference = 0.13; p = 0.69) and triceps (mean difference = 0.59; p = 0.134) or total cholesterol (mean difference = -1.5; p = 0.71). Conclusion: IDPN therapy for 3 months did not improve the anthropometric status of hemodialysis patients with malnutrition.
BACTERIA CAUSED SEPSIS BIOMARKERS Tjempakasari, Artaria; Nasronudin, Nasronudin
Indonesian Journal of Tropical and Infectious Disease Vol. 5 No. 3 (2014)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.692 KB) | DOI: 10.20473/ijtid.v5i3.238

Abstract

Sepsis is a clinical condition of patients with serious infections that show a systemic inflammatory response, with or without a positive blood culture. sepsis is one of the most frequent causes of death in patients in intensive care units. We are at urgent need for biomarkers and reliable measurements that can be applied to risk stratification of septic patients and that would easily identify those patients at the highest risk of a poor outcome. Such markers would be of fundamental importance to decision making for early intervention therapy. Pro-inflammatory cytokines such as tumor necrosis factor- (TNF- ), interleukins-1,-6,-8 (IL-1, IL-6, IL-8) are postulated to play a major role in the pathogenesis of the syndrome. C-reactive protein (CRP) and procalcitonin (PCT) are among a few biomarkers thatincorporated into clinical practice although their precise role in the pathopysiology of sepsis and organ dysfunction still unclear.
Prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) Carrier in Hemodialysis Patients at Dr. Soetomo Academic General Hospital Wicaksono, Eko Oktiawan; Tjempakasari, Artaria; Widodo, Widodo
Indonesian Journal of Tropical and Infectious Disease Vol. 8 No. 3 (2020)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v8i3.16796

Abstract

Chronic kidney disease (CKD) is now a global epidemic, and the prevalence is increasing worldwide. Hemodialysis    is one of the ways to treat by kidney function replacement. Infection is the number two cause of death in patients with hemodialysis (HD). Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of bacteriemia in patients with dialysis. The epidemiological data of MRSA carriers in CKD in Indonesia are still scarce. This study was to determine the prevalence of MRSA carriers in patients at The Kidney and Hypertension Outpatient-clinic and Hemodialysis Installation at Dr. Soetomo Academic General Hospital, Surabaya Indonesia. The study design was descriptive-analytic with a cross- sectional study design. Sampling was collected consecutively. Data on the general characteristics of the research subjects will be analyzed using a Chi-Squared test. There were 150 CKD stage five patients included in this study, the number  of patients has MRSA carrier were 6 (4%), among them, subjects underwent HD MRSA carrier were 2 subjects(2.7%), while for non-HD patients with MRSA were 4 subjects (5.3 %). There were no significant differences in MRSA carriers between HD and non HD groups (p=0.404). Comorbid factors that accompany MRSA carriers are diabetes mellitus, hypertension, kidney stones, gout, and systemic lupus erythematosus (SLE).  This study found, there were no significant differences in the incidence of MRSA carriers in stage five CKD non HD or HD groups. MRSA colonization exists in stage five CKD sufferers, so awareness of MRSA colonization
Correlation between Serum High-Sensitivity C-Reactive Protein Level and Severity of Albuminuria Measured by Urine Albumin-to-Creatinine Ratio in Type 2 Diabetic Patients Febrianto, Dicky; Soelistijo, Soebagijo Adi; Tjempakasari, Artaria
Current Internal Medicine Research and Practice Surabaya Journal Vol. 4 No. 2 (2023): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v4i2.49152

Abstract

Introduction: One of complications in type 2 diabetes mellitus (DM) that require high treatment cost is diabetic kidney disease (DKD), which is characterized by the presence of albuminuria, decrease in glomerular filtration rate, or both. Researches show a positive correlation between type 2 DM and serum high-sensitivity C-reactive protein (hs-CRP) level, a sensitive marker of subclinical inflammation. This study aimed to analyze the correlation between serum hs-CRP level and severity of albuminuria measured by urine albumin-to-creatinine ratio (ACR).Methods: The study was conducted at the Endocrinology Outpatient Clinic of Dr. Soetomo General Academic Hospital, Surabaya, on June-July 2020.Results: The study included 50 patients with type 2 DM, consisting of 25 (50%) men and 25 (50%) women, with median age of 58.0 (42-68) years and mean body mass index (BMI) of 21.91 ± 1.310 kg/m2. Median duration of DM was 12.0 (6-22) years, median HbA1c level was 7.20% (5.7%-12.3%), mean serum crEatinine level was 0.83 ± 0.180 mg/dL, and median estimated glomerular filtration rate (eGFR) value was 92.85 (61.6-121.2) mL/minute/1.73 m2. Median serum hs-CRP level was 1.20 (0.1-4.0) mg/L and median urine ACR value was 49.570 (7.78-426.00) mg/g. Normoalbuminuria was detected in 28% of subjects, microalbuminuria in 66% of subjects, and macroalbuminuria in 6% of subjects. This study showed positive and significant correlation between serum hs-CRP level and severity of albuminuria (r = 0.701; p = <0.001).Conclusion: There was positive and significant correlation betweeen serum hs-CRP level and severity of albuminuria in type 2 diabetic patients.
Autosomal dominant polycystic kidney disease (ADPKD) with multiple complications: Management challenges Djajapranata, Kenneth M.; Tjempakasari, Artaria
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.584

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary polycystic kidney disease characterized by renal enlargement, resulting in renal failure. In Indonesia, the exact prevalence of ADPKD is unknown due to limited reports on the disease. The aim of this study was to report a case of a patient with ADPKD with multiple complications. A 54-year-old male presented to the emergency room of Dr. Soetomo Academic General Hospital, Surabaya, Indonesia, with a chief complaint of dark-red-colored urine for one week. There was a progressive abdominal enlargement over the past five years, which had become more tense and rigid for the past one month. The patient had a history of fatigue and hypertension with routine follow-up. Physical examination on admission showed normal vital signs, and the abdominal assessment revealed a palpable hard mass approximately 4 cm in size in the right upper abdomen. Laboratory test indicated anemia, leukocytosis, lymphopenia, proteinuria, hematuria, leukocyturia, and elevated serum creatinine and urea levels. Abdominal imaging using ultrasonography, computed tomography (CT) scan, and magnetic resonance imaging (MRI) revealed bilateral kidney and liver enlargement containing multiple cysts, suggesting polycystic kidney and liver disease. There was a ruptured cyst in the middle of the left kidney pole with minimal ascites found in the CT scan. The MRI exhibited the presence of multiple cysts in both kidneys, partially filled with blood. The patient was diagnosed with ADPKD, gross hematuria, acute or chronic kidney disease (CKD), urinary tract infection (UTI), normochromic-normocytic anemia, and metabolic acidosis. Dietary control with high-calorie, high-protein, and low-salt diet; fluid balance; and other symptomatic medications were initiated. It is critical to be aware of risk factors associated with the rapid progression of ADPKD in order to be able to provide a favorable impact on the disease prevention and management.