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Octavianus R. H. Umboh

Universitas Sam Ratulangi

Author-ID : 5598508

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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Pengaruh Inflamasi Mikro terhadap Penyakit Ginjal pada Pasien Diabetes Melitus Tipe-2 Sarah Rumondang; Bisuk P. Sedli; Octavianus R. H. Umboh
Medical Scope Journal Vol. 4 No. 1 (2022): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v4i1.44682

Abstract: Diabetic nephropathy is a microvascular damage as a complication of type 2 diabetes mellitus (T2DM) and becomes one of the most frequent causes of chronic renal failure worldwide. This study aimed to determine the effect of micro-inflammation on renal impairment in T2DM patients. This was a literature review study and data were searched using three database sources, namely ClinicalKey, Pubmed, and Google Scholar. The results obtained 10 articles to be reviewed. All reviewed articles stated various increases in inflammatory mediators namely NGAL, NLR, serum cystatin-C, urinary IgG, transferrin, hs-CRP, IL-8, TSA, TLR-4, TLR-2, monocyte ratio CD14+CD16+, pro-inflammatory cytokines Th1 TNF-α, IFN-γ, IL-6, IL-1β, IL-4, and eotaxin, and decreased levels of uromodulin and TNFR1. This occurred due to some components of the body in a state of hyperglycemia wouldl be able to activate the infiltration of hematopoietic cells, especially macrophages in the kidneys, which would further secrete proinflammatory cytokines and reactive oxygen species (ROS). Inflammatory cells present in the kidney are a response to tissue damage, but can also increase cell injury and the progression of DN in its early stages. In conclusion, there is an influence of immune and inflammatory mechanisms on the development of diabetic nephropathy in patients with type 2 diabetes mellitus. Keywords: type 2 diabetes mellitus; micro inflammation; diabetic kidney disease Abstrak: Nefropati diabetik (ND) adalah kerusakan mikrovaskuler sebagai komplikasi DMT2 dan menjadi salah satu penyebab tersering gagal ginjal kronis di seluruh dunia. Penelitian ini bertujuan untuk mengetahui pengaruh inflamasi mikro terhadap penyakit ginjal pada pasien DMT2. Penelitian ini menggunakan metode literature review dengan pencarian data melallui tiga sumber database yaitu ClinicalKey, Pubmed, dan Google Scholar. Hasil penelitian mendapatkan 10 artikel yang di-review yang melaporkan berbagai peningkatan mediator inflamasi, yaitu NGAL, NLR, serum cystatin-C, IgG urin, transferin, hs-CRP, IL-8, TSA, TLR-4, TLR-2, rasio monosit CD14+CD16+, sitokin proinflamasi Th1 TNF-α, IFN-γ, IL-6, IL-1β, IL-4, dan eotaksin, serta penurunan kadar uromodulin dan TNFR1. Hal ini terjadi karena beberapa komponen pada keadaan DMT2 dapat mengaktifkan infiltrasi sel hematopoietik, terutama makrofag pada ginjal, yang akan mengeluarkan sitokin proinflamasi dan reactive oxygen species (ROS). Masuknya sel inflamasi ke dalam ginjal pasien merupakan respon terhadap kerusakan jaringan, tetapi juga dapat meningkatkan cedera sel serta progresifitas ND pada tahap awal. Simpulan penelitian ini ialah terdapat pengaruh mekanisme kekebalan dan inflamasi dalam perkembangan nefropati diabetik pada pasien diabetes mellitus tipe 2. Kata kunci: diabetes melitus tipe 2; inflamasi mikro; penyakit ginjal diabetes

Faktor Risiko Infeksi Hepatitis C pada Penyakit Ginjal Kronis Mario F. Wilson; Bradley J. Waleleng; Octavianus R. H. Umboh
Medical Scope Journal Vol. 4 No. 1 (2022): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v4i1.44857

Abstract:: Hepatitis C, a type of hepatitis caused by hepatitis C virus, has spread worldwide. Chronic kidney disease (CKD) is a condition in which the kidneys lose their function as an organ gradually lasting more than three months. Moreover, the CKD population are susceptible to infection due to their immunity disorder and treatment at health care centers. This study aimed to determine the risk factors for hepatitis C infection in CKD patients. This was a literature review study. Article searches were carried out in three databases, namely PubMed, ClinicalKey, and Google Scholar. The results obtained 10 full-text journals to be reviewed. Hemodialysis was the risk factor that contributed the most to the transmission of HCV to CKD patients. While, kidney transplantation accounted for a portion of HCV infection, but these risk factors could still be prevented and controlled. Blood transfusion was a risk factor for the spread of Hepatitis C virus in CKD which was the rarest since blood screening was carried out. In conclusion, there are three risk factors for hepatitis C virus infection in chronic kidney disease patients based on the possibility of infection sequentially including hemodialysis, kidney transplantation, and blood transfusion. Keywords: hepatitis C; chronic kidney disease; hemodialysis; infection; risk factor Abstrak: Hepatitis C disebabkan oleh virus hepatitis C (VHC) dan telah menyebar ke seluruh dunia. Penyakit ginjal kronis (PGK) adalah kondisi dimana ginjal kehilangan fungsinya sebagai organ secara bertahap yang berlangsung lebih dari tiga bulan. Populasi dengan PGK menjadi kelompok rentan terkena infeksi akibat gangguan imunitas dan perawatan di pusat pelayanan kesehatan. Penelitian ini bertujuan untuk mengetahui faktor risiko infeksi hepatitis C pada pasien PGK. Jenis penelitian ialah suatu literature review. Pencarian artikel dilakukan pada tiga database yaitu PubMed, ClinicalKey, dan Google Scholar. Hasil penelitian mendapatkan 10 jurnal full-text yang dilakukan review. Hemodialisis merupakan faktor risiko yang paling banyak berkontribusi terhadap transmisi VHC pada PGK. Transplantasi ginjal menyumbang sebagian dari infeksi VHC, namun faktor risiko ini masih dapat dicegah dan dikendalikan. Transfusi darah merupakan faktor risiko penyebaran virus Hepatitis C pada PGK yang paling jarang terjadi sejak dilakukannya skrining darah. Simpulan penelitian ini ialah terdapat tiga faktor resiko infeksi virus hepatitis C pada penyakit ginjal kronik berdasarkan kemungkinan terjadinya infeksi secara berurut yaitu hemodialisis, transplantasi ginjal, dan transfusi darah. Kata kunci: hepatitis C; penyakit ginjal kronis; hemodialisis; infeksi; faktor risiko

Diagnosis dan Tatalaksana Sindrom Kardiorenal Evelyne M. Jirajaya; Octavianus R. H. Umboh; Frans E. N. Wantania
Medical Scope Journal Vol. 5 No. 1 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i1.45118

Heart disease and kidney disease are interconnected and have become a global health problem. There is a close relationship between the heart and kidneys, where kidney failure can cause heart injury and conversely heart damage can lead to worsening of kidney function. This condition is called cardiorenal syndrome (CRS). This study aimed to discuss the diagnosis and treatment of cardiorenal syndrome. This was a literature review study using three database resources, namely ClinicalKey, Pubmed, and Google Scholar, to search articles related to inclusion and exclusion criteria. The results obtained 13 articles; 10 articles discussing the diagnosis of CRS and 10 articles discussing the treatment of CRS. The diagnosis of CRS in both acute and chronic conditions could be seen through multi-organ biomarkers from urine and blood samples, imaging, and in assessing the volume status of CRS. Treatment with rapid volume reduction might help to relieve symptoms. Diuretics were the primary agents for correcting volume overload on CRS. There were other alternative treatments such as neurohormonal modulation inhibitors, inotropes, vasodilators/vasopressin, RAAS inhibitors, cardiac device therapy, and others. In conclusion, diagnosis of CRS is confirmed by using multiorgan biomarkers, imaging, and volume status, and its management is performed by correcting volume overload with diuretics or alternatives. Keywords: cardiorenal syndrome; diagnosis; treatment Abstrak: Penyakit jantung dan penyakit ginjal saling berhubungan dan telah menjadi masalah dalam dunia kesehatan. Terdapat hubungan erat antara organ jantung dan ginjal, dimana gagal ginjal dapat memperburuk cedera jantung dan sebaliknya kerusakan jantung dapat mendorong perburukan fungsi ginjal. Keadaan tersebut disebut dengan sindrom kardiorenal (SKR). Penelitian ini bertujuan untuk mengetahui diagnosis dan tatalaksana SKR. Jenis penelitian ini ialah suatu literature review. Pencarian data menggunakan tiga sumber database yaitu ClinicalKey, Pubmed, dan Google Scholar sesuai dengan kriteria inklusi dan eksklusi. Hasil penelitian mendapatkan 13 artikel yang dilakukan review. Terdapat 10 artikel yang membahas diagnosis SKR dan terdapat 10 artikel yang membahas tatalaksana SKR. Penegakan diagnosis pada SKR baik dalam kondisi akut dan kronis dapat dilihat melalui biomarker multi-organ dari sampel urin maupun darah, pencitraan (imaging), dan pada penilaian status volume SKR. Tatalaksana dengan pengurangan volume secara cepat dapat membantu meringankan gejala. Diuretik merupakan agen primer untuk mengoreksi kelebihan volume SKR. Terdapat tatalaksana alternatif lainnya seperti penghambat modulasi neurohormonal, inotropik, vasodilator/vasopressin, penghambat RAAS, terapi perangkat jantung, dan lainnya. Simpulan penelitian ini ialah diagnosis SKR ditegakkan melalui biomarker multiorgan, pencitraan dan penilaian status volume. Tatalaksana dengan pengurangan volume menggunakan diuretik atau alternatif. Kata kunci: sindrom kardiorenal; diagnosis; tatalaksana

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