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All Journal Universa Medicina The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia
Gunawan, Burhan
Unknown Affiliation
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Modulasi Mikrobiota untuk Memperbaiki Laju Filtrasi Glomerulus, Toksin Uremik, dan Penanda Inflamasi pada Gagal Ginjal Kronik: Telaah Sistematik dan Meta-Analisis Gunawan, Burhan; Purwata, Raymond Sebastian; Hidayat, Syarif; Pandapotan, Roy Akur; Jennifer, Jennifer
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Dysbiosis microbiota is considered as one of the consequences and impacts of high uremic toxins in patients with Chronic Kidney Disease (CKD), which can lead to an increased risk of progression and mortality. The aim of this systematic review and meta-analysis was to perform quantitative effect of microbiota modulation for estimated Glomerular Filtration Rate (eGFR), uremic toxin (total-p cresyl/total pCS), and inflammatory marker (hs-CRP) outcome among CKD patients. Methods. Article searches were conducted from PubMed, ScienceDirect, and Cochrane Library data sources from 2010-2022. Assessment of article quality follows the rules of PRISMA (Preferred Reporting Items in Systematic Review and Meta-Analysis). Only randomized controlled trial (RCT) articles investigating the effect of symbiotic, prebiotic, of probiotic for CKD were included in the analysis. Effect size quantify from Standardized Mean Difference (SMD), using a continuous random effect model and described in the forest plot model. Results. A total of 17 RCT studies with a total 867 CKD stage 1-5 subjects (440 subjects in the intervention group and 427 subjects in the control group). The intervention duration ranging from 1-12 months. The studies included had varied on methodologies, with significant heterogenicity (I296,96%, p Conclusions. The administration of probiotic/prebiotic/symbiotic supplements to CKD patients resulted in significant improvements in e-GFR and reductions in total pCS. These results suggest the potential of symbiotic, prebiotic, and probiotic supplementation to improve CKD outcome. Keywords: Chronic kidney disease, e-GFR, hs-CRP, prebiotic, probiotic, uremic toxin
Risk factors of early onset type 2 diabetes mellitus in young adults ≤ 40 years old Gunawan, Burhan; Soerachmad, Soesilowati; Hendrawan, Liana Dewi; Titus, Johana; Cendana, Vira
Universa Medicina Vol. 43 No. 2 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.179-187

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BackgroundThe global prevalence of type 2 diabetes mellitus (T2DM) in adolescents and young adults is dramatically increasing. The aim of this study was to explore numerous risk factors for the occurrence of Pre-DM or T2DM in subjects aged ≤40 years. MethodsA cross-sectional study was conducted involving 100 subjects (50 subjects in the Pre-DM/T2DM group and 50 subjects in the Non Pre-DM/T2DM group). Main inclusion criteria: age ≤40 years, registered in our Diabetes and Endocrine Clinic. Data extracted included demographic, lifestyle, anthropometric, psychosocial, and family history data. Statistical analysis by binary logistic regression model. Results were considered significant at p<0.05 ResultsThere were no differences in demographic variables between the two groups. Multivariate analysis showed that cigarette smoking [aOR 3.17 (95% CI: 1.11-11.28)], hypertension [aOR 2.48 (95% CI: 1.23-7.19)] obesity [aOR 5.11 (95% CI: 2.12-8.21)], history of excessive calorie intake [aOR 3.40 (95% CI: 1.54-5.55)], poor stress management [aOR 2.33 (95% CI: 1.04-3.88)], depression [aOR 5.17 (95% CI:1.63-8.26)], short sleep duration [aOR 2.72 (95% CI: 1.25-6.95)], physical inactivity [aOR 6.14 (95% CI: 1.41-9.22)], family history of T2DM [aOR 6.29 (95% CI: 2.61-9.27)], family history of hypertension [aOR 5.26 (95% CI: 2.18-8.91] were significant influential risk factors of Pre-DM/T2DM. ConclusionThe most influential risk factor for the occurrence of early onset T2DM among young adults was family history of T2DM. Screening of family members of T2DM patients may lead to early intervention and reduced risk of subsequent complications.
Platelet to White Blood Cell Ratio (PWR) to Predict Mortality in Acute on Chronic Liver Failure of Cirrhosis Patient: A Systematic Review Pandapotan, Roy Akur; Gunawan, Burhan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 3 (2022): VOLUME 23, NUMBER 3, December 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2332022180-187

Abstract

Background: Liver cirrhosis (LC) is still being important public health concern, due to the rising of global incidence and mortality. There is risk progression in LC patients to acute-on-chronic liver failure (ACLF) patients with high incidence of complication and high short-term mortality rate. It needs rapid and simpler predictor to immediate and accurate triage of the patient. The aim of this study is to review systematically the role of PWR to predict the mortality in ACLF cirrhosis patient.Method: This systematic review study was identified by searching Pub-Med, Cochrane library, and EMBASE database (2016-2022). Only observational studies were included. ACLF patient was selected as the main subject in each study, and PWR was added as short-term mortality predictor. The Cochran seven step model was used to perform the review.Results: Six cohort retrospective studies met inclusion criteria, including total 1,348 patient ACLF. Half of studies included had high level of evidence. The non-survivor ACLF patient had significantly lower PWR values than survivor. The range of HR of PWR to predict mortality in ACLF was 0.665-0.995, with p value 0.0001. Whereas the cutoff range of PWR value to predict non survivor in ACLF patient was 7.83-14.2.Conclusion: PWR had a predictive efficacy, similar to CLIF-SOFA and MELD score in terms of predicting short-term mortality in ACLF patients. PWR showed significantly independent risk factor of short term mortality in ACLF cirrhotic patient.
Co-Authors Cendana, Vira Hendrawan, Liana Dewi Jennifer Jennifer Purwata, Raymond Sebastian Roy Akur Pandapotan, Roy Akur Soerachmad, Soesilowati Syarif Hidayat Titus, Johana