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All Journal Indonesian Journal of Medicine Jurnal Penyakit Dalam Indonesia
Ratih Tri Kusuma Dewi, Ratih Tri Kusuma
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Medicine & Pharmacology Public Health

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Pengaruh Pemberian N-Acetylcysteine Oral terhadap High Sensitivity C Reactive Protein (Hs-CRP) pada Pasien Hemodialisis Kronis Dewi, Ratih Tri Kusuma; Siregar, Parlindungan; Alwi, Idrus; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
Publisher : UI Scholars Hub

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Pendahuluan. Inflamasi dan stres oksidatif merupakan faktor risiko penyakit kardiovaskuler pada pasien penyakit ginjal kronis yang menjalani hemodialisis. Pasien hemodialisis kronis akan mengalami peningkatan kadar Hs-CRP. Hs-CRP merupakan marker inflamasi yang telah terbukti pada beberapa penelitian bermanfaat dalam memprediksi cardiovascular event. Pemberian N-Acetylcysteine (NAC) oral dapat digunakan sebagai strategi untuk menurunkan proses inflamasi yaitu disfungsi endotel dan stress oksidatif yang berperan pada atherosclerosis pada pasien hemodialsis. Pemberian NAC ini diharapkan dapat menurunkan angka morbiditas dan mortalitas karena penyakit kardiovaskuler. Metode. Penelitian eksperimen dengan Randomized Double Blind Controlled Trial pada 65 pasien hemodialisis kronis yang memenuhi kriteria inklusi di unit hemodialisis RS.Cipto Mangunkusumo Jakarta. Penelitian dilakukan pada Agustus sampai Oktober 2013. Hasil. Perlakuan dengan NAC oral selama 60 hari tidak memberikan perbedaan dibandingkan dengan plasebo. Analisis statistik dengan Mann Whitney menunjukkan bahwa tidak ada penurunan kadar Hs-CRP yang signifikan diantara kedua kelompok dengan p value Δ post1-baseline, Δ post2-baseline, and Δ post2-post1 kelompok NAC dibanding kelompok plasebo secara berurutan yaitu 0.796, 0.379 dan 0.712. Sementara itu, hasil uji Wilcoxon Signed Ranks untuk membandingkan penurunan kadar Hs-CRP pada tiap kelompok dalam tiga interval pengukuran Hs-CRP menunjukkan p value dari perbandingan kadar Hs-CRP untuk masing-masing kelompok baseline:Post1, baseline:Post2 dan Post1:Post2 (kelompok NAC Vs kelompok plasebo) secara berurutan 0.821vs0.651; 0.845vs0.358 dan 0.905vs0.789. Simpulan. Pemberian N-Acetylcysteine oral belum terbukti dapat menurunkan kadar Hs-CRP pada pasien hemodialisis kronis.
Relationship between Quality of Life and Nutritional Status on Chronic Kidney Disease Patients with Dialysis Type Dewi, Ratih Tri Kusuma; Putranto, Wachid; Susanto, Agung; Suseno, Aryo; Purwanto, Bambang; Mangesti, Rini Dwi; Giani, Maia Thalia; Septian, Muhammad Raditia
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
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Factor Related to The Incidence of Ascites in Chronic Kidney Disease Patients Undergoing Hemodialysis at RSUD Dr Moewardi Surakarta: A Cross Sectional Study Yusman, Felizia Alika; Dewi, Ratih Tri Kusuma; Mashuri, Yusuf Ari; Nurhayatun, Evi; Giani, Maia Thalia
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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Introduction. Chronic kidney disease (CKD) is a global health issue with continuously rising prevalence. Fluid overload is a frequent systemic complication which occurs in CKD patients undergoing hemodialysis (HD). One of clinical manifestation of fluid overload in HD patients is ascites. This study aimed to determine the factors related to the incidence of ascites in CKD patients undergoing hemodialysis. Methods. An observational analytic study with a cross-sectional approach was conducted at Dr. Moewardi Hospital, Surakarta from September until October 2019. The subjects were end-stage CKD patients undergoing HD. Subjects were selected by total sampling technique. Data were obtained from medical records tracking. Furthermore, each variable was analyzed using Chi Square and Independent T-test analysis. P value less than 0.05 is considered statistically significant. Results. A total of 116 subjects were recruited in this study. Incidence of ascites was documented in 24 (20.7%) patients. The comorbid of chronic heart failure (CHF) was found in 23 (19.8%) subjects, where this condition was associated with the incidence of ascites [p = 0.003; PR 2.888 (95% CI=1.476–5.650)]. In the subjects with hypoalbuminemia was also related to higher incidence of ascites [p < 0.001; PR 7.800 (95% CI=3.153 – 19.293)]. Meanwhile gender, age, diabetes mellitus, the levels of hemoglobin, ureum, creatinine serum, albumin, hematocrit, and leukocyte were not associated with ascites in CKD patients undergoing HD (p > 0.05). Conclusions. Factors related to the incidence of ascites in patients with chronic kidney disease who have undergone hemodialysis is chronic heart failure and hypoalbuminemia.
Hubungan Rasio Neutrofil Limfosit terhadap Komplikasi Kardiovaskular pada Pasien Penyakit Ginjal Kronik Hemodialisis Akmal, Thariq Hikmatul; Susanto, Agung; Dewi, Ratih Tri Kusuma; Sunggoro, Agus Jati
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. The neutrophil-to-lymphocyte ratio (NLR) is a simple parameter to assess the inflammatory status, especially in chronic kidney disease (CKD) patients experiencing capillary damage due to increased glomerular capillary pressure. In a state of vascular endothelial inflammation, there is a higher tendency to form atherosclerotic plaques and calcification that can induce cardiovascular events such as heart failure, coronary heart disease, and stroke. This study aimed to determine the relationship between the NLR and cardiovascular complications in CKD patients undergoing hemodialysis. Methods. An analytical observational study with cross-sectional approach was conducted among 119 CKD patients undergoing hemodialysis at Dr Moewardi Regional Hospital who met the inclusion and exclusion criteria. The relationship between the two variables was analyzed using Fisher exact test. Results. The majority of subjects in this study were male (51.3%) and were aged over 50 years old (63.9%). Most subjects experienced complications of heart failure (54.6%), followed by coronary heart disease (19.3%), and stroke (17.7%). Analysis of complete blood count data showed a mean neutrophil count of 77.20% (SD 11.49), lymphocytes 13.64% (SD 8.23), and NLR 10.7 (SD 10.3). Notably, a majority of participants exhibited an NLR value ≥3.5, observed in 95 individuals (79.8%). Fisher exact test results indicated a significant relationship between elevated NLR and cardiovascular complications in hemodialysis CKD patients (p-value= 0.028). Conclusion. There is a significant relationship between NLR and cardiovascular complications in CKD patients undergoing hemodialysis.
Correlation between Mortality of COVID-19 Patients with Hypertension and Thorax Radiography Treated in the Intensive Care Unit of Dr. Moewardi Hospital Nurhidayati, Faiza Salsabila; Soewondo, Widiastuti; Dewi, Ratih Tri Kusuma; Putro, Prasetyo Sarwono
Indonesian Journal of Medicine Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Coronavirus 2019 or COVID-19, caused by the new SARS-CoV2 virus, has become a pandemic and attacked more than 200 countries, including Indonesia. The most comorbid disease in COVID-19 patients was hypertension. Chest radiography can predict prognosis and mortality in COVID-19 cases and one of the methods that can be used for chest radiographic assessment is the Brixia Score, specifically designed for COVID-19 patients to measure and analyze the severity of lung abnormalities in patients with COVID-19. This study aimed to find the correlation between the mortality of COVID-19 patients with hypertension and chest radiography using the Brixia Score treated in the intensive care unit (ICU) of Dr. Moewardi Hospital.Subjects and Method: This study used an analytic observational study with a cross-sectional approach. The subjects were 84 COVID-19 patients with hypertension who met the exclusion and inclusion criteria. The independent variable is chest radiography and dependent variable is mortality. Sampling was collected by purposive sampling and the data obtained were analyzed using the contingency coefficient test.Results: There was a significant correlation between the mortality of COVID-19 patients with hypertension and chest radiography as assessed using the Brixia Score (p<0.001). The youngest patient was 20 years old and the oldest was 87 years old.Conclusion: There was a correlation between the mortality of COVID-19 patients with hypertension and chest radiography treated in the ICU RSUD Dr. Moewardi, Surakarta.Keywords: COVID-19, mortality, hypertension, chest radiography, Brixia Score, intensive care unitCorrespondence: Widiastuti Soewondo. Faculty of Medicine Universitas Sebelas Maret Surakarta. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: Widiastuti.sprad56@staff.uns.ac.id. Mobile: 082134368592.Indonesian Journal of Medicine (2022), 07(03): 269-277https://doi.org/10.26911/theijmed.2022.07.03.03 
Co-Authors Akmal, Thariq Hikmatul Bambang Purwanto Cleopas Martin Rumende Giani, Maia Thalia Idrus Alwi Mangesti, Rini Dwi Mashuri, Yusuf Ari Nurhayatun, Evi Nurhidayati, Faiza Salsabila Parlindungan Siregar Putranto, Wachid Putro, Prasetyo Sarwono Septian, Muhammad Raditia Soewondo, Widiastuti Sunggoro, Agus Jati Susanto, Agung Suseno, Aryo Yusman, Felizia Alika