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All Journal Medical Journal of Indonesia Paediatrica Indonesiana Indonesian Journal of Rheumatology Indonesian Journal of Cardiology Indonesian Journal of Kidney and Hypertension Jurnal Penyakit Dalam Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Pringgodigdo Nugroho, Pringgodigdo
Divisi Ginjal Hipertensi, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Polisitemia Sekunder pada Pasien Laki-Laki Muda dengan Sindrom Nefrotik Wardhani, Ariani Intan; Nugroho, Pringgodigdo; Rinaldi, Ikhwan; Sarasawati, Meilania; Miranda, Monik Ediana; Harahap, Agnes Stephanie
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 4
Publisher : UI Scholars Hub

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Abstract

Polycythemia is a condition characterized by an abnormal increase in the total red blood cell mass and is classified into primary and secondary polycythemia. Secondary polycythemia occurs as a physiological response to tissue hypoxia or increased erythropoietin production, without intrinsic abnormalities in erythroid progenitor cells. This condition is rare, particularly when associated with nephrotic syndrome. This report aims to describe a case of secondary polycythemia associated with focal segmental glomerulosclerosis (FSGS). A 20-year-old man presented with generalized edema for five months prior to admission, accompanied by foamy urine. Physical examination revealed peripheral edema and minimal ascites. Laboratory investigations demonstrated massive proteinuria and elevated hemoglobin levels. Renal biopsy confirmed the diagnosis of FSGS, while bone marrow biopsy showed normocellular findings without evidence of malignancy or fibrosis. The patient was treated with methylprednisolone, ramipril, and simvastatin, and underwent four sessions of phlebotomy along with antiplatelet therapy. Following treatment, there was improvement in hemoglobin levels, proteinuria, and blood pressure control. Secondary polycythemia has been reported to be associated with various parenchymal kidney diseases, including FSGS. The proposed mechanisms include increased erythropoietin production due to renal ischemia or dysregulation of erythropoiesis feedback mechanisms. Phlebotomy is an important therapeutic intervention to prevent complications related to hyperviscosity and thromboembolism and has been shown to result in clinical improvement. This case illustrates a rare occurrence of secondary polycythemia in a patient with nephrotic syndrome due to FSGS. Accurate diagnosis and comprehensive management, including phlebotomy, can lead to meaningful clinical improvement. This report is expected to contribute to the literature on the diagnosis and management of secondary polycythemia in kidney disease.
Short-Term Survival and Prognostic Factors in Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study Bundjali, Muhammad Trihatmowijoyo; Marbun, Maruhum Bonar Hasiholan; Rajabto, Wulyo; Rinaldi, Ikhwan; Shatri, Hamzah; Partiningrum, Dwi Lestari; Makmun, Dadang; Nugroho, Pringgodigdo; Koesnoe, Sukamto; Soewondo, Pradana
Kesmas Vol. 21, No. 1
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Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic blood pressure <110 mmHg (hazard ratio [HR] 3.354; 95% confidence interval [CI]: 2.346–4.795; p-value <0.001) and interdialytic weight gain ≥5% (HR 1.685; 95% CI: 1.125–2.521; p-value <0.011) as significant predictors of decreased survival. Other variables, including age, urea, albumin, vascular access, baseline creatinine, and cancer stage, were not significantly associated with short-term survival. These findings underscore the critical role of salt and fluid management, adherence to dietary and dialysis regimens, and close monitoring of weight in improving outcomes. Interventions targeting modifiable factors may improve the survival of cervical cancer patients who require HD. Such approaches, therefore, warrant further investigation.
Urinary screening for early detection of kidney disorders in asymptomatic Indonesian adolescents Ferry Liwang; Reza Fahlevi; Henny Puspitasari; Eka Hidayati; Sudung Pardede; Pringgodigdo Nugroho
Paediatrica Indonesiana Vol. 66 No. 3 (2026): May 2026
Publisher : Indonesian Pediatric Society

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Abstract

Background Chronic kidney disease (CKD) in children, with global incidence ranging from 15–74.7 cases per million, can lead to lifelong sequelae and impose a significant healthcare burden. In Indonesia, Survei Kesehatan Indonesia 2023 showed that among individuals aged 15–24 years, 0.02% had CKD, and 16.2% of those with CKD underwent hemodialysis. Given that the early stages are frequently asymptomatic, urinary screening provides a simple, non-invasive method for early detection and prevention of future deterioration in kidney function. Objective To measure the prevalence of abnormal urinary findings in healthy, asymptomatic Indonesian adolescents aged 12–18 years using dipstick testing and microscopic urinalysis. Methods Over a 2-year period (2023–2024), we screened healthy, asymptomatic adolescents aged 12–18 years using spot (non–first-morning) urine specimens. Urine dipstick and microscopic tests were performed. Data collected included clinical characteristics and urine findings. Abnormalities such as isolated proteinuria, hematuria, leukocyte esterase, nitrite, and crystals were analyzed. Results Among 406 subjects (55.9% male; median age 15.67 years), 17% had isolated proteinuria, 14.3% had isolated hematuria, and 5.9% had both. Microscopic analysis revealed erythrocytes ≥3/hpf in 3.4% of subjects, and proteinuria +3 in 0.5% of subjects. Leukocyte esterase and nitrite were positive in 10.6% and 1.2% of subjects, respectively, though only 18.6% of leukocyte esterase–positive cases had leukocyte sediment >5/hpf. Abnormal crystals were found in 29.6% of cases, mainly associated with high urine specific gravity or urate crystals. Conclusion Proteinuria and hematuria, markers of early kidney damage, are detectable in asymptomatic adolescents. Routine urinary screening should be considered for Indonesian adolescents to facilitate early diagnosis and intervention.
Faktor Risiko yang Berhubungan dengan Kejadian Gangguan Ginjal Akut pada Pasien COVID-19 di RSUPN Dr. Cipto Mangunkusumo Ikapratiwi, Radita; Nugroho, Pringgodigdo; Herikurniawan, Herikurniawan; Widhani, Alvina; Rinaldi, Ikhwan; Yamin, Muhammad; Ariane, Anna; Wafa, Syahidatul
Jurnal Penyakit Dalam Indonesia
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Introduction. Coronavirus disease 2019 (COVID-19) affects not only the respiratory system but also cause systemic complications, including acute kidney injury (AKI). The occurrence of AKI in COVID-19 patients is associated with increased mortality and morbidity. Global data indicate that AKI occurs in approximately 4,3–50,6% of hospitalized COVID-19 patients, particularly among the elderly and those with comorbidities. This acute impairment of kidney function may worsen the course of the disease and increase the burden on hospital services. This study aimed to determine the proportion of AKI and analyze the risk factors associated with the occurrence of AKI in COVID-19 patients at Dr. Cipto Mangunkusumo National General Hospital. Methods. This was an analytical observational study with a cross-sectional design using medical records of adult COVID-19 patients admitted to Dr. Cipto Mangunkusumo National General Hospital from April 2020 to March 2022. Samples were selected using a consecutive sampling method. The main outcome assessed was the occurrence of acute kidney injury and its association with age, sex, hypertension, diabetes, cardiovascular disease, obesity, severity of COVID-19, procalcitonin levels, CRP levels, and D-dimer levels. Data were analyzed using univariate, bivariate, and multivariate logistic regression analyses. Results. Out of 422 subjects analyzed, 113 patients (26.8%) developed AKI. Multivariate analysis showed that age ≥60 years (PR = 2.18; 95% CI: 1.26–3.77; p = 0.005), hypertension (PR = 1.88; 95% CI: 1.06–3.37; p = 0.03), elevated procalcitonin levels (PR = 4.48; 95% CI: 2.56–7.84; p < 0.001), cardiovascular disease (PR = 4.84; 95% CI: 2.57–9.11; p < 0.001), and obesity (PR = 2.52; 95% CI: 1.46–4.33; p = 0.001) were significantly associated with the occurrence of AKI. Conclusions. The proportion of AKI among COVID-19 patients at Dr. Cipto Mangunkusumo National General Hospital was relatively high. Age > 60 years, hypertension, elevated procalcitonin > 0,18, cardiovascular disease, and obesity are risk factors associated with the occurrence of AKI in COVID-19 patients.
Co-Authors Adhiatma, Kresna Agnes Stephanie Harahap Ahani, Ardhi Rahman Aida Lydia Alvina Widhani, Alvina Anna Ariane, Anna Antono, Akbarbudhi Ardhi Rahman Ahani Ari Fahrial Syam Ari Fahrial Syam Arshita Auliana Arshita Auliana Birry Karim Bundjali, Muhammad Trihatmowijoyo Cleopas Martin Rumende Dadang Makmun Danasasmita, Gantira David Santosa Dicky Levenus Tahapary Dono Antono Dwi Lestari Partiningrum Dyah Purnamasari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Eka Ginanjar Eka Laksmi Hidayati, Eka Laksmi Em Yunir Em Yunir Em Yunir, Em Endang Susalit Endang Susalit Erni J. Nelwan, Erni J. Evy Yunihastuti Farid Kurniawan Farid Kurniawan, Farid Farida Isroani Farissa Luthfia Ferry Liwang Gantira Wijayakusumah Danasasmita Grecia Rachmaningrum Hakim, Manfaluthy Hendra Dwi Kurniawan Hendra Dwi Kurniawan, Hendra Dwi Henny A. Puspitasari Herikurniawan, Herikurniawan Ikapratiwi, Radita Ikhwan Rinaldi Imam Subekti Iris Rengganis Khie Chen Krishna Adi Wibisana Krishna Adi Wibisana, Krishna Adi Kuntjoro Harimurti Luthfia, Farissa Marbun, Maruhum Bonar Hasiholan Marcel Prasetyo Marshell Tendean Marshell Tendean Maruhum B.H. Marbun Miranda, Monik Ediana Muhammad Yamin Nunuk Mardiana, Nunuk Nuriawan, Sazkia Aziza Panggabean, Marulam MP Pradana Soewondo Prima Yuriandro Rachmaningrum, Grecia Reza Fahlevi Ridwan Rasyid Robert Sinto Rudi Putranto Rudy Hidayat Samsuridjal Djauzi Samsuridjal Djauzi Santosa, David Sarasawati, Meilania Sazkia Aziza Nuriawan Subekti, Imam Sudung Pardede Sukamto Koesnoe Sulistianingsih, Dyah Purnamasari Syahidatul Wafa, Syahidatul Tri Juli Edi Tarigan Virnanda Amu, Ivan Wardhani, Ariani Intan Wardoyo, Elizabeth Y Wismandari Wisnu Wulyo Rajabto Yoga Yuniadi