Metalia Puspitasari
Division Of Nephrology, Department Of Internal Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta

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Albumin Description of Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients in Sardjito Hospital Yogyakarta Barkah Purwanto; Dewi Yuniasih; Metalia Puspitasari
Ahmad Dahlan Medical Journal Vol. 2 No. 1 (2021): May 2021
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1108.024 KB) | DOI: 10.12928/admj.v2i1.4086

Abstract

Albumin profile is an important sign of nutritional status as a quality-of life parameter, whereas hypoalbuminemia has been shown to be associated with a high mortality rate for patients with End Stage Renal Disease (ESRD) undergoing dialysis including CAPD. The study was conducted to determine serum albumin levels in patients with ESRD undergoing CAPD therapy. The study was conducted in a cross-sectional manner on ESRD patients who were still actively undergoing CAPD in the outpatient Installation of Dr. Sardjito Hospital Yogyakarta until November 2018. Subjects were examined for serum albumin levels. There were 57 research subjects with the category of albumin levels <3.5 g / dL as many as 19 (33.3%), between 3.5-4.0 g / dL as many as 27 (47.3%) and albumin levels> 4.0 g / dL of 11 (19.3%). There were no significant differences in all age groups, BMI and duration of CAPD. Albumin profile can be an independent parameter of quality of life and even a predictor of mortality in CAPD patients because it does not depend on age group, BMI and length of CAPD
Change in Serum Cystatin C Level as Predictor for Length of Hospital Stay in Patients Undergoing Primary Percutaneous Coronary Intervention Putra, Andika; Prasanto, Raden Heru; Puspitasari, Metalia
Acta Interna The Journal of Internal Medicine Vol 12, No 1 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98162

Abstract

Background. Percutaneous Coronary Intervention (PCI) is one of the most frequently performed medical procedures. Length of stay for patients after undergoing PCI should be standardized to achieve the best quality of health services. The existence of complications is one of the main factors considering the length of stay after PCI. Cystatin C has the ability as a predictor of complications in patients with acute coronary syndrome, especially those undergoing PCI, as well as the increase in length of stay associated with complications after the PCI procedure.Objectives. To determine the average changes in serum cystatin C levels, the correlation between serum cystatin C levels and length of treatment, and changes in serum cystatin C levels as predictors of length of stay in patients undergoing primary PCI at Dr. Sardjito Hospital.Methods. Analytical observational study with a prospective cohort method conducted on patients with a STEMI diagnosis who underwent primary PCI procedures in Emergency Room, Cardiovascular Care Unit (CVCU) of Dr. Sardjito Hospital, treated from November 2020 to April 2021. The data was then analyzed for normality, multicollinearity, bivariate, and multivariate tests to see the effect of changes in cystatin C and other variables on the length of stay for patients after primary PCI (p <0.05 is significant).Results. Of the 111 patients, 92 patients were subjected to further analysis. Patients included in the study had an average age of 59.55 (+10.80) years, majority of men, reduced LVEF, using trans-radial PCI access, Killip I, average eGFR of 64 ml / 1.73m2, length of stay in hospital is 5 days, delta cystatin C and creatinine 0.10 and 0.04 U / L, respectively. The increase in cystatin C had a moderate positive correlation (0.502) with the length of hospital stay (p<0.001), in multivariate analysis serum cystatin C does not correlate with length of hospital stay (p=0.590). Other variables including LVEF, eGFR, infection, and contrast-induced acute kidney injury had a significant correlation with length of stay (p<0.001). The multivariate test showed that LVEF, eGFR, and infection had the most significant correlation (p = 0.034; 0.001; 0.005 respectively) to the length of hospital stay with a regression coefficient of 0.72; -0.04; and 1.93.Conclusion. An increase of cystatin C serum does not correlate significantly with the length of hospitalization in STEMI patients undergoing PCI procedure in Dr. Sardjito Hospital.
Effect of Combination Hemodialysis Hemoperfusion on Lowering Leptin Level in Patients with Kidney Failure Receiving Routine Hemodialysis: A Multi-Center Study Naraswari, Ilsya Asti; Puspitasari, Metalia; Wardhani, Yulia
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101288

Abstract

Background: Leptin clearance during conventional haemodialysis (HD) has been found to be minimal or absent. Some authors reported the possibility of decreasing leptin serum levels with high flux membranes, but limited date are available. Leptin has been reported as a marker of inflammation and long-term complications such as cardiovascular events leading to increased quality of life deterioration. Haemodialysis hemoperfusion (HD+HP) has been reported to effectively decrease middle-sized and macromolecular toxin concentrations. In the present study, we compared the effectiveness of high-flux HD and HD + HP can effectively remove serum leptin levels, and is expected to reduce cardiovascular events in patients with kidney failure.Objective: To assess the influence of HD+HP therapy on serum leptin level in routine haemodialysis patients.Metode: Quasi experimental with pre and post exposure measurements in 26 kidney failure patients who received routine HD at three hospital sites were selected according to inclusion criteria and divided into intervention group (HD twice a week + Hemoperfusion once a week) and control group (HD twice a week). Serum leptin levels were compared before and after 8 weeks of therapy, and differences were then compared from each group.Result: Leptin levels reduced significantly (p = 0.017) in the control group (High-Flux HD). Serum leptin levels decreased in HD+HP group but there was no significant differences (p = 0.784). Significant differences were not observed between two modalities (HD and HD+HP) (p = 0.258).Conclusion: Haemodialysis plus hemoperfusion once a week for 8 weeks was not found effectively lowering leptin level compared high-flux HD alone.