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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Ina Kidney
Wangsa, Syahpri Putra
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Nephrogenic Ascites in End-Stage Renal Disease Patients Undergoing Hemodyalisis: Case Series Mulia, Deddy Primadona; Irawan, Rico; Kartika, Herleni; Wangsa, Syahpri Putra; Akbar, Kgs. M. Yusuf Arief; Effendi, Ian; Suhaimi, Novadian; Slamet, Suprapti; Ali, Zulkhair
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.121

Abstract

Ascites occurring in individuals with chronic kidney disease (CKD) undergoing hemodialysis (HD) are referred to as nephrogenic ascites (NA). The pathogenesis of NA remains uncertain but involves many interrelated factors. These factors include inadequate dialysis, low ultrafiltration, poor nutrition, increased peritoneal membrane permeability, and impaired peritoneal lymphatic reabsorption. Frequent accompanying complaints are leg edema, nausea, decreased appetite, weakness, and complaints due to hypotension during HD. NA generally carries a poor long-term prognosis, likewise, with complex therapeutic options, both medical and surgical. Management of NA includes education regarding fluid restrictions, a high protein diet, intensive HD, as well as therapeutic modalities with continuous ambulatory peritoneal dialysis (CAPD) and kidney transplantation. CAPD has been proven to improve quality of life and recovery from ascites. The NA in this case report was all related to the patient's low level of compliance against fluid intake restrictions, particularly while experiencing oliguria or anuria. In this case, intensive education regarding limiting fluid intake and high-protein nutrition seems essential for better patient outcomes. On the other hand, the presence of infectious complications gives poor outcomes. Two patients presented with umbilical hernia, which could be an obstacle for CAPD.
Renal Amyloidosis: A Narrative Literature Review Wangsa, Syahpri Putra; Novadian Suhaimi; Zulkhair Ali; Suprapti Slamet; Ian Effendi; Kgs M Yusuf Arief Akbar; Deddy Primadona Mulia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i11.889

Abstract

Amyloidosis is a disorder in which soluble proteins aggregate and are deposited extracellularly in tissues as insoluble fibrils, causing progressive organ dysfunction. Amyloid fibril formation begins with misfolding of amyloidogenic precursor proteins. The fibrils have a characteristic appearance by electron microscopy and produce double refraction under polarized light when stained with Congo red dye. Classification of amyloidosis is based on the precursor proteins that form amyloid fibrils and the distribution of amyloid deposition both systemically and locally. The main form of systemic amyloidosis; AL amyloid, AA amyloidosis, ATTR amyloid. The kidney is the organ most frequently involved in systemic amyloidosis. Systemic amyloidosis may originate from anomalous proteins, such as immunoglobulin light chains or serum amyloid protein in chronic inflammation or may arise from hereditary disorders. The clinical manifestations of renal amyloidosis vary with the type of amyloid protein and the location and extent of amyloid deposition. Treatment of amyloidosis should be a two-part process; managing symptoms and reducing or stabilizing amyloid protein. Treatment of amyloidosis is focused on reducing the production of amyloidogenic proteins and inhibiting their aggregation.
Co-Authors Akbar, Kgs. M. Yusuf Arief Deddy Primadona Mulia Effendi, Ian Ian Effendi Irawan, Rico Kartika, Herleni Kgs M Yusuf Arief Akbar Mulia, Deddy Primadona Novadian Suhaimi Slamet, Suprapti Suhaimi, Novadian Suprapti Slamet Zulkhair Ali