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All Journal Indonesian Journal of Kidney and Hypertension eJournal Kedokteran Indonesia
Rosmaliana, Rosmaliana
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Regulasi Autonom Berbasis Nervus Vagus terhadap Fungsi Jantung, Inflamasi, dan Kualitas Hidup Penderita Gagal Jantung Alparisi, Bima Diokta; Muzhaffar, Teuku Adib Bariq; Amalia, Nindy Putri; Haryadi, Haryadi; Rosmaliana, Rosmaliana; Amanda, Samira
eJournal Kedokteran Indonesia Vol. 13 No. 3 (2025): Vol. 13 No. 3 - Desember 2025
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.13.1092.1

Abstract

Gagal jantung dapat disebabkan oleh disregulasi saraf autonom yang berkontribusi terhadap remodelling ventrikel. Meta-analisis ini bertujuan untuk menganalisis dan membuktikan secara statistikefektivitas regulasi autonom berbasis nervus vagus dalam memengaruhi fungsi jantung, inflamasi, dankualitas hidup sebagai terapi alternatif non-farmakologi pada gagal jantung.  Tinjauan pustaka dilakukansesuai pedoman Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) dengan penyesuaian terhadap kriteria inklusi dan eksklusi ydengan kerangka People, Intervention, Comparison,Outcome (PICO). Pencarian literatur dilakukan pada bulan Maret 2024. Penilaian risiko bias melalui risk ofbias tool 2.0 (RoB 2.0) dan analisis statistik melalui RevMan 5.4. Sebanyak 7 artikel Randomize ControlledTrial dengan total 1028 subjek dianalisis. Metode ini signifikan terhadap fungsi jantung yaitu Left VentricularEnd-Systolic Volume  (LVESV, p=0,04), global longitudinal (p=0,0002) dan global sirkumstansial (p = 0,002), inflamasi (IL-8 p<0,00001 dan TNF-alpha p=0,0001), serta kualitas hidup MLHFQ score(Minnesota Living withHeart Failure Questionnaire,p=0,006) dan NYHA (New York Heart Association, p=0,02). Namun, tidaksignifikan terhadap komponen  denyut jantung (p=0,41), tekanan darah sistol (p=0,73) dan diastol (p=0,35),BNP (B-type Natriuretic Peptide, p=0,47), LVEF (Left Ventricular Ejection Fraction, p=0,59), LVEDV (LeftVentricular End-Diastolic Volume, p=0,92), e (p=0,11), rasio E/A (Early diastolic filling velocity/ Atrialcontraction filling velocity, p=0,74), efek samping (p=0,72) dan penurunan mortalitas (p=0,32). Regulasiautonom berbasis nervus vagus berpotensi meningkatkan beberapa aspek fungsi jantung, inflamasi, dankualitas hidup, sehingga dapat dipertimbangkan sebagai terapi non-farmakologis tambahan pada gagaljantung.
Finerenone in Diabetic-Kidney Disease, Renal and Cardiovascular Outcome: A Meta-Analysis of Independent Trial Registries Gracia, Felicita; Simanjuntak, Arya Marganda; Amanda, Samira; Mustika, Linda Ida; Juwanto, Juwanto; Sembiring, Ligat Pribadi; Karimi, Jazil; Harahap, Sari; Rosmaliana, Rosmaliana
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.224

Abstract

Background: Diabetic kidney disease (DKD) remains a frequent complication of type 2 diabetes, which significantly increases cardiovascular risk. Despite existing treatments, a substantial risk of disease progression still remains, leading to further exploration in Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist. Objective: This meta-analysis evaluates finerenone’s effects on the improvement of cardiorenal outcomes in DKD. Methods: A Systematic Review and Meta-Analysis (PROSPERO CRD420251122382) followed PRISMA guidelines. PubMed, ScienceDirect, and Epistemonikos utilized and used keywords “Finerenone AND Diabetes AND Chronic Kidney Disease AND Outcomes.” RCTs comparing finerenone to placebo in DKD, reporting renal or cardiovascular outcomes, were included. Data extraction covered study characteristics and outcomes. RevMan 5.4 analyzed data using a random-effects model. Risk of bias (RoB2) and certainty of evidence (GRADE-PRO) were assessed. Results: Three RCTs (19,027 participants) were included for renal outcomes, and two RCTs (13,026 participants) for cardiovascular outcomes. Finerenone significantly reduced the odds of sustained eGFR decline ≥40% (OR 0.83, p=0.0003) and≥57% (OR 0.86, p=0.0001), as well as the major composite kidney outcome (OR 0.76, p<0.0001). ESKD odds reduction (21%) was not statistically significant. For cardiovascular outcomes, finerenone significantly reduced hospitalization for heart failure (OR 0.78, p=0.0001). Trends towards reduced cardiovascular death (OR 0.88, p=0.09) were noted. Studies had low bias risk, and most outcomes showed moderate evidence certainty. Conclusions: Finerenone is associated with significant renoprotection and significantly reduces heart failure hospitalizations in DKD. Finerenone as an effective nonsteroidal mineralocorticoid receptor antagonist for comprehensive management, improving cardiorenal outcomes in this high-risk group.
Co-Authors Alparisi, Bima Diokta Amalia, Nindy Putri Amanda, Samira Gracia, Felicita Harahap, Sari Haryadi - Jazil Karimi Juwanto Juwanto Ligat Pribadi Sembiring Mustika, Linda Ida Muzhaffar, Teuku Adib Bariq Simanjuntak, Arya Marganda