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INDONESIA
Ina Kidney
Published by Indonesian Society of Nephrology (InaSN)
ISSN : -     EISSN : eISSN265     DOI : http://inakidneyhypertension.co.id
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
Indonesian Journal of Kidney and Hypertension is an open accessed online scientific journal managed and published by Perhimpunan Nefrologi Indonesia/Indonesian Society of Nephrology (Pernefri/InaSN). This journal aims to publish peer-reviewed scientific articles to provide novel scientific information in nephrology and hypertension. Authors are encouraged to submit research articles, case reports, evidence-based case report, and review articles that focus in the field of nephrology and hypertension. The subjects eligible for publication include, but not limited to: Chronic kidney disease Electrolyte and pH imbalance Hyperparathyroidism CKD-MBD Anemia Acute kidney injury Renal replacement therapy (dialysis, transplant) Hypertension Onconephrology Nephrotic and nephrtitic syndromes Glomerulonephritis and other glomerulopathy
Arjuna Subject : Kedokteran - Nephrology
Articles 35 Documents
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Estimated Glomerular Filtration Rate and Sleep Quality in Stage 3-5 Non-Dialysis Chronic Kidney Disease Patients: Is There a Correlation? Umboh, Octavianus; Palar, Stella; Moeis, Emma Syarifih
Indonesian Journal of Kidney and Hypertension Vol 1 No 2 (2024): Volume 1 No. 2, August 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i2.136

Abstract

Background: Chronic kidney disease (CKD) is a growing health issue that significantly affects patients' quality of life. CKD patients are prone to sleep disturbances, which can lead to chronic fatigue and a decrease in their quality of life. The Pittsburgh Sleep Quality Index (PSQI) is a parameter that can be used to assess the sleep quality of CKD patients. Objective: This study aims to determine the relationship between estimated glomerular filtration rate (eGFR) and sleep quality in non-dialysis CKD patients. Methods: The research design is an observational analytic study with a cross-sectional approach. The research subjects were stage 3-5 non-dialysis CKD patients aged 18 to 60 years at Prof. Dr. R. D. Kandou Hospital Manado from March to May 2022. The sleep quality of CKD patients was assessed using the PSQI score. Data analysis was performed with a significance level of p < 0.05. Results: A total of 30 patients with stage 3-5 non-dialysis CKD were found. They consisted of 20 males and 10 females, aged 38-59 years, with an average of 59.80 ± 9.86 years. In the normality test using Shapiro-Wilk, the patient samples were not normally distributed (p = .000). For statistical analysis using the Spearman test, a negative correlation was found between eGFR and PSQI scores (r = -0.554), which was statistically significant (p = 0.002). Conclusion: This study found a significant relationship between eGFR and PSQI scores, which shows that a decrease in eGFR worsens the sleep quality of non-dialysis CKD patients.
Severe Clinical Impact of Multiple Wasp Stings: A Case Report of Acute Kidney Injury Fauziyah, Hana; Nasution, Bayu Rusfandi; Nasution, Alwi Thamrin
Indonesian Journal of Kidney and Hypertension Vol 1 No 2 (2024): Volume 1 No. 2, August 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i2.137

Abstract

Wasp stings are prevalent in Indonesia and have occasionally resulted in fatalities. Wasp stings can potentially induce a small localized allergic response, systemic reactions, or even life-threatening illnesses. Receiving several stings from wasps can cause systemic inflammation, resulting in acute kidney injury. We present a case of a 51-year-old female who experienced severe renal impairment as a result of repeated wasp stings. Following the stings, the patient promptly obtained medical attention. However, on the second day after the incident, the patient's renal function declined and experienced anuria. The ultrasonography indicates the presence of nephritis. The patient presented with 103 sting wounds, which resulted in local reactions and were accompanied by systemic symptoms. The patient was administered high-dose steroids and underwent five intermittent hemodialysis sessions, which effectively restored their kidney function. Evidence of enhanced renal function was demonstrated through the restoration of normal urine production, elevated glomerular filtration rate, and significant clinical improvements in the patient. This case illustrates the severe impact on the kidney of a generalized wasp sting and the effect of promptly receiving medical treatment following an enormous wasp sting on the patient's prognosis. Initiating dialysis promptly is crucial for rapidly eliminating toxins and thus preserving renal function.
A Review of Central Vein Catheter for Hemodialysis: Insertion Sites and Techniques Susanto, Jefri Pratama; Rifai, Achmad
Indonesian Journal of Kidney and Hypertension Vol 1 No 2 (2024): Volume 1 No. 2, August 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i2.139

Abstract

Chronic kidney disease (CKD) is a global epidemic, being increasingly prevalent in both developed and developing countries, including Indonesia. Hemodialysis (HD) is the primary renal replacement therapy, along with peritoneal dialysis and kidney transplantation. The effectiveness of HD relies on well-functioning vascular access, such as central vein catheters (CVCs). These catheters are classified by their duration of use: short-term, medium-term, and long-term. They are also distinguished by insertion type (central or peripheral), insertion site (jugular, subclavian, femoral), and number of lumens (single, double, triple). The preferred site for insertion is the internal jugular vein, followed by the femoral vein and the subclavian vein. Techniques for CVC insertion include the central approach, the posterior approach, and others. This article reviews the role of CVC for vascular access in HD. Specifically, various CVC insertion sites and techniques will be examined. The authors will also discuss the available research on the application of CVC as vascular access for HD in Indonesia.
Contemporary Issues in Kidney Disease: Addressing Acute Kidney Injury and Inflammation Nugroho, Pringgodigdo
Indonesian Journal of Kidney and Hypertension Vol 1 No 2 (2024): Volume 1 No. 2, August 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i2.145

Abstract

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The Determinants of Detrimental Changes in Pulse Pressure During Maintenance Hemodialysis Treatments Damayanti, Ratna; Kuswadi, Iri; Prasanto, Raden Heru; Puspitasari, Metalia; Wardhani, Yulia; Kuswadi, Danny Pratama
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.128

Abstract

Background: Studies indicate that large fluctuations in pulse pressure during hemodialysis are associated with cardiovascular events, cardiovascular mortality, and all-cause mortality. Objective: We investigated the determinants of detrimental changes in pulse pressure (ΔPP) during hemodialysis. Methods: This prospective, observational cohort study was conducted from 1 to 30 April 2023 at Dr. Sardjito Hospital Yogyakarta, involving maintenance hemodialysis patients for ≥ 6 months. Patients were categorized into group 1 (detrimental ΔPP, ΔPP >5 mmHg or <−25 mmHg) and group 2 (stable ΔPP, −25 to 5 mmHg). Mann-Whitney, independent-t, chi-square, Fisher exact tests, and logistic regression were applied to evaluate associations between ΔPP groups and clinical variables. Results: This study involved 136 patients, 75 males (55.1%) with a mean age of 52 (18-87). The most common comorbid was hypertension, present in 85 patients (62.5%). The mean hemodialysis vintage of patients was 47.2 (6.5-330.7) months. We found significant difference between group in post-dialysis systolic blood pressure (SBP) (p=0.003), pre-dialysis diastolic blood pressure (DBP) (p=0.015), post-dialysis DBP (p=0.007), ultrafiltration (p=0.041), pre-dialysis mean-arterial-pressure (MAP) (p=0.013), post-dialysis MAP (p=0.002), and alpha-blocker treatment (p=0.037). Multivariate logistic regression analysis shows a significant association between groups of ΔPP with pre-dialysis DBP (p=0.035; OR=1.153; OR=Exp(10xℬ) =4.137) and post-dialysis SBP (p=0.007; OR=1.052; OR=Exp(10xℬ) =1.6487). Conclusion: Our study demonstrates that group 1, with detrimental changes in pulse pressure during hemodialysis, was found to have higher post-dialysis DBP, pre-dialysis DBP, post-dialysis SBP, pre-dialysis MAP, post-dialysis MAP, alpha-blocker treatment, and ultrafiltration, with significant association with post-dialysis SBP and pre-dialysis DBP.
Acute Kidney Injury with Characteristics of Rapidly Progressive Glomerulonephritis Due to Suspected IgA Nephropathy: A Case Report Putri, Sandra Yuliana Andini; Aditiyaputri, Nadhila; Oetomo, Amanukarti Resi
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.141

Abstract

Acute kidney damage (AKI) in glomerular disease is typically characterized by rapidly progressive glomerulonephritis (RPGN). RPGN in IgA nephropathy is uncommon, occurring in less than 10% of patients. RPGN presents diagnostic issues in resource-limited settings. A 34-year-old male patient had acute kidney injury with RPGN characteristics based on clinical symptoms of hypertension, pitting edema, anuria, and hematuria after an upper respiratory tract infection, as well as laboratory findings of proteinuria, persistent microscopic hematuria, and positive erythrocyte casts. Serum creatinine levels rose sharply. Corticosteroids, antihypertensives, and hemodialysis resulted in clinical improvement and fast kidney function recovery. Due to limited resources, no kidney biopsy was conducted. This case provides a diagnostic approach to RPGN in IgA nephropathy in resource-limited settings, along with comprehensive therapy.
Observational Study on How the Frequency of Dialyzer Reuse Impacts Hemodialysis Effectiveness Wicaksono, Ramadi Satryo; Gunawan, Atma; Samsu, Nur; Rifai, Achmad
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.152

Abstract

Background: The increasing practice of dialyzer reuse in hemodialysis raises critical concerns regarding its impact on efficacy, infection risks, and essential metrics such as Urea Reduction Ratio (URR) and Kt/V values. Addressing these concerns is paramount to establishing safe and optimal reuse limits through comprehensive performance assessments. Objective: To evaluate the feasibility of dialyzer reuse by assessing Kt/V and URR measurements. Methods: A prospective cohort study was conducted at RSUD Dr. Saiful Anwar's Hemodialysis Unit from November 2021 to January 2022. Data collection employed a standardized pilot form designed to collate Kt/V and URR data from all participants. Statistical analyses included repeated measures ANOVA to detect temporal changes in average Kt/V and URR, alongside Spearman correlation analysis to explore variable relationships. Results: The study encompassed 15 participants, revealing a statistically significant decline in both Kt/V and URR values across each reuse group (p < 0.05). Specifically, each subsequent reuse of the dialyzer corresponded to a decrement of 0.0469 units in Kt/V and 1.003 units in URR. Notably, by the 7th reuse, hemodialysis adequacy remained satisfactory, achieving an average Kt/V of 1.61. Furthermore, the study indicated that even up to 11 reuses could achieve a Kt/V > 1.4. Similarly, the average URR value for the 7th reuse was 70.207%, with the potential to maintain URR > 65% even after up to 13 reuses. Conclusion: This study unequivocally affirms that hemodialysis adequacy remains satisfactory up to the 7th reuse of dialyzers, despite observed declines in Kt/V and URR values over successive reuses.
Characteristics and Clinical Outcomes of COVID-19 in ESRD Patients Undergoing Hemodialysis in Ngudi Waluyo Wlingi General Hospital in 2020-2022 Wijayanto, Fajar Hadi; Insanitaqwa, Aleyda Zahratunany; Mawaddah, Syarifiyana
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.156

Abstract

Background: The coronavirus disease (COVID-19) pandemic is a major threat to global health care. Comorbidities, including end-stage renal disease (ESRD), are related to an increased risk of severe infection and mortality. Objective: To assess determinants related to the clinical outcomes of COVID-19 in ESRD patients undergoing hemodialysis in Ngudi Waluyo Wlingi General Hospital in 2020-2022. Methods: This study included ESRD patients undergoing maintenance hemodialysis who were hospitalized at Ngudi Waluyo Wlingi General Hospital due to COVID-19 from May 2020 to February 2022. Clinical characteristics were investigated in relation to the severity and survival status. Results: A total of 26 patients (46.15% male) with a mean age of 52.27±13.65 years met the inclusion criteria. Of these, 42.3% had a mild infection, 23% had a moderate infection, 30.77% had a severe infection, and 3.8% had a critical infection. The mortality rate was 23.08%, with a mean length of stay of 15.19±7 days. Age, oxygen saturation, respiratory rate upon admission, lymphocyte and neutrophil levels, and neutrophil-to-lymphocyte ratio were significantly associated with COVID-19 severity. Length of stay was statistically influenced by respiratory rate upon admission. The mortality rate was correlated with the dialysis vintage, levels of hemoglobin, leukocytes, platelets, neutrophils, neutrophil-to-lymphocyte ratio, serum urea, serum creatinine, eGFR, and length of stay. Conclusion: COVID-19 in ESRD patients undergoing hemodialysis were more likely to have a poor prognosis. Identifying determinants is crucial for reducing morbidity and mortality.
Association Between Fluid Administration and Hemoglobin Changes During Perioperative Kidney Transplantation Sanyoto, Arundina; Widiana, I Gde Raka; Mahadita, Gede Wira; Kandarini, Yenny; Ayu, Nyoman Paramita; Erawan, I Gusti Ngurah Agung Tresna
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.157

Abstract

Background: Chronic Kidney Disease (CKD) is a leading cause of mortality worldwide, particularly in Indonesia, so it requires effective treatment options like kidney transplantation. Optimal fluid therapy during the perioperative period is important for stable hemodynamics and graft function. However, guidelines for fluid administration remain lacking. Objective: This study investigates the association between fluid therapy and changes in hemoglobin levels in patients undergoing renal transplantation. Methods: A retrospective observational cross-sectional study was conducted at RSUP Prof. DR. I.G.N.G. Ngoerah Denpasar from January 2016 to August 2024. Data were collected from medical records of patients who underwent kidney transplantation, excluding those with incomplete data. Key variables included daily fluid intake and hemoglobin levels. The coefficient of variance was calculated and continued with correlation analyses utilizing Pearson correlation and linear regression to assess relationships between fluid administration and hemoglobin changes. Results: Of 28 patients, 10 met inclusion criteria, consisting of 4 males and 6 females. Analysis showed a strong correlation between the variance of fluid intake and the variance of hemoglobin levels (R = 0.86; R² = 0.74; P < 0.001). Conclusion: This study demonstrates a significant relationship between post-operative variance of fluid administration and variance of hemoglobin levels following kidney transplantation. It may have an impact on the management of post-operative reduction in hemoglobin levels.
Pathogenesis of Immune-Mediated Glomerulonephritis Samsu, Nur
Indonesian Journal of Kidney and Hypertension Vol 1 No 3 (2024): Volume 1 No. 3, December 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i3.158

Abstract

Most forms of glomerulonephritis (GN) are characterized by a pathogenic immune response, which is mediated by the action of various immune system elements, both innate and adaptive. What is clear is that the immunopathogenesis of GN is very broad and complex. Deposits of immune complexes in the glomeruli activate complement and glomerular injury due to the involvement of circulating inflammatory cells and glomerular intrinsic cells, ultimately resulting in a wide variety of clinical manifestations, which depend in part on the location and immunopathology of the patient, including genetic and environmental factors, from asymptomatic to rapidly progressive GN. Most of the treatment strategies for GN are non-specific, consisting of corticosteroids and cytotoxic agents. Thus, an advanced understanding of GN immunopathogenesis may offer many opportunities for future therapeutic interventions on an individual basis. To further facilitate understanding of the pathogenesis of GN, the author also includes a graphical abstract.

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