23 research outputs found
PENGARUH PUASA RAMADAN TERHADAP MALONDIALDEHYDE, POLY (ADP RIBOSA) POLYMERASE, SIRTUIN 1, NUCLEAR RECEPTOR SUBFAMILY 1 GROUP D MEMBER 1 DAN TRANSFORMING GROWTH FACTOR BETA PADA PENYAKIT GINJAL KRONIS
No full textLatar Belakang: Penyakit ginjal kronis (PGK) merupakan masalah kesehatan global
dengan prevalensi yang terus meningkat. Penelitian ini bertujuan menganalisis
pengaruh puasa Ramadan terhadap biomarker penting pada pasien PGK. Metode:
Penelitian kohort prospektif dilakukan pada 30 pasien PGK stadium 1, 2, dan 3A yang
menjalani puasa Ramadan. Pengukuran kadar MDA, PARP, SIRT1, NR1D1, dan TGFβ dilakukan sebelum puasa, 2 minggu selama puasa, dan setelah puasa menggunakan
metode ELISA. Hasil: Terjadi penurunan signifikan pada kadar ureum, glukosa darah
puasa, HbA1C, dan asam urat (p<0,05). MDA dan SIRT1 menurun secara signifikan
(p<0,001), sementara PARP dan NR1D1 meningkat signifikan (p<0,001). TGF-β juga
menunjukkan penurunan. Tidak ada perubahan signifikan pada profil lipid, kreatinin,
dan albumin.
Kesimpulan: Puasa Ramadan memiliki efek signifikan pada beberapa parameter
biokimia dan marker biologis pada pasien PGK stadium awal. Perubahan ini
menunjukkan potensi perbaikan pada stres oksidatif, autofagi sel, regulasi inflamasi,
dan irama sirkadian. Penelitian lebih lanjut diperlukan untuk mengevaluasi efek jangka
panjang dan implikasi klinis dari temuan ini dalam manajemen PGK
Intoksikasi Alkohol Akibat Minuman Keras Oplosan
No full textThe incidence of alcoholic liquor poisoning (alcoholic liquor) in Indonesia shows a high number. One of the causes of alcohol poisoning is methanol. Methanol poisoning in Indonesia usually occurs as a result of drinking mixed alcohol liquor. It has been reported a male 23 years old with decreased consciousness after drinking oplosan alcohol suspected to contain methanol. The examination reveals that patients has metabolic acidosis, toxic optic neuropathy (TON) and erosive gastritis. Treatment was acidosis correction, prevent formation of metabolites, hemodialysis with supportive and symptomatic teraphy .
Keywords: methanol, poisoning, alcohol mixed liquo
Intoksikasi Alkohol Akibat Minuman Keras Oplosan
No full textThe incidence of alcoholic liquor poisoning (alcoholic liquor) in Indonesia shows a high number. One of the causes of alcohol poisoning is methanol. Methanol poisoning in Indonesia usually occurs as a result of drinking mixed alcohol liquor. It has been reported a male 23 years old with decreased consciousness after drinking oplosan alcohol suspected to contain methanol. The examination reveals that patients has metabolic acidosis, toxic optic neuropathy (TON) and erosive gastritis. Treatment was acidosis correction, prevent formation of metabolites, hemodialysis with supportive and symptomatic teraphy .Keywords: methanol, poisoning, alcohol mixed liquo
Beyond Serum Creatinine: Urinary KIM-1 as a Predictive Biomarker for Subclinical Acute Kidney Injury and Chronic Kidney Disease Progression: A Systematic Review and Meta-Analysis
No full textBackground: The global burden of chronic kidney disease (CKD) is escalating, requiring earlier and more precise diagnostic modalities. Traditional reliance on serum creatinine and glomerular filtration rate (GFR) creates a significant blind spot regarding structural tubular integrity. A dangerous diagnostic window known as subclinical acute kidney injury (AKI) exists when tubular damage progresses despite preserved filtration function. This study aims to systematically analyze the diagnostic accuracy of urinary kidney injury molecule-1 (uKIM-1) in detecting subclinical injury and quantify its predictive value for CKD progression in populations where serum creatinine fails to provide an early warning.
Methods: A systematic review and meta-analysis of five pivotal studies were conducted, encompassing experimental models of ischemia-reperfusion and human cohorts involving Autosomal Dominant Polycystic Kidney Disease (ADPKD), Diabetic Nephropathy, and Contrast-Induced AKI. Data were synthesized using random-effects models to calculate Standardized Mean Differences (SMD) and pooled Hazard Ratios (HR) to assess the prognostic value of uKIM-1 for long-term renal decline.
Results: The analysis demonstrated that uKIM-1 levels remained significantly elevated during apparent functional recovery where serum creatinine had returned to baseline. In experimental models, persistent uKIM-1 elevation correlated strongly with histological evidence of interstitial fibrosis (r > 0.70). Clinical cohorts revealed that elevated KIM-1 is a robust independent predictor of progression to ESRD, with hazard ratios ranging from 1.34 to 3.30. Pooled analysis showed a Risk Ratio of 2.45 (95% CI: 1.55 – 3.88; p < 0.0001).
Conclusion: Urinary KIM-1 serves as a sensitive and specific biomarker for subclinical tubular injury, identifying the at-risk"phenotype missed by creatinine. Its persistent elevation signifies maladaptive repair and predicts the transition from AKI to CKD, supporting its clinical integration for early risk stratification
Biomarker Acute Kidney Injury (AKI) pada Sepsis
No full textSepsis didefinisikan sebagai infeksi bersama dengan manifestasi sistemik dari infeksi. Sepsis berat adalah penyebab 50% kasus acute kidney injury (AKI) pada pasien kritis. Patofisiologi cedera ginjal akut (AKI) pada sepsis disebabkan oleh respon inflamasi, toksin dan perubahan hemodinamik glomerulus. Tingkat keparahan disfungsi ginjal tergantung pada tingkat keparahan sepsis. Perubahan laju filtrasi glomerulus (GFR) adalah fenomena AKI yang terlambat. Diagnosis AKI dengan mengukur kreatinin serum. Sayangnya, kreatinin adalah indikator yang kurang dapat diandalkan selama perubahan akut pada fungsi ginjal. Munculnya penanda biologis baru dalam lingkup AKI sangat membantu bagi dokter untuk dapat mendiagnosa awal AKI. Penanda biologis AKI bisa menjadi komponen serum atau urin. Penanda biologis urin menjanjikan untuk mendeteksi awal AKI, sehingga dapat berguna untuk diagnosis dini
The Emerging Role of Integrins in Diabetic Kidney Disease: A Systematic Review and Meta-Analysis of Their Diagnostic and Prognostic Utility for Early Risk Stratification
No full textBackground: Current biomarkers for diabetic kidney disease (DKD), notably albuminuria and eGFR, are markers of established renal damage, limiting opportunities for early intervention. Integrins, cell-matrix adhesion receptors integral to podocyte health, are emerging as potential upstream indicators of the initial injury that drives DKD. This systematic review and meta-analysis provide the first quantitative synthesis of the evidence on the diagnostic and prognostic utility of integrins in DKD.
Methods: Following PRISMA guidelines, we systematically searched PubMed, Scopus, Embase, and Web of Science for studies published up to July 2025. We included studies that evaluated integrins in urine, serum, or tissue for the diagnosis of early DKD (microalbuminuria) or for predicting disease progression. Data were pooled using bivariate random-effects models for diagnosis and generic inverse variance models for prognosis.
Results: Eight studies involving 2,874 patients met the inclusion criteria. For diagnosing early DKD, five studies (n=1,880) yielded a pooled sensitivity of 0.88 (95% CI: 0.82-0.92) and specificity of 0.85 (95% CI: 0.79-0.90). The area under the summary receiver operating characteristic curve was 0.91 (95% CI: 0.88-0.94), indicating excellent accuracy. A subgroup analysis of non-invasive samples (urine/serum) demonstrated similarly high performance. For prognosis, three prospective studies (n=1,224) showed that elevated baseline integrins were associated with a significantly increased risk of disease progression (pooled Hazard Ratio: 2.15, 95% CI: 1.65-2.79) over a median 5-year follow-up.
Conclusion: Based on the current, albeit limited, evidence, integrins show significant promise as highly sensitive and specific biomarkers for the early detection and potent predictors for the progression of DKD. While these preliminary findings require validation in larger cohort studies, the measurement of non-invasive integrins may represent a valuable future tool for improving early DKD risk stratification
The Role of Immunophenotyping in the Diagnosis of Acute Leukemia: A Narrative Literature Review
No full textLeukemia is the expansion of leukocyte cells in the bone marrow, which results in an increase in the number of leukocyte cells in the blood circulation and abnormal cell proliferation in the lymphatic tissue. The diagnosis of leukemia is established based on anamnesis, physical examination, and laboratory and confirmed by supporting examinations such as bone marrow aspiration to immunophenotyping. This literature review aimed to describe the role of immunophenotyping in the diagnosis of acute leukemia. The working process of immunophenotyping consists of a group of cells stained with a fluorochrome-conjugated antibody as a dye that is targeted to antigens on the cell surface. Most of these antigens are assigned a cluster of differentiation (CD) numbers. In conclusion, immunophenotyping analysis using multiparameter flow cytometry is an essential tool in detecting leukemia. Immunophenotyping examination is very useful for determining the diagnosis of leukemia. Targeted therapy is one of the modalities of leukemia therapy that is selective for certain cells that can be given based on the results of immunophenotyping
Effect of Ramadan Fasting on DNA Repair, Immune System, Inflammation and Cognitive Function in Chronic Kidney Disease Patients: A Systematic Literature Review
No full textBackground: There have been many studies that say Ramadan fasting has a positive effect on reducing BMI, blood sugar, inflammatory factors, and DNA Repair. However, there are still no guidelines for fasting in patients with chronic kidney disease (CKD) both nationally and internationally. This study aimed to conduct a review to explore the effects of Ramadan fasting against chronic kidney disease, specifically on DNA repair, Immune System, Inflammation, and Cognitive Function in patients with chronic kidney disease.
Methods: This study is a systematic literature review (SLR) with sources obtained from various reputable journal databases such as PubMed, Cochrane Library, EBSCO, and Elsevier using relevant keywords. The selected articles have passed the inclusion and exclusion criteria. A total of 39 articles that discuss fasting were obtained from Ramadan in chronic kidney disease patients on metabolic response and inflammatory markers in the body.
Results: Ramadan fasting has a positive effect on the response to anti-inflammatory, expression of protective genes, markers of kidney and liver function, protective proteome, and oxidative stress.
Conclusion: Ramadan fasting may provide a short-term protective effect against levels of systemic inflammation
β2-Microglobulin: A Powerful Biomarker for Chronic Kidney Disease Progression
No full textBackground: Chronic kidney disease (CKD) is a global health concern with increasing prevalence. Early detection and accurate prognosis are crucial for effective management. β2-microglobulin (β2M) has emerged as a promising biomarker in CKD, but its prognostic value requires further evaluation. This meta-analysis aimed to comprehensively assess the association between β2M and CKD progression.
Methods: A systematic search of PubMed, Embase, and Cochrane Library was conducted for studies published between 2013 and 2024 investigating the relationship between β2M and CKD progression. Studies were included if they reported hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between β2M levels and renal endpoints (e.g., end-stage renal disease [ESRD], doubling of serum creatinine, or a decline in estimated glomerular filtration rate [eGFR]). A random-effects model was used to pool the HRs.
Results: Six eligible studies involving 5,420 participants were included. The pooled analysis demonstrated a significant association between elevated β2M levels and increased risk of CKD progression (HR = 2.15; 95% CI: 1.78-2.59; p < 0.001). Subgroup analyses revealed that this association remained consistent across different CKD stages and underlying etiologies.
Conclusion: Elevated β2M is a strong and independent predictor of CKD progression. Its incorporation into clinical practice may improve risk stratification and guide therapeutic interventions in CKD patients
The Effectiveness of Antiplatelet Therapy in COVID-19 Patients: A Narrative Literature Review
No full textCoagulopathy is a feature of severe COVID-19 disease and contributes to an increased risk of thromboembolic complications and death. This literature review aimed to describe the effectiveness of antiplatelet therapy in COVID-19 patients. There is an inverse relationship between the likelihood of COVID-19 infection, duration of illness and death, and use of antiplatelets for primary prevention. A study showed that COVID-19 patients who did not receive antiplatelet drugs had three times the risk of dying with antiplatelet drugs. This study shows the strong effect of antiplatelet drugs on reducing the mortality rate of COVID-19 patients. Another study showed that COVID-19 patients who received antiplatelet drugs had 1.18 times the risk of dying than those without antiplatelet drugs. This study shows that antiplatelet therapy does not affect the reduction in mortality in patients hospitalized with COVID-19. In conclusion, the effectiveness of antiplatelet administration in COVID-19 patients is still unclear, so further research is needed
