Hypertension may lead to complications of kidneys and blood vessels. Measurement of urea, creatinine, and platelet indices can be markers of renal function and endothelial dysfunction in hypertensive patients. This study aimed to analyze the profile and correlation between renal function parameters such as urea and creatinine and platelet indices (MPV, PDW, and PCT) with blood pressure in hypertensive patients. One hundred and thirty-third hypertensive patients treated at Wahidin Sudirohusodo Hospital from April to July 2019 were involved in this cross-sectional study. Researchers collected demographic data, blood pressure degrees (based on ESC 2018), systolic and diastolic blood pressure, and urea, creatinine, and platelet index value (MPV, PDW, and PCT) data from the medical record. Descriptive analysis, Spearman test, Fisher exact test, and Kruskal-Wallis test were used confidence interval of 95%. A total of 133 participants were involved in this research. There were significant difference between the mean age (p=0.023), MPV (p=0.032), and PCT (p=0.019) to the degree of hypertension, while gender (p=0.185), urea (p=0.106), creatinine (p=0.498), platelet (p=0.094) and PDW (0.826) showed no significant difference. The bivariate correlation test showed that urea (rs= -0.232 p=0.007) and creatinine (rs= -0.180 p=0.038) had a positive correlation with systolic blood pressure. Platelets index, MPV (rs=0.285 p=0.001), and PDW (rs=0.179) were positively correlated to systolic blood pressure. Also, urea levels and creatinine were positively correlated with MPV value. There was an increase in MPV along with the increase of urea, creatinine. An increase in MPV could be a predictor of endothelial damage and the risk of atherothrombosis.
Diabetic nephropathy is one of the fairly severe Diabetes Mellitus (DM) complications and the main cause of renal failure that can result in mortality. Hyperglycemia in DM induces kidney injury that may result in hemodynamic and metabolic alterations, endothelial dysfunction and inflammatory cells activation. A persistent and continuous inflammation is observed in diabetic nephropathy. One of the inflammation process progression indicators is Neutrophil-Lymphocyte Ratio (NLR). To find out the relationship between NLR and decreased Glomerular Filtration Rate (GFR) in diabetic nephropathy. This study was an observational study with a retrospective approach. This study was conducted in Clinical Pathology Laboratory Installation and Medical Record Installation of Dr. Wahidin Sudirohusodo Makassar Hospital by collecting the patient’s data during February 2015 to February 2016. Patients that were diagnosed as type 2 DM without diabetic nephropathy complication were taken as control and those diagnosed as type 2 DM with diabetic nephropathy were treated as study subjects. One hundred and thirteen (113) samples met the inclusion criteria, consisting of 73 diabetic nephropathy patients with Chronic Kidney Disease (CKD) 13 diabetic nephropathy patients without CKD and 27 type 2 DM patients without diabetic nephropathy complication. Patients consisted of 57 males (50.4%) and 56 females (49,6%). Neutrophil-lymphocyte ratio and GFR values in the group of diabetic nephropathy without CKD were 2.03±0.68 and 85.38±24.63, respectively. Whereas, the NLR and GFR values in control group were 1.74±0.54 and 90.03±28.60, respectively. In the group of diabetic nephropathy with CKD, NLR value increased by 3.19±1.83 and GFR decrease by 30.54±16.45. Spearman test indicated a significant relationship between NLR increase and decreased GFR (r = -0.635, p=0.00). There is a significant relationship between NLR increase and decreased GFR in patients with diabetic nephropathy.
Pleural effusion is excessive pleural fluid accumulation in the aimed pleural cavity, are categorized into exudate and transudate. Light’s criteria (1972) has become a classic criteria to distinguish pleural effusion types. Other criteria were evaluated such as pleural fluid uric acid. The aimed of this study was to analyze the difference of uric acid level between transudate and exudate and to compare it with Light’s criteria. A cross-sectional study was conducted in Clinical Pathology Laboratory of the Dr. Wahidin Sudirohusodo Hospital Makassar in September 2016. Uric acid level of pleural effusion samples was measured by ABX Pentra 400. Statistical analysis used Mann-Whitney U test, significance was indicated if p<0.05. Cut-off, sensitivity and specificity of uric acid used ROC curve. Total subjects were 56 patients, mean age 49.54+13.63 years-old, 31 males (55.4%) and 25 females (44.6%). Most cases were exudative effusion (58.9%) with 19 malignancy cases (33.9%). Uric acid level median was 6.6 mg/dL (3.24-17.50 mg/dL) higher in transudate than exudate 5.01 mg/dL (0.6-9.40 mg/dL) (p=0.001). The cut-off point for pleural fluid uric acid was 5.845 mg/dL, with a sensitivity of 78.3% and specificity of 66.7%. Sensitivity and specificity of Light’s criteria was 97% and 60.9%. There was a significant difference between pleural fluid uric acid level in transudate and exudate, higher in transudate than exudate. Light’s criteria were higher in sensitivity than uric acid, but lower in specificity. Further research is needed with better sampling method to reduce bias.
Cytokine release syndrome and Acute Respiratory Distress Syndrome (ARDS) increase the incidence of Acute Kidney Injury (AKI) in COVID-19 patients, which is associated with a poor prognosis and risk of death. The purpose of this study was to analyze urea, creatinine, and eGFR values as predictors of mortality in COVID-19 patients. A retrospective cohort study was carried out using secondary data from medical records of 311 COVID-19 patients who were treated at the Hasanuddin University State Higher Education Hospital from August 2020 to August 2021. Data were analyzed using the Mann-Whitney test, Chi-Square, and Logistic Regression. The risk of mortality for COVID-19 patients with urea levels > 53 mg/dL was 5.128 times higher than that of urea levels ‰ 53 mg/dL (OR=5.128; CI =2.530 – 10.391, p<0.001). The risk of mortality for COVID-19 patients with creatinine levels > 1.3 mg/dL was 2.696 times higher than that of creatinine levels ‰ 1.3 mg/dL (OR= 2.696; CI = 1.330 – 5.463, p<0.001). The risk of mortality in COVID-19 patients with an eGFR < 90 mL/min/1.73 m2 was 3.692 times higher than that of an eGFR ‰ 90 mL/min/1.73 m2 (OR=3.692; CI = 2.134 – 6.389, p<0.001). Multiple logistic regression analysis showed that urea and eGFR were better predictors of mortality than creatinine (OR= 0.374, p=0.002 vs. OR 0.344, p=0.007 vs. OR 1.192, p=0.694). The COVID-19 patient group with high serum urea and creatinine levels and low eGFR values had a greater risk of mortality compared to the group of patients who had normal results. Urea levels and eGFR values were better predictors of mortality than serum creatinine.
Background: Chronic renal failure (CRF) is a clinical syndrome caused by a chronic decrease and gradual progression in kidney function. One of the complications of CRF can cause hypoalbuminemia. Hemodialysis can also cause hypoalbuminemia associated with inflammation and malnutrition due to loss of protein during dialysis. This study aims to analyze the albumin levels in pre and post hemodialysis CRF patients in Dr. Wahidin Sudirohusodo Hospital, Makassar.Methods: A retrospective study with cross sectional study design using secondary data obtained from the medical record was conducted among 50 patients at Dr. Wahidin Sudirohusodo Hospital, Makassar. Pre and post hemodialysis serum albumin levels of CRF patients from the Medical Record Installation were collected during September 2017 – 2018 period. Variables assessed in this study were gender, age, albumin levels, and the comparison of albumin levels based on gender. Data were analyzed using SPSS version 22 for Windows.Results: There were 52.0% male and 48.0% of female patients in this study. Most of the respondents were age 40-49 years old interval (30.0%). There was no significant difference in albumin levels between pre (3.07±0.63 g/dL) and post (3.05±0.54 g/dL) HD patients (p=0.665). Also, There was no significant difference in albumin levels in pre and post HD patients between male (p=0.434) and female (p=0.778).Conclusion: There were no significant differences between serum albumin levels pre and post hemodialysis in patients with CRF as well as based on gender.
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