AbstrakPopulasi lansia yang terus meningkat mengakibatkan semakin kompleksnya penyakit yang diderita dikarenakan penurunan fungsi organ-organ tubuh, salah satunya pembuluh darah. Pembuluh darah akan mengalami penurunan nitrit oksida yang menyebabkan aterosklerosis, sebagai penyebab utama terjadinya hipertensi. Perubahan gaya hidup dan faktor nutrisi berkaitan erat dengan kejadian hipertensi. Padahal, masyarakat Indonesia cenderung menyukai makanan sumber karbohidrat. Tujuan dari penelitian ini yaitu menganalisis hubungan konsumsi karbohidrat dengan tingkat tekanan darah pada lansia dengan sampel anggota aktif Karang Wreda Sriwijaya dan Semeru Jaya Sumbersari Jember sejumlah 47 sampel. Penelitian ini bersifat analitik observasional dengan metode cross sectional. Pada penelitian ini, sampel diwawancarai karakteristiknya (usia, jenis kelamin, riwayat hipertensi). Selanjutnya sampel diwawancarai untuk mengetahui pola konsumsi karbohidrat menggunakan metode Food Recall 24-jam sebanyak tiga kali di waktu yang berbeda dengan waktu maksimal 2 minggu dan diukur tekanan darahnya menggunakan sphygmomanometer air raksa. Hasil penelitian berdasarkan uji korelasi Spearman diperoleh nilai p=0,00 untuk konsumsi karbohidrat dengan tekanan darah sistolik dan p=0,02 pada diastolik. Kesimpulan dari penelitian ini adalah adanya hubungan antara konsumsi karbohidrat dengan tekanan darah sistolik dan diastolik. Kata kunci: konsumsi karbohidrat, tekanan darah, lansia Abstract The increasing population of elderly causes getting more complex illness because impairment in organ function, one of them is the blood vessels. Blood vessels will have decreased nitrite oxide that causes atherosclerosis, as
Chronic kidney diasease (CKD) is one of world health problem with increased incidence. Kidney function impairment contribute to cardiovascular complication that has been the main cause of CKD patient death. The impairment of cardiovascular function mainly caused by decreased of systolic left ventricular function. Stage V CKD patients need renal replacement therapy such as hemodialysis. Hemodialysis known to has positive effect on cadiovascular function by decreasing volume overload and uremic toxin. Echocardiography is a non-invasive method to assess cardiovascular function i.e. systolic left ventricular function. The aim of this study is to describe the improvement of systolic left ventricular function in stage V CKD patients after going through hemodialysis. The subject of this study are 30 patients, ≥18 years old diagnosed with Stage V CKD and undergo routine hemodialysis in RSD dr. Soebandi Jember. The data analyzed with Wilcoxon test and shown significance (p=0,000). This study concludes there is a significant improvement on systolic left ventricular function in CKD patients before and after hemodialysis in RSD dr. Soebandi Jember. Keywords: Systolic Left Ventricular Function, Hemodialysis, Chronic Kidney Disease, Echocardiography
ABSTRAKPenyakit ginjal kronik (PGK) stadium V banyak menyerang organ tubuh lain seperti organ jantung yang dapat menyebabkan terjadinya penyakit kardiovaskuler (PKV). Salah satunya PKV yang diakibatkan oleh PGK stadium V yaitu penurunan kinetik segmen ventrikel kiri. Penyakit kardiovaskuler terjadi karena kelebihan cairan dan penumpukan toksin uremik. Penyakit ginjal kronik stadium V tidak bisa disembuhkan sehingga memerlukan terapi yaitu hemodialisis (HD). Hemodialisis dapat mengurangi kelebihan cairan, toksin uremik, dan menjaga keseimbangan elektrolit pada PGK stadium V. Cairan yang membaik dan toksin uremik yang menurun dapat mengurangi beban jantung dan regangan sehingga pasokan darah ke area miokard tertentu meningkat dan kinetik segmen ventrikel kiri meningkat. Tujuan penelitian ini yaitu untuk mengetahui pengaruh HD terhadap perubahan kinetik segmen ventrikel kiri pada pasien PGK stadium V di RSD dr. Soebandi Jember. Desain penelitian yang digunakan adalah quasi-experimental one group pretest-postest design. Sampel penelitian berjumlah 30 pasien. Responden ditentukan dengan teknik nonprobability sampling dengan metode purposive sampling. Data yang digunakan yaitu data primer dan data sekunder. Analisis data menggunakan uji Wilcoxon. Berdasarkan hasil penelitian diperoleh distribusi sampel berdasarkan usia terbanyak pada rentang 45-54 tahun, berdasarkan jenis kelamin diperoleh perempuan lebih banyak, berdasarkan lama hemodialisis diperoleh jangka waktu terbanyak hemodialisis >24 bulan dan berdasarkan tekanan darah sebelum dan sesudah hemodialisis diperoleh pasien terbanyak mengalami hipertensi. Uji hipotesis menggunakan uji Wilcoxon didapatakan p-value = 0,000. Dari hasil analisis tersebut bisa diambil kesimpulan yaitu terdapat pengaruh hemodialisis terhadap kinetik segmen ventrikel kiri pada pasien PGK stadium V di RSD dr Soebandi Jember. ABSTRACT Chronic kidney disease (CKD) stage V attacks other organs such as heart that can cause cardiovascular disease (CVD
AbstrakPenyakit ginjal kronis stadium V merupakan penyakit yang ditandai dengan laju filtrasi glomerulus yang mencapai <15 ml/menit per 1,73m 2 . Hemodialisis merupakan salah satu terapi penyakit ginjal kronis stadium V tetapi menghabiskan dana terbanyak dibandingkan terapi lainnya. Penggunaan kembali dialyzer diharapkan dapat menurunkan biaya hemodialisis tetapi menggunakan kembali dialyzer dapat mempengaruhi hemodialisis karena terjadi perubahan permeabilitas, penurunan kualitas, serta perbesaran diameter pori-pori membran dialyzer yang menyebabkan hilangnya albumin serum, protein, lemak, dan glukosa. Berdasarkan analisis data yang meliputi pengukuran albumin serum, indeks masa tubuh dan tebal lemak kulit bisep dan trisep, tidak terdapat perbedaan yang signifikan dengan nilai signifikansi masing-masing adalah p=0,111 (albumin serum sebelum hemodialisis menggunakan dialyzer baru dan reuse), p=0,017 (albumin serum sesudah hemodialisis menggunakan dialyzer baru dan reuse), p=0,062 (selisih albumin serum sebelum dan sesudah hemodialisis menggunakan dialyzer baru dan reuse), p=0,183 (indeks masa tubuh sesudah hemodialisis menggunakan dialyzer baru dan reuse), p=0,326 (tebal lemak kulit bisep sesudah hemodialisis menggunakan dialyzer baru dan reuse), dan p=0,161 (tebal lemak kulit trisep sesudah hemodialisis menggunakan dialyzer baru dan reuse).Kata kunci: penyakit ginjal kronis stadium V, hemodialisis, albumin serum, indeks masa tubuh, tebal lemak kulit bisep dan trisep, dialyzer reuse Abstract Stage V chronic kidney disease is a kidney disease with a glomerular filtration rate that reaches <15 ml/minute per 1.73m2. Hemodialysis is one of the therapies for stage V chronic kidney disease but spends the most funds compared to other therapies. Reusing the dialyzer can reduce the cost of hemodialysis, but it can affect hemodialysis because of changes in permeability, decreased quality, and enlargement of the diameter of the dialyzer membrane which causes loss of serum albumin, protein, fat, and glucose. Based on the analysis data which included measurement of serum albumin levels, body mass index and biceps and triceps skinfold thickness, there were no significant differences with the significance values respectively p=0.111 (serum albumin level before hemodialysis using new and reuse dialyzer), p=0.017 (serum albumin level after hemodialysis using new and reuse dialyzer), p=0.062 (difference in serum albumin levels before and after hemodialysis using new and reuse dialyzer), p=0.183 (body mass index after hemodialysis using new and reuse dialyzer), p=0.326 and p=0.161 (biceps and triceps skinfold thickness after hemodialysis using new and reuse dialyzer).
Abstrake-Jurnal Pustaka Kesehatan, vol. 6 (no. 1), Januari 2018 97 Diagnosis of benign prostate hyperplasia (BPH) can be established through transabdominal ultrasonography (TAUS), a noninvasive supportive examination which measure prostate volume (PV), and intravesical prostatic protrusion (IPP Keywords: BPH, international prostate symptom score, transabdominal ultrasonographyDiagnosis dari benign prostate hyperplasia (BPH) dapat ditegakkan melalui pemeriksaan penunjang noninvasif transabdominal ultrasonography (TAUS) yang mengukur prostate volume (PV) dan intravesical prostatic protrusion (IPP). Beratnya gejala obstruksi yang dirasakan oleh pasien dinilai dengan kuesioner international prostate symptom score (IPSS). Penelitian ini bertujuan untuk mengetahui hubungan antara PV dan IPP terhadap IPSS pada pasien BPH. Penelitian analitik observasional dengan desain studi cross sectional yang dilaksanakan di poli bedah urologi RS Bina Sehat Jember, RS Paru Jember dan RS Bhayangkara Bondowoso selama bulan Oktober-November 2016 pada 30 responden. Rata-rata PV 52,01±25,18 mL, rara-rata IPP 12,67±6,69 mm, dan rata-rata skor IPSS 25,60±9,20. Hasil uji korelasi Spearman antara PV terhadap IPSS-Voiding, IPSS-Storage, dan total skor IPSS serta IPP terhadap IPSS-Voiding menunjukkan tidak ada korelasi yang bermakna (p=0,319; p=0,067; p=0,085; p=0,183). Uji korelasi Spearman antara IPP terhadap IPSS-Storage dan total skor IPSS memiliki nilai p=0,012 dan r=0,451 serta p=0,027 dan r=0,404 menunjukkan adanya korelasi yang bermakna dengan kekuatan korelasi sedang. Secara statistik IPP berkorelasi lebih baik terhadap skor IPSS dibandingkan dengan PV.
Stage V chronic kidney disease (CKD) patients need renal replacement therapy. Hemodialysis is main choice for renal replacement therapy and correlates with changes of left ventricular function. Left ventricular diastolic function is one parameter of left ventricular function. The aim of this study was to analyze the effect of hemodialysis towards left ventricular diastolic function in stage V CKD patients at RSD dr. Soebandi Jember. This study included 30 patients (17 female, age 48,20±8,02 years) and underwent echocardiography 30 min before and after a hemodialysis session. Sample characteristics were divided into sex, age, duration of hemodialysis, blood pressure before and after hemodialysis. Diastolic function was measured with E/E’ ratio. Diastolic function criteria of 16 samples (53,5%) were normal (E/E’ ratio <10) after doing a hemodialysis session. Mean ratio E/E’ was significantly reduced (13,09±4,55 vs 11,6±5,04, p<0,05). In conclusion, hemodialysis could increase left ventricular diastolic function in stage V CKD patients at RSD dr. Soebandi Jember.
Diazinon is the most commonly used pesticide in Indonesia. It may increase the production of free radicals that triggers the lipid peroxidation process which will produce the final product, MDA, which can damage cells and tissues, especially the kidneys. Neem gum with its high polysaccharide is a good antioxidant agent to neutralize free radicals. The purpose of this study was to determine the effect of neem gum administration to prevent the increase in kidney MDA levels of wistar rats induced by diazinon. Thirty wistar rats were divided into 6 groups, K0 (given cornoil), K1 (induced DZN 40 mg/kgBW), groups P1, P2, P3, and P4, administered with neem gum as a drinking water at a dose 3.75 g/kgBW, 7.5 g/kgBW, 15 g/kgBW, and 30 g/kgBW and induced by DZN 40 mg/kgBW. The treatment was carried out for 8 days, in which diazinon induction and neem gum solution were administered simultaneously. The average renal MDA levels are K0=20.85±1.10; K1=26.98±5.87; P1=26.84±3.75; P2=21.43±3.44; P3=20.23±3.27; P4=21.99±1.70. One Way ANOVA test showed a significant difference (p<0.05). The LSD posthoc test showed a significant difference in the treatment groups P2, P3, and P4 compared to the K1 group (p<0.05). This shows that the neem gum solution at a dose of 7.5 g/kgBW, 15 g/kgBW, and 30 g/kgBW can prevent the increase of kidney MDA level in wistar rats induced by diazinon. Keywords: Pesticide, oxidative stress, Antioxidant, Neem gum
Stage V Chronic Kidney Disease (CKD) is one of the most common medical case in the world. Stage V CKD defined as a condition where the renal function decrease progressively, marked by the GFR <15/ml/minute/1,73 m2, with or without kidney damage history for three months. Patients diagnosed with Stage V CKD often needs kidney replacement therapy, one of which is hemodialysis. The cost needed for hemodialysis was considered as too expensive, forcing lots of medical staff in most countries using the method known as re-use hemodialyzer. Re-use hemodialyzer is a term for using the same hemodialyzer (or hemodialysis machine) for the same patient but on a different therapy session. The main purpose for this research is to investigate the sodium level in patients with Stage V CKD whose using new and re-use hemodialyzer in Hemodialysis Installation of RSD dr. Soebandi Jember. Analytic Observational Study is used for this research combined with Cross Sectional Study in December 2018. Total of 19 samples chosen with inclusion and exclusion criteria. Collected data is analyzed using paired t-test. The conclusion that can be obtained from this research is that there is no significant difference between sodium level in patients with Stage V CKD whose using new and re-use hemodialyzer (p=0,904). The effectivity and quality of the hemodialyzer is thought to be the main factor for this result. Keywords: Chronic Kidney Disease, sodium, re-use hemodialyzer
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