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"Latar belakang: Tingkat keparahan cedera ginjal iskemia-reperfusi (I/R) berhubungan erat dengan tingginya angka kesakitan dan kematian. Hasil penelitian terdahulu pada manusia dan hewan telah mebuktikan bahwa Neutrophil Gelatinase Associated Lipocalin (NGAL) dapat mendeteksi dan memprediksi terjadinya cedera ginjal I/R dini. Tujuan penelitian ini adalah untuk membuktikan bahwa peningkatan kadar NGAL serum dan urin berhubungan dengan kerusakan epitel tubuli ginjal pada tikus yang mengalami iskemia reperfusi dini.Metode: Peneltian ini menggunakan 28 ekor tikus Sprague-Dawley jantan sebagai hewan model, dikelompokkan dalam 4 kelompok: sham 4 jam (Sham 4), sham 8 jam (Sham 8), iskemia 10 menit reperfusi 4 jam (I/R 4), dan iskemia 10 menit reperfusi 8 jam (I/R 8). Analisis kadar kreatinin serum diperiksa dengan metode Jaffe, sedangkan NGAL serum dan urin menggunakan metode ELISA Direct Sandwich. Evaluasi tingkat kerusakan jaringan ginjal dilakukan secara semi kuantitatif pada sediaan histologi dengan pulasan HE. Deskripsi kelainan tingkat seluler ginjal diperjelas melalui evaluasi menggunakan mikroskop elektron dan Imunohistokimia (IHK).Hasil: Kadar NGAL serum berkorelasi bermakna dengan tingkat kerusakan ginjal (ρSpearman NGAL serum = 0,701, p < 0,001), juga kadar NGAL urin berkorelasi bermakna dengan tingkat kerusakan ginjal (ρSpearman = 0,689, p < 0,001). Tingkat ekspresi NGAL lebih tinggi pada kelompok I/R dibanding sham (t-test, t = -26635,046, p < 0,001), juga tingkat kerusakan ginjal tikus (t-test, t = -5,028, p < 0,001), dan kadar NGAL serum dan urin pada kelompok I/R berbeda nyata dibanding sham (Mann-Whitney, U = 0, p < 0,001). Pada cutoff point 136,95 ng/mL dan 58,69 ng/mL berturut ? turut untuk NGAL serum dan urin diperoleh sensitivitas = 1, spesifisitas = 1.Kesimpulan: Peningkatan kadar NGAL serum dan urin berkorelasi dengan kerusakan epitel tubuli ginjal pada tikus yang mengalami cedera ginjal iskemia reperfusi dini.

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Background: The severity of ischemia-reperfusion (I/R) kidney injury is highly correlated with mortality and morbidity rate. Research on human and animal prove that NGAL predicts kidney injury at early phase. The objective of this study is to prove that the increase in serum and urinary NGAL are correlated with kidney tubular epithelial damage, and this increase has occurred in initiation phase, indicated by rat kidney histopathology in an early I/R model.

Methods: Twenty eight male Sprague-Dawley rats were divided into 4 groups: 4 hour sham (Sham 4), 8 hour sham (Sham 8), 10 minute ischemia 4 hour reperfusion (I/R 4) and 10 minute ischemia 8 hour reperfusion (I/R 8). Blood, urine and kidney samples were collected. Serum creatinine level was analyzed with Jaffe method, while serum and urinary NGAL level were analyzed with direct sandwich ELISA method. Evaluation of kidney damage were measured semi quantitatively in tissue stained with HE. Further evaluation to confirm cellular changes on kidney was performed by electron microscope and immunohistochemistry.

Results: Serum NGAL was found significantly correlated with degree of kidney tissue damage (ρSpearman NGAL serum = 0.701, p < 0.001), also urinary NGAL (ρSpearman = 0.689, p < 0.001). NGAL expression differs significantly between I/R group and sham (t-test, t = -26635.056, p < 0.001), also kidney damage (t-test, t = -5.028, p < 0.001), and serum and urinary NGAL levels (Mann-Whitney, U = 0, p < 0.001). With cutoff points of 136.95 ng/mL and 58.69 ng/mL subsequently for serum and urinary NGAL , it is found that sensitivity = 1, specificity = 1.

Conclusion: Elevation of serum and urinary NGAL are significantly correlated with epithelial tubular kidney damage on rat undergoing early ischaemia reperfusion."

"Latar Belakang: Tujuan penelitian untuk melihat neutrophil gelatinase associated lipocalin (NGAL) pada pasien sepsis. Dimana NGAL merupakan biomarker yang dini untuk acute kidney injury (AKI). Metode Penelitian Penelitian kualitatif dengan desain uji diagnostik Pengambilan sampel secara cross sectional dan consecutive sampling pada 50 orang anak yang sepsis yang terdiri dari 28 sepsis, 22 sepsis berat di ruang rawat intensif anak di RS. Ciptomangunkusomo Jakarta dan RS.Wahidin Sudirohusodo Makassar. Hasil: Kadar NGAL urin pada pasien sepsis berat lebih tinggi dibandingkan sepsis. Nilai sensitifitas NGAL urin 100% dan spesifisitas 63,63%. NGAL urin meningkat lebih dulu bila dibandingkan dengan kreatinin serum. Kesimpulan NGAL dapat dipakai sebagai petanda dini terjadinya AKI.

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Introduction: The aim of this study to observe the neutrophil gelatinase associated lipocalin (NGAL) in pediatric sepsis. From previous study NGAL was early biomarker for AKI. Methods. This study is a qualitative study for diagnostic test. Sample was collected by cross sectional and consecutive sampling on 50 sepsis children, consist of 28 sepsis, 22 severe sepsis in pediatric intensive care unit Ciptomangunkusomo Hospital Jakarta and Wahidin Sudirohusodo Hospital Makassar.

Result: The value of urinary NGAL in severe sepsis is higher than sepsis. The Sensitivity and specificity is 100% and 63,63% this study suggest that urinary NGAL increase earlier than serum creatinine. Conclusion. Therefore urinary NGAL can be used as early biomarker for AKI."

"Latar belakang Sisplatin merupakan pengobatan utama untuk karsinoma nasofaring KNF , tetapi berpotensi menimbulkan nefrotoksisitas. Selain kadar BUN dan kreatinin serum, KIM-1 dan NGAL diduga cukup sensitif untuk mendeteksi nefrotoksisitas. Penelitian ini bertujuan untuk mengevaluasi kadar KIM-1 dan NGAL dalam urin untuk mendeteksi gangguan fungsi ginjal pada pasien KNF stadium lanjut yang mendapatkan kemoterapi berbasis sisplatin.Metode: Penelitian ini merupakan penelitian kohort prospektif. Subyek penelitian dibagi dalam 3 kelompok: pasien yang belum pernah terpapar dan yang sudah pernah mendapatkan kemoterapi berbasis sisplatin 75-100 mg/m serta pasien yang belum pernah mendapatkan kemoterapi sisplatin dan kemudian diberi sisplatin 40 mg/m 2 . Kadar KIM-1, NGAL dalam urin serta kadar BUN dan kreatinin dalam serum diukur pada saat sebelum dan sesudah mendapatkan sisplatin pada ketiga kelompok. Analisis statistik yang digunakan adalah uji ANOVA, uji Pearson, Spearman, Kolmogorov-Smirnov dan SPSS versi 22,0.Hasil: Terdapat perbedaan selisih kadar BUN yang bermakna antara sebelum dan sesudah diterapi pada ketiga kelompok p=0.0001 . Perbedaan selisih kadar NGAL dalam urin pada penelitian ini juga berbeda bermakna antara sebelum dan sesudah diterapi terhadap ketiga kelompok p=0,025 , tetapi ada perbedaan rerata pada sepasang kelompok yang bermakna hanya didapatkan pada kelompok yang belum pernah dikemoterapi 40 mg/m 2 dan kelompok yang sudah pernah diberi kemoterapi 75-100 mg/m 2 p=0,02. Perbedaan selisih kadar KIM-1 tidak bermakna pada ketiga kelompok p=0,275.Kesimpulan: Sisplatin menunjukkan akumulasi nefrotoksisitas yang tergantung pada dosis dose-dependent manner . Pengukuran kadar NGAL dalam urin dapat mendeteksi nefrotoksisitas tahap dini, tetapi belum bisa menggantikan peran BUN. Pengukuran kadar KIM-1 dalam urin tidak dapat mendeteksi gangguan fungsi ginjal.

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Background: Cisplatin is the main treatment for nasopharyngeal carcinoma NPC with a potency of causing nephrotoxicity. In addition to serum BUN and creatinine levels, KIM 1 and NGAL levels is assumed to be quite sensitive in detecting nephrotoxicity. The study was aimed to evaluate urinary KIM 1 and NGAL level to detect kidney dysfunction in patients with advanced stage NPC who received cisplatin based chemotherapy.

Method: The study was a cohort prospective study. Subjects were categorized into 3 groups, i.e. patients who had never received and who had received 75 100 mg m2 cisplatin based chemotherapy as well as those who had never received any cisplatin based chemotherapy and were subsequently received 40 mg m cisplatin. The levels of urinary KIM 1, NGAL and serum level of BUN and creatinine were measured before and after receiving cisplatin in the three groups. Statistical analysis used in our study were ANOVA, Pearson, Spearman, KolmogorovSmirnov test and SPSS version 22.0.

Results: There was a significant difference of delta BUN level before and after treatment in all three groups p 0.0001 . Delta urinary NGAL level was also significantly different between before and after treatment in all groups p 0.025 however, a significant mean difference of a pair group was only found between those who never had 40 mg m 2 chemotherapy and those who had received 75 100 mg m 2 chemotherapy p 0.02 while delta KIM 1 level showed no significant difference in all three groups p 0.275.

Conclusion: Cisplatin may cause accumulated nephrotoxicity, which has dosedependent manner. Measuring urinary NGAL level can detect an early stage of kidney dysfunction however, it still cannot replace the role of BUN. Measurement of urinary KIM 1 level cannot detect kidney dysfunction."

"Latar Belakang: Tuberkulosis paru (TB) masih menjadi salah satu penyebab morbiditas dan mortalitas di seluruh dunia. Dalam dua dekade terakhir penyakit TB resisten obat (TBRO) telah muncul sebagai ancaman bagi kesehatan masyarakat seluruh dunia. NGAL merupakan partikel granulosit neutrofil yang mengalami pematangan dan menjadi gelatinase. NGAL terlibat dalam kekebalan bawaan untuk menghalangi bakteri mengambil zat besi untuk pertumbuhan. Pada pasien dengan komorbid anemia akan terjadi penurunan kekebalan bawaan sehingga pada TBRO dengan anemia bakteri Mtb akan mendapat zat besi dari tubuh manusia untuk bereplikasi. Namun masih belum terdapat data kadar protein serum NGAL pada pasien TBRO dengan anemia.Metode : Penelitian ini merupakan penelitian analitik observasional menggunakan desain potong lintang yang dilakukan di poliklinik dan ruang rawat inap MDR RSUP Persahabatan pada bulan Juli-September 2023. Jumlah subyek penelitian adalah 73 pasien TBRO yang belum memulai pengobatan dengan anemia dan tanpa anemia yang memenuhi kriteria inklusi dan eksklusi. Sampel darah subyek diambil sebanyak 3cc.Serum darah diambil lalu disimpan dalam lemari es suhu -200C. selanjutnya dilakukan pemeriksaan ELISA teknik sandwich dan diambil kadar protein NGAL. Variabel lainnya diambil dari rekam medis RSUP Persahabatan.Hasil : Pada penelitian ini didapatkan pasien TBRO dengan anemia memiliki IMT yang menunjukkan tingkat malnutrisi yang bermakna (p:0,026, OR 2,9(1,1-7,5). Penelitian ini juga mengidentifikasi peningkatan jumlah neutrofil (p:0,002, OR 0,2(0,06-0,5) dan penurunan jumlah limfosit (p:0,006, OR (4,2 (1,4-9,8) pada kelompok pasien anemia, yang tercermin dalam NLR yang meningkat (p:0,028, OR 0,3(0,09-0,9). Hasil yang ditemukan juga menunjukkan bahwa pasien TBRO dengan anemia memiliki lesi paru yang lebih luas secara statistik (p:0,048, OR 2,7(0,9-7,3). Kadar NGAL menunjukkan hasil median 82,76 (67,59) yang lebih tinggi dibandingkan dengan kelompok pasien TBRO anemia dan kelompok TBRO tanpa anemia 59,24(91,98) namun tidak bermakna (p: 0,26). Terdapat korelasi yang bermakna kadar NGAL dengan leukosit (r:0,295, p:0,011), neutrofil (r:0,297, p:0,011), limfosit (r:-0,343,p:0,003) dan NLR (r:0,336,p:0,004).Kesimpulan: Terdapat peningkatan kadar NGAL pada pasien TBRO dengan anemia dibandingkan tanpa anemia namun tidak bermakna secara statistik.

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Background: Pulmonary tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide. In the last two decades, drug-resistant tuberculosis (DR-TB) has emerged as a global health threat. NGAL is a neutrophil granulocyte- derived protein that undergoes maturation and becomes gelatinase. NGAL is involved in innate immunity by blocking bacteria from acquiring iron for growth. In patients with anemia, there is a reduction in innate immunity, in patient DR-TB with anemia allowing Mtb bacteria to obtain iron from the human body for replication. However, there is currently no data on serum NGAL protein levels in DR-TB patients with anemia.

Methods: This study is an observational research using a cross-sectional design conducted in the outpatient clinic and inpatient ward of MDR RSUP Persahabatan in July-September 2023. The research subjects were 73 subject DR-TB patients who not yet started treatment with or without anemia and met the inclusion and exclusion criteria. Blood samples of the subjects were collected as much as 3cc. The blood serum was separated and stored in a -20°C freezer. Furthermore, ELISA examination using the sandwich technique was performed, and NGAL protein levels were measured.

Results: In this study, DR-TB patients with anemia had BMI indicating significant malnutrition (p: 0.026, OR 2.9(1.1-7.5). This study also identified an increase in the number of neutrophils (p: 0.002, OR 0.2(0.06-0.5) and a decrease in the number of lymphocytes (p: 0.006, OR 4.2(1.4-9.8) in the anemia patient group, as reflected in the increased NLR (p: 0.028, OR 0.3(0.09-0.9). The findings also showed that DR-TB patients with anemia had statistically larger lung lesions (p: 0.048, OR 2.7(0.9-7.3). NGAL levels showed a higher median result between the DR-TB patient group with anemia 82,76 (67,59) and the group without anemia 59,24 (91,98), but it was not statistically significant (p: 0.26). NGAL have significant corelation among leukocyte (r:0,295, p:0,011), neutrophil (r:0,297,p:0,011), limphocyte (r:-0,343,p:0,003) and NLR (r:0,336,p:0,004)

Conclusion: There is a increase in NGAL levels in DR-TB patients with anemia compared to those without anemia. However, this findings do not reach statistical significance."

"ABSTRAKLatar Belakang : Para pekerja yang melakukan aktivitas fisik di lingkungan panas tinggi dapat mengalami gangguan pada ginjal. Selain glomerulus, bagian tubulointerstium yang memiliki fungsi penting reabsorsi dan sekresi, diduga juga mengalami gangguan. Ingin diketahui lebih lanjut ada tidaknya gangguan pada sel tubulus ginjal para pekerja setelah 4 jam pajanan panas tinggi melalui pemeriksaan NGAL urin yang lebih spesifik.Metode : Desain penelitian ini adalah baseline study dan pre-post study.Dilakukan di bagian hotpress outsole pabrik sepatu di Tangerang bulan April 2015. Data primer didapat melalui wawancara, pemeriksaan langsung tinggi dan berat badan serta pengambilan sampel NGAL urin dilakukan 2 kali, sebelum dan sesudah 4 jam kerja terpajan tekanan panas tinggi (29,0 oC - 31,05 oC ISBB). Untuk pemeriksaan kadar NGAL menggunakan kit komersial (Quantikine kit Human Lipocalin-2/NGAL Immunoassay).Hasil : 68 pekerja memenuhi kriteria inklusi penelitian dan 100 % adalah laki-laki berusia 20-40 tahun yang sehat. Didapatkan nilai NGAL urin awal sebelum terpajan panas antara 0.03 ng/ mL ? 12,82 ng/mL dengan median 1.52 ng/mL. Dari pemeriksaan setelah 4 jam kerja terpajan panas terdapat 25 responden (36,8% ) mengalami kenaikan nilai NGAL dalam urin dengan median kenaikan sebesar 0,35 mg/dL sedangkan 43 responden (63,2%) tidak mengalami kenaikan nilai NGAL dalam urin .Simpulan: Tidak terdapat peningkatan yang dianggap bermakna pada rerata nilai NGAL dalam urin para pekerja pabrik yang tepajan tekanan panas tinggi selama 4 jam kerja.

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ABSTRACT

Background : Workers performing physical activities in heat-stress environment could have kidney disorder. Beside glomerulus, tubulointerstitium which has important function of reabsorption and secretion, is suspected to also have injury. Further exploration on the impact on kidney tubules cells on the workers after 4 hours exposed to heat-stress through more specific examination of urine NGAL (uNGAL).

Method : Design of this research are baseline study and pre-post study, conducted at the hotpress outsole department at a shoe factory in Tangerang in April 2015. Primary data obtained through interview, direct examination on height and weight and taking sample of uNGAL twice time, before and after 4 hours of moderate working activities in the area of high heat-stress (29,0 oC - 31,05 oC WGBT) . Examining NGAL level by using commercial kit (Quantikine kit Human Lipocalin-2/NGAL Immunoassay).

Result : 68 workers fit with criteria inclusion study and 100% are healthy men aged between 20-40 years. The result of uNGAL initial scores are between 0.03 ng/ mL ? 12,82 ng/mL with median of 1.52 ng/mL. After 4 hours of moderate working activities in the area of high heat-stress there are 25 workers ( 36,8% ) have increase uNGAL level with median of 0,35 mg/dL, while the other 43 workers (63,2%) have not.

Summary : There is no significant changes of urine NGAL score after 4 hours of working within worker population in the area of high heat-stress."

"Latar Belakang. Mortalitas akibat sepsis di ICU masih cukup tinggi meskipun telah semakin cepatnya diagnosis dan perbaikan perawatan suportif dan angkanya semakin meningkat dengan insiden acute kidney injury yang merupakan bagian dari disfungsi organ akibat sepsis. Asam askorbat dikatakan dapat memperbaiki disfungsi organ disebabkan efeknya yang sinergis terhadap patofisiologi sepsis. Peranan asam askorbat dalam menurunkan disfungsi organ masih kontroversial. Penelitian ini ingin menganalisis efek pemberian asam askorbat intravena terhadap perbaikan fungsi ginjal pada pasien sepsis/ syok sepsis yaitu dengan melihat efek terhadap kadar urin neutrophil gelatinase associated lipocalin (uNGAL), produksi urin dan balans kumulatif. Metodologi. Penelitian ini merupakan penelitian uji klinis dengan desain penelitian uji acak terkontrol, dilakukan pada pasien usia > 18 tahun dengan sepsis berdasarkan kriteria sepsis-3 yang masuk ICU dalam 6 sampai 24 jam pascaresusitasi setelah diagnosis sepsis. Kriteria penolakan yaitu pasien dengan gangguan ginjal kronik dengan hemodialisis, kelainan batu ginjal, dengan masalah ginjal dalam 3 bulan terakhir. Pasien akan dikeluarkan apabila diberikan kortikosteroid dan mendapatkan terapi pengganti ginjal dalam < 72 jam observasi. Penelitian dilakukan di ICU Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo pada April 2019-Juli 2019. Sebanyak 33 sampel dirandomisasi secara randomisasi sederhana dan dikelompokan menjadi kelompok perlakuan (18 sampel) dan kontrol (15 sampel). Data demografik dasar dicatat saat masuk ICU. NGAL urin (ng/mL) diperiksa pada jam 0, 24, 48 dan 72 setelah terapi. Produksi urin (ml/kg/jam) dan balan kumulatif (L) dicatat pada jam 24, 48 dan 72 setelah terapi. Analisis statistik dengan uji Mann Whitney untuk data numerik dengan persebaran tidak normal, uji T independen untuk data dengan persebaran normal dan uji Fisher untuk data kategorik perbandingan antara kedua kelompok intervensi. Analisis multivariat untuk pengukuran serial menggunakan generalized estimating equations (GEE) untuk membandingkan antara kedua kelompok dalam waktu pengukuran yang berulang. Nilai signifikansi dengan nilai p < 0,05. Hasil. Tidak terdapat perbedaan pada kadar NGAL urin, produksi urin, balans kumulatif antara dua kelompok di setiap jamnya. Kesimpulan. Pada penelitian ini pemberian asam askorbat intravena tidak mempunyai efek terhadap kadar NGAL urin, produksi urin, balans kumulatif.

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Background. Sepsis-related mortality in intensive care unit (ICU) remains despite improved diagnostic technology and supportive treatment. Acute kidney injury, one of frequent organ dysfunctions in sepsis, increases risk of mortality. Ascorbic acid could improve organ dysfunction because its direct effect on sepsis pathophysiology. The role of ascorbic acid on improving organ dysfunction remains controversial. This study wished to analyze the effects of intravenous ascorbic acid on kidney function improvement among septic patients by evaluating urine neutrophil gelatinase associated lipocalin (uNGAL), urine output and cumulative fluid balance.

Method. This study was randomized controlled trial held in Cipto Mangunkusumo Hospital from April to July 2019. The inclusion criteria were adult patients aged > 18 years who met sepsis-3 criteria and were admitted to the ICU within 6-24 h after resuscitation and sepsis recognition. The exclusion criteria were patients with hemodialysis-dependent chronic kidney disease, kidney stones or other kidney problems within last 3 months. The drop out criteria were patients underwent renal replacement therapy in the ICU and given corticosteroid less than 72 h after recruitment. Subjects were randomized using simple randomization and divided into two groups with treatment (18 subjects) and control (15 subjects). Baseline demographic data was recorded on the first day. Daily measurements of urine NGAL (ng/ mL) was started as baseline level and continued at 24, 48 and 72 h after treatment. Urine output (ml/kg/h), cumulative fluid balance (L) was recorded at at 24, 48 and 72 h after treatment. Comparison between both groups was analysed by using Mann Whitney test (not normally distributed data), T independent test (normally distributed data) for numerical data and Fisher test for categorical data. Multivariate analysis using generalized estimating equations was used for serial measurement analysis. Level of significant was determined at p-value <0.05.

Result. There were no significant differences in uNGAL, urine output, cumulative fluid balance between the two groups at each hour respectively.

Conclusion. This study showed that intravenous vitamin CMultin administration had no effect on urine NGAL, urine output, cumulative fluid balance."

"Latar belakang: Cedera iskemia/reperfusi (CIR) terjadi pada situasi saat aliran darah menuju jaringan terhambat atau bahkan terhenti sama sekali sehingga sel mengalami iskemia. Reperfusi berperan penting untuk kelangsungan hidup suatu jaringan dan sel. Namun ternyata proses reperfusi dapat menyebabkan cedera mikrovaskular dengan meningkatnya produksi reactive oxygen species (ROS). Angka kejadiannya 15/100.000 per tahun dengan angka morbiditas 30% dalam 30 hari pascainsiden dan angka kematian sebesar 18%. Salah satu terapi tata laksana cedera reperfusi adalah pemberian antioksidan yang dapat mengikat ROS yaitu selenium. Beberapa studi telah membuktikan kerusakan akibat cedera iskemia/reperfusi pada jantung, ginjal, otak dan paru dapat dicegah dengan pemberian selenium. Namun belum ada penelitian mengenai penggunaan selenium sebagai faktor proteksi jantung akibat dampak dari cedera iskemia/reperfusi tungkai akut.Metode: Penelitian ini merupakan sebuah studi eksperimental untuk meneliti pengaruh pemberian selenium terhadap derajat kerusakan jantung yang dinilai secara histopatologis. Menggunakan rancangan post-test only control, penelitian ini menggunakan tikus Sprague-Dawley (SD). Tikus ini dibagi dalam tiga kelompok meliputi satu kelompok kontrol (KK) dan dua kelompok perlakuan (KP) Penelitian dilakukan di Animal Laboratorium Rumah Sakit Hewan Pendidikan, Fakultas Kedokteran Hewan, Institut Pertanian Bogor dan Laboratorium Patologi Anatomi Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo. Faktor yang dinilai yaitu luas area kerusakan, edema interstisium, pembengkakan sel, infiltrasi leukosit, nekrosis, perdarahan, dan derajat kerusakan. Data yang diperoleh diuji menggunakan uji Fisher exact.Hasil: Terdapat 15 sampel hewan coba pada penelitian ini. Tidak ada hewan coba yang mati dan mengalami efek samping pemberian selenium selama penelitian. Tidak didapatkan hasil bermakna pada luas area kerusakan, edema interstisium, pembengkakan sel, infiltrasi leukosit, nekrosis, perdarahan, dan derajat kerusakan.Kesimpulan: Pemberian selenium tidak menurunkan derajat kerusakan jaringan miokardium akibat CIR tungkai pada tikus SD. Studi lebih lanjut dengan sampel yang lebih besar, dosis dan waktu pemberian selenium yang berbeda, dan penanda kerusakan jaringan yang lebih sensitif diperlukan untuk mengkonfirmasi dan mengklarifikasi temuan kami.

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Background: Ischemia/reperfusion injury (CIR) occurs in a situation when blood flow to a tissue is obstructed or even completely stopped causing cells to experience ischemia. Reperfusion plays an important role for the survival of tissue and cells. However, it turns out that the reperfusion process can cause microvascular injury by increasing the production of reactive oxygen species (ROS). The incidence rate is 15/100,000 per year with a morbidity rate of 30% within 30 days after incident and a mortality rate of 18%. One of the therapies for managing reperfusion injury is the administration of an antioxidant that can bind ROS, namely selenium. Several studies have proven that damage after ischemia/reperfusion injury to the heart, kidneys, brain, and lungs can be prevented by administering selenium. However, there has been no research on the use of selenium as a cardiac protective factor due to the impact of acute limb ischemia/reperfusion injury.

Methods: This research is an experimental study to examine the effect of selenium administration on the degree of heart damage assessed histopathologically. Using a post-test only control design, this study used Sprague Dawley rats (SD). These rats were divided into three groups including one control group (KK) and two treatment groups (KP). The study was conducted at the Animal Laboratory of the Educational Animal Hospital, Faculty of Veterinary Medicine, Bogor Agricultural Institute and Laboratory of Anatomical Pathology, Dr. Cipto Mangunkusumo hospital. The factors assessed were the area of ??change, interstitial edema, cell swelling, leukocyte infiltration, necrosis, bleeding, and degree of damage. The data obtained were tested using Fisher's exact test.

Results: There were 15 experimental animal samples in this study. None of the experimental animals died and experienced side effects of selenium administration during the study. There were no significant results for the area of change, interstitial edema, cell swelling, leukocyte infiltration, necrosis, bleeding, and degree of damage.

Conclusion: Administration of selenium did not reduce the degree of myocardial tissue damage due to leg IRI in SD rats. Further study with larger samples, different selenium dosage and administration times, and more sensitive tissue damage biomarkers is needed to confirm and clarify our findings."

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Latar belakang: Riset Kesehatan Dasar 2018 menemukan bahwa 38/10.000 penduduk Indonesia berusia >15 tahun menderita penyakit ginjal kronis (PGK). Morbiditas dan mortalitas utama pada penderita PGK disebabkan karena sindrom kardiorenal tipe 4. Toksin urea pada penderita PGK dapat menyebabkan inflamasi sistemis serta perburukkan stres oksidatif, mengakibatkan disfungsi endotel dan aterosklerosis yang bisa berujung pada penyakit kardiovaskuler. Sejumlah studi menemukan bahwa simvastatin memiliki efek antiinflamasi dan antioksidan yang ditunjukkan dengan penurunan malondialdehid (MDA), penanda tidak langsung inflamasi dan stres oksidatif.  

Tujuan: Penelitian ini bertujuan untuk mengetahui efek pemberian simvastatin dan pengaruhnya terhadap stres oksidatif pada tikus model PGK melalui pengamatan kadar MDA di jantung dan serum.

Metode: Tikus Sprague-Dawley (n=12) dibagi secara acak menjadi 3 kelompok: kelompok sham (S), model PGK melalui metode 5/6 nefrektomi (N), dan model PGK dengan pemberian simvastatin 10 mg/kgBB selama 4 minggu (NS). Pengukuran kadar MDA jantung dan serum dilakukan melalui Thiobarbituric Acid Reactive Substance Assay. Data selanjutnya diolah melalui uji One-Way Anova.

Hasil: Ditemukan rerata kadar MDA jantung sebagai berikut: S=1,3708 nmol/mg protein; NS=1,2574 nmol/mg protein; dan N=0,4129 nmol/mg protein. Ditemukan rerata kadar MDA serum sebagai berikut: NS=1,5924 nmol/ml; N=1,2667 nmol/ml; dan S=1,2171 nmol/ml. Temuan pada penelitian ini bertentangan dengan teori yang sudah ada. Meski demikian, perbedaan kadar MDA antarkelompok pada penelitian ini tidak bermakna secara statistik (p>0,05).  

Simpulan: Tidak terdapat perbedaan kadar MDA yang bermakna secara statistik baik pada kelompok S, kelompok N, dan kelompok NS.

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Introduction: Riset Kesehatan Dasar 2018 found that 38/10.000 Indonesian population aged >15 years were suffering from Chronic Kidney Disease (CKD). CKD patients’ morbidity and mortality are majorly caused by type 4 cardiorenal syndrome. Urea toxin in CKD patients can cause systemic inflammation and oxidative stress, causing endothelial dysfunction and atherosclerosis that can lead to cardiovascular diseases. Several studies found that simvastatin had antiinflammatory and antioxidant effects, shown by the reduction of malondyaldehyde (MDA), an indirect inflammatory and oxidative stress marker.

Objective: This research aims to determine the effects of simvastatin administration on oxidative stress in CKD rat model by measuring cardiac and serum MDA levels.

Method: Sprague-Dawley rats (n=12) were randomly divided into 3 groups: sham (S), CKD model by 5/6 nephrectomy (N), and CKD model with 10 mg/kgBB simvastatin administration for 4 weeks (NS). Cardiac and serum MDA levels were measured using Thiobarbituric Acid Reactive Substance Assay. Data collected were analyzed using One-Way Anova test.

Results: The average cardiac MDA levels found were as followed: S=1.3708 nmol/mg protein; NS=1.2754 nmol/mg protein; and N=0.4129 nmol/mg protein. The average serum MDA levels found were as followed: NS=1.5924 nmol/ml; N=1.2667 nmol/ml; and S=1.2171 nmol/ml. These findings contradict existing theories. However, the differences among treatments and MDA levels are not statistically significant (p>0.05).

Conclusion: There isn’t statistically significant difference among the MDA levels in the S, the N, and the NS group

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"Penyakit Ginjal Kronis (PGK) merupakan kondisi dengan penurunan laju filtrasi glomerulus (LFG). Penurunan LFG mengaktivasi Sistem-Renin-Angiotensin-Aldosteron (RAAS) dan menyebabkan penumpukan toksin uremik yang meningkatkan stres oksidatif. Irbesartan adalah obat yang berperan dalam inhibisi RAAS dan diduga memiliki peranan dalam menurunkan stres oksidatif. Tujuan: Mengetahui efek antioksidan Irbesartan dan pengaruhnya terhadap stres oksidatif jantung dan serum tikus model PGK metode 5/6 nefrektomi melalui pengukuran kadar malondialdehid. Metode: Penelitian ini merupakan penelitian eksperimental menggunakan jaringan jantung dan serum tikus tersimpan. Sampel terdiri atas 3 kelompok, yaitu sham (S, jantung dan serum: n=4), nefrektomi 5/6 (N, jantung: n=4; serum: n=3) dan nefrektomi 5/6 dengan pemberian Irbesartan 20 mg/kgBB/hari selama 4 minggu (N+I, jantung dan serum: n=4). Kemudian dilakukan pengukuran kadar malondialdehid melalui uji Thiobarbituric Acid Reactive Substance Assay (TBARS) pada jaringan tersimpan. Analisis statistik dilakukan dengan SPSS v25.0 menggunakan uji One-Way ANOVA. Hasil: Tidak terdapat perbedaan bermakna secara statistik (p>0,05) antara ketiga kelompok pada pemeriksaan kadar malondialdehid jantung dan serum tikus (jantung: p=0,060; serum: p=0,162). Kesimpulan: Tidak terdapat perbedaan bermakna pada kadar malondialdehid jantung dan serum tikus model PGK metode 5/6 nefrektomi dengan dan tanpa pemberian Irbesartan.

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Background: Chronic kidney disease (CKD) is a condition that triggers a decrease in glomerular filtration rate. The reduction can activate Renin-Angiotensin-Aldosterone System (RAAS) and leads to an accumulation of oxidative stress. Irbesartan is a drug that functions to inhibit RAAS and is thought to have an effect on lowering the oxidative stress.

Objectives: To understand irbesartan’s antioxidant effects and its impact on oxidative stress in cardiac tissues and serum on rat models of 5/6 nephrectomy-induced CKD through the measurement of malondialdehyde levels.

Methods: This study is an experimental study utilizing stored heart and serum. The samples consists of three groups, which are Sham (S, heart and serum: n=4), 5/6 nephrectomy (N, heart: n=4; serum: n=3), and 5/6 nephrectomy administered with Irbesartan 20 mg/kgW/day for 4 weeks (N+I, heart and serum: n=4). Statistical analyses were done using SPSS v25.0 and examined using One-Way ANOVA.

Results: There were no significant results between the three groups based on the levels of heart and serum malondialdehyde (heart: p=0.060; serum: p=0.162).

Conclusion: There were no significant differences in the levels of heart and serum malondialdehyde on rat models of 5/6 nephrectomy-induced CKD with the administration of Irbesartan compared and without the administration of Irbesartan."

"Latar belakang: Penyakit ginjal kronis (PGK) merupakan masalah kesehatan global dengan prevalensi dan mortalitas yang meningkat dalam tiga dekade terakhir. PGK dipicu oleh kerusakan sebagian nefron dan menyebabkan peningkatan beban kerja nefron lainnya. Proses ini memicu aktivasi sistem renin-angiotensin-aldosteron (SRAA) yang menyebabkan peningkatan tekanan kapiler glomerulus, stress oksidatif, dan mediator inflamasi sehingga berujung pada kerusakan nefron yang lebih luas. Angiotensin receptor blocker (ARB) sebagai obat penghambat SRAA yang telah menjadi lini pertama terapi PGK. Statin merupakan obat antihiperlipidemia yang memiliki efek antiinflamasi dan digunakan untuk mencegah komplikasi kardiovaskular pada PGK. Kerusakan ginjal pada PGK dapat diamati dengan adanya perubahan struktur histologis pada glomerulus dan tubulus ginjal. Belum banyak penelitian yang membahas pengaruh ARB dan statin terhadap perbaikan PGK ditinjau dari perbaikan histologi glomerulus dan tubulus nefron ginjal. Tujuan: Menganalisis pengaruh pemberian ARB dan statin terhadap histopatologi ginjal tikus model PGK dengan 5/6 nefrektomi (5/6 Nx). Metode: Penelitian ini melakukan uji eksperimental dengan menggunakan bahan biologis tersimpan ginjal tikus Sprague-Dawley untuk melihat pengaruh ARB, statin, dan kombinasi ARB + statin pada hipertrofi glomerulus dan kerusakan tubulus ginjal tikus PGK dengan 5/6 Nx. Sediaan histologi menggunakan pewarnaan H&E dan dilakukan pengamatan terhadap diameter glomerulus dan tubular injury score. Analisis data menggunakan SPSS dengan uji anova satu arah dan post hoc bonferroni untuk diameter glomerulus dan uji Kruskal-Wallis dengan post hoc Mann-Whitney untuk tubular injury score.Hasil: Pada pengukuran diameter glomerulus, hasil menunjukkan bahwa kelompok 5/6 Nx mempunyai diameter glomerulus yang lebih besar signifikan dibanding kelompok lainnya. Kelompok ARB, statin, dan kombinasi ARB + statin menunjukan diameter glomerulus yang lebih kecil secara signifikan dibandingkan kelompok 5/6 Nx. Tidak ada perbedaan signifikan antar kelompok pemberian obat. Kombinasi ARB+statin memiliki skor tubular injury lebih kecil signifikan dibandingkan kelompok 5/6 Nx. Monoterapi ARB atau statin menunjukkan tren lebih kecil pada skor tubular injury dibandingkan 5/6 Nx namun tidak signifikan secara statistik. Kesimpulan: Kombinasi Angiotensin receptor blocker dan statin dapat menghambat kerusakan histologi ginjal tikus model penyakit ginjal kronis dengan 5/6 nefrektomi.

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Background: Chronic kidney disease (CKD) is a global health problem with increased prevalence and mortality in the last three decades. CKD is started by damage of nephrons that causes an increase in the workload of the remaining nephrons. This process triggers activation of the renin-angiotensin-aldosterone system (RAAS) which causes increased glomerular capillary pressure, oxidative stress, and inflammatory mediators, leading to more extensive nephrons damage. Angiotensin receptor blocker (ARB) as an inhibitor of RAAS has become the first line of CKD therapy. Statins are antihyperlipidemic drugs that have anti-inflammatory effects and are used to prevent cardiovascular complications in CKD. Renal damage in CKD can be observed with changes in the histological structure of the glomerulus and renal tubules. However, there are few studies that discuss the effect of ARBs and statins on the improvement of CKD in terms of the histology of glomerular and tubular renal nephrons.

Aim: Analyzing the effect of ARB and statin administration on kidney histopathology of CKD-model rats with 5/6 nephrectomy (5/6 Nx).

Method: This study is an experimental study using stored biological material of Sprague-Dawley rat kidney. This study want to see the effect of ARB, statin, and ARB + statin combination on glomerular hypertrophy and renal tubular damage in CKD rats with 5/6 Nx. Histology slides are stained with H&E staining and glomerular diameter and tubular injury score are observed. Data analysis using SPSS with one-way ANOVA test and bonferroni hoc post test for glomerular diameter and with Kruskal-Wallis test and Mann-Whitney post hoc test for tubular injury score.

Result: in comparison with control, the 5/6 Nx group significantly had a larger glomerular diameter. The ARB, statin, and combination groups showed significantly smaller glomerular diameter than the 5/6 Nx group. There were no significant differences between the drug administration groups. The ARB + statin combination group significantly had a smaller tubular injury scores compared to the 5/6 Nx group. ARB or statin monotherapy groups showed a smaller tubular injury scores compared to 5/6 Nx but was not statistically significant.

Conclusion: The combination of angiotensin receptor bocker and statin inhibit renal histological damage in chronic kidney disease rat model with 5/6 nephrectomy."