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"Penyakit ginjal kronik (PGK) merupakan salah satu komplikasi serius yang sering terjadi pada pasien diabetes melitus tipe 2. Dibutuhkan sebuah penanda yang dapat mendeteksi PGK sejak awal untuk mencegah progresifitasnya. Penelitian ini bertujuan untuk menganalisis hubungan antara kadar malondialdehida (MDA) serum dengan estimasi laju filtrasi glomerulus (eLFG). MDA merupakan penanda stres oksidatif yang diprediksi berperan dalam tahap awal kerusakan ginjal. Desain penelitian ini adalah potong lintang. Populasi yang digunakan adalah pasien DM tipe 2 rawat jalan di Puskesmas Pasar Minggu. Sampel yang dianalisis sejumlah 50 orang (14 laki-laki, dan 36 perempuan, rentang usia 39-74 tahun), diambil dengan tenik total sampling. Kadar MDA diukur secara spektrofotometri berdasarkan reaksi antara MDA dengan asam tiobarbiturat, dengan nilai koefisien korelasi (r) dari metode tersebut 0,9996 dan koefisien variasi (%KV) intra dan antar pengukuran berkisar 2,75-13,33%. Nilai eLFG diukur berdasarkan metode kinetik Jaffe, dengan koefisien korelasi (r) 0,9994 dan %KV intra dan antar pengukuran berkisar 2,91 – 9,52%. Kadar MDA pasien DM tipe 2 diperoleh 0,82 ± 0,26 nmol/ml, dan nilai eLFG diperoleh 78,30 ± 26,77 (Cockroft-Gault); 76,08 ± 24,17 (MDRD study); dan 79,25 ± 21,04 (CKD-EPI). Terdapat hubungan yang bermakna antara kadar MDA dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (p =0,039, r = -0,293), tetapi tidak terlihat hubungan yang bermakna dengan nilai eLFG berdasarkan persamaan MDRD study dan CKD-EPI (p = 0,051 dan p = 0,053; r = -0,277 dan r = -0,275).

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Chronic kidney disease (CKD) is one of serious complication that most common in type 2 diabetes mellitus patients. It is important to find a marker that can detect it earlier to prevent its progression. The aim of this study was to analyze the correlation between malondialdehyde (MDA) concentration and estimated glomerular filtration rate (eGFR). MDA is an oxidative stress marker which was predicted allies in early stage of kidney damage.

The design of this study is cross sectional. The population was type 2 DM outpatients at Pasar Minggu Local Government Clinic. Total sampling method was used in sample selection. Samples being analyzed were as much as 50 patients (14 males, 36 females, age ranges : 39-74 years). MDA was measured by spectrophotometric based on its reaction with thiobarbituric acid. The coefficient correlation (r) of this method was 0.9996 and the coefficient of variation (%CV) within and between run were 2.75 - 13.33%.

eGFR was measured based on kinetic Jaffe method. Its coefficient correlation (r) was 0.9994 and %CV within and between run were 2.91-9.52%. MDA concentration in type 2 DM patients in this research was 0.82 ± 0.26 nmol/mL and the eGFR values were 78.30 ± 26.77 (Cockroft-Gault); 76.08 ± 24.17 (MDRD study); and 79.25 ± 21.04 (CKD-EPI). There was a significant correlation between MDA concentration and eGFR based on Cockroft-Gault formula (p =0.039, r = -0.293), but there were no significant correlation between MDA concentration and eGFR based on MDRD study and CKD-EPI (p = 0.051 and p = 0.053; r = -0.277 and r = -0.275)."

"Malondialdehida merupakan produk peroksidasi lipid yang diduga bertanggung jawab sebagai penyebab terjadinya nefropati diabetik. Penelitian ini menilai hubungan antara kadar malondialdehida serum dengan UACR dan laju filtrasi glomerulus sebagai parameter fungsi ginjal. Penelitian ini menggunakan 54 pasien diabetes melitus tipe 2 sebagai sampel (3 laki-laki dan 51 perempuan, rentang usia 42-74 tahun). Kadar malondialdehida serum diukur secara spektrofotometri menggunakan asam tiobarbiturat. Laju filtrasi glomerulus diperoleh dari nilai kreatinin serum. Kreatinin urin diukur dengan metode Jaffe dan albumin urin diukur dengan metode bromkresol hijau. Kadar malondialdehida pasien diabetes diperoleh sebesar 2,46 ± 2,58 nmol/mL; nilai UACR sebesar 42,32 ± 76,67; dan nilai laju filtrasi glomerulus sebesar 104,75 ± 46,16 (Cockroft-Gault); 89,52 ± 25,86 (MDRD study); dan 99,49 ± 46,11 (CKD-EPI). Hasil analisis hubungan antara malondialdehida dengan Cockroft-Gault (p = 0,491, r = -0,096); MDRD study (p = 0,618, r = -0,069); CKD-EPI (p = 0,611, r = -0,071); UACR (p = 0,583, r = 0,076). Ditemukan hubungan yang bermakna antara nilai UACR dengan laju filtrasi glomerulus Cockroft-Gault (p = 0,019, r = -0,318); MDRD study (p = 0,007, r = -0,361); CKD-EPI (p = 0,010, r = -0,348). Tidak ditemukan hubungan yang bermakna antara malondialdehida dengan laju filtrasi glomerulus dan UACR.

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Malondialdehyde is a product of lipid peroxidation that is suspected as a cause of diabetic nephropathy. This study assessed the relation between malondialdehyde level with UACR and glomerular filtration rate as renal function parameters. This study is using 54 patients type 2 diabetes mellitus as samples (3 men and 51 women, age range 42-74 years).

Malondialdehyde was measured by spectrophotometry using tiobarbiturat acid. Glomerular filtration rate was obtained from serum creatinine value. Urine creatinine was measured based on Jaffe method and urine albumin was measured with bromcressol green. Malondialdehyde level of diabetic patients was 2.46 ± 2.58 nmol/mL; UACR was 42.32 ± 76.67; and glomerular filtration rate were 104.75 ± 46.16 (Cockroft-Gault); 89.52 ± 25.86 (MDRD study); and 99.49 ± 46.11 (CKD-EPI).

The analysis result of the relationship between malondialdehyde and Cockroft-Gault (p = 0.491, r = -0.096); MDRD study (p = 0.618, r = -0.069); CKD-EPI (p = 0.611, r = -0.071); and UACR (p = 0.583, r = 0.076) . There were significant correlation between UACR and glomerular filtration rate Cockroft-Gault (p = 0.019, r = -0.318); MDRD study (p = 0.007, r = -0.361 ); CKD-EPI (p = 0.010, r = -0.348). There were no significant correlation between malondialdehyde level and glomerular filtration rate or UACR."

"[Penyakit ginjal kronik (PGK) adalah salah satu komplikasi yang biasanya terjadi pada pasien diabetes melitus tipe 2. Pendeteksian PGK dilakukan dengan menghitung nilai estimasi laju filtrasi glomerulus (eLFG) maupun urine albumin creatinine ratio (UACR). Salah satu biomarker yang sedang diteliti adalah senyawa 8-iso-Prostaglandin F2α. Tujuan dari penelitian ini adalah menganalisis kadar 8-iso-Prostaglandin F2α dan hubungannya dengan eLFG. Sampel yang dianalisis adalah pasien diabetes melitus tipe 2 wanita di Puskesmas Pasar Minggu yang dikumpulkan oleh peneliti sebelumnya tahum lalu secara total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang dihitung dengan rumus Cockroft-Gault, MDRD study, serta CKD-EPI, sedangkan kadar 8-iso-Prostaglandin F2α diukur dengan menggunakan metode ELISA (Enzyme Linked Immunosorbent Assay). Kadar 8-iso-Prostaglandin F2α diperoleh 7069,38 ± 7611,13 pg/mg kreatinin dan nilai eLFG diperoleh 93,15 ± 37,65 (Cockroft-Gault); 89,47 ± 34,30 (MDRD study); dan 87,05 ± 24,69 (CKD-EPI). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG (92 pasien) berdasarkan persamaan Cockroft-Gault (r = 0,396; p = < 0,001), MDRD (r = 0,375; p = < 0,001) dan CKD-EPI (r = 0,342; p = 0,001). Sehingga diketahui terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dengan α = 0,05.;Chronic Kidney Desease (CKD) is one of complication that most common in type 2 diabetes mellitus patients. The detection of CKD is be done by calculating estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). One of the biomarkes being studied is 8-iso-Prostaglandin F2α. The aim of this study was to analyze concentration of 8-iso-Prostaglandin F2α and its correlation with estimated glomerular filtration rate (eGFR). Samples analyzed were type 2 diabetes mellitus woman patients at Pasar Minggu Local Government Clinic that collected by previous researcher last year in total sampling . eGFR was obtained based on the measurement of serum creatinine, 8-iso-Prostaglandin F2α was measured by ELISA (Enzyme Linked Immunosorbent Assay) method. Concentration of 8-iso-Prostaglandin F2α was 7069,38 ± 7611,13 pg/mg creatinine and the eGFR values 93,15 ± 37,65 (Cockroft-Gault); 89,47 ± 34,30 (MDRD study); and 87,05 ± 24,69 (CKD-EPI). The correlation between 8-iso-Prostaglandin F2α concentration and eGFR (92 samples) is based on Cockroft-Gault (r = 0,396; p = < 0,001), MDRD (r = 0,375; p = < 0,001) and CKD-EPI (r = 0,342; p = 0,001). So there was a significant correlation between 8-iso-Prostaglandin F2α concentration and eGFR., Chronic Kidney Desease (CKD) is one of complication that most common in type 2 diabetes mellitus patients. The detection of CKD is be done by calculating estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). One of the biomarkes being studied is 8-iso-Prostaglandin F2α. The aim of this study was to analyze concentration of 8-iso-Prostaglandin F2α and its correlation with estimated glomerular filtration rate (eGFR). Samples analyzed were type 2 diabetes mellitus woman patients at Pasar Minggu Local Government Clinic that collected by previous researcher last year in total sampling . eGFR was obtained based on the measurement of serum creatinine, 8-iso-Prostaglandin F2α was measured by ELISA (Enzyme Linked Immunosorbent Assay) method. Concentration of 8-iso-Prostaglandin F2α was 7069,38 ± 7611,13 pg/mg creatinine and the eGFR values 93,15 ± 37,65 (Cockroft-Gault); 89,47 ± 34,30 (MDRD study); and 87,05 ± 24,69 (CKD-EPI). The correlation between 8-iso-Prostaglandin F2α concentration and eGFR (92 samples) is based on Cockroft-Gault (r = 0,396; p = < 0,001), MDRD (r = 0,375; p = < 0,001) and CKD-EPI (r = 0,342; p = 0,001). So there was a significant correlation between 8-iso-Prostaglandin F2α concentration and eGFR.]"

"Hingga saat ini, penanda biologis yang menggambarkan gangguan fungsi ginjal akibat diabetes melitus (DM) belum dapat mendeteksi adanya kerusakan sejak dini. Studi ini bertujuan untuk mengetahui hubungan antara 8-iso-Prostaglandin F2α dengan laju filtrasi glomerulus yang diestimasi (eLFG) sebagai penanda gangguan fungsi ginjal yang terjadi pada pasien DM tipe 2. Sebagai salah satu senyawa penanda terjadinya stres oksidatif, 8-iso-Prostaglandin F2α diduga berkaitan dengan gangguan fungsi ginjal sebagai salah satu komplikasi diabetes. Kadar 8-iso-Prostaglandin F2α diukur dari urin dan nilai eLFG dihitung dari kreatinin serum. Sampel urin dan serum diambil dari 36 pasien DM tipe 2 dengan teknik total sampling. Metode spektrofotometri digunakan untuk mengukur kadar kreatinin serum, sedangkan untuk pengukuran kadar 8-iso-Prostaglandin F2α digunakan metode enzyme immunoassay. Data lain yang diperlukan diperoleh melalui kuesioner. Hasil yang diperoleh menunjukkan bahwa peningkatan kadar 8-iso-ProstaglandinF2α berbanding terbalik dengan penurunan nilai eLFG pasien DM tipe 2. Namun, hubungan tersebut tidak bermakna secara statistik. Faktor usia dan kadar glukosa darah merupakan faktor yang paling mempengaruhi nilai eLFG pada pasien DM tipe 2.

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Until now, biological marker that describes renal dysfunction due to diabetes mellitus (DM) have not been able to detect any damage early. This study aimed to determine the relationship between 8-iso-Prostaglandin F2α with estimated Glomerular Filtration Rate (eGFR) as a marker of renal dysfunction at type 2 diabetes mellitus. As one of the markers of oxidative stress, 8-iso-ProstaglandinF2α assumed to be associated with renal dysfunction as a complication of diabetes mellitus. The levels of 8-iso-Prostaglandin F2α measured from urine, and eGFR calculated from serum creatinine. Urine and serum samples taken from 36 type 2 DM patients, using total sampling method.

Spectrophotometric used to measure levels of serum creatinine and the levels of 8-iso-Prostaglandin F2α was measured by enzyme immunoassay. Other necessary data obtained through questionnaires. The results showed that increasing level of 8-iso-ProstaglandinF2α was inversely proportional to the decline in eGFR of type 2 DM patients. However, these correlation was not significant statistically. Age and blood glucose were the factors that could effect the value of eGFR in type 2 DM patients."

"Gangguan fungsi ginjal merupakan salah satu komplikasi yang sering terjadi pada pasien diabetes melitus tipe 2. Pendeteksian dini dengan menggunakan senyawa 8-iso-Prostaglandin F2α dan KIM-1 diperlukan untuk mencegah progresifitasnya. Dalam penelitian ini dilakukan analisis hubungan antara kadar 8-iso-Prostaglandin F2α dan KIM-1 urin dengan estimasi laju filtrasi glomerulus (eLFG). Sampel yang dianalisis adalah 40 orang pasien diabetes melitus tipe 2 di Puskesmas Pasar Minggu, dengan teknik total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang diukur menggunakan metode kinetik Jaffe, sedangkan kadar 8-iso-Prostaglandin F2α dan KIM-1 diukur dengan menggunakan metode ELISA (Enzyme Linked Immunosorbent Assay). Kadar 8-iso-Prostaglandin F2α diperoleh 6633,87 ± 1292,62 pg/mg kreatinin, kadar KIM-1 diperoleh 8,23 ± 3,23 ng/mL dan nilai eLFG diperoleh 99,65 ± 41,12 (Cockroft-Gault); 96,59 ± 41,90 (MDRD study); dan 100,79 ± 40,07 (CKD-EPI). Hubungan antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (r = 0,520; p = 0,001), MDRD (r = 0,477; p = 0,004) dan CKD-EPI (r = 0,403; p = 0,013), serta setelah perokok dieksklusi, berdasarkan ketiga persamaan, yaitu Cockroft-Gault (r = 0,595; p = 0,001), MDRD (r = 0,554; p = 0,003) dan CKD-EPI (r = 0,559; p = 0,003). Hubungan antara kadar KIM-1 dengan nilai eLFG berdasarkan persamaan Cockroft-Gault (r = -0,155; p = 0,339), MDRD (r = -0,173; p =0,285) dan CKD-EPI (r = -0,024; p = 0,883). Sehingga diketahui terdapat hubungan yang bermakna antara kadar 8-iso-Prostaglandin F2α dengan nilai eLFG dan tidak terdapat hubungan yang bermakna antara KIM-1 dengan nilai eLFG.

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Renal dysfunction is one of complication that most common in type 2 diabetes mellitus patients. The earlier detection is needed to prevent its progression with 8-iso-Prostaglandin F2α and KIM-1. The aim of this study was to analyze concentration of 8-iso-Prostaglandin F2α and KIM-1urine and its correlation with estimated glomerular filtration rate (eGFR). Samples analyzed were 40 type 2 diabetes mellitus patients at Pasar Minggu Local Government Clinic, used total sampling method.

eGFR was obtained based on the measurement of serum creatinine on kinetic Jaffe method, 8-iso-Prostaglandin F2α and KIM-1 was measured by ELISA (Enzyme Linked Immunosorbent Assay) method. Concentration of 8-iso-Prostaglandin F2α was 6633,87 ± 1292,62 pg/mg creatinine, concentration of KIM-1 was 8,23 ± 3,23 ng/mL and the eGFR values were 99,65 ± 41,12 (Cockroft-Gault); 96,59 ± 41,90 (MDRD study); and 100,79 ± 40,07 (CKD-EPI).

The correlation between 8-iso-Prostaglandin F2α concentration and eGFR is based on Cockroft-Gault (r = 0,520; p = 0,001), MDRD (r = 0,477; p = 0,004) and CKD-EPI (r = 0,403; p = 0,013), and the correlation between 8-iso-Prostaglandin F2α concentration after smoker exclution and eGFR based on Cockroft-Gault (r = 0,595; p = 0,001), MDRD (r = 0,554; p = 0,003) and CKD-EPI (r = 0,559; p = 0,003). But the correlation between KIM-1 concentration and eGFR based on Cockroft-Gault (r = -0,155; p = 0,339), MDRD (r = -0,173; p =0,285) and CKD-EPI (r = -0,024; p = 0,883). So there was a significant correlation between 8-iso-Prostaglandin F2α concentration and eGFR, and also there were no significant correlation between KIM-1 concentration and eGFR."

"[Saat ini belum ada penanda biologis yang dapat digunakan untuk mendeteksi PGK sejak dini. Rasio albumin terhadap kreatinin urin (UACR) dan estimasi laju filtrasi ginjal (eLFG) digunakan sebagai penanda gangguan fungsi ginjal. Penelitian ini bertujuan untuk mengetahui hubungan antara UACR dengan eLFG pada pasien DM tipe 2 dengan normoalbuminuria dan mikroalbuminuria. Sampel yang dianalisis adalah urin dan serum 90 orang pasien DM tipe 2 di Puskesmas Pasar Minggu yang dikumpulkan tahun lalu, dengan teknik total sampling. Kreatinin urin diukur dengan metode kinetic jaffe. Albumin urin diukur dengan metode bromkresol hijau. eLFG diperoleh dari nilai kreatinin serum. Hasil rerata UACR yang didapatkan (15,60±1,93). Hasil rerata eLFG Cockroft Gault (95,65±4,17), MDRD (89,71±3,65) dan CKD-EPI (87,00±2,62). Hasil hubungan antara UACR dengan eLFG rendah MDRD (p= 0,004,r= -0,422); Cockroft (p= 0,083,r= -0,261); CKD-EPI (p= 0,006,r= -0,404), sedangkan dengan LFG tinggi MDRD (p= 0,020, r= 0,346); Cockroft (p= <0,0-01, r= 0,540); CKD (p= 0,002, r= 0,449). Kesimpulan yang didapatkan yaitu hubungan bermakna antara UACR dengan eLFG rendah dan tinggi. Tidak ditemukan hubungan yang bermakna antara UACR normoalbuminuria dan mikroalbumnuria dengan eLFG. ;Diabetes mellitus type 2 is one of the causes complication of chronic kidney disease (CKD). Currently there are no biological markers that can be used to detect CKD early. Urinary albumin to creatinine ratio (UACR) and estimated kidney filtration rate (eLFG) is used as a marker of impaired kidney function. This study aimed to determine the relationship between UACR with eLFG in patient type 2 diabetes mellitus with normoalbuminuria and microalbuminuria. Samples were urine and serum of 90 patients with type 2 diabetes mellitus in Puskesmas Pasar Minggu which were collected last year, with total sampling technique. Urinary creatinine was measured by Jaffe kinetic method. Urine albumin was measured by the method bromkresol green. eLFG obtained from serum creatinine values. UACR results obtained (15.60 ± 1.93). Results eLFG Cockroft Gault (95.65 ± 4.17), MDRD (89.71 ± 3.65) and CKD-EPI (87.00 ± 2.62). Results relationship between UACR with low eLFG MDRD (p = 0.004, r = -0.422); Cockroft (p = 0.083, r = -0.261); CKD (p = 0.006, r = -0.404), while the high eLFG MDRD (p = 0.020, r = 0.346); Cockroft (p = <0.001, r = 0.540); CKD (p = 0.002, r = 0.449) so there is a significant relationship between UACR with low and high eLFG. There is no significant relationship between UACR normoalbuminuria and microalbuminuria with eLFG., Diabetes mellitus type 2 is one of the causes complication of chronic kidney disease (CKD). Currently there are no biological markers that can be used to detect CKD early. Urinary albumin to creatinine ratio (UACR) and estimated kidney filtration rate (eLFG) is used as a marker of impaired kidney function. This study aimed to determine the relationship between UACR with eLFG in patient type 2 diabetes mellitus with normoalbuminuria and microalbuminuria. Samples were urine and serum of 90 patients with type 2 diabetes mellitus in Puskesmas Pasar Minggu which were collected last year, with total sampling technique. Urinary creatinine was measured by Jaffe kinetic method. Urine albumin was measured by the method bromkresol green. eLFG obtained from serum creatinine values. UACR results obtained (15.60 ± 1.93). Results eLFG Cockroft Gault (95.65 ± 4.17), MDRD (89.71 ± 3.65) and CKD-EPI (87.00 ± 2.62). Results relationship between UACR with low eLFG MDRD (p = 0.004, r = -0.422); Cockroft (p = 0.083, r = -0.261); CKD (p = 0.006, r = -0.404), while the high eLFG MDRD (p = 0.020, r = 0.346); Cockroft (p = <0.001, r = 0.540); CKD (p = 0.002, r = 0.449) so there is a significant relationship between UACR with low and high eLFG. There is no significant relationship between UACR normoalbuminuria and microalbuminuria with eLFG.]"

"[ABSTRAKGangguan fungsi ginjal yang sering terjadi pada pasien diabetes melitus tipe 2 diperankan oleh stres oksidatif. Belum diketahui efektivitas pengobatan diabetes melitus tipe 2 terhadap gangguan fungsi ginjal. Penelitian ini membandingkan dan menganalisis hubungan hidrogen peroksida urin yang merupakan produk stress oksidatif dan estimasi Laju Filtrasi Glomerulus (eLFG) pada kelompok pengobatan sulfonilurea dan kombinasi biguanid-sulfonilurea. Penelitian ini menggunakan desain penelitian kohort retrospektif dengan jumlah sampel 50 orang yang diambil di RSK Dr. Sitanala Tangerang dengan teknik total sampling. Nilai eLFG diperoleh berdasarkan nilai kreatinin serum yang diukur menggunakan metode kinetik Jaffe, sedangkan hidrogen peroksida urin menggunakan metode FOX (Ferrous ion Oxidation Xylenol Orange) 1. Nilai hidrogen peroksida urin pada dua kelompok pengobatan tidak memiliki perbedaan yang bermakna (p = 0,69). Sedangkan nilai eLFG pada dua kelompok juga tidak memiliki memiliki perbedaan yang bermakna dengan Cockroft Gault adalah p = 0,884; MDRD p = 0,886; dan CKDEP p= 0,490. Analisis hubungan hidrogen peroksida urin dengan eLFG berdasarkan persamaan MDRD dan CKDEPI menghasilkan hubungan positif bermakna (r = 0,326; p = 0,021) dan (r = 0,282; p = 0,047).

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ABSTRACT

, Renal dysfunction which frequently occurs in type 2 diabetes mellitus patients caused by oxidative stress. The effectiveness of the type 2 diabetes mellitus treatment to renal dysfunction is unknown. This study compare and analyze the correlation between urinary hydrogen peroxide which is a product of oxidative stress and estimated glomerular filtration rate (eGFR) in the treatment groups of sulfonylurea and combination biguanide-sulfonylurea. This study used a retrospective cohort study design with 50 sampels that was taken in Dr. Sitanala Tangerang hospital with total sampling technique. Estimated GFR value obtained based on serum creatinine values were measured using a kinetic Jaffe method, while the urinary hydrogen peroxide using FOX (Ferrous ion Oxidation Xylenol Orange) 1. Value of urinary hydrogen peroxide in the two treatment groups did not have significant difference (p = 0.69) , While the value eGFR the two groups did not have significant differences with the Cockroft Gault is p = 0.884; MDRD p = 0.886; and CKDEP p = 0.490. Analysis of urinary hydrogen peroxide and eGFR based on the MDRD equation and CKDEPI generate significant positive correlation (r = 0.326; p = 0.021) and (r = 0.282; p = 0.047).

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"Nefropati diabetik disebabkan oleh peningkatan aktivitas NADPH oksidase NOX yang diinduksi angiotensin II dan hipergikemia. Terapi ACE-inhibitor dan ARB memiliki potensi dalam menghambat aktivitas NOX. Namun perbandingan efektivitas keduanya belum diketahui. Peningkatan Aktivitas NOX ditandai oleh penurunan NADPH serum dan laju filtrasi glomerulus LFG. Namun hubungan antara NADPH serum dengan LFG juga belum diketahui. Tujuan dari penelitian ini adalah membandingkan kadar NADPH serum dan eLFG pada pasien diabetes melitus DM tipe 2 yang mendapat terapi ACE-inhibitor dan ARB serta menilai hubungan NADPH serum dengan eLFG. Penelitian ini menggunakan metode cross sectional. Pengambilan sampel dilakukan pada periode April hingga Mei 2018 di RSCM dan Puskesmas Kecamatan Pasar Minggu. Subjek dibagi menjadi 2 kelompok, yaitu kelompok yang mendapat terapi ACE-inhibitor n=11 dan kelompok yang mendapat terapi ARB n=25. Kadar NADPH dan kreatinin serum diukur menggunakan metode kolorimetri. Kelompok ARB memiliki rata-rata konsentrasi NADPH yang lebih tinggi 9,61 1,33 dibandingkan dengan kelompok ACE-Inhibitor 6,56 1,5 namun tidak memiliki perbedaan yang bermakna p>0,05. Selain itu kelompok ARB juga memiliki rata-rata eLFG 66,24 3,95 yang lebih tinggi dibandingkan dengan kelompok ACE-Inhibitor 61,11 7,41 namun tidak memiliki perbedaan yang signifikan p>0,05. Namun demikian terdapat hubungan yang bermakna dan positif antara kadar NADPH serum dengan eLFG r= 0,383.

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Diabetic nephropathy is caused by increased activity of NADPH oxidase NOX induced angiotensin II and hyperglycaemia. ACE inhibitor and ARB therapy have the potential to inhibit NOX activity. But the comparison of the effectiveness of both is unknown. Increased NOX activity is characterized by decreased serum NADPH and glomerular filtration rate GFR. However, the association between serum NADPH and GFR is also unknown. The purpose of this study was to compare serum NADPH and eGFR levels in type 2 diabetes mellitus DM patients who receiving ACE inhibitor and ARB therapy and also to evaluate serum NADPH association with eGFR. This research use cross sectional method. Sampling was conducted from April to May 2018 at RSCM and Puskesmas Kecamatan Pasar Minggu. Subjects were divided into 2 groups, the group receiving ACE inhibitor therapy n 11 and the group receiving ARB therapy n 25. NADPH and serum creatinine levels were measured using colorimetric method. The ARB group had a higher mean serum NADPH concentration 9.61 1.33 than the ACE Inhibitor group 6.56 1.5 but did not have a significant difference p 0.05 . In addition the ARB group also had an average eGFR 66.24 3.95 higher than the ACE Inhibitor group 61.11 7.41 but did not have a significant difference p 0.05. However, there was a significant and positive relationship between serum NADPH levels and eGFR r 0.383."

"Glomerulus pada nefropati diabetik dapat berkembang bahkan di bawah normoalbuminuria kondisi yang menghasilkan hiperfiltrasi glomerulus pada tahap awal. Salah satunya stres oksidatif penanda adalah kompleks oxLDL-β2 glikoprotein I yang berpartisipasi dalam glomerulosklerosis dan fibrosis interstitial. Penelitian ini bertujuan untuk menilai korelasi oxLDL-β2 glikoprotein I nilai konsentrasi dan eGFR kompleks dihitung menggunakan persamaan CKD-EPI dalam tipe 2 pasien diabetes mellitus untuk mencari penanda biologis potensial pada nefropati diabetik tahap hyperfiltration. Penelitian ini menggunakan desain cross-sectional yang dilakukan multisenter di 2015 di RSK. Sitanala, 2016 dan 2019 di Pusat Kesehatan Utama Pasar Minggu. Jumlah seluruhnya sampel (n = 180) dibagi menjadi dua kelompok, pasien eGFR ≥ 90 ml/menit/1,73 m2 (n = 118) dan eGFR 60-89 ml/menit/1,73 m2 (n = 62). The oxLDL-β2glycoprotein I serum kompleks dianalisis dengan AtherOx® ELISA Test Kit. Studi ini menunjukkan bahwa di sana tidak ada perbedaan yang signifikan secara statistik dari karakteristik dasar dan klinis karakteristik dari dua kelompok sampel, di samping usia (p <0,001). Itu juga menunjukkan ada tidak ada perbedaan yang signifikan (p = 0,262) dalam perbandingan serum oxLDL-β2glycoprotein I kadar kompleks dalam kelompok eGFR ≥ 90 ml/menit/1,73 m2 (0,51 ± 0,04 unit/mL) dan kelompok eGFR 60-89ml/menit/1,73 m2 (0,49 ± 0,05 unit/mL). Selain itu, tidak ada perbedaan signifikan (p = 0,071) kadar serum kompleks oxLDL-β2 glikoprotein I dengan subyek normoalbuminuria dan albuminuria dalam kelompok sampel. Berdasarkan Analisis, kompleks serum oxLDL-β2glycoprotein I tidak cukup spesifik sebagai penanda nefropati diabetik awal.

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Glomerular lesions in diabetic nephropathy can develop even under normoalbuminuria conditions that produce glomerular hyperfiltration in the early stages. One of them is oxidative stress The marker is a glycoprotein I oxLDL-β2 complex that participates in glomerulosclerosis and interstitial fibrosis. This study aims to assess the correlation of oxLDL-β2 glycoprotein I Complex concentration and eGFR values ​​are calculated using the CKD-EPI equation in type 2 diabetes mellitus patients to look for potential biological markers in diabetic nephropathy hyperfiltration stage. This study uses a cross-sectional design that is carried out in multicenter2015 in SSR. Sitanala, 2016 and 2019 at the Pasar Minggu Main Health Center. Total number the sample (n = 180) was/1.73 m2 (n = 118) and eGFR 60-89 ml/min/1.73 m2 (n = 62). The oxLDL-β 2 glycoprotein I complex serum was analyzed with the AtherOx® ELISA Test Kit. This study shows that there there were no statistically significant differences in baseline and clinical characteristics of the two sample groups, besides age (p <0.001). That also shows there there was no significant difference (p = 0.262) in the ratio of serum oxLDL-β2 glycoprotein I complex levels in the eGFR group ≥ 90 ml/min/1.73 m2 (0.51 ± 0.04 units/mL) and eGFR group 60-89 ml/min/1.73 m2 (0.49 ± 0.05 units/mL). Other than that, nothing significant difference (p = 0.071) serum levels of oxLDL-β2 glycoprotein I with normoalbuminuria and albuminuria subjects in the sample group. Based on Analysis, the serum oxLDL-β 2 glycoprotein I complex is not specific enough as a marker Early diabetic nephropathy."

"ABSTRAKStres oksidatif berperan dalam kerusakan fungsi ginjal pada pasien diabetes melitus tipe 2. Hingga saat ini belum ada penanda yang dapat mendeteksi kerusakan ginjal sejak awal. Penelitian ini bertujuan menganalisis kadar hidrogen peroksida pada urin sebagai penanda stres oksidatif dan mengungkap hubungan dengan estimasi laju filtrasi glomerulus sebagai parameter fungsi ginjal. Kadar hidrogen peroksida urin dan nilai eLFG juga dibandingkan antara dua kelompok pengobatan untuk mengetahui efektivitas pengobatan pada pasien diabetes melitus tipe 2. Desain penelitian yang digunakan adalah cross sectional dengan jumlah sampel keseluruhan sebanyak 84 orang. Pengambilan sampel dilakukan di puskesmas kecamatan Pasar Minggu. Nilai hidrogen peroksida urin diperoleh dengan pengukuran menggunakan metode Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) dan dinormalisasi dengan nilai kreatinin urin. Pengukuran kreatinin urin dilakukan dengan metode kinetik Jaffe. Perhitungan nilai eLFG diperoleh dengan 3 tiga rumus yaitu Cockroft-gault, MDRD, dan CKD-EPI. Kadar hidrogen peroksida urinpada dua kelompok pengobatan tidak berbeda bermakna (p = 0,545. Hasil uji beda nilai eLFG pada dua kelompok juga tidak berbeda bermakna (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Hasil analisis hubungan kadar hidrogen peroksida urin dengan ketiga nilai eLFG tidak menunjukkan hubungan yang bermakna (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703).

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ABSTRACTOxidative stress plays a major role in renal dysfunction caused by type 2 diabetesmelitus. Up to now, there is no biomarker can be used in early detection of renal dysfunction. This study aims to analyze of urinary hydrogen peroxide concentration as biomarker of oxidative stress and correlated it with estimated Glomerular Filtration Rate as parameters of renal function. Urinary hydrogen peroxide and value of eGFR were also compared between the two groups of treatment to find out the effectiveness of treatment in type 2 diabetic patients. Design of this study was cross sectional with 84 sample that was taken in Puskesmas Pasar Minggu. Concentration of urinary hydrogen peroxide were measured with Ferrous ion Oxidation Xylenol Orange 1 (FOX-1) method and normalize with urine creatinine that measured with kinetic Jaffe method. Three formulations used to measure value of eGFR were Cockroft-gault, MDRD, dan CKD-EPI. Concentration of urinary hydrogen peroxide in two groups of treatment have no significant difference (p = 0,545), while value of eGFR also didn?t have significant different (Cockroft-Gault p = 0,677; MDRD p = 0,830; dan CKD-EPI p= 0,548). Results of correlation analysis urinary hydrogen peroxide with eGFR showedno significant correlation (Cockroft-Gault p = 0,900 ; MDRD p = 0,842; dan CKD-EPI p= 0,703)."