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Abstrak :
Hemodialisis merupakan terapi pengganti fungsi ginjal terbanyak pada pasien gagal ginjal tahap akhir. Pasien yang menjalani terapi hemodialisis rutin sering mengalami penurunan kualitas hidup. Penelitian ini bertujuan menganalisis hubungan pola terapi, nilai ureum-kreatinin plasma dan hemoglobin dengan kualitas hidup pasien hemodialisis. Desain menggunakan cross sectionaldengan consecutive sampling terhadap 62 responden yang menjalani hemodialisis rutin di RSUD Dr. Soedarso Pontianak. Penilaian kualitas hidup dengan menggunakan kuesioner SF-36. Data menggunakan hasil regresi linier bergandamenunjukkan ada hubungan signifikan (p<0,05) antara durasi, frekuensi, terapi eritropoetin,nilai ureum-kreatinin plasma, hemoglobin, dan keputusasaan dengan kualitas hidup. Perawat perlu meningkatkan kualitas asuhan keperawatan untuk meningkatkan kualitas hidup pasien hemodialisis. ......Hemodialysis is the most renal replacement therapy for end stage renal disease. Patients undergoing regular hemodialysis often experience decreased in quality of life. The aim of this study was to analyze the relationship between pattern of therapy, urea-creatinine level of plasma and hemoglobin with quality of life patients undergoing hemodialysis. Research design used is cross sectional with consecutive sampling to 62 respondents underwent regular hemodialysis at Dr Soedarso general hospital. Quality of life was measured using SF-36 questionnaires. Data using the multiple linear regression showed no significant relationship (p <0.05) between duration, frequent, Erythropoietin therapy, urea-creatinine level of plasma, hemoglobin and hopelessness with patients quality of life. Nurses need to enhance quality of nursing care to improve the quality of life for the patients undergo hemodialysis.

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ABSTRAK
Sistem perkemihan merupakan sistem yang penting untuk membuang sisa-sisa metabolisme makanan yang dihasilkan oleh tubuh. Salah satunya yaitu kreatinin dalam urin, namun seringkali urin datang ke laboratorium sudah tidak segar lagi dan telah dikeluarkan beberapa jam sebelumnya tanpa bahan pengawet. Penyimpanan sampel ini penting untuk diperhatikan, Salah satu cara yang saat ini dipergunakan untuk penyimpanan sampel urin yaitu dengan cara penyimpanan sampel urin didalam suhu rendah dan penambahan pengawet. Penelitian ini bertujuan untuk mengetahui pengaruh waktu dan kondisi penyimpanan urin terhadap kestabilan kreatinin. Pendeteksian kreatinin didasarkan pada reaksi Jaffe yang terjadi antara kreatinin dan asam pikrat dalam medium basa untuk membentuk senyawa berwarna orange dan diukur dengan menggunakan spetrofotometer UV-Visibel. Absorbansi dari senyawa yang terbentuk diukur pada panjang gelombang 483 nm. Metode yang digunakan memenuhi beberapa kriteria validasi yaitu, linieritas, presisi, batas deteksi, batas kuantifikasi, serta perolehan kembali. Diperoleh nilai R2 ≥ 0.998 dengan rentang 200- 1000 ppm. Nilai presisi yang dinyatakan dengan %RSD berada pada 2.42% - 6.39%. Batas deteksi yang diperoleh yaitu 0.96 ppm dan batas kuantifikasi 3.20 ppm. Persen perolehan kembali didapat 107%. Kemudian metode ini digunakan dalam menganalisa kadar senyawa kreatinin. Didapat kondisi penyimpanan yang paling baik adalah dengan penambahan pengawet dan disimpan pada suhu 8oC.

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ABSTRACT
Urinal System is a system that is essential to remove the remain of the food produced by the metabolism of the body. One of them is of creatinine, but the urine is often no longer fresh when it comes to the laboratory and has been saved for several hours without preservatives. Sample storage is important thing to be concerned. One of the sample storage which is currently used for urine samples is saving the samples in the low temperature and the addition of preservatives. This study aims to determine the effect of time and storage conditions on the stability of creatinine. Creatinine detection based on the Jaffe reaction which occurs between creatinine and picric acid in alkaline medium to form a orange colored compound. Absorbance of the compound formed was measured by spectrophotometer UV-Visible at a wavelength of 483 nm. The method used had met several criteria in terms of validation of linearity, precision, limit of detection, limit of quantification, and recovery. Obtained R2 value ≥ 0.998 with a range of 200-1000 ppm. Precision values are expressed as % RSD is at 2.42% - 6.39%. The detection limit is 0.96 ppm obtained and quantification limits of 3.20 ppm. Percent recoveries obtained 107%. Then the method is used to analyze the levels of creatinine compounds. Obtained the best storage conditions is the addition of preservatives and stored at 8oC.

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[ABSTRAK
Telah dilakukan penelitian untuk mengetahui kadar kreatinin plasma tikus putih (Rattus norvegicus L.) jantan galur Sprague-Dawley setelah pemberian infusa daun sukun (Artocarpus altilis). Sebanyak 30 ekor tikus dibagi menjadi 6 kelompok, yaitu 2 kelompok kontrol dan 4 kelompok perlakuan yang diinduksi CCl4 kemudian diberikan infusa daun sukun dengan dosis 1,35; 2,7; 5,4; dan 10,8 g/kg BB. Uji kualitatif pada infusa daun sukun menunjukkan bahwa infusa daun sukun memiliki aktivitas antioksidan serta mengandung senyawa alkaloid dan flavonoid. Infusa diberikan sebanyak empat kali dengan selang waktu 12 jam. Pengambilan darah dilakukan sebanyak tiga kali, yaitu sebelum perlakuan, 12 jam setelah induksi CCl4, dan satu jam setelah pemberian infusa terakhir. Analisis sampel darah dilakukan menggunakan metode kolorimetri. Induksi CCl4 berhasil meningkatkan kadar kreatinin plasma tikus di atas batas normal. Rerata kadar kreatinin plasma tikus setelah pemberian infusa terakhir yaitu KK1 (0,80 0,11); KK2 (1,44 0,21); KP1 (1,12 0,42); KP2 (0,76 0,40); KP3 (0,56 0,06); dan KP4 (0,76 0,17). Uji LSD (P<0,05) menunjukkan bahwa terdapat perbedaan bermakna antara KK2 dengan KK1, KP2, KP3, dan KP4. Hal tersebut menunjukkan bahwa pemberian infusa daun sukun dengan dosis 2,7; 5,4; dan 10,8 g/kg BB berpengaruh terhadap kadar kreatinin plasma tikus. ABSTRACT
The present study was aim to assess plasma creatinine levels of male albino Sprague-Dawley rats (Rattus norvegicus L.) after breadfruit leaf (Artocarpus altilis) infusion intake. Thirty male rats were devided into six groups, consisting of two control group and four treatment groups CCl4-induced and were given breadfruit leaves infusion at concentration dose of 1,35; 2,7; 5,4; and 10,8 g/kg body weight, respectively. Qualitative test of breadfruit leaves infusion showed that it has antioxidant activity and positively contains alkaloid and flavonoid. Breadfruit leaves infusion were given orally and administered four times, with an interval of twelve hours. Plasma creatinine levels were measured three times, before treatment; 12 hours after CCl4-induced; and 1 hour after the last breadfruit infusion intake using colorimetric method. Plasma creatinine levels was elevated above the upper limits of normal after CCl4-induced. Mean of plasma kreatinine levels of the last analysis: KK1 (0,80 0,11); KK2 (1,44 0,21); KP1 (1,12 0,42); KP2 (0,76 0,40); KP3 (0,56 0,06); and KP4 (0,76 0,17) mg/dl. Least significant diffrence (LSD) test (P<0,05) showed a significant effect of breadfruit leaves infusion at dose of 2,7; 5,4; and 10,8 g/kg bw on plasma creatinine levels of rats. , The present study was aim to assess plasma creatinine levels of male albino Sprague-Dawley rats (Rattus norvegicus L.) after breadfruit leaf (Artocarpus altilis) infusion intake. Thirty male rats were devided into six groups, consisting of two control group and four treatment groups CCl4-induced and were given breadfruit leaves infusion at concentration dose of 1,35; 2,7; 5,4; and 10,8 g/kg body weight, respectively. Qualitative test of breadfruit leaves infusion showed that it has antioxidant activity and positively contains alkaloid and flavonoid. Breadfruit leaves infusion were given orally and administered four times, with an interval of twelve hours. Plasma creatinine levels were measured three times, before treatment; 12 hours after CCl4-induced; and 1 hour after the last breadfruit infusion intake using colorimetric method. Plasma creatinine levels was elevated above the upper limits of normal after CCl4-induced. Mean of plasma kreatinine levels of the last analysis: KK1 (0,80 0,11); KK2 (1,44 0,21); KP1 (1,12 0,42); KP2 (0,76 0,40); KP3 (0,56 0,06); and KP4 (0,76 0,17) mg/dl. Least significant diffrence (LSD) test (P<0,05) showed a significant effect of breadfruit leaves infusion at dose of 2,7; 5,4; and 10,8 g/kg bw on plasma creatinine levels of rats. ]

Abstrak :
Pendahuluan: Penyakit ginjal diabetikum PGD merupakan komplikasi diabetes dan etiologi utama dari penyakit ginjal kronis PGK . Konsumsi diet yang tinggi akan fruktosa dan kolesterol dapat berujung pada PGD. Obat yang menjadi lini pertamanya adalah penghambat sistem renin-angiotensin-aldosteron RAA , seperti kaptopril. Diperlukan agen yang dapat membantu penanganan PGD dengan menargetkan jalur patofisiologis lainnya. Beberapa studi telah menunjukkan potensi efek renoprotektif dari Acalypha indica AI , sehingga dapat menjadi alternatif penanganan PGD. Metode: Sebanyak 32 ekor tikus Sprague-Dawley dibagi ke dalam enam kelompok, dengan empat yang mendapatkan diet tinggi fruktosa dan kolesterol DTFK dan dua mendapatkan diet normal selama tujuh minggu. Selama empat minggu berikutnya tiga kelompok DTFK mendapatkan terapi dengan AI 250 mg/kgBB , kaptopril 2,5 mg/kgBB , dan kombinasi keduanya, sementara satu kelompok diet normal diterapi dengan AI. Dilakukan pengukuran kadar ureum dan kreatinin serum dari sampel darah yang diperoleh sebelum minggu ke-7 dan sesudah terapi diberikan minggu ke-11. Hasil: Pada kelompok normal, pemberian AI dapat menurunkan kadar ureum dan kreatinin serum, meskipun tidak berbeda secara signifikan dengan kontrol normal. Pada kelompok DTFK, monoterapi AI dan kaptopril dapat menurunkan kadar ureum serum jika dibandingkan dengan kontrol negatif, namun tidak berbeda secara signifikan. Sementara itu, kadar keratinin serum kedua kelompok tersebut mengalami penurunan. Terapi kombinasi ditemukan menimbulkan peningkatan kadar ureum dan kreatinin serum yang berbeda secara signifikan dengan kelompok kaptopril dan kedua kelompok normal. Ini dapat mengindikasikan potensi interaksi antagonistik antara AI dan kaptopril. Kesimpulan: Pemberian AI secara tunggal cenderung memberikan efek protektif terhadap ginjal, meskipun tidak signifikan secara statistik. Terdapat potensi interaksi antagonistik antara AI dengan kaptopril, yang dapat berdampak negatif bagi ginjal. Diperlukan penelitian lebih lanjut untuk mengkaji efek renoprotektif dari AI dan potensi interaksi antagonistiknya dengan kaptopril.

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Introduction Diabetic kidney disease DKD is a complication of diabetes and main etiology of chronic kidney disease CKD . Consumption of diets with high fructose and cholesterol content may lead to the development of DKD. Drugs that inhibit the rennin angiotensine aldosterone RAA system, such as captopril, are the first line treatment for the disease. Studies have shown that Acalypha indica AI has a potential renoprotective effect, thus it may become an alternative treatment for DKD. Method Thirty two Sprague Dawley rats are divided into six groups, with four groups receiving high fructose and high cholesterol diet HF CD and two groups receiving normal diet for seven weeks. After that, for another four weeks, three groups with HF CD received treatment with AI 250 mg kgBW , captopril 2,5 mg kgBW , and both, while one group with normal diet received treatment with AI. Serum urea and creatinine levels from blood samples collected before week 7 and after the therapy was given week 11 were measured. Results In the normal group, AI therapy decreases serum urea and creatinine levels, but the difference is not stastically significant. In the HF CD group, AI and captopril monotherapy is shown to decrease serum urea and creatinine levels compared to negative control group, though not statistically significant. Meanwhile, the serum creatinine levels of the two groups decrease. Combination therapy group is found to elevate serum urea and creatinine levels. The elevation of serum urea level is significantly different with captopril group and the two normal groups. This may indicate potential antagonistic interaction between AI and captopril. Conclusion AI as a monotherapy has a tendency to give protective effect to the kidney, though is not statistically significant. This study has also shown antagonistic interaction between AI and captopril, which may have negative effects toward the kidney. Another study should be conducted to learn more about the renoprotective effect of AI and its potential antagonistic interaction with captopril.

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ABSTRAK
Leukemia Limfoblastik Akut LLA merupakan penyakit keganasan sel darah yang ditandai dengan akumulasi sellimfoblas dan sering terjadi pada anak-anak.. Pemberian cytarabine dapat secara klinis mengeradikasi sisa-sisa selkeganasan, namun memiliki efek samping salah satunya dapat merusak jaringan ginjal. Sampai saat ini, protokolbelum memiliki pedoman tentang penyesuaian dosis rejimen cytarabine kepada berbagai kelompok usia anak.Penelitian ini bertujuan untuk melihat perbedaan nilai kreatinin darah di kelompok usia yang berbeda. Desainpenelitian adalah potong lintang dengan consecutive sampling pada 50 pasien yang sesuai dengan kriteria. Datadidapatkan dari Laboratorium Departemen Patologi Klinik RSCM berdasarkan rekam medis yang didapatkan dariRS Ciptomangun Kusumo. Data nilai kreatinin pada kelompok usia yang berbeda memperlihatkan persebaranyang tidak normal dengan nilai median kreatinin darah 0.4mg/dL p=0.00 . Perbandingan median kedua kelompokdilakukan dengan uji Mann ndash; Whitney dan menunjukkan hasil signifikan dengan nilai median kelompok usia 1-12 tahun sebesar 0.3mg/dL dan kelompok usia 13-18 tahun sebesar 0.5mg/dL dengan selisih nilai median0.2mg/dL p=0.001 . Terjadi peningkatan nilai kreatinin lebih banyak pada subjek kelompok usia 13-18 tahun 23.5 dibandingkan dengan kelompok usia 1-12 tahun 6.1 . Perbedaan median nilai kreatinin darah antarakelompok usia 1-12 tahun dan 13-18 tahun tidak menunjukan peningkatan melebihi batas ambang, namunbermakna secara statistik.

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ABSTRACT
Acute Lymphoblastic Leukemia ALL is a blood neoplastic disease which characterized by accumulation oflymphoblastic cells and occurs frequently in children. The medication protocol has many regiments withCytarabine among all of the drugs which being used for the reinduction phase therapy. It has some adverse effectslike damaging kidneys by certain mechanisms. This study aims to see the difference of the level of serum creatininein different pediatric age groups. This study is using cross sectional as the design of the study with 50 samplesaccording to the criteria using consecutive sampling technique. Datas gathered from Laboratory of ClinicalPathology Department according to medical record from Cipto Mangunkusumo National Hospital. The serumcreatinine level from both pediatric age groups shows an uneven distribution with 0.4mg dL p 0.00 as the medianof the serum creatinine level from both groups. The comparison of both median tested by Mann Whitney methodand shows a significant result with 0.3mg dL as the median of pediatric aged 1 12 group and 0.5mg dL as themedian of pediatric aged 13 18 group with 0.2mg dL as the difference between both median p 0.001 . Pediatricaged 13 18 group shows more subject with increased serum creatinine level 23.5 than the pediatric aged 1 12group 6.1 . The median difference of serum creatinine level between pediatric group aged 1 12 and 13 18 showsan increasing serum creatinine value below the cut off but statistically significant.

Abstrak :
Latar Belakang: Ventilasi mekanik merupakan salah satu prosedur yang sering digunakan dalam penatalaksanaan pasien sakit kritis yang mengalami gagal napas. Penggunaan ventilator jangka panjang (Prolonged Mechanical Ventilation, PMV) meningkatkan morbiditas dan mortalitas. Salah satu faktor risiko yang berperan dalam terjadinya PMV adalah malnutrisi dan sarkopenia, yang ditandai dengan hilangnya massa dan fungsi otot. Di satu sisi, sakit kritis sendiri ditandai dengan hipermetabolisme dan peningkatan katabolisme protein otot itu sendiri. Pemantauan massa otot di perawatan intensif menjadi penting, namun belum ada metode pengukuran yang cukup praktis dalam menggambarkan massa otot tubuh. Creatinine Height Index dapat menjadi salah satu penanda massa otot tubuh sehingga diperkirakan terdapat perbedaan perubahan Creatinine Height Index terhadap keberhasilan penyapihan pada pasien dengan penggunaan ventilator jangka panjang. Metode: Penelitian ini merupakan studi prospektif observasional pada pasien sakit dengan PMV di RSUPN dr. Cipto Mangunkusumo dan RS Universitas Indonesia. Dilakukan pengukuran Creatinine Height Index (CHI) pada 72 jam pertama pemakaian intubasi dan diulang pada saat pasien ekstubasi atau maksimal hari ke-14 penggunaan ventilator. Hasil Creatinine Height Index akan dilihat berdasarkan keberhasilan penyapihan. Karakteristik subjek lainnya meliputi usia, jenis kelamin, riwayat asupan bahan makanan sumber kreatin, aktivitas fisik pra admisi, imbang cairan kumulatif, asupan energi dan protein selama perawatan di ICU. Hasil: Terdapat 27 subjek dengan rerata usia 46 tahun dan mayoritas laki-laki (67%). Nilai CHI awal dan akhir tidak berbeda pada kelompok yang berhasil maupun yang gagal menyapih (p = 0,466 dan p = 0,494), namun nilai perubahan CHI berbeda bermakna secara statistik pada mereka yang mengalami berhasil menyapih dan gagal menyapih (p= 0,009). Kelompok yang gagal menyapih mengalami penurunan nilai CHI sebesar 3,9 (-18,3;23,7)%. Kesimpulan: Tidak terdapat perbedaan bermakna pada nilai CHI awal maupun akhir pada kelompok yang berhasil dan gagal menyapih. Terdapat perbedaan bermakna secara statistik pada perubahan nilai CHI pada kelompok yang berhasil dan gagal menyapih. Kelompok yang gagal menyapih mengalami penurunan nilai CHI, sementara kelompok yang berhasil menyapih tidak mengalami hal tersebut ......Background: Mechanical ventilation is one of the procedures that frequently used in the management of critically ill patients experiencing respiratory failure. Prolonged mechanical ventilation increases morbidity and mortality. One of the risk factors contributing to prolonged mechanical ventilation (PMV) is malnutrition and sarcopenia, characterized by loss of muscle mass and its function. On one hand, critical illness itself is marked by hypermetabolism and increased muscle protein catabolism. Monitoring muscle mass in intensive care is essential, but there is currently no practical method for describing whole-body muscle mass. Creatinine Height Index could serve as an indicator of body muscle mass, suggesting potential differences between Creatinine Height Index level changes and successful weaning in patients with prolonged mechanical ventilation. Methods: This study is a prospective observational study conducted on critically ill patients with prolonged mechanical ventilation (PMV) at RSUPN dr. Cipto Mangunkusumo and RS Universitas Indonesia. Creatinine Height Index (CHI) was measured within the first 72 hours of intubation and repeated upon extubation or by day 14 of ventilation. CHI results were then categorized based on weaning success. Other subject characteristics included age, gender, history of dietary creatine intake, pre-admission physical activity, cumulative fluid balance, energy intake, and protein intake during ICU hospitalization. Results: There were 27 subjects with a mean age of 46 years, predominantly male (67%). Initial and final CHI values did not differ between the successful and failed weaning groups (p = 0.466 and p = 0.494, respectively), but there was a statistically significant difference in the change in CHI values between those who successfully weaned and those failed (p = 0.009). The failed weaning group experienced a decrease in CHI values by 3.9 (-18.3; 23.7)%. Conclusion: There was no significant difference in initial or final CHI values between the groups that successfully weaned and those who failed. However, there was a statistically significant difference in the CHI values alteration between those groups. The failed weaning group experienced a decrease in CHI values, while the successful weaning group did not.