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"Monitoring efek samping obat perlu dilakukan terutama untuk antibiotik golongan aminoglikosida dengan indeks terapi sempit sehingga dapat meminimalisir masalah terkait obat. Penelitian ini bertujuan untuk melakukan monitoring efek samping obat pada pasien yang mendapatkan antibiotik aminoglikosida di Instalasi Rawat Inap RSUP Fatmawati periode Maret-Mei 2017. Metode penelitian yang digunakan adalah deskriptif analitik dengan pengambilan data secara prospektif menggunakan data primer dari wawancara pasien serta data sekunder dari resep pasien dan rekam medis. Data dikumpulkan secara total sampling. Analisis kasualitas efek samping dilakukan dengan menggunakan algoritma Naranjo. Total pasien yang memenuhi kriteria inklusi sebagai subjek penelitian adalah 33 pasien. Sebanyak 14 pasien 42,4 mengalami efek samping nefrotoksik dan 5 pasien 15,2 mengalami ototoksik. Berdasarkan analisis algoritma Naranjo, 5 kejadian 15,15 dikategorikan mungkin probable . Hasil uji chi square menunjukkan tidak ada hubungan antara usia P = 0,726 dan jenis kelamin P = 0,620 dengan efek samping obat.

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Monitoring of drug side effects needs to be done especially for aminoglycoside antibiotic with narrow therapeutic index to minimize drug related problems. The purpose of this research was to monitor the side effects of patients who received aminoglycoside antibiotics at the Inpatient Installation of Fatmawati Hospital from March to May 2017. The method of this research was analytical descriptive with prospective data were collected from primary data through patient interview and secondary data through patient prescription and medical record. Data were collected by total sampling.

Causality analysis of side effects was done by using Naranjo Algorithm. Total patients who participated for the study were 33 patients. Fourteen patients 42.4 experienced nephrotoxicity and 5 patients 15,2 experienced ototoxicity. Based on Naranjo algorithm analysis, five 15,15 were catagorized as probable. The result of chi square test showed there was no correlation between age P 0.726 and sex P 0.620 with drug side effects."

"Latar belakang: Gangguan ginjal akut (GnGA) pada anak sakit tidak kritis salah satunya dapat terjadi akibat pajanan agen nefrotoksik. Aminoglikosida (AG) merupakan agen nefrotoksik yang sering digunakan, tetapi GnGA terkait AG (GnGA-AG) seringkali terlambat atau tidak terdeteksi karena sifatnya yang non-oligurik dan pemantauan fungsi ginjal yang tidak adekuat pasca pemberian AG. Saat ini belum ada penelitian yang menyajikan data insidens dan prediktor GnGA-AG di Indonesia.Tujuan: Tujuan penelitian ini adalah untuk mengetahui insidens GnGA-AG dan faktor prediktornya pada pasien anak sakit tidak kritis.Metode: Penelitian ini merupakan studi deskriptif analitik dengan rancangan penelitian kohort retrospektif observasional. Penelitian dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM) menggunakan data rekam medik dari Januari 2023 hingga Desember 2024. Subyek penelitian adalah pasien anak usia 1 bulan hingga 18 tahun dengan sakit tidak kritis yang dirawat di RSCM, mendapatkan terapi AG dan diperiksakan kadar kreatinin darah. Kriteria eksklusi meliputi pasien yang diketahui memiliki kelainan anatomi dan fungsi ginjal sebelumnya, pasien transplantasi organ, jatuh dalam kondisi sakit kritis dan meninggal. Faktor risiko yang diteliti adalah durasi terapi aminoglikosida, pajanan nefrotoksik lain, penyakit dasar hematologi-onkologi, fokus infeksi saluran pernapasan, dan lama rawat sebelum pemberian AG.Hasil: Pemeriksaan kreatinin serum dilakukan pada 52,2% (83/159) subyek yang diinklusi. Gangguan fungsi ginjal ditemukan pada 19,3% (16/83) pasien yang diperiksakan kreatinin serum, dengan setengahnya (8/16) termasuk dalam GnGA derajat 1. Dari 83 subyek, 89% (74/83) mendapat terapi AG dengan durasi 5 hari atau lebih; 47% (39/83) mendapat 3 nefrotoksik atau lebih; 36% (30/83) dengan penyakit dasar terkait hematologi-onkologi; 22,9% (19/83) mendapat terapi AG atas indikasi infeksi saluran pernapasan; 50,6% (42/83) telah dirawat lebih dari 9 hari sebelum inisiasi AG. Tidak terdapat perbedaan proporsi faktor risiko pada kelompok dengan GnGA-AG dan tidak GnGA-AG. Pada subyek dengan GnGA-AG, 10/16 (62,5%) mendapat terapi AG dengan dosis harian ganda. Satu dari 16 pasien yang mengalami GnGA-AG masih mengalami penurunan fungsi ginjal pada evaluasi 3 bulan setelahnya.Simpulan: Insidens GnGA-AG pada anak sakit tidak kritis di RSCM adalah 19,3%. Terdapat tren peningkatan GnGA-AG pada subyek yang mendapat terapi AG dengan durasi 5 hari atau lebih, mendapat nefrotoksik 3 jenis atau lebih, memiliki penyakit dasar hematologi-onkologi, dan fokus infeksi saluran pernapasan.

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Background: One of the leading causes of acute kidney injury (AKI) in non-critically ill pediatric petients is exposure to nephrotoxic agents. Aminoglycosides (AG) are one of the commonly used nephrotoxic agents. However, AKI associated to AG (AG-AKI) is often delayed in detection due to its non-oliguric nature and inadequate monitoring of kidney function after AG administration. Currently, no studies have presented data on the incidence and predictors of AKI-AG in Indonesia.

Objective: This study aims to determine the incidence of AG-AKI and its predictors in non-critically ill pediatric patients.

Method: This study is a descriptive analytic study with retrospective observational cohort design. The study was conducted at Cipto Mangunkusumo Hospital (RSCM), utilizing medical record data from January 2023 to December 2024. Study subjects included pediatric patients aged 1 month to 18 years, non-critically ill, who received AG therapy and underwent serum creatinine evaluation. Exclusion criteria included patients with known pre-existing anatomical or functional kidney abnormalities, organ transplant recipients, critically ill patients, and those who passed away during observation. Risk factors investigated were the duration of AG therapy, exposure to other nephrotoxic agents, underlying hematology-oncology diseases, respiratory tract infection as the infection focus, and length of hospital stay before AG administration.

Results: Post AG serum creatinine was evaluated in 52.2% (83/159) of included subjects. Kidney dysfunction was identified in 19.3% (16/83) of patients, with half (8/16) classified as AKI stage 1. Among the 83 subjects, 89% (74/83) received AG therapy for 5 days or more; 47% (39/83) were exposed to three or more nephrotoxic agents; 36% (30/83) had underlying hematology-oncology conditions; 22.9% (19/83) received AG therapy for respiratory tract infections; and 50.6% (42/83) had been hospitalized for more than 9 days before AG initiation. No significant differences in risk factor proportions were found between the AG-AKI and non-AG-AKI groups. Among AG-AKI subjects, 10/16 (62.5%) received AG therapy with a multiple daily dose. One of the 16 AG-AKI patients exhibited persistent kidney dysfunction upon evaluation 3 months later.

Conclusion: The incidence of AG-AKI among non-critically ill pediatric patients at RSCM was 19.3%. There is a trend of increased AG-AKI in subjects who received AG therapy for 5 days or more, were exposed to 3 or more nephrotoxic agents, had underlying hematology- oncology conditions, and had respiratory tract infections as the primary infection site."

"Latar BelakangKemoterapi dengan cisplatin merupakan modalitas utama pada terapi pada kanker ovarium, walaupun telah diketahui toksisitasnya pada berbagai organ termasuk ginjal. Kurkumin, senyawa fenolik yang diperoleh dari Curcuma longa, diketahui memiliki efek proteksi pada ginjal akibat cisplatin pada berbagai model toksisitas in vivo. Namun, efek kurkumin pada ginjal dibatasi oleh bioavailabilitasnya yang rendah. Kelompok penelitian kami telah berhasil mengembangkan formulasi kurkumin nanopartikel baru yang telah terbukti memperbaiki efikasi cisplatin pada model kanker ovarium. Namun, belum diketahui apakah formulasi kurkumin nanopartikel ini juga dapat memperbaiki fungsi dan kondisi inflamasi pada ginjal yang disebabkan oleh cisplatin.MetodeSebanyak 24 ekor tikus Wistar betina dibagi menjadi: 6 ekor tikus normal (sham treatment) dan 18 ekor tikus yang diinduksi menjadi kanker ovarium dengan DMBA. Tikus kanker ovarium dibagi menjadi 3 kelompok masing-masing 6 ekor yang menerima cisplatin 4 mg/kgBB/minggu atau cisplatin 4 mg/kgBB/minggu +kurkumin 100 mg/kgBB/hari atau cisplatin 4 mg/kgBB/minggu + nanokurkumin 100 mg/kgBB/hari. Terapi diberikan selama 4 minggu, kemudian dilakukan terminasi dan diambil darah dan organ ginjal untuk analisis penanda fungsi ginjal dan inflamasi.HasilNanokurkumin dapat menurunkan kadar ureum serum signifikan dibandingkan kelompok cisplatin, namun tidak mempengaruhi kadar kreatinin dan sedikit menurunkan kadar neutrophil gelatinase-associated lipocalin (NGAL). Nanokurkumin tidak berhasil menurunkan kadar penanda inflamasi: TNF-, IL-1β dan IL-6.KesimpulanNanokurkumin memiliki kecenderungan untuk memperbaiki beberapa penanda fungsi ginjal dalam darah pada model kanker ovarium yang diberikan cisplatin, namun tidak mempengaruhi kadar penanda inflamasi di ginjal.

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Background

Cisplatin remains the main modality of treatment for ovarian cancer, despite its known toxic effects to various organs, including the kidney. Curcumin, a phenolic compound derived from Curcuma longa, was known to have a renoprotective effect on cisplatin- induced in vivo models. However, the beneficial effect of curcumin on the kidney is limited by its low bioavailability. Our research group has successfully developed a novel curcumin nanoparticle formulation that has been shown to improve the efficacy of cisplatin in ovarian cancer models. However, it is not yet known whether this curcumin nanoparticle formulation can also improve kidney function and inflammatory conditions caused by cisplatin in ovarian cancer models.

Method

A total of 24 female Wistar rats were divided into: 6 normal rats (sham treatment) and 18 rats induced to develop ovarian cancer with DMBA. Ovarian cancer rats were divided into 3 groups of 6 each receiving cisplatin 4 mg/kgBW/week or cisplatin 4 mg/kgBW/week + curcumin 100 mg/kgBW/day or cisplatin 4 mg/kgBW/week + nanocurcumin 100 mg/day. kgBB/day. Therapy was given for 4 weeks, then terminated and blood and kidney were taken for analysis of markers of kidney function and inflammation.

Results

Nanocurcumin lowered serum urea levels significantly compared to the cisplatin group. However, nanocurcumin did not alter creatinine levels and slightly reduced serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations. Nanocurcumin was did not affect the inflammatory markers studied: TNF-, IL-1β and IL-6.

Conclusion

Nanocurcumin has a tendency to improve several markers of kidney function in cisplatin- treated ovarian cancer models. However, the effect was not associated by the alteration of inflammatory cytokines in the kidney."