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"Komplikasi penyakit ginjal pada pasien diabetes melitus ditandai oleh eksresi albumin secara progresif melalui urin dan penurunan laju filtrasi glomerulus. Komplikasi tersebut dapat dicegah atau diperlambat progresivitasnya dengan pemberian terapi antidiabetes. Metformin dan kombinasi metformin-sulfonilurea adalah antidiabetes yang sering diberikan kepada pasien diabetes melitus tipe 2, terutama di puskesmas. Penelitian ini bertujuan membandingkan urine albumine-to-creatinine ratio UACR dan estimation of glomerular filtration rate eGFR sebagai parameter fungsi ginjal antara dua kelompok pengobatan pada pasien diabetes melitus tipe 2. Desain penelitian yang digunakan adalah potong lintang dengan tehnik consecutive sampling. Sebanyak 88 sampel pasien diabetes melitus tipe 2 yang menggunakan metformin n=37 atau kombinasi metformin-sulfonilurea n=51 minimal selama satu tahun berpuasa selama 8 jam sebelum pengambilan urin dan darah untuk analisis UACR dan eGFR. Nilai UACR diperoleh dari perbandingan kadar albumin urin dengan kreatinin urin. Nilai eGFR diperoleh dengan menggunakan persamaan The Chronic Kidney Disease Epidemiology Collaboration CKD-EPI. Kreatinin serum dan kreatinin urin diukur secara kolorimetri enzimatik sedangkan albumin urin diukur secara imunoturbidimetri. Hasil menunjukan bahwa rata-rata nilai eGFR kelompok metformin dan kelompok kombinasi metformin-sulfonilurea berada pada kategori yang sama yaitu 60-89 mL/menit/1,73 m2 meskipun rata-rata nilai eGFR pada kelompok metformin lebih rendah daripada kelompok kombinasi metformin-sulfonilurea. Nilai UACR pada kelompok metformin lebih rendah daripada kelompok kombinasi metformin-sulfonilurea tetapi tidak menunjukan adanya perbedaan bermakna p>0,05.

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Complication of renal disease in diabetes melitus patient is characterized by progressive urinary albumin excretion and decreased glomerular filtration. The complication could be prevented or slowed down by theraphy antidiabetic. Metformin and sulphonylurea is the most comonly drugs prescribed as antidiabetic theraphy especially at public health centre. This study aimed to comparing urine albumin to creatinine ratio UACR and estimation of glomerular filtration rate eGFR as paramter of renal function between two type of theraphy on diabetes mellitus type 2 patient Design of this study was cross sectional and consecutive sampling method. A total of 88 samples of diabetes mellitus type 2 patient who was enrolled had taken metformin n 37 or combination of metformin sulphonylurea n 51 for at least one year fasted for 8 hours prior to urine and blood collection for UACR and eGFR analysis. UACR value was obtained from comparison of urine albumin with urine creatinine concentration. The value of eGFR was obtained using The Chronic Kidney Disease Epidemiology Collaboration CKD EPI equation. Serum creatinine and urine creatinine was measured by colorimetric enzymatic assay meanwhile urine albumin was measured by immunoturbidimetry. The result showed the average eGFR value in two groups were in the same category 60 89 mL menit 1,73 m2 although eGFR value average in metformin group lower than combination metformin sulphonylurea group. UACR in metformin group was lower than combination metformin sulphonylurea group but didn rsquo t show a significant different p 0,05."

"Penyakit Ginjal Diabetes (PGD) dapat menyebabkan albuminuria, yang berkembang menjadi insufisiensi ginjal. Namun, sekitar 20-40% kasus PGD merupakan PGD normoalbuminuria, yaitu gangguan fungsi ginjal dengan kadar albumin normal. Penelitian ini untuk membandingkan metabolit urin pada pasien penyakit ginjal diabetes dengan normoalbuminuria dan albuminuria yang mengonsumsi metformin-glimepirid. Desain penelitian potong lintang dengan metode consecutive sampling di Puskesmas Kecamatan Pasar Minggu dan RSUD Jati Padang. Sampel urin dan darah dikumpulkan untuk pengukuran HbA1c, UACR, dan analisis metabolit urin. Sebanyak masing-masing 16 pasien dibagi menjadi kelompok PGD normoalbuminuria dan PGD albuminuria, serta dianalisis metabolit urinnya menggunakan metabolomik tidak tertarget dengan Quadruple Time of Flight Liquid Chromatography-Mass Spectrometry. Metabolit yang berbeda signifikan divisualisasi dengan Projections to Latent Structures Discriminant Analysis (PLS-DA). Lalu, dianalisis nilai Variable Importance for the Projection (VIP) > 1.0; Fold Change (FC) >1,2 (p<0,05); dan Area Under the Receiver Operating Characteristic Curve (AUROC). Metabolit dengan nilai Area Under Curve (AUC) > 0,65 dinilai sebagai biomarker potensial. Tidak ada perbedaan bermakna pada karakteristik dasar dan klinis pada kedua kelompok, kecuali HbA1c (p<0,001). Terdapat 20 metabolit urin yang berbeda signifikan pada kelompok PGD normoalbuminuria dan albuminuria. Dari analisis jalur metabolisme pada metabolit tersebut ditemukan empat jalur metabolisme, yaitu metabolisme gliserofosfolipid, eter lipid, fenilalanin, dan triptofan. Dari keempat jalur metabolisme tersebut, ditemukan tiga metabolit biomarker potensial, yaitu glycerophosphocholine, hippuric acid, dan 2-aminobenzoic acid. Ketiga metabolit tersebut berkurang secara signifikan dari kondisi normoalbuminuria ke albuminuria. Oleh karena itu, diperlukan studi lanjut mengenai ketiga metabolit tersebut pada perkembangan PGD normoalbuminuria dan albuminuria.

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Diabetic Kidney Disease (DKD) leads to albuminuria and gradually progresses to renal insufficiency. However, about 20-40% of DKD are normoalbuminuric DKD, which has impaired kidney function with normal albumin levels. This study compared urine metabolites in patients consuming metformin-glimepiride with normoalbuminuric and albuminuria DKD. The research design was cross-sectional with consecutive sampling method at Pasar Minggu District Public Health Centre and Jati Padang Hospital. Urine and blood samples were collected for measurement of HbA1c, UACR, and metabolite analysis. There were each 16 samples divided into normoalbuminuric DKD group and albuminuria DKD group. All subjects were analysed using non-targeted metabolomics with Quadruple Time of Flight Liquid Chromatography-Mass Spectrometry. The signature metabolites were determined by Projections to Latent Structures Discriminant Analysis (PLS-DA) with Variable Importance for the Projection (VIP) > 1.0; Fold Change (FC) >1.2 (p<0.05); and Area Under the Receiver Operating Characteristic Curve (AUROC). Metabolites with an Area Under Curve (AUC) value > 0.65 are considered potential biomarkers. There were no significant differences in baseline and clinical characteristics of two groups, except for HbA1c (p<0.001). There were 20 metabolites identified between two groups. The metabolic pathway analysis of these metabolites found that four metabolic pathways were glycerophospholipid, ether lipid, phenylalanine, and tryptophan metabolism. There were three potential biomarkers, glycerophosphocholine, hippuric acid, and 2-aminobenzoic acid, enriched in these four metabolic pathways. Compared between normoalbuminuric and albuminuria groups these three metabolites were significantly reduced. Therefore, further studies are needed regarding these three metabolites in the development of normoalbuminuric and albuminuria DKD."