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Abstrak :
ABSTRAK Suhu di area hot pres dalam kisaran 1650 C-185 0 C. Tingkat beban kerja ringan sampai dengan sedang, lama kerja 8 jam per hari. Upaya perlindungan tidak selalu bisa dicapai akibat faktor alam, teknis maupun faktor individu. Efek tekanan panas terhadap tubuh memberikan reaksi vasodilatasi pembuluh darah dan efek berkeringat. Belum ada data yang memberikan gambaran efek tekanan panas dalam jangka panjang terhadap fungsi ginjal. Diperlukan upaya deteksi secara dini untuk menghindari efek kerusakan ginjal yang bersifat permanen. Metode : Penelitian ini dilakukan secara potong lintang. Responden dipilih secara rendom. Tekanan panas diukur dengan alat Quest temp 34. Kadar cystatin C serum dianalisa dengan metode PENIA yang dijabarkan dalam estimasi laju filtrasi glomerolus dengan metode CKD EPI. Berat jenis urin diukur pada awal kerja dan akhir shift kerja. Variabel lainnya diperoleh melalui pemeriksaan fisik dan wawancara. Outcome didefiniskan sebagai gangguan ginjal yaitu kenaikan atau penurunan estimasi laju filtrasi glomerulus dibadingkan dengan nilai rerata sesuai usia dengan standar deviasi sebesar 15 ml/menit. Faktor dominan yang mempengaruhi gangguan ginjal diperoleh dari analisa multivariat dengan regresi logistik menggunakan SPSS 17,5. Hasil : Penelitian ini dilakukan terhadap 101 responen di area dengan tekanan panas antara 28,50 C-31,50 C (ISBB). Prevalensi gangguan ginjal sebesar 17,9%(hyperfiltrasi sebesar 16% dan hipofiltrasi 1,9%). Lama terpajan >15343 jam memiliki risiko terjadinya gangguan ginjal sebesar 7 kali lipat (OR 7,919) dibandingakan dengan lama terpajan ≤15343 jam dengan nilai p 0,001. Pada uji multivariat diperoleh faktor usia >29 tahun merupakan faktor risiko. Terjadi peningkatan risiko 16 kali lipat (OR16,39) pada pekerja dengan usia > 29 tahun dengan nilai p 0,000. Kesimpulan : Prevalensi gangguan ginjal (abnormal eLFG) pada pekerja hot press sebesar 17,9% (hyperfiltrasi sebesar 16% dan hipofiltrasi 1,9%). Usia merupakan faktor dominan gangguan ginjal. Usia >29 dan memiliki risiko 16 kali lipat lebih tinggi sedangkan lama terpajan >15343 jam memiliki risiko 7 kali lipat (OR 7,919).

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ABSTRACT Background: Temperature in hot press area in the range 1650 C-185 0 C. Workers performed of activity with mild to medium load for 8 hours per day. Protective measures can not always be achieved due to natural factors, technical and individual factors. The effects of heat stress on the body to react vasodilatation and sweating effect. No data that gives an explanation of the effects of heat stress in the long term on kidney function. Early detection efforts are needed to avoid the effects of permanent kidney damage. Metode: The motode of this study is a cross-sectional basis. Respondents were selected rendom. Heat stress was measured by Quest temp 34. Cystatin C serum level was analyzed by the method PENIA which described into glomerular filtration rate estimate by the method of CKD EPI. While the urine specific gravity was measured at the beginning and end of the work shift work. Other variables obtained through physical examination and interviews. Outcome of renal disorder is defined as an increase or decrease in filtration rate estimation glomerular which is compared to an average value according to age with a standard deviation of 15 ml / min. Dominant factor affecting kidney disorders derived from multivariate logistic regression analysis using SPSS 17,5. Result: The study was conducted on 101 responen who work in areas with hot pressure between 28.50 C to 31.50 C (WBGT). The prevalence of renal disorder was 17.9%(16% classified as hyperfiltration and 1,9% as hypofiltration). Period of long term exposure > 15343 hours had a risk of kidney disorder by 7-fold (OR 7.919 with p value of 0.001. In multivariate analysis obtained risk >29 years of age is the dominant factor of risk to kidney disorders. Occurred 16-fold increased risk (OR16,39) in workers with age> 29 years with p value of 0.000. Conclusion: The prevalence of kidney disorder to hotpress workers at 17.9% (16% classified as hyperfiltration and 1,9% as hypofiltration). Period of long term exposure > 15343 hours had a risk of kidney disorder by 7-fold (OR 7.919). Dominant factor related to kidney disorder is age.>29 years. Occurred 16-fold increased risk (OR16,39) in workers with age> 29 years.

Abstrak :
[ABSTRAK
Latar belakang : Pekerja yang bekerja di lingkungan panas mempunyai resiko tinggi mengalami gangguan ginjal akibat dehidrasi kronis. Gangguan ginjal dapat dicegah jika kelainan dapat dideteksi dan diterapi sejak awal dimana resiko kesakitan dan kematian juga akan berkurang. Pemeriksaan yang biasa dilakukan dalam praktek sehari-hari pada saat ini adalah dengan kreatinin. Namun pemeriksaan kreatinin baru menunjukkan kelainan pada penurunan LFG lanjut. Cystatin C dikatakan bisa mendeteksi gangguan ginjal lebih awal sebelum kadar kreatinin meningkat sehingga dapat segera dilakukan tindakan pencegahan untuk menghindari kerusakan ginjal lebih lanjut. Metode penelitian:` Penelitian dilakukan dengan desain Cross sectional. Dilakukan pada 94 pekerja laki-laki yang dipilih secara random sampling. Data dikumpulkan dengan wawancara, pemeriksaan fisik, pemeriksaan laboratorium. Kadar cystatin c serum diukur dengan metode Immunonephelometri, kreatinin diukur dengan metode enzymatik, kemudian dihitung estimasi Laju Filtrasi Glomerulus berdasar Cystatin C dan kreatinin dengan metode CKD EPI. Hasil penelitian dilakukan analisa univariate dan bivariate. Hasil: Didapatkan prevalensi Gangguan Fungsi Ginjal dari Pemeriksaan Cystatin C pada Pekerja terpapar panas dengan Laju Filtrasi Glomerulus normal sebesar 17 %. Terdapat hubungan yang bermakna antara usia dan gangguan ginjal (p=0,000) dengan OR 13,22. Terdapat hubungan yang bermakna antara masa kerja dengan gangguan ginjal (p = 0,043) dengan OR 6,67. Kesimpulan: LFG dengan Cystatin C dapat mendeteksi lebih dini gangguan ginjal sebelum kreatininnya meningkat dengan prevalensi 17% sehingga dengan upaya promotif dan preventif yang dilakukan diharapkan dapat mencegah gangguan ginjal lebih lanjut.;

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ABSTRACT
Background: Workers who work in hot environments have a high risk of having renal disorders due to chronic dehydration. Renal disorders can be prevented if the abnormality can be detected and treated early in the beginning where the risk of morbidity and mortality is lower, as well. The common test conducted in daily practice today is the creatinine clearance test. However, creatinine clearance test shows abnormalities only in an advance reduced GFR. Cystatin C is known to be able detecting renal disorders in early stage before the creatinine level increases so that precautions can be taken to prevent a more advance renal damage. Study Method: This study used a cross sectional design. It was conducted to 94 workers whom selected with random sampling. Data was collected by interview, physical examination, and laboratory tests. Serum level of Cystatin C was measured by the method of immunonephelometry. Creatinine was measured by enzymatic method and subsequently, Glomerular Filtration Rate was estimated based on cystatin and creatinine using CKD EPI method. Univariate and bivariate analysis was performed to the results. Result: The study suggest that there is prevalence of renal disorders based on Cystatin C test in heat-exposed workers with normal glomerular filtration rate by 17%. There is a significant association between age and renal disorder (p = 0,000) with OR 13.22. There is a significant relation between period of employment with renal disorder (p = 0,001) with OR 6.57. Conclusion: Cystatin-based GFR is able to detect renal disorder at early stage before the creatinine level increases with prevalence of 17% so that further renal damage is expected to be able prevented with promotion and prevention attempts. ;Background: Workers who work in hot environments have a high risk of having renal disorders due to chronic dehydration. Renal disorders can be prevented if the abnormality can be detected and treated early in the beginning where the risk of morbidity and mortality is lower, as well. The common test conducted in daily practice today is the creatinine clearance test. However, creatinine clearance test shows abnormalities only in an advance reduced GFR. Cystatin C is known to be able detecting renal disorders in early stage before the creatinine level increases so that precautions can be taken to prevent a more advance renal damage. Study Method: This study used a cross sectional design. It was conducted to 94 workers whom selected with random sampling. Data was collected by interview, physical examination, and laboratory tests. Serum level of Cystatin C was measured by the method of immunonephelometry. Creatinine was measured by enzymatic method and subsequently, Glomerular Filtration Rate was estimated based on cystatin and creatinine using CKD EPI method. Univariate and bivariate analysis was performed to the results. Result: The study suggest that there is prevalence of renal disorders based on Cystatin C test in heat-exposed workers with normal glomerular filtration rate by 17%. There is a significant association between age and renal disorder (p = 0,000) with OR 13.22. There is a significant relation between period of employment with renal disorder (p = 0,001) with OR 6.57. Conclusion: Cystatin-based GFR is able to detect renal disorder at early stage before the creatinine level increases with prevalence of 17% so that further renal damage is expected to be able prevented with promotion and prevention attempts. , Background: Workers who work in hot environments have a high risk of having renal disorders due to chronic dehydration. Renal disorders can be prevented if the abnormality can be detected and treated early in the beginning where the risk of morbidity and mortality is lower, as well. The common test conducted in daily practice today is the creatinine clearance test. However, creatinine clearance test shows abnormalities only in an advance reduced GFR. Cystatin C is known to be able detecting renal disorders in early stage before the creatinine level increases so that precautions can be taken to prevent a more advance renal damage. Study Method: This study used a cross sectional design. It was conducted to 94 workers whom selected with random sampling. Data was collected by interview, physical examination, and laboratory tests. Serum level of Cystatin C was measured by the method of immunonephelometry. Creatinine was measured by enzymatic method and subsequently, Glomerular Filtration Rate was estimated based on cystatin and creatinine using CKD EPI method. Univariate and bivariate analysis was performed to the results. Result: The study suggest that there is prevalence of renal disorders based on Cystatin C test in heat-exposed workers with normal glomerular filtration rate by 17%. There is a significant association between age and renal disorder (p = 0,000) with OR 13.22. There is a significant relation between period of employment with renal disorder (p = 0,001) with OR 6.57. Conclusion: Cystatin-based GFR is able to detect renal disorder at early stage before the creatinine level increases with prevalence of 17% so that further renal damage is expected to be able prevented with promotion and prevention attempts. ]

Abstrak :
ABSTRAK Panas merupakan faktor fisik yang sering ditemui di dunia industri. Panas kerap membuat pekerja kehilangan cairan karena berkeringat. Pajanan pestisida dapat membuat seorang pekerja mengeluarkan cairan tubuh berlebih karena keringat. Kedua hal ini yaitu pajanan panas dan pestisida dapat mempengaruhi status hidrasi pekerja. Penelitian ini bertujuan untuk mengetahui hubungan antara pajanan panas dan pestisida terhadap status hidrasi pekerja di PT.X. Desain penelitian adalah cross sectional dengan jumlah sampel 75 orang. Pengumpulan data dilakukan sebanyak dua kali lewat pengisian kuesioner, pemeriksaan fisik, dan pemeriksaan urin. Status hidrasi dinilai berdasarkan pengukuran berat jenis urin sebelum dan sesudah bekerja. Hasil penelitian menunjukkan tidak terdapat hubungan antara faktor demografi dan faktor pekerjaan dengan status hidrasi, kecuali faktor umur menunjukkan hubungan yang bermakna dengan status hidrasi (p=0,007) setelah bekerja. Tidak terdapat hubungan antara pajanan panas dan pestisida dengan status hidrasi (p>0,05). Responden yang dehidrasi sebelum bekerja ditemukan 69,3%. Tidak didapatkan hubungan antara faktor demografi dan faktor pekerjaan dengan status hidrasi pekerja, kecuali umur berhubungan secara bermakna dengan status hidrasi setelah bekerja. Tidak didapatkan hubungan pajanan panas dan pestisida dengan status hidrasi. Hal ini dikarenakan karakteristik dari karbamat yang non lipophilic dan cepat dimetabolisme dari tubuh sehingga tidak didapat akumulasi kronik. Sebelum bekerja responden telah mengalami dehidrasi sebesar 69,3%. Hal ini dikarenakan tidak cukupnya asupan air minum selama bekerja akibat terpajan panas (kriteria NIOSH). Pekerja disarankan untuk minum air sebanyak 200 ml setiap 20 menit untuk mencegah terjadinya dehidrasi, dan menggunakan APD selama bekerja.

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ABSTRACT Heat stress is a physical hazard that is often to find in industry. It cause a worker loss their body fluid through sweating. Pesticide exposure make a worker produce more sweat. Both heat stress and pesticide exposure influence hydration status. This study is intended to know the association between heat stress and pesticide exposure with hydration status among workers in PT.X. Design of this study is cross sectional with a number of respondent are 75 worker. Data collection was done two times by completing questionnaire, physical examination and urine specific gravity test. Hydration status was determined by measuring urine specific gravity before and after working. The results showed that there is no association between heat stress and pesticide exposure with hydration status before and after working (p>0,05). There is no association between demography and working factor with hydration status, except age (p=0,007). Dehydration before working was found 69,3%. This study gets no association between demography and working factor with hydration status, except age. Heat stress and pesticide exposure did not show association with hydration status. Characteristic of carbamate which is fast metabolized and non lipophilic cause the body has no chronic accumulation. Respondent have had dehydrated before working as many 69,3%. Lack of water consumption is the main reason (NIOSH criteria). It is recommended to take 200 ml water in every 20 minutes to prevent dehydration, and to use PPE while working.

Abstrak :
Latar Belakang. Prevalensi penyakit ginjal kronik di Indonesia termasuk 60 besar negara dengan prevalensi penyakit ginjal kronik stadium akhir tertinggi dan menimbulkan biaya kesehatan nomor dua terbesar. Prevalensi tersebut lebih tinggi pada pekerjaan agrikultural, salah satunya adalah petani. Petani merupakan pekerjaan berisiko tinggi dengan pajanan pestisida, panas, logam berat dan zat lainnya sehingga dapat menimbulkan gangguan fungsi ginjal. Penelitian bertujuan mengetahui prevalensi gangguan fungsi ginjal serta faktor risiko yang berhubungan pada petani padi di Jawa Barat, Indonesia. Metode. Penelitian dengan desain potong lintang dilakukan pada Oktober 2017-Januari 2018 dengan pengambilan sampel menggunakan random cluster sampling. Penelitian dilakukan dengan wawancara, pemeriksaan fisik, dan pemeriksaan darah Cystatin C dan Asetilkolinesterase AChE Eritrosit, urin rutin dan urin kadmium. Analisis data dilakukan dengan program SPSS Statistics 20.0. Hasil. Sebanyak 100 subjek, petani padi, dianalisis untuk mendapatkan prevalensi gangguan fungsi ginjal dan faktor risiko yang berhubungan. Sebanyak 55 subjek 55 mengalami gangguan fungsi ginjal. AChE eritrosit dan kadmium urin tidak berhubungan dengan gangguan fungsi ginjal. Faktor risiko individu yang berhubungan dengan gangguan fungsi ginjal yaitu indeks massa tubuh abnormal dengan OR sebesar 2,51 95 CI 1,04-6,09 dan proteinuria p= 0,031 . Faktor risiko dominan gangguan fungsi ginjal pada petani padi adalah masa kerja lebih dari 10 tahun dengan OR sebesar 4,292 95 CI 1,014-18,170. Simpulan. Prevalensi gangguan fungsi ginjal pada petani padi sebesar 55 . Faktor risiko dominan gangguan fungsi ginjal pada petani padi adalah masa kerja di atas 10 tahun. Perlu dilakukan tindakan preventif dan promotif segera untuk mencegah perburukan fungsi ginjal pada petani padi.

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Background. Indonesia is the top 60 countries with a high prevalence of end stage chronic kidney disease and it accounts for the second highest national health cost. The prevalence is higher in the agricultural work population. Farmers are occupations at risk of exposure to pesticides, heat, heavy metals and other substances that can cause impaired renal function. The goal is to know the prevalence of renal function disorder and related risk factors among rice farmers in West Java. Methods. A cross sectional study was conducted on October 2017 January 2018 using random cluster sampling method. All subject underwent interviews using questionnaires, physical examination, Erythrocyte Acetylcholinesterase AChE , urine routine and urine cadmium tests. Data analysis was performed by SPSS Statistics 20.0 for univariate, bivariate and multivariate. Result. 100 subjects included were analyzed. Fifty five subjects 55 had kidney function disorder. The AChE and cadmium urine were not associated with kidney function disorder. Risk factors associated with kidney function disorder were abnormal body mass index with OR of 2, 51 95 CI 1.04 6.09, p 0,038 and proteinuria p 0.031 . The dominant risk factor for kidney function disorder in rice farmers was more than 10 years of working with OR of 4,292 95 CI 1.014 18,170, p 0,048. Conclusion. The prevalence of kidney function disorder in rice farmers was 55 . The dominant risk factor for kidney function disorder among rice farmers was more than 10 years of working. The promotive and preventive action should be done immediately to prevent kidney function worsen.

Abstrak :
Latar Belakang: Penyakit ginjal kronik (PGK) dilaporkan berhubungan dengan peningkatan risiko kejadian ulkus pedis dan amputasi pada diabetes melitus (DM). Namun, data mengenai hal tersebut masih terbatas termasuk di Indonesia. Tujuan penelitian ini adalah untuk mengetahui pengaruh PGK terhadap kejadian ulkus pedis dan amputasi ekstremitas bawah dalam 3 tahun. Metode: Penelitian ini merupakan studi kohort retrospektif pada DM berusia >18 tahun dengan menggunakan data sekunder di RSUP Fatmawati pada periode Januari – Desember 2016. Kesintasan terhadap ulkus pedis dan amputasi ekstremitas bawah berdasarkan LFG dihitung dan dianalisis melalui kurva Kaplan Meier. Adjusted hazard ratio (aHR) dinilai dengan menggunakan analisis multivariate Cox proportional hazards. Hasil: Dari 204 subjek penelitian, 108 orang (52,9%) memiliki LFG > 60, 54 orang (26,5%) memiliki LFG 30-59, dan 42 orang (20,6%) memiliki LFG <30 ml/menit/1,73 m2. Kesintasan ulkus pedis dalam 3 tahun adalah 75,7% untuk LFG <30; 86,4% untuk LFG 30-59; dan 94,1% untuk LFG > 60 ml/menit/1,73 m2. Laju insidens ulkus pedis per 1000 orang per bulan adalah 7,98 untuk LFG <30; 4,08 untuk LFG 30-59; dan 1,61 untuk LFG >60 ml/menit/1,73m2. Pasien dengan LFG 30-59 dan LFG <30 ml/menit/1,73 m2 memiliki adjusted HR 1,36 (IK 95% 0,39-4,66) dan 4,39 (IK 95% 1,18-16,4) terhadap ulkus pedis dibandingkan dengan LFG > 60 ml/menit/1,73 m2. Tidak dilakukan analisis lebih lanjut pada luaran amputasi ekstremitas bawah karena tidak ada pasien yang mengalami luaran pada kelompok LFG >60 ml/menit/1,73 m2 Kesimpulan: PGK mempengaruhi kejadian ulkus pedis dalam 3 tahun pada pasien DM dan risiko ulkus pedis dalam 3 tahun semakin meningkat seiring dengan semakin berat derajat PGK. Pengaruh PGK terhadap kejadian amputasi ekstremitas bawah masih belum dapat disimpulkan pada penelitian ini. ......Background: Chronic kidney disease (CKD) has been reported associated with poor prognoses in foot ulcers and lower extremity amputation (LEA) in patients with diabetes melitus (DM). However, the study is still limited and never been done in Indonesia. The objective of this study is to evaluate the impact of CKD on foot ulcers and LEA in patients with diabetes. Methods: This was a retrospective cohort study in Internal Medicine out-patient clinic in Fatmawati General Hospital. All subjects were enrolled between January-December 2016 who had history of DM, age >18 years old and had a history of DM. Foot ulcer-free and amputation-free survival for estimated glomerular filtration rate (eGFR) >60, 30-59, and <30 ml/min/1,73 m2 were calculated and analyzed by Kaplan-Meier curves. Adjusted hazard ratio (HR) was analalyzed using multivariate Cox proportional hazards. multivariate model. Results: A total of 204 individuals were included: 108 (52,9%) in eGFR >60, 54 in eGFR 30-59, and 42 in eGFR <30 ml/min/1,73 m2. Foot ulcer free survival for patient with eGFR <30, 30-59, >60 ml/min/1.73 m2 were 75,7%; 86,4%; and 94,1% respectively. Unadjusted foot ulcer incidence rates per 1000 patients per month were 7,98 for eGFR <30; 4,08 for eGFR 30-59; and 1,61 for eGFR >60 ml/menit/1.73m2. For the development of foot ulcer compared with eGFR > 60 ml/min/ 1.73 m2, adjusted HR for patient with eGFR 30-59 ml/min/1.73 m2 was 1,36 (CI 95% 0,39-4,66) and for eGFR < 30 ml/min/1.73 m2 was 4,39 (CI 95% 1,18-16,4). HR for LEA could not be analyzed because there were no patient who had been amputated after 3 years follow up in group eGFR >60 ml/min/1.73 m2. Conclusion: CKD increased the risk of foot ulcer in 3 years among DM patients. The risk was increased concomitant with the severity of CKD. The impact of CKD on LEA could not be concluded in this study.

Abstrak :
Latar belakang dan Tujuan Indonesia saat ini masih mcnggunakan bensin bertimbal dengan tingkat pencemaran timbal di udara tinggi. Jakarta Barat merupakso wilayab di DKI Jakarta yang paling padat dilalul kendaraan bermotor. Tujuan penelitian ini adalah diketahuinya hubungan kadar timbal di dalam darah terbadap terjadinya hipertensi pada polisi yang bekerja di jalan dan faktor-faktor lain, seperti obesitas, riwayat keluarga hipertensi, kebiasaan merokok. konsmnsi kopi, perilaku memakai masker dan olahraga dengan terjadinya hipertensi. Metode penelitian Penelitian ini dilakukan di wilayab kerja polsek Jakarta Barat. Populasi penelitian adalah polisi yang bekerja di jalan. Disain penelitian adalah studi Cross Sectional, dengan analisis kasus konlrol, 30 kasus dan 60 konlrol dillrutsertakan ) da1am penelitian ini. Kastt; diperoleh dengan cam consecuiive sampling. Pengumpulan data dilakukan dengan cara wawancara, pengukuran berat badan, pengukuran tinggi badan, pengukuran tekanan darab dan analisis kadar timbal dalam darah. Hasil penelitian Rerata kadar timbal di dalam darah adalab 19.83 , dengan nilai median 18.80. Terdapat hubungan yang signifikan antarn faktor obesitas (OR = 5,1) riwayat keluarga hipcrtensi (OR=l7,68) dan kadar Pb dalam darab (OR=4,5) dengan kejadian hipertensi. Kesimpulan dan Saran Ada pengarah kadar timbal di dalam darah, dengan kejadian hipertensi. Saran yang diajukan adalah melakukan pemeriksaan kadar timbal dalam darah minimal sekali setahun, termasuk melakukan upaya penurunan pajanan timbal, dan menurunkan berat badan polisi yang bekerja di jalan.

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Tile Background and Tbe Objectives Most of the cities in Indonesia are still using head gases which causes high lead level pollution. West Jakarta is one of the .areas that high burden of motor vehicles and is among the worst polluted area in Jakarta city. The aim of this study is to identify the relation of blood lead levels and hypertension among traffic police and other related factors such as obesity ,family history of hypertension, smoking,. consumption of coffee, use of mask as protection and physical exercise. The Research Method This research was carried out in the work territory Sector Police West Jakarta. The research population was traffic police assigned on the road. A cross sectional study design was used with case control analysis. Sixty cases and 30 controls Were recruited for this study Cases were recruited consecutively. Data was'collected by interviews, physical examination and measuring blood lead level. The Conclusion and the Reccomendation A significant relationship was'found between blood lead level and hypertension incident. Police with the blood lead level ?: 18,80 JWdL had a risk almost of 6,5 times higher to get hypertension. It is recommended that blood lead level should be measured at least once a year and reduce police weight that worked in the road.

Abstrak :
ABSTRAK
Peningkatan tekanan darah (TD) merupakan salah satu permasalahan dunia. Salah satu penyebabnya adalah gaya hidup masyarakat yang mengarah ke obesitas sentral. Rasio lemak viseral abdomen (LVA) terhadap lemak subkutan abdomen (LSA) merupakan indikator obesitas sentral yang dapat digunakan untuk mendeteksi dini peningkatan TD. Disain penelitian ini merupakan potong lintang dengan tujuan untuk mengetahui korelasi antara rasio LVA : LSA dengan TD pada laki-laki usia produktif dengan aktivitas sedang di Indonesia. Pengambilan data dilakukan di salah satu perusahaan di Bekasi pada bulan Oktober 2014. Sebanyak 52 orang subjek bersedia ikut serta dalam penelitian dan memenuhi kriteria penelitian. Didapatkan hasil rerata indeks massa tubuh (IMT) subjek 24,60 kg/m2, dan sebagian besar subjek mempunyai IMT dengan BB lebih. Rerata persentase massa lemak (ML) subjek 18,92%, dan sebagian besar subjek mempunyai persentase ML dapat diterima. Seluruh subjek mempunyai TD sistolik dan diastolik normal. Nilai tengah luas area LVA sebesar 90 cm2 dan LSA 142 cm2. Seluruh subjek mempunyai rasio LVA : LSA normal. Korelasi antara rasio LVA : LSA dengan TD adalah r= 0,356 untuk TD sistolik dan r= 0,244 untuk TD diastolik. Kesimpulan penelitian ini adalah terdapat korelasi yang tidak bermakna secara statistik antara rasio LVA : LSA dengan TD, namun terdapat kcenderungan korelasi yang cukup kuat.

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ABSTRACT
Increased blood pressure (BP) is one of the world's problems. It might be caused by lifestyles that lead to central obesity. The ratio of abdominal visceral adipose tissue (VAT) to the abdominal subcutaneous adipose tissue (SAT) is one indicator of central obesity which can be used for early detection of elevated BP. This study used cross-sectional study with aim to determine the correlation between ratio of abdominal VAT : SAT with BP in men of reproductive age with moderate activity in Indonesia. The data were obtained in one company in Bekasi on October 2014, 52 subjects signed the consent and matched the study criterias. Subjects showed a mean BMI 24.60 kg /m2, and most of them were overweight. The mean of subjects’ FM percentage was 18.92%, and most of them had an acceptable FM percentage. All subjects had normal systolic and diastolic BP. The median VAT area was 90 cm2 and SAT area was 142 cm2. All of the subjects had normal ratio of abdominal VAT : SAT. Correlation between ratio of abdominal VAT : SAT were r= 0,356 for systolic BP and r= 0,244 for diastolic BP. The conclussion of the study is there was not significant correlation between ratio of abdominal VAT : SAT with BP, although there were a tedency for fairly strong correlation.

Abstrak :
[Latar Belakang Transplantasi ginjal adalah modalitas terapi pengganti ginjal yang paling baik bagi pasien dengan Penyakit Ginjal Tahap Akhir (PGTA). Saat ini di Indonesia transplantasi ginjal dengan donor hidup mulai semakin sering dilakukan, terutama di RSUPN Cipto Mangunkusumo, di mana dalam beberapa tahun terakhir lebih dari 50% kasus transplantasi ginjal di Indonesia dilakukan di rumah sakit ini. Walaupun demikian, data mengenai hasil transplantasi di Indonesia, baik kesintasan 1 tahun graft maupun pasien, serta faktor yang diduga mempengaruhinya masih belum ada. Diharapkan hasil transplantasi di rumah sakit ini dapat menggambarkan hasil secara keseluruhan di Indonesia. Metode Studi kohort retrospektif pada resipien transplantasi ginjal di RSUPN-CM dari Januari 2010 hingga Mei 2014. Data didapatkan dari penelusuran rekam medis serta menghubungi pasien secara langsung. Masing-masing resipien diikuti sejak tanggal transplantasi hingga kematian atau Mei 2015. Proporsi kesintasan graft dan pasien pada 1 tahun post transplantasi dan pada akhir studi didokumentasikan. Kurva Kaplan-Meier digunakan untuk menggambarkan kesintasan pasien secara keseluruhan. Studi deskriptif dilakukan dengan melihat perbedaan proporsi variabel serta perbedaan rerata atau median pada pasien yang mengalami kegagalan graft 1 tahun serta tidak, serta pasien yang bertahan hidup atau meninggal. Hasil Berdasarkan hasil consecutive total sampling didapatkan 157 resipien yang menjalani transplantasi ginjal di RSUPN-CM, 137 resipien di antaranya memenuhi kriteria penelitian, seluruhnya mendapatkan ginjal dari donor hidup. Usia resipien rata-rata adalah 47,9 ± 13,9 tahun, rerata IMT 22,8 ± 3,7 kg/m2, dan proporsi resipien dengan diabetes 35,8%. Didapatkan 7 pasien mengalami disfungsi graft primer (kegagalan transplantasi), sehingga 130 pasien diikuti untuk melihat kesintasan jangka panjang. Pada akhir tahun pertama, didapatkan angka death-censored graft survival adalah 95,4%, all-cause graft survival 85,4%, kesintasan pasien 88,5%, dan death with a functioning graft sebesar 10%. Pada akhir studi, didapatkan angka kesintasan tersebut berturut-turut adalah 94,6%, 80%, 82,3%, dan 14,6%, dengan median waktu pengamatan 24 bulan (1 ? 64 bulan). Kurva Kaplan Meier menunjukkan angka mortalitas tertinggi didapatkan pada bulan-bulan awal post transplantasi. Kegagalan graft dan kematian didapatkan lebih banyak pada resipien yang berusia lebih tua, mengidap diabetes melitus, serta memiliki indeks komorbiditas yang tinggi. Penyebab kematian utama adalah infeksi (11,5%) diikuti dengan kejadian kardiovaskular (3,8%). Simpulan Death-censored graft survival 1 tahun resipien transplantasi ginjal di Indonesia sudah sangat memuaskan. Angka death with functioning graft masih cukup tinggi, sehingga menurunkan all-cause graft survival dan kesintasan pasien 1 tahun. Walaupun demikian, secara keseluruhan hasil ini masih sebanding dengan negara-negara berkembang lainnya.;Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 ? 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries;Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 ? 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries;Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 ? 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries, Background Kidney transplant is established as the preferred modality for end stage renal disease patients. Living donor kidney transplant is increasingly popular in Indonesia, especially in Cipto Mangunkusumo Hospital, comprising more than 50% of all transplant procedures performed in Indonesia. However, data regarding one-year graft and patient survival in Indonesia is still scarce. This single-center study is hoped to represent the characteristics and results of graft and patient survival of living donor kidney transplant in Indonesia. Methods A retrospective cohort study with total consecutive sampling is performed on all kidney transplant recipients in Cipto Mangunkusumo Hospital from January 2010 until May 2014. Data is acquired by analysing medical records and contacting patients directly. Each recipient is followed from the day of transplant until death or May 2015, whichever comes first. One-year graft and patient survival is documented. Kaplan-Meier Curve is used to describe patient survival until the end of study. Descriptive studies on risk factors of graft and patient survival is also conducted, using differences in proportions, means, and medians appropriately. Results Within the timeframe there are 157 recipients of living donor kidney transplants, 137 of which fulfill the inclusion criteria. The mean age is 47.9 ± 13.9 years, mean BMI is 22.8 ± 3.7 kg/m2, and 35.8% of all recipients are diabetics. Primary non-function/early transplant failure is present in 7 patients, so that 130 recipients are included for long term survival descriptions. In the end of the first year post transplant, death-censored graft survival is 95.4%, all-cause graft survival is 85.4%, patient survival is 88.5%, and death with a functioning graft is 10%. By the end of the study, the corresponding survival results are 94.6%, 80%, 82.3%, and 14.6%, respectively, with a median observation time of 24 months (1 – 64 months). Kaplan-Meier curve showed that the mortality rate is higher in the early months after transplant. More deaths and graft failures are found in older and diabetic recipients, as well as those with a high comorbidity index. The main causes of death are infections (11.5%) and cardiovascular diseases (3.5%). Conclusions The outcome of one-year death-censored graft survival in Indonesia is very satisfactory. The incidence of death with functioning graft is relatively high, causing a decline in one-year patient survival and all-cause graft survival. However, the overall results are still comparable to other developing countries]

Abstrak :
Pendahuluan: PGK merupakan penyakit yang sering memiliki beberapa komorbid sehingga perlu menggunakan berbagai terapi kombinasi obat. Oleh sebab itu, polifarmasi sering dilakukan dan salah satu konsekuensinya adalah terjadinya potensi interaksi obat (PIO). PIO dianggap sebagai masalah pengobatan yang dapat dicegah, namun dalam praktik klinis dapat mengakibatkan efek samping obat (ESO) atau reaksi obat yang merugikan. Hal tersebut tentu akan mempengaruhi klinis dan keberhasilan pengobatan serta keamanan penggunaan obat pada pasien PGK. Penelitian ini bertujuan untuk mengetahui pola peresepan pasien PGK dan pengaruhnya terhadap potensi interaksi dan efek samping obat yang dicurigai akibat interaksi obat. Metode: Penelitian ini merupakan penelitian non eksperimental dan pengambilan data dilakukan secara potong lintang pada pasien PGK rawat jalan stadium 3-5 pre-dialisis di rumah sakit Cipto Mangunkusumo (RSCM) dalam periode Januari 2019 sampai dengan Desember 2020. Data diambil dari electronic health record dan pusat rekam medis RSCM. Rujukan potensi interaksi obat menggunakan software Micromedex. Hasil: Terdapat 106 pasien yang memenuhi persyaratan dan diambil menjadi subjek penelitian. Hasil penelitian menunjukkan bahwa pada pasien PGK rawat jalan stadium 3- 5 pre-dialisis di RSCM tahun 2019-2020, terdapat 111 jenis obat yang diresepkan dan obat yang paling sering diresepkan adalah bisoprolol (36,5%). Proporsi pasien yang mendapatkan pengobatan dengan potensi interaksi obat adalah 76% (81 pasien), sedangkan proporsi pasien yang mengalami ESO yang dicurigai akibat interaksi obat adalah 28% (23 pasien) dari 81 pasien dengan PIO. ESO tersebut berupa hiperglikemi (17 pasien), hipertensi (1 pasien), hiperkalemi (1 pasien) dan hipotensi (1 pasien). Terdapat hubungan yang bermakna secara statistik antara variabel perancu yaitu, jumlah obat > 10, komorbid jantung dan DM dengan ESO yang dicurigai akibat interaksi obat (p<0.05). Hasil multivariat mendapatkan hanya komorbid jantung (gagal jantung dan penyakit jantung koroner) yang memiliki hubungan yang bermakna secara statistik dengan ESO yang dicurigai akibat interaksi obat (p = 0,03). Kesimpulan: Pada penelitian ini, sebanyak 76% pasien mendapatkan pengobatan dengan PIO. Sedangkan 28% pasien dari 81 pasien dengan PIO mengalami ESO yang dicurigai akibat interaksi obat. ESO yang paling banyak dialami adalah hiperglikemi. Komorbid jantung merupakan faktor risiko terjadinya ESO yang dicurigai akibat interaksi obat. ......Introduction: CKD often has several comorbidities so it is necessary to use various drug combination therapies. Therefore, it can lead to polypharmacy and one of its consequences is the occurrence of potential drug-drug interactions (DDI). DDI is considered a problem that can be prevented, but in clinical practice it can result in adverse drug reactions (ADR). This will certainly affect the clinical and treatment success as well as the safety of the drug use in CKD patients. This study was aimed to determine the prescribing pattern and its effect on potential DDI and ADR that are suspected due to DDI. Methods: This was a non-experimental cross-sectional study, conducted on CKD outpatients stage 3-5 pre-dialysis at Cipto Mangunkusumo Hospital in the period January 2019 to December 2020. Data were taken from electronic health records and the hospital’s medical record. The Micromedex software was used as a reference for potential drug interactions. Results: There were 106 patients who met the requirements and were taken as research subjects. The results showed that in CKD out-patients stage 3-5 pre-dialysis at RSCM in 2019-2020, there were 111 types of drugs prescribed and the most frequently prescribed drug was bisoprolol (36.5%). The proportion of patients who received treatment with a potential DDI was 76% (81 patients), while the proportion of patients who experienced ADR suspected due to DDI was 28% (23 patients) from 81 patients with suspected DDI. The ADRs were hyperglycemia (17 patients), hypertension (1 patient), hyperkalemia (1 patient) and hypotension (1 patient). There was a statistically significant association between the confounding variables, namely, number of drugs, cardiovascular disease and DM with ADR suspected due to DDI (p<0.05). Multivariate analysis found that only cardiovascular disease (congestive heart failure and coronary artery disease) had a statistically significant relationship with ADR suspected due to DDI (p = 0.03). Conclusion: In this study, 76% of patients received treatment with potential DDI. Meanwhile, 23% from 81 patients patients with DDI experienced ADR suspected due to drug interactions. The most often occuring ADR is hyperglycemia. It was found that cardivascular comorbidity is a risk factor for having an ADR suspected cause by DDI.

Abstrak :
ABSTRAK Latar Belakang: Perubahan hemodinamik selama hemodialisis (HD) kronik dapat menimbulkan hipoperfusi dan iskemia koroner yang dapat menyebabkan cedera miokard yang ditandai dengan peningkatan kadar troponin I (cTnI) sehingga dapat menjadi penanda yang potensial untuk kejadian tersebut. Hemodialisis 2 kali seminggu berisiko membuat laju ultrafiltrasi (UFR) dan volume ultrafiltrasi (UFV) yang lebih tinggi sehingga menimbulkan kejadian hipovolemia yang lebih besar. Tujuan: Penelitian ini bertujuan untuk mengetahui proporsi pasien yang mengalami peningkatan cTnI intradialisis dan satu bulan setelah HD serta mengetahui hubungan antara faktor-faktor lama HD, UFR, UFV, hipotensi intradialisis (IDH), dan diabetes melitus (DM) dengan peningkatan kadar cTnI tersebut. Metode: Penelitian ini merupakan studi kohort prospektif untuk menilai kadar cTnI sebelum dan sesudah HD. Sebanyak 138 subyek yang menjalani HD 2 kali seminggu memenuhi kriteria inklusi. Pemeriksaan kadar cTnI menggunakan reagen ARCHITECH STAT. Nilai cut off cTnI untuk laki-laki adalah 34,0 pg/mL dan untuk perempuan 15,6 pg/mL. Analisis bivariat dan multivariat dilakukan untuk mengetahui hubungan antara lama HD, UFR, UFV, IDH dan DM dengan peningkatan cTnI intradialisis dan satu bulan setelah HD. Hasil: Dari 138 subyek, sebanyak 57 subyek (41,3%) mengalami peningkatan kadar cTnI. Kadar cTnI meningkat secara signifikan selama HD (p<0,001) . Faktor DM berhubungan dengan peningkatan kadar cTnI (OR 2,207 (IK 95% 1,056-4,616), p=0,033), yang mempunyai risiko 2,2 kali dalam peningkatan kadar cTnI. Setelah satu bulan, sebanyak 53 dari 132 subyek (40,2%) mengalami peningkatan kadar cTnI yang signifikan. Sebanyak 31 pasien (23,4%) mengalami peningkatan kadar cTnI 50% di atas cut off. Analisis multivariat menunjukan tidak terdapat hubungan antara lama HD, UFR, UFV, IDH, dan DM dengan peningkatan kadar cTnI satu bulan setelah HD. Simpulan: Proporsi pasien yang mengalami peningkatan cTnI intradialisis sebesar 41,3% dan satu bulan setelah HD sebesar 40,2%. Diabetes melitus berhubungan dengan peningkatan cTnI intradialisis, sedangkan lama HD, UFV, UFR, dan IDH tidak berhubungan dengan peningkatan cTnI. Lama HD, UFV, UFR, IDH, dan DM tidak berhubungan dengan peningkatan kadar cTnI satu bulan setelah HD.

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ABSTRACT Background: Hemodynamic changes during chronic hemodialysis (HD) may induce coronary hypoperfusion and coronary ischemia which lead to asymptomatic myocardial injury marked by the increase in cardiac troponin I (cTnI) levels which make this cTnI a potential marker for these events. Two time a week HD increase the risk of higher ultrafiltration rate (UFR) and ultrafiltration volume (UFV) contributing to higher hipovolemia events. Objective: The aims of this study is to identify the proportion of patients experiencing elevated intradialytic and 1-month after HD cTnI, and determine association between HD vintage, UFR, UFV, intradialitic hypotention (IDH) and diabetes mellitus (DM) factors and the elevated of cTnI. Method: This study is a prospective cohort study examining cTnI levels before and after single HD session. A total 138 patient underwent twice-weekly regimens of HD. Levels of cTnI levels was tested using ARCHITECH STAT reagents. The cut-off points of cTnI were 34.0 pg/mL and 15.6 pg/mL for men and women, respectively. Bivariate and multivariate analysis were used to determine the association between HD vintage, UFR, UFV, IDH, and DM and the increased of intradialytic and 1-month after HD cTnI. Results: Out of 138 patients, 57 (41,3%) subjects had elevated intradialytic cTnI level. The cTnI levels increased significantly during HD (p <0.001). Diabetes has association with the increased levels of cTnI during intradialytic (OR 2,207 (CI 95% 1,056-4,616), p=0,033), which has a 2,2 times increased risk of cTnI levels. After 1 month, 53 of 132 subjects (40.2%) experienced significant increases in cTnI levels. A total of 31 patients (23.4%) had an increase of cTnI levels 50% above cut off. Multivariate analysis showed no association between HD vintage, UFR, UFV, IDH, DM and the elevated levels of 1-month after HD cTnI. Conclusion: The proportion of patients with elevated intradialytic cTnI is 41.3%. and 1-month after HD cTnI is 40.2%. Diabetes mellitus has association with the increased levels of cTnI during intradialytic while HD vintage, UFV, UFR and IDH have no association with the increased levels of cTnI. Hemodialysis vintage, UFR, UFV, IDH, and DM have no association with the increased levels of 1- month after HD cTnI.