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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."

"NADP terbentuk sejalan dengan pembentukan radikal bebas anion superoksida O2 - yang dapat menyebabkan stres oksidatif dan berujung pada komplikasi ginjal yang disebut dengan nefropati diabetik pada pasien diabetes melitus tipe 2. Salah satu faktor yang dapat meningkatkan radikal bebas O2 - adalah peningkatan angiotensin II pada ginjal dan dapat dihambat oleh penghambat sistem renin-angiotensin, yaitu inhibitor ACE dan ARB. Penelitian ini bertujuan untuk mengetahui perbandingan terapi inhibitor ACE dan ARB dalam mengatasi stres oksidatif yang diukur melalui kadar NADP serum dan dikorelasikan dengan nilai estimasi laju filtrasi glomerulus eLFG sebagai parameter yang sudah sering digunakan untuk menandakan perubahan fungsi ginjal. Kadar NADP serum diukur menggunakan uji NADP /NADPH dengan metode kolorimetri dan nilai eLFG dihitung menggunakan persamaan CKD-EPI. Penelitian ini dilakukan di RSUPN Dr. Cipto Mangunkusumo dan Puskesmas Kecamatan Pasar Minggu. Subjek penelitian dibagi menjadi dua kelompok pasien diabetes melitus tipe 2, yaitu kelompok yang mendapat inhibitor ACE n = 11 dan kelompok yang mendapat ARB n = 25 . Rata-rata kadar NADP serum pada kelompok inhibitor ACE adalah 3,4576 pmol/ml dan pada kelompok ARB adalah 5,6240 pmol/ml p = 0,091, sedangkan nilai eLFG pada kelompok inhibitor ACE adalah 61,109 ml/menit/1,73 m2 dan pada kelompok ARB adalah 66,240 ml/menit/1,73 m2 p = 0,510. Korelasi antara kadar NADP serum dengan nilai eLFG r = -0,032; p = 0,851. Data hasil penelitian menunjukkan bahwa inhibitor ACE dan ARB tidak berbeda signifikan dalam menurunkan kadar NADP serum dan mempertahankan fungsi ginjal, selain itu tidak terdapat korelasi signifikan antara kadar NADP serum dengan nilai eLFG pada kedua kelompok sampel.

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NADP is formed in line with the formation of superoxide anion O2 free radical which can cause oxidative stress and lead to renal complications called diabetic nephropathy in type 2 diabetes mellitus. One of the factors that can increase O2 free radical is increased angiotensin II in the kidneys and can be inhibited by the inhibitor of the renin angiotensin system, ie ACE inhibitors and ARBs. This study aims to determine the comparison of ACE inhibitor and ARB therapy in overcoming oxidative stress measured through serum NADP levels and correlate them with estimated glomerular filtration rate eGFR as a parameter that has been frequently used to indicate changes in renal function. Serum NADP levels were measured using an NADP NADPH assay by colorimetric method and eGFR values were calculated using the CKD EPI equation. This research was conducted at Dr. Cipto Mangunkusumo National Central General Hospital and District Health Clinics Pasar Minggu. The subjects were divided into two groups of patients with type 2 diabetes mellitus, the group receiving ACE inhibitors n 11 and the group receiving ARBs n 25. The mean serum NADP level in the ACE inhibitor group was 3,4576 pmol ml and in the ARB group was 5,6240 pmol ml p 0,091, whereas the eGFR value in the ACE inhibitor group was 61,109 ml minute 1,73 m2 and in the ARB group was 66,240 ml minute 1,73 m2 p 0,510. The correlation between serum NADP levels and eGFR values r 0,032 p 0,851. The results showed that ACE inhibitors and ARBs did not differ significantly in reducing serum NADP levels and maintaining renal function, and there was no significant correlation between serum NADP levels and eGFR values in both groups."

"Disfungsi ginjal adalah salah satu komplikasi kronik pada pasien diabetes melitus tipe 2 DM tipe 2 yang diketahui sebagai nefropati diabetik. Salah satu penanda yang digunakan sebagai pendeteksi kerusakan ginjal adalah rasio albumin kreatinin UACR. Selain UACR, kolagen tipe IV banyak diteliti terkait fungsinya sebagai pendeteksi awal nefropati diabetik. Tujuan penelitian ini adalah untuk menilai perbedaan UACR, kadar kolagen tipe IV urin, serta mengetahui hubungan keduanya pada pasien yang menerima terapi angiotensin-converting enzyme inhibitors ACEI dan angiotensin receptor blockers ARB sebagai kelas yang menghambat perkembangan nefropati diabetik pada pasien DM tipe 2. Penelitian dilakukan dengan menggunakan studi cross sectional dan teknik pengambilan consecutive sampling. Terdapat dua kelompok dalam penelitian ini, pasien dengan terapi ACEI n = 14 dan ARB n = 26. Kolagen tipe IV urin dianalisis dengan menggunakan ELISA kit. Albumin dan kreatinin urin diukur dengan menggunakan metode imunoturbidimetri dan kolorimetri. Kadar kolagen tipe IV urin dihitung dengan normalisasi pengukuran kolagen tipe IV urin dengan kadar kreatinin urin. Pada nilai UACR, rerata kedua kelompok ACEI = 276,61 65,119 g/mg kreatinin urin; ARB = 87,25 24,743 g/mg kreatinin urin menunjukkan perbedaan bermakna p = 0,019, kedua kelompok ACEI = 117,14 37,36 ng/mg kreatinin urin; ARB = 14,19 1,46 ng/mg kreatinin urin juga menunjukkan perbedaan bermakna pada kadar kolagen tipe IV urin p < 0,001. Uji korelasi antara nilai UACR dan kadar kolagen tipe IV urin menunjukkan hubungan moderat pada kedua kelompok penelitian r = 0,489; p = 0,001. Hasil menunjukkan bahwa kelompok ARB memiliki tingkat kolagen tipe IV urin yang lebih rendah dibandingkan dengan ACEI, sehingga terapi dengan ARB kemungkinan dapat menghambat perkembangan nefropati diabetik.

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Renal dysfunction is one of chronic complications in type 2 diabetes mellitus patients T2DM known as diabetic nephropathy DN. Urine albumin creatinine ratio UACR is a widely used test for detection of DN. Beside of UACR, type IV collagen has been studied to its function as an early detection of DN. The aim of this study was to compare differences in UACR, urinary type IV collagen, and their correlation in patients with angiotensin converting enzyme inhibitors ACEI versus angiotensin receptor blockers ARB treatment as classes with respect to delay the development of DN in patients with type 2 diabetes by using cross sectional study and consecutive sampling method. There were 2 groups in this study, patients with ACEI n 14 and ARB therapy n 26. Urinary type IV collagen were analyzed using ELISA kit. Urine albumine and urine creatinine was measured by using immunoturbidimetry and colorimetric method. Urinary type IV collagen levels were calculated by normalizing type iv collagen with urine creatinine levels. Results showed that UACR ACEI 276,61 65,119 g mg urine creatinine ARB 87,25 24,743 g mg urine creatinine showed significant differences p 0.019, urinary type IV collagen ACEI 117,14 37,36 ng mg urine creatinine ARB 14,19 1,46 ng mg urine creatinine showed significant differences p 0.001. Correlation between UACR and urinary type IV collagen presented a moderate correlation in both studied groups r 0.489 p 0.001. The results showed that group with ARB treatment have lower level of urinary type IV collagen compared to groups with ACEI treatment, conclude that ARB more likely to inhibit the development of DN."

"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)."

"Patogenesis nefropati diabetik (ND) merupakan hasil interaksi faktor hemodinamik, metabolik dan lingkungan serta faktor genetik. ND biasanya tidak terdeteksi secara klinis sampai terjadi kerusakan ginjal yang bermakna dapat berupa glomerulosklerosis, tubular atrofi dan fibrosis interstitial. KIM-1 dapat digunakan sebagai penanda adanya kerusakan tubulus ginjal. Hubungan polimorfisme gen ACE dengan nefropati diabetes masih tidak konsisten. Penelitian ini merupakan studi cross sectional komparasi antara dua kelompok penyandang DMT2 dengan atau tanpa nefropati yang bertujuan untuk mengetahui adanya kerusakan tubulus, polimorfisme gen ACE dan menganalisis hubungannya dengan kadar KIM-1 terhadap terjadinya kelainan tubulus. Didapatkan adanya peningkatan ekskresi KIM-1 urin pada 19 subjek pre-nefropati dengan median 1,3 (interquartile 1,5) ng/mL, 25 subjek nefropati insipien dengan median 1,6 (interquartile 2,3) ng/mL dan 12 subjek nefropati overt dengan rerata kadar KIM-1 3,1 ± 2,4 ng/mL. Terdapat polimorfisme gen ACE pada penyandang DMT2. Proporsi genotipe DD 9,3%, ID 33,3% dan II 57,4% pada kelompok NND, pada kelompok ND proporsi genotipe DD 4,7%, ID 34,1% dan genotipe II 61,2%. Dijumpai adanya hubungan bermakna antara alel D dengan peningkatan ekskresi KIM-1 urin pada kelompok pre-nefropati (p = 0,030). Peningkatan kadar KIM-1 urin pada kelompok pre-nefropati menunjukkan adanya kerusakan tubulus yang merupakan proses awal nefropati DM. Distribusi genotipe polimorfisme gen ACE pada penelitian ini menyerupai penelitian lain di negara-negara Asia, sedangkan di negara Eropa genotipe DD lebih banyak daripada genotipe II. Hubungan bermakna alel D dengan kadar KIM-1 hanya pada kelompok prenefropati mungkin disebabkan adanya faktor lain seperti kadar glukosa, kontrol glikemik, ureum, kreatinin dan kadar trigliserida yang memengaruhi. Simpulan: Terdapat peningkatan ekskresi KIM-1 urin pada penyandang DMT2 kelompok pre-nefropati yang meningkat secara bermakna pada penyandang DMT2 dengan nefropati overt. Peningkatan ekskresi KIM-1 urin dapat dipakai sebagai penanda kerusakan tubulus. Terdapat polimofisme gen ACE pada penyandang DMT2. Genotipe II lebih banyak dibanding genotipe ID dan DD. Dijumpai adanya hubungan alel D dengan peningkatan kadar KIM-1 urin pada penyandang DMT2 pre-nefropati.

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The pathogenesis of nephropathy diabetic (ND) is the result of the interaction of haemodynamic, metabolic, environment, and genetic factors. In general, ND was clinically undetectable until kidney has been damaged significantly, in the form of glomerulosclerosis, tubular atrophy, or interstitial fibrosis. KIM-1 can be used as the initial indicator of kidney tubules damage. The relationship between ACE gene polymorphism and diabetic nephropathy was still inconsistent.

This research was a comparative cross-sectional study on two groups of DMT2 patients with and without nephropathy diabetic. The objectives of this study were to identify the tubules damage, ACE gene polymorphism, and to analyze the relationship between the degree of KIM-1 and the tubules damage. The increase of KIM-1 urine excretion was found in 19 pre-nephropathy subject (median = 1.3 with interquartile 1.5 ng/mL), in 25 incipient nephropathy subject (median = 1.6 (2.3) ng/mL), in 12 overt nephropathy subject (Mean = 3.1 ± 2,4 ng/mL). ACE polymorphism gene was found in DMT2 patients. In the NDD group, the genotype proportion of DD = 9.3%, ID = 33.3% and II = 57.4%. Whereas, in the ND group, the figures were 4.7%, 34.1% and 61.2%, respectively.

Significant relationship was found between allele D and the increase of KIM-1 urine on pre-nephropathy group (p = 0.030). The increase of KIM-1 urine on prenephropathy group shows the tubules damage which is the initial process of nephropathy diabetic. The genotype distribution of ACE gene polymorphism in this study was similar with the studies in Asian countries; however, in European countries the genotype DD is found higher than genotype II. The significant relationship between allele D and KIM-1 level in pre-nephropathy group might be the influence of other factors, such as glucose level, glycaemic control, urea, creatinine, and triglyceride level.

Conclusion: There was KIM-1 excretion increased on DMT2 pre-nephropathy group, which increase significantly in DMT2 overt nephropathy group. The increase of KIM-1 urine excretion can be used as the indicator of tubules damage. ACE gene polymorphism was found in DMT2 group, with genotype II was higher than genotype ID and DD. A significant relationship between allele D and the increase of KIM-1 urine excretion was found in pre-nephropathy group."

"[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.]"

"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."

"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."

"Stres oksidatif yang diinduksi hiperglikemia memainkan peran utama dalam patogenesis komplikasi ginjal di antara pasien diabetes mellitus tipe 2, yang dikenal sebagai nefropati diabetik. Peroksidasi asam arakidonat, salah satu komponen membran fosfolipid yang dapat ditemukan sebagian besar di sel mesangial glomerulus, membentuk kelompok zat mirip prostaglandin yang disebut isoprostanes. Salah satu metabolit, 8-iso-Prostaglandin F2α, diketahui memiliki aktivitas vasokonstriktif yang kuat, yang diduga terkait dengan patofisiologi hiperfiltrasi glomerulus pada tahap awal nefropati diabetik. Oleh karena itu, penelitian multisenter cross-sectional ini dilakukan untuk mengevaluasi apakah 8-iso-Prostaglandin F2α dikaitkan dengan hiperfiltrasi glomerulus, yang tercermin oleh perkiraan laju filtrasi glomerulus (eGFR) yang tinggi. Pengambilan sampel dilakukan pada tahun 2019 di Puskesmas Pasar Minggu (n = 57). Sampel yang diperoleh peneliti sebelumnya pada tahun 2015 di Rumah Sakit Sitanala, dan pada tahun 2016 dan 2017 di Puskesmas Pasar Minggu juga digunakan dalam penelitian ini (n = 154). Semua spesimen serum dan urine partisipan dianalisis untuk mengukur kreatinin serum dan konsentrasi 8-iso-Prostaglandin F2α urin mereka masing-masing. Kreatinin serum digunakan untuk menghitung eGFR berdasarkan persamaan CKD-EPI. 8-iso-Prostaglandin F2α urine diukur menggunakan metode ELISA kompetitif. Sampel (n = 211) dibagi menjadi dua kelompok berdasarkan nilai eGFR ≥90 dan 60-89 mL/menit/1,73 m2. Hasil analisis statistik menunjukkan bahwa tidak ada perbedaan karakteristik dasar antara kedua kelompok, kecuali usia peserta (p <0,001). Rerata 8-iso-Prostaglandin F2α urin ditemukan lebih tinggi pada kelompok eGFR ≥90. Namun, perbedaannya tidak signifikan secara statistik (p = 0,214), menunjukkan bahwa 8-iso-Prostaglandin F2α mungkin terkait dengan hiperfiltrasi glomerulus tetapi masih belum cukup spesifik untuk digunakan sebagai penanda tahap awal nefropati diabetik.

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Oxidative stress induced by hyperglycemia plays a major role in the pathogenesis of kidney complications among patients with type 2 diabetes mellitus, known as diabetic nephropathy. Arachidonic acid peroxidation, one of the components of the phospholipid membrane that can be found mostly in mesomer cells glomerulus, forming a group of prostaglandin-like substances called isoprostanes. One of the metabolites, 8-iso-Prostaglandin F2α, is known to have strong vasoconstrictive activity, which is thought to be related to the pathophysiology of glomerular hyperfiltration in the early stages of diabetic nephropathy. Therefore, this cross-sectional multicenter study was conducted to evaluate whether 8-iso-Prostaglandin F2α was associated with glomerular hyperfiltration, which was reflected by the high estimated glomerular filtration rate (eGFR). Sampling was carried out in 2019 at the Pasar Minggu Health Center (n = 57). Samples obtained by previous researchers in 2015 at Sitanala Hospital, and in 2016 and 2017 at Pasar Minggu Health Center were also used in this study (n = 154). All participants' serum and urine specimens were analyzed to measure serum creatinine and their respective urine 8-iso-Prostaglandin F2α concentrations. Serum creatinine is used to calculate eGFR based on the CKD-EPI equation. 8-iso-Prostaglandin F2α urine is measured using the competitive ELISA method. The sample (n = 211) was divided into two groups based on eGFR values ​​of ≥90 and 60-89 mL/min/1.73 m2. Statistical analysis showed that there were no differences in baseline characteristics between the two groups, except the age of the participants (p <0.001). The mean 8-iso-Prostaglandin F2α urine was found to be higher in the eGFR group ≥90. However, the difference was not statistically significant (p = 0.214), suggesting that 8-iso-Prostaglandin F2α might be associated with glomerular hyperfiltration but still not specific enough to be used as a marker for the early stages of diabetic nephropathy."