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Asep
Peran 25 (OH)D Terhadap Aktivitas Plasma Renin dan Plasma Aldosteron pada Pekerja Terpajan Timbel = The Correlation between Blood Lead Level, 25(OH)D, Plasma Renin Activity, and Plasma Aldosterone among Indonesian Male Workers
"Latar belakang:
Penelitian sebelumnya menunjukkan bahwa kemungkinan mekanisme pengaruh pajanan timbel terhadap tekanan darah dan penyakit ginjal kronis adalah melalui Sistem Renin-Angiotensin-Aldosteron (RAAS). Aktivitas Plasma Renin (PRA) dan Plasma Aldosteron merupakan dapat digunakan sebagai penanda dini untuk gangguan ginjal awal akibat pajanan timbel. Penelitian juga menunjukkan bahwa vitamin D sebagai antioksidan memiliki peran penting dalam aksis RAAS dan dalam mencegah stres oksidatif akibat pajanan timbel. Penelitian ini bertujuan untuk menganalisis korelasi antara pajanan timbel, 25(OH)D, dan Renin-Aldosteron pada pekerja.
Metode
Dalam penelitian cross-sectional ini, kami menyelidiki korelasi antara kadar timbel dalam darah (BLL), 25(OH)D, PRA, dan Aldosteron pada pekerja laki-laki di empat lokasi yang diketahui terpajan timbel sebelumnya atau saat ini pada area kegiatan daur ulang baterai asam timbel di Jawa, Indonesia. Penelitian ini dilakukan dari bulan Mei hingga Juli 2023.
Hasil
BLL ditemukan pada semua subjek, dengan nilai terkecil 1,17 ug/dL dan terbesar 58,83 ug/dL. Kami menemukan BLL berkorelasi positif dengan kadar 25(OH)D (r = 0,206, p = 0,043) dan rasio renin aldosteron (r = 0,203, p = 0,046), serta berkorelasi negatif dengan PRA (r = -0,266, p = 0,009). Kami juga menemukan rasio BLL-25(OH)D berkorelasi negatif dengan PRA (r= -0,256, p=0,011)
Kesimpulan
Penelitian ini menemukan bahwa median BLL di antara para pekerja lebih tinggi dari yang direkomendasikan BEI.
Terdapat korelasi positif antara BLL dan kadar 25(OH)D, hasil penelitian ini menunjukkan bahwa pajanan timbel dengan vitamin D bergantung pada dosis dan hubungan antara keduanya saling berinteraksi satu sama lain. BLL dan PRA ditemukan signifikan namun berkorelasi negatif. BLL dan aldosteron tidak signifikan dan tidak berkorelasi. BLL memiliki korelasi positif dengan rasio aldosteron-renin. BLL dapat menyebabkan hiperaldosteronisme relatif.
Background:
Previous studies showed that a possible mechanism effect of lead exposure on blood pressure and chronic kidney disease is through the Renin-Angiotensin-Aldosterone System (RAAS) axis. Plasma Renin Activity (PRA) and Plasma Aldosterone are the possible markers of early renal disorders due to lead exposure. Studies also showed that Vitamin D as an antioxidant has a vital role in the RAAS axis and in preventing oxidative stress due to pollutant exposure. This study aimed to analyze the correlation between lead exposure, 25(OH)D, and Renin-Aldosterone in workers' settings.
Method
In this cross-sectional study, we investigated the correlation between blood lead level (BLL), 25 (OH)D, PRA, and Aldosterone among male workers in four locations with known previous or present exposure to lead in lead acid battery recycling activity areas in Java, Indonesia. The study was conducted from May to July 2023.
Result
BLL were found in all subjects, with the smallest value of 1.17 ug/dL and the largest of 58.83 ug/dL. We found BLL a positive correlation with 25(OH)D levels (r=0,206, p=0,043) and aldosterone renin-ratio (r=0.203, p=0.046), and a negative correlation with PRA (r= -0.266, p=0.009). We also found BLL-25(OH)D ratio a negative correlation with PRA(r=-0.256, p=0.011)
Conclusion
This study found that the median BLL among the workers was higher than the recommended BEI.
There is a positive correlation between BLL and 25(OH)D levels, the results of this study indicate that lead exposure to vitamin D is dose-dependent and the relationship between them is interacting with each other. BLL and PRA were found to be significant but negatively correlated. BLL and aldosterone were not significant and not correlated. BLL have a positive correlation with the aldosterone-renin ratio. BLL may cause relative hyperaldosteronism.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Tesis Membership  Universitas Indonesia Library
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Risyifa Audinia
Renin Urin sebagai Senyawa Penanda Potensial Penyakit Ginjal Diabetes pada Pasien Diabetes Melitus: Systematic Review = Urinary Renin as Potential Marker of Diabetic Kidney Disease in Diabetes Mellitus Patients: Systematic Review
"ABSTRAK
Penyakit ginjal diabetes merupakan salah satu penyebab utama gagal ginjal stadium akhir, sehingga dibutuhkan penanda biologis yang spesifik dan sensitif untuk mengantisipasi progresi penyakit. Sistem renin-angiontensin aldosteron diketahui memiliki peran yang signifikan dalam perkembangan awal penyakit ginjal diabetes, sehingga renin sebagai salah satu komponen sistem renin-angiotensin aldosteron memiliki potensi sebagai penanda awal penyakit ginjal diabetes. Penulisan review article ini bertujuan untuk mengkaji literatur-literatur terkini yang meneliti hubungan kadar renin pada urin dengan perkembangan kerusakan ginjal. Review bersifat sistematik berdasarkan acuan Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) tahun 2009 dengan pendekatan kualitatif. Literatur yang dikaji diperoleh melalui pencarian internet pada database ScienceDirect, PubMed, dan SpringerLink. Sebanyak 5 literatur dipilih berdasarkan kriteria yang ditetapkan. Hasil analisis literatur menunjukkan bahwa potensi renin urin sebagai penanda biologis penyakit ginjal diabetes cukup besar dikarenakan renin urin akan meningkat pada kondisi kerusakan ginjal. Selain itu, renin urin juga dapat menggambarkan aktivitas sistem renin-angiotensin aldosteron intrarenal dan memiliki korelasi positif dengan albuminuria. Hasil analisis literatur juga menunjukkan bahwa tidak adanya korelasi antara eLFG dan renin urin pada pasien dengan penyakit ginjal diabetes. Namun, renin urin secara signifikan lebih tinggi pada pasien dengan penyakit ginjal diabetik dibandingkan dengan pasien dengan penyakit ginjal kronis.
ABSTRACT
Diabetic kidney disease is one of the main causes of end-stage renal disease, therefore there is a need for specific and sensitive biological markers to anticipate progression of the disease. The renin-angiontensin aldosterone is known to have a significant role in the early development of diabetic kidney disease, that means renin as one of the components of the renin-angiotensin aldosterone system has a potential as an early biomarker for diabetic kidney disease. This review article aims to review latest literatures that studied the relationship of renin levels in urine with the development of kidney damage in patients with diabetes or chronic kidney disease. This systematic review was written based on the Reference Reporting Item Options for Systematic Review and Meta-Analysis Guide (PRISMA) of 2009 with a qualitative approach. The literature studied was obtained through an internet search in the ScienceDirect, PubMed, and SpringerLink databases. A total of 5 literatures were chosen based on specified criteria. The results of the literature analysis showed that urinary renin has a promising potential as a biological marker for diabetic kidney disease because urinary renin will likely increase in presence kidney damage. In addition, urinary renin can also describe the activity of the intrarenal renin-angiotensin aldosterone system and positively corelates with albuminuria. The results of the literature analysis also showed no correlations between eGFR and urinary renin in patients with diabetic kidney disease. However, urinary renin were significantly high in patients with diabetic kidney disease compared to patients with chronic kidney disease."
Depok: Fakultas Farmasi Universitas Indonesia, 2020
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UI - Skripsi Membership  Universitas Indonesia Library
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Lubis, Siska Mayasari
Hubungan antara kadar aktivitas renin plasma dengan hipertensi pada penderita hiperplasia adrenal kongenital defisiensi enzim 21-hidroksilase = Association between plasma renin activity with hypertension in children with congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency
"Latar belakang: Hipertensi bukan merupakan manifestasi klinis pasien hiperplasia adrenal kongenital defisiensi enzim 21-hidroksilase (HAK 21-OHD), oleh karena itu perlu diketahui angka kejadian hipertensi pada pasien HAK 21-OHD serta kemungkinan penyebabnya. Tujuan: Mengetahui hubungan antara kadar aktivitas renin plasma (PRA) dengan hipertensi pada anak HAK 21-OHD. Metode: Suatu studi analitik observasional dengan rancangan penelitian potong lintang. Sampel penelitian adalah anak HAK 21-OHD yang berusia >6 bulan-18 tahun, dipilih secara consecutive sampling, kemudian dibandingkan antara 2 kelompok, hipertensi dan tidak hipertensi. Hasil: Sebanyak 40 anak dianalisis, 20 subjek di kelompok hipertensi dan 20 subjek tidak hipertensi. Hipertensi ditemukan pada 16 dari 27 subjek (59,3%) HAK tipe salt wasting dan 4 dari 13 subjek (30,8%) HAK tipe simple virilizing. Diperoleh perbedaan rerata yang bermakna kadar PRA antara kelompok hipertensi dengan tidak hipertensi pada tipe salt wasting p=0,016). Risiko mengalami hipertensi pada pasien HAK tipe salt wasting dengan kadar PRA rendah adalah 1,09 kali setelah dikontrol variabel jenis kelamin, kadar 17-OHP, dan dosis terakhir fludrokortison. Dosis terakhir hidrokortison memiliki hubungan yang signifikan terhadap kejadian hipertensi pada pasien HAK tipe salt wasting. Kesimpulan: Kejadian hipertensi pada pasien HAK 21-OHD saat penelitian berlangsung adalah 32%. Risiko hipertensi pada pasien HAK tipe salt wasting dengan kadar PRA rendah adalah 1,09 kali setelah dikontrol variabel jenis kelamin, kadar 17-OHP awal, dan dosis terakhir fludrokortison.
Background: Hypertension is an uncommon manifestation of congenital adrenal hyperplasia due to 21-hydroxylase enzyme deficiency (21-OHD CAH), therefore it is necessary to estimate the incidence of hypertension in 21-OHD CAH patients and the possible causes. Objective: To evaluate the association between plasma renin activity levels (PRA) with hypertension in children with 21-OHD CAH. Methods: An observational analytic study with a cross sectional study design. The subjects were 21-OHD CAH children, aged >6 months to 18 years, selected by consecutive sampling and then compared between 21-OHD CAH with hypertension and non hypertension groups. Results: A total of 40 subjects were analyzed, 20 subjects in the hypertension and 20 subjects in non hypertension groups. There were 16 from 27 (59.3%) and 4 from 13 subjects (30.8%) with hypertension in CAH salt wasting and simple virilizing types, respectively. There was significant mean difference in PRA levels between hypertension and non hypertension groups in CAH salt wasting patients (p=0,016). The risk of hypertension in CAH salt wasting patients with low PRA levels was 1,09 times after controlling for sex variables, 17-OHP levels, and the last dose of fludrocortisone. The last dose of hydrocortisone had a significant relationship with the incidence of hypertension in CAH salt wasting type patients. Conclusion: The incidence of hypertension in 21-OHD CAH patients during the study period was 32%. The risk of hypertension in CAH salt wasting patients with low PRA levels was 1.09 times after being controlled by sex, 17 OHP level, and the last dose of fludrocortisone."
Depok: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tesis Membership  Universitas Indonesia Library
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Shinta Ayu Nurfaradilla
Pengaruh koadministrasi ekstrak air hibiscus sabdariffa terhadap profil farmakokinetika kaptopril, tekanan darah dan level biomarker sistem renin angiotensin aldosteron = Effect of hibiscus sabdariffa aqueous extract co-administration on the Pharmacokinetic profile of captopril, blood pressure, and biomarker level of renin angiotensin aldosterone system
"Ekstrak air Hibiscus sabdariffa (HS) telah digunakan sebagai pengobatan tradisional pada terapi hipertensi. Banyak orang menggabungkan penggunaan ekstrak air HS dengan kaptopril sehingga dapat berpotensi menimbulkan interaksi. Penelitian ini bertujuan untuk mengetahui pengaruh koadministrasi ekstrak air HS terhadap profil farmakokinetika kaptopril, tekanan darah, dan biomarkersistem renin angiotensin aldosteron (RAAS). Studi farmakokinetika dilakukan terhadap empat kelompok tikus (n = 6). Kelompok I menerima suspensi kaptopril tunggal (CAP; 4,5 mg/200 g BB) sementara kelompok II, III, dan IV menerima koadministrasi ekstrak air HS (15 mg/200 g BB, 30 mg/200 g BB, dan 60 mg/200g BB) dan kaptopril 4,5 mg/200 g BB. Untuk pengukuran tekanan darah dan level biomarker RAAS, digunakan tujuh kelompok tikus (n = 6) berbeda yang terdiri dari satu kelompok sham dan enam kelompok tikus model 2K1C. Pada tikus model 2K1C, hipertensi diinduksi dengan pemasangan mikroklip stainless steel (ID: 0,20 mm) pada arteri ginjal kiri. Kelompok tikus model terdiri dari kontrol negatif (2K1C, tidak diobati), kontrol positif (4,5 mg/200 g BB kaptopril), ekstrak air HS tunggal (30 mg/200 g BB), dan 3 kelompok koadministrasi yang menerima ekstrak air HS (15, 30, atau 60 mg/200g BB) dan kaptopril 4,5 mg/200 g BB. Pemberian ekstrak dan kaptopril dilakukan secara peroral. Seluruh perlakuan dilakukan selama 2 minggu. Ketiga dosis koadministrasi ekstrak HS dapat mempengaruhi profil farmakokinetika kaptopril secara signifikan. Nilai AUC0-t, AUC0-, dan Cmax, pada kelompok tersebut mengalami penurunan, sementara nilai Cl/F dan Vd/F mengalami peningkatan. Seluruh pemberian terapi pengobatan menyebabkan penurunan tekanan darah secara signifikan mendekati kelompok sham. Level renin plasma, aktivitas serum angiotensin converting enzyme (ACE), dan level angiotensin II plasma pada kelompok 2K1C mengalami kenaikan yang signifikan dibandingkan dengan kelompok sham. Aktivitas serum ACE dan level angiotensin II plasma pada seluruh kelompok terapi mengalami penurunan signifikan dan nilainya mendekati kelompok sham. Ekstrak air HS tunggal dapat menurunkan tekanan darah, namun koadministrasi dengan kaptopril tidak memberikan efek tambahan. Oleh karena itu, dapat disimpulkan bahwa pemberian koadministrasi ekstrak air HS dengan kaptopril dapat mempengaruhi profil farmakokinetika kaptopril secara signifikan, namun tidak memberikan pengaruh yang signifikan terhadap penurunan tekanan darah dan level biomarker RAAS.
Hibiscus sabdariffa (HS) extract has been used as traditional medicine during management of hypertension. Many people co-administered HS aqueous extract with captopril thus predispose herb-drug interaction. The purpose of this study was to determine the effect of HS aqueous extract co-administration on the pharmacokinetic profile of captopril, blood pressure, and biomarker level of renin angiotensin aldosterone system (RAAS). Pharmacokinetic study was performed on four groups of rats (n = g). Group I received captopril suspension only (CAP; 4.5 mg/200 g BW), while group II, III, and IV received co-administration of Hibiscus sabdariffa extract (15 mg/200 g BW, 30 mg/200 g BW, and 60 mg/200 g BW respectively) and captopril 4.5 mg/200 g BW. Blood pressure and biomarker level of RAAS measurement were performed on another 7 groups (n = 6), a SHAM group and six 2K1C groups. In 2K1C animals, hypertension was induced by placing a stainless micro clip (inner diameter of 0.20 mm) on left renal artery. The 2K1C animals consist of negative control (2K1C, no treatment), positive control (captopril 4.5 mg/200 g BW), HS aqueous extract (30 mg/200 g BW), and three co-administration groups receiving HS aqueous extract (15, 30, or 60 mg/200 g BW) plus 4.5 mg/200 g BW captopril. Extract and captopril administration were given by oral gavage. All treatments were performed for two weeks. Pharmacokinetic profile of captopril was changed significantly by all co-administration doses of HS aqueous extract. The AUC0-t, AUC0-, and Cmax value of those groups were decreased, conversely the Cl/F and Vd/F value were increased. Blood pressure was significantly reduced by all the drug treatments approaching the level of SHAM controls. Plasma renin level, serum angiotensin converting enzyme (ACE) activity, and plasma angiotensin II level were also significantly elevated in the 2K1C group compared to the SHAM group. Both serum ACE activity and plasma angiotensin II level were significantly reduced approaching the SHAM group levels by all the drug treatments. HS aqueous extract can reduce blood pressure but may not provide any additional benefit. Therefore, we can conclude that co-administration of HS aqueous extract with captopril could affect the pharmacokinetic profile significantly, however it didnt have significant effect on the decrease in blood pressure and RAAS biomarker level."
Depok: Fakultas Farmasi Universitas Indonesia, 2019
T53603
UI - Tesis Membership  Universitas Indonesia Library