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Abstrak :
Latar Belakang: Cisplatin merupakan salah satu obat kemoterapi yang biasa digunakan untuk mengobati berbagai jenis kanker. Namun, meskipun kemampuannya sangat baik dalam mengatasi kanker, cisplatin dapat menyebabkan nefrotoksisitas. Curcumin memiliki efek antioxidan dan anti inflamasi yang diperkirakan dapat melindungi ginjal dari toksisitas cisplatin. Namun, bioavailabilitas curcumin yang rendah menjadi perhatian utama. Pada percobaan ini, kami akan membandingkan efektivitas kurkumin dan nanokurkumin dalam hal proteksi terhadap ginjal pada tikus yang diberikan cisplatin injeksi diperiksa menggunakan KIM-1 dan NGAL sebagai biomarker nefrotoksisitas akut. Metode: Tikus Sprague-dawley jantan dipilih secara acak dan dikelompokkan ke dalam 5 grup (n = 5 tikus/grup) dengan perlakuan yang berbeda; normal, cisplatin, cisplatin + curcumin, cisplatin + nanocurcumin 50 mg/kgBB, dan cisplatin + nanocurcumin 100 mg/kgBB. Dosis cisplatin yang digunakan sebesar 7 mg/kgBB. Pada hari ke 10, tikus dikorbankan dan ginjal diambil untuk dianalisis. Ekspresi KIM-1 dan NGAL pada ginjal dianalisa menggunakan RT-PCR. Hasil: Tidak ada perbedaan diantara seluruh kelompok (p>0.05). Namun, ekspresi kedua gen lebih rendah pada grup yang diberikan nanocurcumin. Konklusi: Ekspresi KIM-1 dan NGAL menurun setelah administrasi nanocurcumin, meskipun tidak signifikan.
Background: Cisplatin is one of the chemotherapy drugs that is commonly used to treat many kinds of cancer. However, despite its great effect, cisplatin can trigger nephrotoxicity due to its usage. Curcumin, has antioxidant and anti-inflammatory effect that has been suggested to be able to protect the kidney from cisplatin toxicity. Nevertheless, its low bioavailability has become one of the major concern. In this experiment, we will compare the effectivity of curcumin and nanocurcumin in protecting the kidney from cisplatin-induced nephrotoxicity using KIM-1 and NGAL as the biomarker of acute kidney failure Method: Sprague Dawley rats are randomly divided into 5 groups (n = 5 rats/group) with different treatment; normal, cisplatin, cisplatin+curcumin, cisplatin+nanocurcumin 50 mg/kgBW, cisplatin+nanocurcumin 100mg/kgBW. The dose of cisplatin used in this research is 7mg/kgBW. On the 10th day of experiment, the rat is sacrified and the kidneys are taken for analysis. Then, KIM and NGAL expression in the kidney is analyzed using qRT-PCR. Results: There are no statistical significancy between all group (p>0.05). However, expression of both KIM-1 and NGAL decrease in group treated using Nanocurcumin Conculsion: The expression of both KIM-1 and NGAL are repressed by nanocurcumin, although it is statistically not significant.

Abstrak :
Latar Belakang: Tuberkulosis paru (TB) masih menjadi salah satu penyebab morbiditas dan mortalitas di seluruh dunia. Dalam dua dekade terakhir penyakit TB resisten obat (TBRO) telah muncul sebagai ancaman bagi kesehatan masyarakat seluruh dunia. NGAL merupakan partikel granulosit neutrofil yang mengalami pematangan dan menjadi gelatinase. NGAL terlibat dalam kekebalan bawaan untuk menghalangi bakteri mengambil zat besi untuk pertumbuhan. Pada pasien dengan komorbid anemia akan terjadi penurunan kekebalan bawaan sehingga pada TBRO dengan anemia bakteri Mtb akan mendapat zat besi dari tubuh manusia untuk bereplikasi. Namun masih belum terdapat data kadar protein serum NGAL pada pasien TBRO dengan anemia. Metode : Penelitian ini merupakan penelitian analitik observasional menggunakan desain potong lintang yang dilakukan di poliklinik dan ruang rawat inap MDR RSUP Persahabatan pada bulan Juli-September 2023. Jumlah subyek penelitian adalah 73 pasien TBRO yang belum memulai pengobatan dengan anemia dan tanpa anemia yang memenuhi kriteria inklusi dan eksklusi. Sampel darah subyek diambil sebanyak 3cc. Serum darah diambil lalu disimpan dalam lemari es suhu -200C. selanjutnya dilakukan pemeriksaan ELISA teknik sandwich dan diambil kadar protein NGAL. Variabel lainnya diambil dari rekam medis RSUP Persahabatan. Hasil : Pada penelitian ini didapatkan pasien TBRO dengan anemia memiliki IMT yang menunjukkan tingkat malnutrisi yang bermakna (p:0,026, OR 2,9(1,1-7,5). Penelitian ini juga mengidentifikasi peningkatan jumlah neutrofil (p:0,002, OR 0,2(0,06-0,5) dan penurunan jumlah limfosit (p:0,006, OR (4,2 (1,4-9,8) pada kelompok pasien anemia, yang tercermin dalam NLR yang meningkat (p:0,028, OR 0,3(0,09-0,9). Hasil yang ditemukan juga menunjukkan bahwa pasien TBRO dengan anemia memiliki lesi paru yang lebih luas secara statistik (p:0,048, OR 2,7(0,9-7,3). Kadar NGAL menunjukkan hasil median 82,76 (67,59) yang lebih tinggi dibandingkan dengan kelompok pasien TBRO anemia dan kelompok TBRO tanpa anemia 59,24(91,98) namun tidak bermakna (p: 0,26). Terdapat korelasi yang bermakna kadar NGAL dengan leukosit (r:0,295, p:0,011), neutrofil (r:0,297, p:0,011), limfosit (r:-0,343,p:0,003) dan NLR (r:0,336,p:0,004). Kesimpulan: Terdapat peningkatan kadar NGAL pada pasien TBRO dengan anemia dibandingkan tanpa anemia namun tidak bermakna secara statistik. ......Background: Pulmonary tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide. In the last two decades, drug-resistant tuberculosis (DR-TB) has emerged as a global health threat. NGAL is a neutrophil granulocyte- derived protein that undergoes maturation and becomes gelatinase. NGAL is involved in innate immunity by blocking bacteria from acquiring iron for growth. In patients with anemia, there is a reduction in innate immunity, in patient DR-TB with anemia allowing Mtb bacteria to obtain iron from the human body for replication. However, there is currently no data on serum NGAL protein levels in DR-TB patients with anemia. Methods: This study is an observational research using a cross-sectional design conducted in the outpatient clinic and inpatient ward of MDR RSUP Persahabatan in July-September 2023. The research subjects were 73 subject DR-TB patients who not yet started treatment with or without anemia and met the inclusion and exclusion criteria. Blood samples of the subjects were collected as much as 3cc. The blood serum was separated and stored in a -20°C freezer. Furthermore, ELISA examination using the sandwich technique was performed, and NGAL protein levels were measured. Results: In this study, DR-TB patients with anemia had BMI indicating significant malnutrition (p: 0.026, OR 2.9(1.1-7.5). This study also identified an increase in the number of neutrophils (p: 0.002, OR 0.2(0.06-0.5) and a decrease in the number of lymphocytes (p: 0.006, OR 4.2(1.4-9.8) in the anemia patient group, as reflected in the increased NLR (p: 0.028, OR 0.3(0.09-0.9). The findings also showed that DR-TB patients with anemia had statistically larger lung lesions (p: 0.048, OR 2.7(0.9-7.3). NGAL levels showed a higher median result between the DR-TB patient group with anemia 82,76 (67,59) and the group without anemia 59,24 (91,98), but it was not statistically significant (p: 0.26). NGAL have significant corelation among leukocyte (r:0,295, p:0,011), neutrophil (r:0,297,p:0,011), limphocyte (r:-0,343,p:0,003) and NLR (r:0,336,p:0,004) Conclusion: There is a increase in NGAL levels in DR-TB patients with anemia compared to those without anemia. However, this findings do not reach statistical significance.

Abstrak :
Latar belakang: Thalassemia merupakan kelainan hemoglobin yang diturunkan secara autosomal resesif terbanyak di dunia, termasuk di Indonesia. Eritropoiesis inefektif dan hemolisis yang mengakibatkan terjadinya anemia, disertai kelebihan besi, dan toksisitas kelasi besi dapat menganggu fungsi organ, salah satunya ginjal. Tujuan: Mengetahui profil tubulus ginjal dan faktor yang memengaruhi pada transfusion dependent thalassemia (TDT) remaja Metode: Penelitian deskriptif analitik yang dilakukan dengan potong lintang. Subyek adalah TDT remaja usia 10-18 tahun yang datang ke RSCM pada Januari 2024 sampai Februari 2024. Subyek diekslusi jika terdapat riwayat penyakit ginjal, demam, gejala infeksi saluran kemih, serta mendapatkan kortikosteroid, trimetoprim, aminoglikosida atau sefalosporin generasi pertama dalam 1 minggu terakhir berdasarkan anamnesis dan catatan medik. Setelah informed consent didapatkan dari orangtua, dilakukan pengambilan data demografi dasar, pengukuran status antropometri, dan pengukuran tekanan darah. Pengambilan sampel darah dilakukan sebelum transfusi rutin dan pengambilan sampel urin pertama di pagi hari untuk dilakukan pemeriksaan fungsi ginjal. Hasil: Dari 55 subyek, proporsi jenis kelamin 1:1 dengan median usia 14 (10-17) tahun. Median usia terdiagnosis thalassemia adalah 24 (2-180) bulan. Mayoritas subyek adalah thalassemia-! (72,7%), sedangkan thalassemia-!/HbE 27,3%. Status nutrisi gizi baik 45,5%, gizi kurang 34,5%, dan gizi buruk 20%. Jenis kelasi besi yang diberikan antara lain, deferipron (DFP) 61,8%, deferasiroks (DFX) 29,1%, dan kombinasi (DFP dan DFX) 7,3%, sedangkan 1 pasien tanpa terapi. Rerata kadar hemoglobin adalah 8,5 (SD 1,1) g/dL dengan nilai median feritin 4.604,2 (753,86-30.472,67) ng/dL. Prevalens disfungsi tubulus ginjal adalah 96,3%, meskipun prevalens penurunan fungsi ginjal hanya 1,8%. Profil fungsi tubulus ginjal berupa hiperurikosuria (94,5%), proteinuria (39,1%), peningkatan NGAL/kreatinin urin (23,6%), hiperkalsiuria (21,8%), dan hiperfosfaturia (20%). Tidak terbukti hubungan rasio NGAL/kreatinin urin terhadap anemia pre- transfusi, status kelebihan besi, dan jenis kelasi besi. Hiperfiltrasi glomerulus terjadi pada 63,6% subyek dan NGAL/kreatinin urin dan proteinuria memiliki hubungan yang bermakna terhadap hiperfiltrasi glomerulus dini (p=0,029 dan p=0,025). Kesimpulan: Disfungsi tubulus banyak ditemukan pada TDT remaja. Tidak terbukti hubungan rasio NGAL/kreatinin urin terhadap anemia pre-transfusi, status kelebihan besi, dan jenis kelasi besi. Pemeriksaan fungsi ginjal sebaiknya dilakukan secara rutin pada TDT remaja. ......Background: Thalassemia is the most common hemoglobin disorder in Indonesia. Ineffective erythropoiesis and haemolysis result in anemia, accompanied by iron overload, and iron chelation toxicity can disrupt organ function, one of which is the kidneys. Objective: To determine renal tubule function and its contributing factors in transfusion dependent thalassemia (TDT) adolescents. Method: This is an analytical descriptive study in cross-sectional. Subjects were TDT adolescent aged 10-18 years who came to RSCM from December 2023 to January 2024. Subjects were excluded if they had a history of kidney disease, fever, symptoms of urinary tract infection, and received corticosteroids, trimethoprim, aminoglycosides or first generation cephalosporins within the last 1 week based on anamnesis and medical records. Informed consent was obtained from the parents and basic demographic data, anthropometric status measurements and blood pressure measurements were taken. Blood samples are taken before routine transfusions and first morning urine samples are taken to check kidney function. Results: Of the 55 subjects, the gender proportion was 1:1 with a median age of 14 (10- 17) years. The median age at diagnosis was 24 (2-180) months. The majority of subjects were !-thalassemia (72.7%), while !-thalassemia/HbE was 27.3%. The nutritional status was normal 45.5%, wasting 34.5%, and severe wasting 20%. The types of iron chelation given included deferiprone (DFP) 61.8%, deferasirox (DFX) 29.1%, and combination (DFP and DFX) 7.3%, while 1 patient had no therapy. The mean hemoglobin level was 8.5 (SD 1.1) g/dL with a median ferritin value of 4,604.2 (753.86-30,472.67) ng/dL. The prevalence of renal tubular dysfunction is 96.3%, although the prevalence of decreased renal function is only 1.8%. The renal tubular function profile consisted of hyperuricosuria (94.5%), proteinuria (39.1%), increased urinary NGAL/creatinine (23.6%), hypercalciuria (21.8%), and hyperphosphaturia (20%). There is no correlation between the urine NGAL/creatinine ratio and pre-transfusion anemia, iron overload status, and type of iron chelation. Glomerular hyperfiltration occurred in 63.6% subjects and urinary NGAL/creatinine and proteinuria had a significant correlation to early glomerular hyperfiltration (p=0.029 and p=0.025). Conclusion: Tubular dysfunction is often found in adolescent TDT. There is no relationship between the urine NGAL/creatinine ratio and pre-transfusion anemia, iron overload status, and type of iron chelation. Kidney function evaluation should be carried out routinely in adolescent TDT.

Abstrak :
Latar Belakang. Mortalitas akibat sepsis di ICU masih cukup tinggi meskipun telah semakin cepatnya diagnosis dan perbaikan perawatan suportif dan angkanya semakin meningkat dengan insiden acute kidney injury yang merupakan bagian dari disfungsi organ akibat sepsis. Asam askorbat dikatakan dapat memperbaiki disfungsi organ disebabkan efeknya yang sinergis terhadap patofisiologi sepsis. Peranan asam askorbat dalam menurunkan disfungsi organ masih kontroversial. Penelitian ini ingin menganalisis efek pemberian asam askorbat intravena terhadap perbaikan fungsi ginjal pada pasien sepsis/ syok sepsis yaitu dengan melihat efek terhadap kadar urin neutrophil gelatinase associated lipocalin (uNGAL), produksi urin dan balans kumulatif. Metodologi. Penelitian ini merupakan penelitian uji klinis dengan desain penelitian uji acak terkontrol, dilakukan pada pasien usia > 18 tahun dengan sepsis berdasarkan kriteria sepsis-3 yang masuk ICU dalam 6 sampai 24 jam pascaresusitasi setelah diagnosis sepsis. Kriteria penolakan yaitu pasien dengan gangguan ginjal kronik dengan hemodialisis, kelainan batu ginjal, dengan masalah ginjal dalam 3 bulan terakhir. Pasien akan dikeluarkan apabila diberikan kortikosteroid dan mendapatkan terapi pengganti ginjal dalam < 72 jam observasi. Penelitian dilakukan di ICU Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo pada April 2019-Juli 2019. Sebanyak 33 sampel dirandomisasi secara randomisasi sederhana dan dikelompokan menjadi kelompok perlakuan (18 sampel) dan kontrol (15 sampel). Data demografik dasar dicatat saat masuk ICU. NGAL urin (ng/mL) diperiksa pada jam 0, 24, 48 dan 72 setelah terapi. Produksi urin (ml/kg/jam) dan balan kumulatif (L) dicatat pada jam 24, 48 dan 72 setelah terapi. Analisis statistik dengan uji Mann Whitney untuk data numerik dengan persebaran tidak normal, uji T independen untuk data dengan persebaran normal dan uji Fisher untuk data kategorik perbandingan antara kedua kelompok intervensi. Analisis multivariat untuk pengukuran serial menggunakan generalized estimating equations (GEE) untuk membandingkan antara kedua kelompok dalam waktu pengukuran yang berulang. Nilai signifikansi dengan nilai p < 0,05. Hasil. Tidak terdapat perbedaan pada kadar NGAL urin, produksi urin, balans kumulatif antara dua kelompok di setiap jamnya. Kesimpulan. Pada penelitian ini pemberian asam askorbat intravena tidak mempunyai efek terhadap kadar NGAL urin, produksi urin, balans kumulatif. ......Background. Sepsis-related mortality in intensive care unit (ICU) remains despite improved diagnostic technology and supportive treatment. Acute kidney injury, one of frequent organ dysfunctions in sepsis, increases risk of mortality. Ascorbic acid could improve organ dysfunction because its direct effect on sepsis pathophysiology. The role of ascorbic acid on improving organ dysfunction remains controversial. This study wished to analyze the effects of intravenous ascorbic acid on kidney function improvement among septic patients by evaluating urine neutrophil gelatinase associated lipocalin (uNGAL), urine output and cumulative fluid balance. Method. This study was randomized controlled trial held in Cipto Mangunkusumo Hospital from April to July 2019. The inclusion criteria were adult patients aged > 18 years who met sepsis-3 criteria and were admitted to the ICU within 6-24 h after resuscitation and sepsis recognition. The exclusion criteria were patients with hemodialysis-dependent chronic kidney disease, kidney stones or other kidney problems within last 3 months. The drop out criteria were patients underwent renal replacement therapy in the ICU and given corticosteroid less than 72 h after recruitment. Subjects were randomized using simple randomization and divided into two groups with treatment (18 subjects) and control (15 subjects). Baseline demographic data was recorded on the first day. Daily measurements of urine NGAL (ng/ mL) was started as baseline level and continued at 24, 48 and 72 h after treatment. Urine output (ml/kg/h), cumulative fluid balance (L) was recorded at at 24, 48 and 72 h after treatment. Comparison between both groups was analysed by using Mann Whitney test (not normally distributed data), T independent test (normally distributed data) for numerical data and Fisher test for categorical data. Multivariate analysis using generalized estimating equations was used for serial measurement analysis. Level of significant was determined at p-value <0.05. Result. There were no significant differences in uNGAL, urine output, cumulative fluid balance between the two groups at each hour respectively. Conclusion. This study showed that intravenous vitamin CMultin administration had no effect on urine NGAL, urine output, cumulative fluid balance.

Abstrak :
ABSTRAK Latar Belakang : Para pekerja yang melakukan aktivitas fisik di lingkungan panas tinggi dapat mengalami gangguan pada ginjal. Selain glomerulus, bagian tubulointerstium yang memiliki fungsi penting reabsorsi dan sekresi, diduga juga mengalami gangguan. Ingin diketahui lebih lanjut ada tidaknya gangguan pada sel tubulus ginjal para pekerja setelah 4 jam pajanan panas tinggi melalui pemeriksaan NGAL urin yang lebih spesifik. Metode : Desain penelitian ini adalah baseline study dan pre-post study.Dilakukan di bagian hotpress outsole pabrik sepatu di Tangerang bulan April 2015. Data primer didapat melalui wawancara, pemeriksaan langsung tinggi dan berat badan serta pengambilan sampel NGAL urin dilakukan 2 kali, sebelum dan sesudah 4 jam kerja terpajan tekanan panas tinggi (29,0 oC - 31,05 oC ISBB). Untuk pemeriksaan kadar NGAL menggunakan kit komersial (Quantikine kit Human Lipocalin-2/NGAL Immunoassay). Hasil : 68 pekerja memenuhi kriteria inklusi penelitian dan 100 % adalah laki-laki berusia 20-40 tahun yang sehat. Didapatkan nilai NGAL urin awal sebelum terpajan panas antara 0.03 ng/ mL ? 12,82 ng/mL dengan median 1.52 ng/mL. Dari pemeriksaan setelah 4 jam kerja terpajan panas terdapat 25 responden (36,8% ) mengalami kenaikan nilai NGAL dalam urin dengan median kenaikan sebesar 0,35 mg/dL sedangkan 43 responden (63,2%) tidak mengalami kenaikan nilai NGAL dalam urin . Simpulan: Tidak terdapat peningkatan yang dianggap bermakna pada rerata nilai NGAL dalam urin para pekerja pabrik yang tepajan tekanan panas tinggi selama 4 jam kerja.

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ABSTRACT Background : Workers performing physical activities in heat-stress environment could have kidney disorder. Beside glomerulus, tubulointerstitium which has important function of reabsorption and secretion, is suspected to also have injury. Further exploration on the impact on kidney tubules cells on the workers after 4 hours exposed to heat-stress through more specific examination of urine NGAL (uNGAL). Method : Design of this research are baseline study and pre-post study, conducted at the hotpress outsole department at a shoe factory in Tangerang in April 2015. Primary data obtained through interview, direct examination on height and weight and taking sample of uNGAL twice time, before and after 4 hours of moderate working activities in the area of high heat-stress (29,0 oC - 31,05 oC WGBT) . Examining NGAL level by using commercial kit (Quantikine kit Human Lipocalin-2/NGAL Immunoassay). Result : 68 workers fit with criteria inclusion study and 100% are healthy men aged between 20-40 years. The result of uNGAL initial scores are between 0.03 ng/ mL ? 12,82 ng/mL with median of 1.52 ng/mL. After 4 hours of moderate working activities in the area of high heat-stress there are 25 workers ( 36,8% ) have increase uNGAL level with median of 0,35 mg/dL, while the other 43 workers (63,2%) have not. Summary : There is no significant changes of urine NGAL score after 4 hours of working within worker population in the area of high heat-stress.

Abstrak :
Latar belakang Sisplatin merupakan pengobatan utama untuk karsinoma nasofaring KNF , tetapi berpotensi menimbulkan nefrotoksisitas. Selain kadar BUN dan kreatinin serum, KIM-1 dan NGAL diduga cukup sensitif untuk mendeteksi nefrotoksisitas. Penelitian ini bertujuan untuk mengevaluasi kadar KIM-1 dan NGAL dalam urin untuk mendeteksi gangguan fungsi ginjal pada pasien KNF stadium lanjut yang mendapatkan kemoterapi berbasis sisplatin. Metode: Penelitian ini merupakan penelitian kohort prospektif. Subyek penelitian dibagi dalam 3 kelompok: pasien yang belum pernah terpapar dan yang sudah pernah mendapatkan kemoterapi berbasis sisplatin 75-100 mg/m serta pasien yang belum pernah mendapatkan kemoterapi sisplatin dan kemudian diberi sisplatin 40 mg/m 2 . Kadar KIM-1, NGAL dalam urin serta kadar BUN dan kreatinin dalam serum diukur pada saat sebelum dan sesudah mendapatkan sisplatin pada ketiga kelompok. Analisis statistik yang digunakan adalah uji ANOVA, uji Pearson, Spearman, Kolmogorov-Smirnov dan SPSS versi 22,0. Hasil: Terdapat perbedaan selisih kadar BUN yang bermakna antara sebelum dan sesudah diterapi pada ketiga kelompok p=0.0001 . Perbedaan selisih kadar NGAL dalam urin pada penelitian ini juga berbeda bermakna antara sebelum dan sesudah diterapi terhadap ketiga kelompok p=0,025 , tetapi ada perbedaan rerata pada sepasang kelompok yang bermakna hanya didapatkan pada kelompok yang belum pernah dikemoterapi 40 mg/m 2 dan kelompok yang sudah pernah diberi kemoterapi 75-100 mg/m 2 p=0,02. Perbedaan selisih kadar KIM-1 tidak bermakna pada ketiga kelompok p=0,275. Kesimpulan: Sisplatin menunjukkan akumulasi nefrotoksisitas yang tergantung pada dosis dose-dependent manner . Pengukuran kadar NGAL dalam urin dapat mendeteksi nefrotoksisitas tahap dini, tetapi belum bisa menggantikan peran BUN. Pengukuran kadar KIM-1 dalam urin tidak dapat mendeteksi gangguan fungsi ginjal. ...... Background: Cisplatin is the main treatment for nasopharyngeal carcinoma NPC with a potency of causing nephrotoxicity. In addition to serum BUN and creatinine levels, KIM 1 and NGAL levels is assumed to be quite sensitive in detecting nephrotoxicity. The study was aimed to evaluate urinary KIM 1 and NGAL level to detect kidney dysfunction in patients with advanced stage NPC who received cisplatin based chemotherapy. Method: The study was a cohort prospective study. Subjects were categorized into 3 groups, i.e. patients who had never received and who had received 75 100 mg m2 cisplatin based chemotherapy as well as those who had never received any cisplatin based chemotherapy and were subsequently received 40 mg m cisplatin. The levels of urinary KIM 1, NGAL and serum level of BUN and creatinine were measured before and after receiving cisplatin in the three groups. Statistical analysis used in our study were ANOVA, Pearson, Spearman, KolmogorovSmirnov test and SPSS version 22.0. Results: There was a significant difference of delta BUN level before and after treatment in all three groups p 0.0001 . Delta urinary NGAL level was also significantly different between before and after treatment in all groups p 0.025 however, a significant mean difference of a pair group was only found between those who never had 40 mg m 2 chemotherapy and those who had received 75 100 mg m 2 chemotherapy p 0.02 while delta KIM 1 level showed no significant difference in all three groups p 0.275. Conclusion: Cisplatin may cause accumulated nephrotoxicity, which has dosedependent manner. Measuring urinary NGAL level can detect an early stage of kidney dysfunction however, it still cannot replace the role of BUN. Measurement of urinary KIM 1 level cannot detect kidney dysfunction.

Abstrak :
Kemoterapi dengan cisplatin merupakan modalitas utama pada terapi pada kanker ovarium, walaupun telah diketahui toksisitasnya pada berbagai organ termasuk ginjal. Kurkumin, senyawa fenolik yang diperoleh dari Curcuma longa, diketahui memiliki efek proteksi pada ginjal akibat cisplatin pada berbagai model toksisitas in vivo. Namun, efek kurkumin pada ginjal dibatasi oleh bioavailabilitasnya yang rendah. Kelompok penelitian kami telah berhasil mengembangkan formulasi kurkumin nanopartikel baru yang telah terbukti memperbaiki efikasi cisplatin pada model kanker ovarium. Namun, belum diketahui apakah formulasi kurkumin nanopartikel ini juga dapat memperbaiki fungsi dan kondisi inflamasi pada ginjal yang disebabkan oleh cisplatin. Metode Sebanyak 24 ekor tikus Wistar betina dibagi menjadi: 6 ekor tikus normal (sham treatment) dan 18 ekor tikus yang diinduksi menjadi kanker ovarium dengan DMBA. Tikus kanker ovarium dibagi menjadi 3 kelompok masing-masing 6 ekor yang menerima cisplatin 4 mg/kgBB/minggu atau cisplatin 4 mg/kgBB/minggu +kurkumin 100 mg/kgBB/hari atau cisplatin 4 mg/kgBB/minggu + nanokurkumin 100 mg/kgBB/hari. Terapi diberikan selama 4 minggu, kemudian dilakukan terminasi dan diambil darah dan organ ginjal untuk analisis penanda fungsi ginjal dan inflamasi. Hasil Nanokurkumin dapat menurunkan kadar ureum serum signifikan dibandingkan kelompok cisplatin, namun tidak mempengaruhi kadar kreatinin dan sedikit menurunkan kadar neutrophil gelatinase-associated lipocalin (NGAL). Nanokurkumin tidak berhasil menurunkan kadar penanda inflamasi: TNF-, IL-1β dan IL-6. Kesimpulan Nanokurkumin memiliki kecenderungan untuk memperbaiki beberapa penanda fungsi ginjal dalam darah pada model kanker ovarium yang diberikan cisplatin, namun tidak mempengaruhi kadar penanda inflamasi di ginjal. ......The effects of nanocurcumin on kidney function and inflammatory markers in rat model of ovarian cancer treated with cisplatin Cisplatin remains the main modality of treatment for ovarian cancer, despite its known toxic effects to various organs, including the kidney. Curcumin, a phenolic compound derived from Curcuma longa, was known to have a renoprotective effect on cisplatin- induced in vivo models. However, the beneficial effect of curcumin on the kidney is limited by its low bioavailability. Our research group has successfully developed a novel curcumin nanoparticle formulation that has been shown to improve the efficacy of cisplatin in ovarian cancer models. However, it is not yet known whether this curcumin nanoparticle formulation can also improve kidney function and inflammatory conditions caused by cisplatin in ovarian cancer models. Method A total of 24 female Wistar rats were divided into: 6 normal rats (sham treatment) and 18 rats induced to develop ovarian cancer with DMBA. Ovarian cancer rats were divided into 3 groups of 6 each receiving cisplatin 4 mg/kgBW/week or cisplatin 4 mg/kgBW/week + curcumin 100 mg/kgBW/day or cisplatin 4 mg/kgBW/week + nanocurcumin 100 mg/day. kgBB/day. Therapy was given for 4 weeks, then terminated and blood and kidney were taken for analysis of markers of kidney function and inflammation. Results Nanocurcumin lowered serum urea levels significantly compared to the cisplatin group. However, nanocurcumin did not alter creatinine levels and slightly reduced serum neutrophil gelatinase-associated lipocalin (NGAL) concentrations. Nanocurcumin was did not affect the inflammatory markers studied: TNF-, IL-1β and IL-6. Conclusion Nanocurcumin has a tendency to improve several markers of kidney function in cisplatin- treated ovarian cancer models. However, the effect was not associated by the alteration of inflammatory cytokines in the kidney.