Abstract
Inflammation and oxidative stress are risk factors of cardiovascular diseases among chronic kidney disease patients. There is increasing of HsCRP level in stage V CKD patients wih CAPD. N-Acetyl Cysteine(NAC) is a compounds containing thiol with antioxidant and anti-inflammatory effects. This research obejectives was to examine the effect of oral NAC in the decline of HsCRP level in stage V CKD patients with CAPD. This is an experimental research with Randomized Double Blind Control Trial, involving 30 patients CKD with CAPD Dr Moewardi Hospital and complete inclusion and exclusion criteria, divided 15 patients as a control group (placebo) and 15 patients as a treatment group of oral NAC. Examination of data research variables have been performed before and after 8 weeks treatment. The results were the level of HsCRP in control group before treatment and after treatment (15,76±42,79 vs 16,50±30,63). Level of HsCRP in treatment group before treatment and after treatment (29,53±76,52 vs 4,56±12,85) was decrease statistically significant with p< 0,05. The N-Acetyl Cysteine orally can decreased the level of HsCRP in stage V CKD patients with CAPD. Keywords : N-Acetyl Cysteine , CAPD, HsCRP
Highlights
PENDAHULUAN Peningkatan stres oksidatif dan inflamasi kronis pada pasien penyakit ginjal kronis (PGK) yang menjalani dialisis telah banyak didokumentasikan (Oberg et al, 2004; Silvestein, 2009; Nanayakkara and Gailland, 2010; Fontanet et al, 2011)
There is increasing of High sensitivity C-Reactive Protein (HsCRP) level in stage V CKD patients wih Continuous Ambulatory Peritoneal Dialysis (CAPD)
This research obejectives was to examine the effect of oral NAC in the decline of HsCRP level in stage V CKD patients with CAPD
Summary
PENDAHULUAN Peningkatan stres oksidatif dan inflamasi kronis pada pasien penyakit ginjal kronis (PGK) yang menjalani dialisis telah banyak didokumentasikan (Oberg et al, 2004; Silvestein, 2009; Nanayakkara and Gailland, 2010; Fontanet et al, 2011). Maupun mortalitas akibat penyakit jantung vaskuler pada pasien PGK yang menjalani dialisis melalui keterlibatannya dalam inisiasi dan progresi proses aterogenesis (Silvestein, 2009; Nanayakkara and Gailland, 2010; Fortes et al, 2007). Efek antioksidan NAS dapat terjadi secara langsung melalui interaksi dengan ROS elektrofilik maupun sebagai prekusor glutation (Dekhuijen, 2004), suatu antioksidan vital yang melindungi sel dari stres oksidatif yang diketahui menurun pada PGK (Santangelo, 2004). Sampel penelitian diambil acak pada semua pasien PGK stadium V yang telah menjalani CAPD selama 3 bulan sampai 5 tahun di instalasi Ginjal Hipertensi RSUD Dr Moewardi Surakarta, memenuhi kriteria inklusi dan eksklusi dan bersedia diambil darahnya untuk penelitian.
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