THE INDONESIAN JOURNAL OF NEPHROLOGY AND HYPERTENSION Vol. 8, No.2, April - Juni 2008
DAFTAR lSI
..-
EDITORIAL
LAPORAN KASUS
TRANSFUSION- RELATEDACUTE LUNG INURY (TRAU)
TRANSFUSION-RELATEDACUTE LUNG INJURY (TRAU)
Dharmeizar
IN DONOR KIDNEY TRANSPLANTATION PATIENT - A CASEREPORT Nur Samsu*, Santoso Chandra*, Djoko Wibisono*, Rudi
LAPORAN PENEUTIAN
Supriyadi*,
Yenni Kandarini*,
Bonar M Marbun**,
Dharmeizar**, E. Susalit** ADIPONECTINAND ASSOCIATEDFACTORSIN CONTINUOUS AMBULATORY PERITONEALDIALYSIS TINJAUAN PUSTAKA
(CAPO) PATIENTS YennyKandarini, RakaWid/ana and Ketut Suwitra
POUMORFISME GENSISTEM RENJNANGIOTENSIN
,
HUBUNGAN PENINGKATAN KADAR TGF- B1 PADA
ALDOSTERONDAN HIPERTENSI
PENDERITA HIPERTENSI ESENSIAL DENGAN FUNGSI
Fredie Irijanto
GINJAL DITINJAU DARI MIKROALBUMINURIA
DAN
LAJU FILTRASIGLOMERULUS
INFLAMASI PADA PENYAKITGINJAL KRONIK DAN
Rudi Supriyad/, Nanny Natalia, HM Rachmat Soelaeman,
HUBUNGANNYA DENGANPENYAKIT
EndaySukandar
KARDIOVASKULAR Pringgodfgdo Nugroho, Dharmeizar
KORESPONDENSI& PANDUAN BAGI PENUUS
ISSN 0853-1137
Vol. 8, No.2, April - Juni 2008
Perhimpunan Nefrologi Indonesia (PERNEFRI) Sekretariat
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Ginjal Hipertensi, Vol.8, NO.2, April - Juni 2008
I Susunan Redaksi Pelindung: Ketua PERNEFRI ex officio Ketua Dewan Editor: Dr. Parlindungan Siregar, Sp.PD-KGH Wakil Ketua Dewan Editor: Dr. Dharmeizar, Sp.PD-KGH Anggota Dewan Editor: J
DR.Dr. Suhardjono, SpPD-KGH, KGer
o
Dr. Pranawa, Sp.PD-KGH
.j
Dr. Ardaya, Sp.PD-KGH
..j
DR. Dr. Imam Effendi, SpPD-KGH
o
DR. Dr. Bimanesh Sutarjo, Sp.PD-KGH
..j
Dr. Lucky Aziza Bawazier, SpPD-KGH
.j
Dr. Dwi Juwono, Sp.PD-KGH
..j
Dr. Ginova Nainggolan, SpPD-KGH
..j
Prof. Dr. Wiguno Prodjosudjadi, Ph.D.,
.j
Dr. Tunggul Situmorang, Sp.PD-KGH, DipI/M.Med.Si
Editor Kehormatan: .j
Dr. J. Pudji Rahardjo, Sp.PD-KGH
.j
Prof. Dr. M. S. Markum, Sp.PD-KGH
.j
Prof. Dr. Harun Rasyid Lubis, Sp.PD-KGH
.j
Prof. Dr. Enday Sukandar, Sp.PD-KGH
.j
Prof. Dr. Jose Roesma, Ph.D, Sp.PD-KGH
.j
Dr. E. J. Kapojos, Sp.PD-KGH
.j
Prof. DR, Dr. Endang Susalit, Sp.PD-KGH
.:J
Prof. Dr. Made Sukahatya, Sp.PD-KGH
,::; Prof. Dr. Agus Tessy, Sp.PD-KGH
Sp.PD-KGH
:/ Prof. DR. Dr. Mochammad Sja'bani, Sp.PD-KGH
,::; Prof. Dr. Sutisna Himawan, Sp.PA (K) ..J Prof. Dr. Husein Alatas, Sp. A (K)
Bendahara: Dr. Aida Lydia, Sp.PD-KGH Publikasi: Arlinda Simanjuntak Administrasi dan Iklan : Ir. Tety Sidabutar Distribusi : PERNEFRI Lay Out & Design: PERNEFRI - Ferdy Lumbantobing
Ginjal Hipertensi, Vo1.8, NO.2, April
Juni 2008
NJAL HIPERTENS
I Daftar
lsi
Editorial TRANSFUSION
73 -74
- RELATED ACUTE LUNG INURY (TRAU)
Dharmeizar
Laporan Penelitian ADIPONECTIN
AND ASSOCIATED FACTORS IN CONTINUOUS AMBULATORY
PERITONEAL DIALYSIS
(CAPO) PATIENTS
75 -79
Yenny Kandarini, Raka Widiana and Ketut Suwitra HUBUNGAN
PENINGKATAN
KADAR TGF- B1 PADA PENDERITA HIPERTENSI ESENSIAL DENGAN
GINJAL DITINJAU DAR I MIKROALBUMINURIA
FUNGSI
DAN LAJU FILTRASI GLOMERULUS
RudlSupriyadi, Nanny Natalia, HM Rachmat Soe/aeman, EndaySukandar
80 - 90
Laporan Kasus TRANSFUSION-RELATED
ACUTE LUNG INJURY (TRAU) IN DONOR KIDNEY TRANSPLANTATION
PATIENT-
A CASE REPORT
Nur Samsu*, Santoso Chandra*, Djoko Wibisono*, Rudi Supriyadi*, Yenni Kandarini*"Bonar M Marbun**, Dharmeizar**, E. Susalit**
91- 95
Tinjauan Pustaka POLIMORFISME
GEN SISTEM RENIN ANGIOTENSIN ALDOSTERON DAN HIPERTENSI
Fredie Irijanto INFLAMASI
96 -105
PADA PENYAKIT GINJAL KRONIK DAN HUBUNGANNYA
DENGAN PENYAKIT
KARDIOVASKULAR
Pringgodigdo Nugroho, Dharmeizar
Korespondensi
& Panduan
Bag~Penulis
106-115
116- 117
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Laporan Kasus
TRANSFUSION-RELATED ACUTE LUNG INJURY (TRALI) IN DONOR KIDNEY TRANSPLANTATION PATIENT – A CASE REPORT Nur Samsu*, Santoso Chandra*, Djoko Wibisono*, Rudi Supriyadi*, Yenni Kandarini*, Bonar M Marbun**, Dharmeizar**, E. Susalit**. *Peserta program pendidikan konsultan, **Divisi Ginjal dan Hipertensi FKUI-RSCM Jakarta.
Abstract Transfusion-related acute lung injury (TRALI) is defined as noncardiogenic pulmonary edema related to transfusion therapy. It is a potentially life-threatening, underrecognized and underreported complication of transfusion. Symptoms usually begin within 1-2 hours up to 6 hours and severity may range from mild to severe (life threatening). Clinically indistinguishable from acute respiratory distress syndrome (ARDS). The diagnosis of TRALI relies on excluding other diagnoses and based primarily on clinical simptoms and signs, not laboratory findings. The minimum requirements for diagnosis of TRALI was occurrence of acute repiratory distress during or within 6 hrs of transfusion, absence of signs of circulatory overload, and radiographic evidence of bilateral pulmonary infiltrates. The pathogenesis of TRALI may be explained by a two-hit hypothesis, with the first hit being an underlying condition of the patient. The second hit may involve the presence of biologically active lipids or leucocyte antibodies in transfused blood component. No specific treatment for TRALI. Maintenance of hemodynamic status is the most beneficial and appropriate therapy. Ventilatory support and saline infusion are probably the only standard therapies for TRALI. We reported a 24 yaers old male-kidney related transplantasion donor patien with TRALI that occur approximately 2 hours after transfusion of pack red cell on day-3 of nephrectomy. Transfusion was indicated for patien because of acute bleeding. Patiens developed dyspnea, cyanosis, cough with pink frothy sputum, along with physical findings of bilateral pulmonary edema. The CXR examination showed bilateral pulmonary infiltrates. A patien was given intubation and ventilatory support and inproved with resolution of the pulmonary infiltrasion within the first 4 days.
PENDAHULUAN Transfusion-related acute lung injury (TRALI) adalah edema paru non-kardiogenik yang berkaitan dengan terapi transfusi. TRALI merupakan salah satu penyebab tersering morbiditas dan mortalitas terkait transfusi.1 Istilah ini pertama kali diusulkan oleh Popovsky tahun 1983 untuk menjelaskan adanya kumpulan gejala klinik dan gambaran laboratorium yang terjadi selama 6 jam transfusi plasma yang mengandung produk-produk darah.2 Pada umumnya gejala-gejala respiratory distress terjadi dalam 2 – 6 jam pertama dari saat permulaan transfusi darah, hanya beberapa kasus terjadi lebih lambat, bahkan smapai 48 jam.1 Timbulnya TRALI
