MOCHAMMAD THAHA
Institute of Tropical Disease, Universitas Airlangga, Jalan Mulyoreijo, Surabaya 60115, Indonesia Department of Internal Medicine Faculty of Medicine, Faculty of Medicine, Universitas Airlangga, Jalan Mayjen Prof Dr Moestopo 47, Surabaya 60131, In

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ACTI ON OF N- ACETYLCYSTEI NE ON ASYMMETRI C DIMETHYLARGININE AND ALBUMINURIA IN STAGE 1-4 NONDIABETIC CHRONIC KIDNEY DISEASE PATIENTS THAHA, MOCHAMMAD; Widodo, Widodo; Yogiantoro, Moh.; NILAMSARI, WENNY PUTRI; YUSUF, MOCHAMAD; Tomino, Yasuhiko
Indonesian Journal of Tropical and Infectious Disease Vol 1, No 3 (2010)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (671.052 KB) | DOI: 10.20473/ijtid.v1i3.2198

Abstract

Background: Uremic patients are in a pro-oxidant state and show an increased level of asymmetric dimethylarginine (ADMA), which is due to increased PRMT1 activity and reduced dimethylarginine dimethylaminohydrolase (DDAH) as degradation enzymes. Reactive oxidant species may play an important role in increasing the action of PRMT1 and in inhibiting the action of DDAH. Albuminuria and ADMA are closely correlated with progression of cardiovascular disease in chronic kidney disease (CKD) patients as well as indicators for decreasing renal function. Although ACEIs and/or ARBs reduced albuminuria in CKD patients, the results are still conflicting. Several factors in these patients may play important roles in the mechanism of albuminuria such as oxidative stress. The antioxidant N-acetylcysteine may prove to have beneficial therapeutic effect, because it can reduce oxidative stress as shown by evidence in humans, and subsequently increase ADMA. The objective of the present study is to explore the contribution of the antioxidant N-acetylcysteine (NAC) to the decrease of ADMA and albuminuria in non-diabetic CKD patients. Material and Methods: Patients with non-DM CKD stage 1–4 with albuminuria were randomized to receive ACEI and/or ARB alone (control group) or with antioxidant NAC 600 mg orally twice a day (treatment group). Observations were performed for 3 months to measure ADMA and albuminuria before and after-treatment. 80 patients in total 40 in the control group and 40 in the treatment group were used. Results: After oral treatment with NAC, the plasma level of ADMA in the treatment group increased from 0.604 µmol/l to 0.689 µmol/l, whereas ADMA level in the control group exhibited a higher increase from 0.561 µmol/l to 0.743 µmol/l. The increases in these groups were significantly different (p < 0.02). Moreover, the level of albuminuria was reduced from 148.12 µg/mg • cr to 132.7 µg/mg • cr in the treatment group, and from 75.25 µg/mg • cr to 71.85 µg/mg • cr in the control group. The difference was significant (p < 0.001). Conclusion: The anti-oxidant N-acetylcysteine can be used as adjuvant therapy to inhibit the progression of CKD in patients by decreasing the ADMA level and albuminuria.
Anthropometry-based Body Fat Percentage Predicts High hs-CRP in Chronic Kidney Disease Patients Thaha, Mochammad; Empitu, Maulana Antiyan; Kadariswantiningsih, Ika Nindya; Nugroho, Cahyo Wibisono; Hasanatuludhhiyah, Nurina; Rasyid, Haerani; Hakim, Zaky El; Suryansyah, Maulana Muhtadin; Alda, Rieza Rizqi; Alsagaff, Mohammad Yusuf; Amin, Mochammad; Santoso, Djoko; Suzuki, Yusuke
The Indonesian Biomedical Journal Vol 10, No 2 (2018)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (939.595 KB) | DOI: 10.18585/inabj.v10i2.397

Abstract

BACKGROUND: Obesity is an important cardiovascular risk factor and associated with low grade inflammation in chronic kidney disease (CKD) patients. This study aims to assess the association between body fat with serum high sensitivity C-reactive protein (hs-CRP) level in CKD patients.METHODS: A cross-sectional study was performed in 71 CKD patients. Anthropometric measurements included body weight, height, body mass index (BMI), body fat percentage (BFP), skinfold thickness (SKF) of triceps and biceps were performed by trained physician. BFP was calculated using Kwok’s Formula and hs-CRP was measured by Particle enhanced Turbidimetry.RESULTS: The averaged BMI of our subjects was 25.8±4.4. There was no significant difference in BMI between pre-dialysis and hemodialysis CKD patients. Positive correlation was found between BFP and hs-CRP (r=0.266; p<0.05), while there was no significant correlation between BMI and hs-CRP.CONCLUSION: Body fat percentage was associated with hs-CRP. Hence, it will be more beneficial to assess nutritional status in CKD using BFP rather than BMI alone since it was demonstrated to correlate with hs-CRP in our studyKEYWORDS: CKD, obesity, inflammation, body fat, hs-CRP
Could Complete Blood Count Parameters and Non-fasting Cholesterol Profile Describe Inflammation and Oxidative Stress in Chronic Kidney Disease? Kadariswantiningsih, Ika Nindya; Thaha, Mochammad; Nugroho, Cahyo Wibisono; Hamidah, Berliana; Rasyid, Haerani; Hakim, Zaky El; Suryansyah, Maulana Muhtadin; Alsagaff, Mohammad Yusuf; Santoso, Djoko; Empitu, Maulana Antiyan; Suzuki, Yusuke
The Indonesian Biomedical Journal Vol 10, No 3 (2018)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (821.638 KB) | DOI: 10.18585/inabj.v10i3.451

Abstract

BACKGROUND: Establishment of inexpensive clinical laboratory tests to evaluate inflammation and oxidative stress is urgently needed in the limited resources settings. This study aims to investigate the potential of complete blood count (CBC) parameters and non-fasting cholesterol profile parameters to describe inflammation and oxidative stress in chronic kidney disease (CKD) patients.METHODS: Measurement of CBC, non-fasting cholesterol profile, high sensitivity C-reactive protein (hs-CRP) and malondialdehyde (MDA) were performed in 71 CKD patients grouped into hemodialysis (HD) and non-hemodialysis (non-HD). Correlation analysis were performed to assess the potential of CBC and cholesterol profile to describe the level of hs-CRP and MDA.RESULTS: In the HD group, total cholesterol was moderately associated with hs-CRP while total cholesterol/HDL-C ratio, monocyte/HDL-C ratio, monocyte/LDL-C ratio, neutrophil/HDL-C ratio, neutrophil/LDL-C ratio, platelet/HDL-C ratio and platelet/LDL-C ratio were strongly associated with hs-CRP. In the non-HD group,only neutrophil/total cholesterol ratio and platelet/total cholesterol ratio that were associated with hs-CRP. Total cholesterol, monocyte/LDL-C ratio, neutrophil/LDL-C ratio and platelet/LDL-C ratio were moderately associated with MDA while total cholesterol/HDL-C ratio, monocyte/HDL-C ratio, neutrophil/HDL-C ratio and platelet/HDL-C ratio were strongly associated respectively with MDA in HD group. In the non-HD group, total cholesterol/HDL-C ratio, neutrophil/HDL-C ratio and platelet/HDL-C ratio were moderately associated with MDA in non-HD group while monocyte/HDL-C ratio was weakly associated with MDA.CONCLUSION: Some CBC parameters and non-fasting cholesterol profile such as cholesterol/HDL-C, monocyte/HDL-C, neutrophil/HDL-C and platelet/HDL-C ratio showed a potential to describe the inflammation and stress oxidative markers, given some strong associations with the level of hs-CRP and MDA. Further study is needed to assess whether this parameter represent long-term prognostic value among CKD patients.KEYWORDS: inflammation, oxidative stress, CRP, MDA, TAC, 8-OHdG, CBC, cholesterol
Determiner of Poor Sleep Quality in Chronic Kidney Disease Patients Links to Elevated Diastolic Blood Pressure, hs-CRP, and Blood-count-based Inflammatory Predictors Empitu, Maulana Antiyan; Kadariswantiningsih, Ika Nindya; Thaha, Mochammad; Nugroho, Cahyo Wibisono; Putri, Eka Arum Cahyaning; Hakim, Zaky El; Suryansyah, Maulana Muhtadin; Alda, Rieza Rizqi; Alsagaff, Mohammad Yusuf; Amin, Mochammad; Santoso, Djoko; Suzuki, Yusuke
The Indonesian Biomedical Journal Vol 11, No 1 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i1.452

Abstract

BACKGROUND: Sleep deprivation is strongly associated with cardiovascular disease (CVD) via sympathetic overstimulation and systemic inflammation in general population. However, the significance of poor sleep quality in chronic kidney disease (CKD) is still underexplored.METHODS: This study assessed the sleep quality of 39 with non-dialysis CKD (ND CKD) patients and 25 hemodialysis CKD (HD CKD) patients using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Poor sleeper was defined as individual with PSQI > 5.RESULTS: The prevalence of poor sleeper (30% vs. 60%, p=0.029) and the cummulative PSQI (ND CKD 4.5±4.4, HD CKD 8±6, p=0.038) are different between ND CKD and HD CKD groups. Among the ND CKD, there are association between short sleep duration (< 5 hours per day) with elevated diastolic blood pressure groups (r=0.421, p<0.05); habitual sleep efficiency with platelet-to-lymphocyte ratio (r= 0.532, p<0.0001); daytime dysfunction with increased hs-CRP (r=0.345, p=0.032) and neutrophil-to-lymphocyte ratio (r=0.320, p=0.046). In HD CKD group, a requirement to use sleep medication was associated with elevated highsensitivity C-reactive protein (hs-CRP) level (r=0.434, p=0.030) and decreased monocyte-to-lymphocyte ratio (r=- 0.410, p=0.042); daytime dysfunction was associated with serum hs-CRP (r=0.452, p=0.023).CONCLUSION: This study revealed that some features of poor sleep quality in CKD patients including low sleep efficiency, daytime dysfunction and requirement to use sleep medication were associated with increased diastolic blood pressure, hs-CRP and blood-count-based inflammatory predictors. Thus, this finding prompt to pay closer attention to sleep complaints in the management of CVD risk factors in CKD patients.KEYWORDS: sleep quality, chronic kidney disease, blood pressure, inflammation
Comparison of High-sensitivity C-reactive Protein Level between Chronic Kidney Disease Stages Thaha, Mochammad; Imroati, Tri Asih; wardana, aditia; Widodo, S; Pranawa, S; irwanadi, chandra
Biomolecular and Health Science Journal Vol 1, No 1 (2018): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1125.644 KB) | DOI: 10.20473/bhsj.v1i1.8226

Abstract

ABSTRACTAim : This research is to evaluate the hs-CRP level comparison between CKD stages in Dr. Soetomo General Hospital Surabaya.Methods: An analytic observational cross-sectional study, evaluating the differences of hs-CRP level between CKD stages in 72 patients (mean age 55.49±7.62 years, the ratio between male:female was 1:1.48, mean BMI 24.18±3.64 kg/m2, 36.11% diabetics, 43.05% on ACEI/ARB, 29.16% on statin), recruited from Nephrology Outpatient Clinic, Dr Soetomo General Hospital, Surabaya, from January to May 2014. The stages were stratified  according to the MDRD formula.Results: The mean hs-CRP of  CKD stage 3 was 2.29±2.86, stage 4 was 2.48 ± 2.19, and non-dialysis stage 5 was 2.09 ± 2.54. The analysis using Kruskal-Wallis test showed no significant differences among patients with  CKD stage 3, stage 4, and non-dialysis stage 5 (median 1.25 vs 1.80 vs 1.05 mg/L; p=0.430). No significant differences of the serum hs-CRP level were detected between diabetics and non diabetics in stage 3, 4, and non-dialysis stage 5  (p=0.673 vs 0.666 vs 0.138); between patients with and without ACEI/ARB treatment (p=0.610 vs 0.649 vs 0.671); and between patients with and without statin treatment (p=0.852 vs 0.341 vs 0.309).Conclusion: The elevation of serum hs-CRP level can not indicate the decline of kidney function, but it still needs further investigations.
ANTI-HIV DAN SUBTIPE HIV PADA PASIEN HEMODIALISIS Handajani, Retno; Thaha, Mochammad; Amin, Mochamad; Wungu, Citrawati Dyah Kencono; Rianto, Edhi; Pranawa, Pranawa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1124

Abstract

Anti-Human Immunodeficiency Virus (Anti-HIV) was performed from 100 plasma Chronic Kidney Disease (CKD) stage 5 patientswith continuous hemodialysis (HD) at the Hemodialysis Instalation Dr Soetomo hospital, Surabaya, Indonesia, using three (3) kind ofreagents: Tri-line HIV Rapid test Device from Acon for HIV 1/2/O as strips form, Foresight HIV 1/2/O Antibody EIA Test Kit from Aconand Anti-HIV 1+2/Subtype O ELISA from Axiom. HIV RNA and HIV subtype were detected by Reverse Transcription Polymerase ChainReaction (RT-PCR) based on HIV gag region and analysis of DNA result. Seventy three % patients were hemodialysed twice in a week andonly 14% with duration more than five (5) years. Most of the patients (43%) were hemodialysed between 100?300 times. From the 100plasma samples was obtained only one (1%) man patient plasma sample with positive anti-HIV. A weak positive of RT-PCR result wasnot succeed to be sequenced for determining the HIV subtype. This cause was suspected due to low levels of HIV RNA in blood. The resultsof this study was expected can be used as an additional management consideration of hemodialysis patients at the Hemodialysis Unit.