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"Latar Belakang dan tujuan: penyakit ginjal stadium akhir (End Stage Renal Disease/ESRD) prevalensinya meningkat secara signifikan di seluruh dunia, termasuk di Indonesia. Pada penyakit ginjal kronik dan ESRD mudah sekali terjadi asidosis metabolik, guna mencegahnya diberikan suplemen NaHCO3 oral atau hemodialisis. Sebagian klinisi tetap memberikan suplementasi NaHCO3 oral pada pasien ESRD yang sudah menjalani hemodialisis rutin, namun sebagian lagi tidak. Penelitian ini bertujuan mengevaluasi apakah masih diperlukan suplementasi NaHCO3 oral pada pasien yang sudah menjalani hemodialisis rutin dua kali seminggu.Metode: Penelitian observasional analitik dengan desain potong lintang dilakukan di Unit Hemodialisis Rumah Sakit Pusat Pertamina Jakarta pada Desember 2019 hingga Februari 2020. Sampel secara konsekutif dipilih dari pasien dengan hemodialisis rutin 2 kali per minggu minimal 3 bulan dan tidak dalam kondisi hemodinamik yang tidak stabil; 30 orang yang mendapat suplementasi NaHCO3 oral dan 30 orang yang tidak. Sampel darah vena pre dialisis diambil untuk pemeriksaan analisis gas darah guna mengukur kadar HCO3.Hasil: Rerata lama HD per kali tindakan pada kelompok tanpa suplementasi (4 jam 14 menit), dan kelompok dengan suplementasi NaHCO3 (4 jam 26 menit) tidak berbeda signifikan ( p =0.051 , CI= -0,4006 - 0,0006). Proporsi pasien ESRD dengan hemodialisis rutin tanpa suplementasi NaHCO3 oral yang mencapai kadar HCO3 pre dialisis dalam rentang normal adalah 26,7%, sedangkan yang mendapat suplementasi NaHCO3 Toral proporsinya secara signifikan lebih tinggi yaitu 53,3% (p=0,035, PR= 1,57; IK=1,013-2,438).

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Background and aim: the prevalence of end-stage renal disease (ESRD) has increased significantly worldwide, including in Indonesia. In chronic kidney disease and ESRD metabolic acidosis is very easy to occur, to prevent it given oral NaHCO3 supplements or hemodialysis. Some clinicians continue to provide oral NaHCO3 supplementation to ESRD patients who are already undergoing routine hemodialysis, but some do not. This study aims to evaluate whether oral NaHCO3 supplementation is still necessary in patients who have undergone routine hemodialysis twice a week.

Methods: An analytic observational study with cross-sectional design was carried out in the Hemodialysis Unit of Pertamina Central Hospital Jakarta from December 2019 to February 2020. Samples were consecutively selected from patients with routine hemodialysis twice per week for at least 3 months and were not in a hemodynamically unstable condition; 30 people who received oral NaHCO3 supplementation and 30 people who did not. Pre-dialysis venous blood samples were taken for blood gas analysis to measure HCO3 levels.

Results: The mean length of HD per action in the group without supplementation (4 hours 14 minutes), and the group with NaHCO3 supplementation (4 hours 26 minutes) was not significantly different (p = 0.051, CI = -0.4006 - 0.0006). The proportion of ESRD patients with routine hemodialysis without oral NaHCO3 supplementation who achieved pre-dialysis HCO3 levels in the normal range was 26.7%, while those who received oral NaHCO3 supplementation were significantly higher at 53.3% (p = 0.035, PR = 1, 57; IK = 1,013-2,438).

Conclusion: In ESRD patients with routine HD 2 times per week (8 hours / week, HCO3 supplementation is still needed to maintain predialysis HCO3 levels within the normal range."

"Sulfadiazin, salah satu terapi infeksi saluran kemih pilihan, berpotensi mengakibatkan kristaluria ataupun gangguan ginjal lainnya karena bersifat sukar larut dalam urin. Hal itu dapat dicegah dengan alkalinisasi urin karena ekskresi sulfadiazin meningkat pada pH urin basa. Penelitian ini bertujuan untuk mengetahui pengaruh pH urin terhadap waktu paruh sulfadiazin pada tikus putih jantan. Penelitian dilakukan dengan menggunakan 25 ekor tikus putih jantan galur Sprague-Dawleyyang terbagi dalam lima kelompok, yaitu kontrol normal yang hanya diberi larutan CMC 0,5%; kontrol sulfadiazin (285,7 mg/kg BB); dan tiga kelompok yang diberi sulfadiazin serta larutan NaHCO3 10% tiap 6 jam dengan variasi dosis yang telah dipilih (dosis 1, 2, dan 3 berturut-turut adalah 0,9; 1,8; dan 2,7 mg/g BB). Pemberian seluruhnya dilakukan secara oral. Pemberian larutan NaHCO3 10% pada kelompok 3, 4, dan 5 dimulai dari satu jam sebelum pemberian sulfadiazin. Serapan yang diberikan oleh sulfadiazin dalam urin diukur pada jam ke-1,5; 3,5; 6,5; 10,5; 13,5; dan 18 menggunakan spektrofotometer UV-Vis. Hasil penelitian menunjukkan bahwa makin basa pH urin, maka makin banyak jumlah kumulatif sulfadiazin yang diekskresi dan makin singkat waktu paruh rata-ratanya pada tikus putih jantan.

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Sulfadiazine, one of the chosen therapy for urinary tract infection, potentially causing crystalluria or other kidney disorders because it?s difficult dissolve in urine. It can be prevented by alkalinization of urine due to increased excretion of sulfadiazine in alkaline urine. This research was carried out to know the impact of urinary pH on sulfadiazine?s half-time on male albino rats. This study was conducted by using 25 male Sprague-Dawley rats which is divided into 5 groups: normal control that was given only CMC 0,5% solution; control sulfadiazine (285,7 mg/kg BW); and three groups were given sulfadiazine and NaHCO3 10% solution every 6 hours with variation doses which was selected (dose 1, 2, and 3 successively is 0,9; 1,8; and 2,7 mg/g BW). Giving all done orally. Solution of NaHCO3 10% given to group 3, 4, and 5 starting from one hour before giving sulfadiazine. Absorbance by sulfadiazine in urine was measured at hours-1,5; 3,5; 6,5; 10,5; 13,5; and 18 using UV-Vis spectrophotometer. The results showed that the more alkaline pH of urine, then the greater number of sulfadiazine was excreted and the average half-time was sooner on male albino rats. "