Pengaruh terapi kombinasi L-Carnitine dan Ubiquinone terhadap kadar Malondialdehyde pada penderita gagal ginjal kronik yang menjalani hemodialisis rutin

FUNAY, Prijander L.B, Prof.Dr.dr. H. Mochammad Sja'bani, M.Med.Sc.,SpPD-KGH

2005 | Tesis | PPDS I Ilmu Penyakit Dalam

Latar Belakang: Stres oksidatif meningkat pada penderita gagal ginjal kronik yang menjalani hemodialisis. Stres oksidatif merupakan faktor risiko aterosklerosis. L-carnitine dan Ubiquinone berperan sebagai antioksidan. Kadar L-carnitine dan Ubiquinone pada penderita gagal ginjal kronik yang menjalani hemodialisis menurun. Penurunan ini menyebabkan peningkatan stres oksidatif dan meningkatkan peroksidasi lipid. Keadaan ini menyebabkan kenaikan kadar malondialdehyde. Tujuan: Untuk mengetahui seberapa besar pengaruh pemberian kombinasi L-carnitine dan Ubiquinone terhadap kadar malondialdehyde pada penderita gagal ginjal kronik yang menjalani hemodialisis rutin dibandingkan dengan plasebo. Bahan dan Cara Penelitian: Delapan puluh tujuh penderita gagal ginjal kronik yang menjalani hemodialisis rutin di Instalasi Dialisis RS Sardjito Yogyakarta ikut dalam penelitian klinik acak buta ganda ini. Subyek dibagi menjadi 2 kelompok. Kelompok terapi (42 subyek) mendapat kombinasi L-carnitine 2000 mg dan Ubiquinone 120 mg per hari peroral selama 8 minggu. Kelompok kontrol (45 subyek) mendapatkan plasebo. Dilakukan pemeriksaan kadar malondialdehyde sebelum dan sesudah perlakuan. Hasil: Tidak terdapat perbedaan bermakna pada karakteristik dasar kedua kelompok. Rerata kadar malondialdehyde sesudah perlakuan pada kelompok terapi tidak berbeda bermakna dibandingkan dengan plasebo ( 3,48 ± 0,22 μmol/l vs 3,47 ± 0,22 μmol/l p=0,915). Kesimpulan: Kombinasi L-carnitine 2000 mg dan Ubiquinone 120 mg per hari per oral selama 8 minggu pada penderita gagal ginjal kronik yang menjalani hemodialisis rutin tidak menurunkan rerata kadar malondialdehyde secara bermakna dibandingkan plasebo.

Background: Patients with chronic renal failure and haemodialysis were associated with increased oxidative stress. Oxidative stress, which occurs when there is excessive free-radical production or low antioxidant levels, has recently been implicated as a causative factor in atherogenesis. L-carnitine and Ubiquinone play a role as antioxidant. L-carnitine and Ubiquinone level in chronic kidney disease patients on routine haemodialysis were decreased, which lead to oxidative stress. This leads to increased lipid peroxidation. Plasma level of malondialdehyde was measured as a marker of lipid peroxidation. Objectives: To determine how much is the effect of combination L-carnitine and Ubiquinone on plasma level of malondialdehyde in chronic kidney disease patients with routine haemodialysis compared to placebo. Methods: Eighty-seven chronic kidney disease patients with routine haemodialysis were included in this randomized-double blind placebo controlled trial. The trial group (42 subjects) received a combination of 2000 mg L-carnitine and 120 mg Ubiquinone oraly for 8 weeks. The control group (45 subjects) received placebo. Plasma level of malondialdehyde was measured before and after treatment was analyzed. Results: There’s no significant difference on baseline characteristic among groups. The mean plasma level of malondialdehyde in trial group has no significant difference compared to control group (3,48 ± 0,22 μmol/l vs 3,47 ± 0,22 μmol/l , CI 95% -0,101 – 0,114, p=0,915). Conclusion: The combination of L-carnitine and Ubiquinone has no decreased serum malondialdehyde levels compared to placebo.

Kata Kunci : Gagal Ginjal Kronik,Hemodialisis Rutin,L Carnitine, Chronic Kidney Disease, Haemodialysis, L-carnitine, Ubiquinone, Oxidative Stress, Lipid Peroxidation, Malondialdehyde.