EFFECTIVITY AND RENAL SAFETY OF CYCLOSPORINE AND METHYLPREDNISOLONE COMBINATION THERAPY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

Cyclosporine and methylprednisolone combination are second line therapy for moderate to severe systemic lupus erythemathosus. Some study suggest that the combination were effective to decrease of systemic lupus erythematosus disease activity. But record from the study, cyclosporine cause nephrotoxicity side effect. Therefore, this study should be considered to monitore therapy effect on disease activity and renal side effect. The aim of this study is to analyze the effect of cyclosporine and methylprednisolone combination therapy on disease activity in systemic lupus erythematosus (SLE) assessed by MEX-SLEDAI and renal side effect assessed by creatinine, ureum and proteinuria. A cohort, observational prospective study was conducted to determine the effect of cyclosporine and methylprednisolone combination therapy on disease activity of SLE and renal side effect of this combination. Patients who met criteria were given cyclosporine and methylprednisolone combination that normally renal function tests. MEX-SLEDAI score, creatinine, ureum and proteinuria were measured for fourth times (one time in one mounth), before study, 1st mounth, 2nd mounth, and 3rd mounth. The study comprised 9 patients SLE were given cyclosporine and methylprednisolone combination that normally renal function tests. All patients were female and had productive age. At 3rd mounth, there was increase patients who had MEX-SLEDAI score <2 (55,6%) and one patient (11,1%) had increase of creatinine, ureum and proteinuria. In conclusion, cyclosporine and methylprednisolone combination therapy showed the effectiveness and safety in 88,9% patients and renal dysfunction in 11,1% patients

Therapy of resistant hypertension in patients with chronic kidney disease complications of anemia in hemodialysis: A case report

Chronic Kidney Disease (CKD) is closely related to hypertension. Increasing the severity of CKD is associated with more difficult blood pressure control. Appropriate therapeutic management is needed to prevent complications due to uncontrolled hypertension. We report the case of a 78- year-old female patient with a diagnosis of hypertension and end-stage CKD with a history of undergoing hemodialysis for 4 years. The patient has been taking antihypertensive drugs such as Angiotensin Receptor Blockers, Calcium Channel Blockers and Diuretics. However, the administration of three antihypertensive drugs still could not help achieve the expected blood pressure target where the systolic blood pressure was still above 160 mmHg. The patient also has anemia as a common complication of chronic kidney disease. Appropriate management of therapy with fourth-line therapy and hemoglobin repair is necessary to achieve improved clinical outcomes and reduce renal worsening

Hepatoprotector in cases of dengue hemorrhagic fever as a prevention of hepatic damage: a case report

Dengue Hemorrhagic Fever (DHF) is classified as an arbovirus disease which is a public health problem in the world. The causative agent of DHF is the dengue virus, namely the RNA virus of the genus Flavivirus and the family Flaviviridae. Hepatic impairment is often observed in DHF cases with asymptomatic or asymptomatic elevations in serum transaminases up to severe manifestations in the form of acute liver failure. It was reported that DHF patients had mild hepatic impairment with clinical manifestations of mild hepatomegaly, hypoalbumin, normal SGOT/SGPT values, and clinical conditions of nausea – vomiting. To prevent worsening liver damage, combination therapy with Ursodeoxycholic Acid (UDCA) and curcumin was given as a hepatoprotector. The use of curcumin can reduce serum levels of transaminase, Malondialdehyde (MDA) or markers of oxidative stress and increase hepatic glutathione concentrations which work in free radical detoxication, while the role of UDCA is as a hepatoprotector by reducing the level of oxidative stress in liver cells