suremmARY In 15 children with advanced chronic renal failure, glomerular filtration rate was determined by different methods. Inulin clearance correlated well with the mean of creatinine and urea clearance, and also with 51-chromium edetic acid (EDTA) clearance measured over 24 hours. The absolute values of creatinine clearance and of 51Cr-EDTA clearance measured up to 8 hours were higher than inulin clearance. In advanced renal failure both the 5'Cr-EDTA clearance measured over 24 hours, and the mean of creatinine and urea clearance, provide acceptable estimates of true glomerular filtration rate.

Hipertensi pada kehamilan sering terjadi (6-10 %) dan meningkatkan risiko morbiditas dan mortalitas pada ibu, janin dan perinatal. Pre-eklampsia/eklampsia dan hipertensi berat pada kehamilan risikonya lebih besar. Hipertensi pada kehamilan dapat digolongkan menjadi pre-eklampsia/ eklampsia, hipertensi kronis pada kehamilan, hipertensi kronis disertai pre-eklampsia, dan hipertensi gestational. Pengobatan hipertensi pada kehamilan dengan menggunakan obat antihipertensi ternyata tidak mengurangi atau meningkatkan risiko kematian ibu, proteinuria, efek samping, operasi caesar, kematian neonatal, kelahiran prematur, atau bayi lahir kecil. Penelitian mengenai obat antihipertensi pada kehamilan masih sedikit. Obat yang direkomendasikan adalah labetalol, nifedipine dan methyldopa sebagai first line terapi. Penatalaksanaan hipertensi pada kehamilan memerlukan pendekatan multidisiplin dari dokter obsetri, internis, nefrologis dan anestesi. Hipertensi pada kehamilan memiliki tingkat kekambuhan yang tinggi pada kehamilan berikutnya. Hypertension complicates 6% to 10% of pregnancies and increases the risk of maternal, fetal and perinatal morbidity and mortality. Preeclampsia / eclampsia and severe hypertension in pregnancy are at greater risk. Four major hypertensive disorders in pregnancy have been described by the American College of Obstetricians and Gynecologists (ACOG): chronic hypertension; preeclampsia-eclampsia; chronic hypertension with superimposed preeclampsia; and gestational hypertension. The current review suggests that antihypertensive drug therapy does not reduce or increase the risk of maternal death, proteinuria, side effects, cesarean section, neonatal and birth death, preterm birth, or small for gestational age infants. The quality of evidence was low. Recommendations for treatment of hypertension in pregnancy are labetalol, nifedipine and methyldopa as first line drugs therapy. Although the obstetrician manages most cases of hypertension during pregnancy, the internist, cardiologist, or nephrologist may be consulted if hypertension precedes conception, if end organ damage is present, or when accelerated hypertension occurs. Women who have had preeclampsia are also at increased risk for hypertension in future pregnancies.

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Patients with chronic kidney disease (CKD) tend to have hyperkalemia. They worry about the consumption of fruit for fear of increased serum potassium levels and therefore require a restricted potassium diet. Soursop fruit (Annona muricata Linn.) is believed to be beneficial for CKD and cardiovascular risk. This study was conducted to investigate the effect of soursop fruit supplement consumption on serum potassium levels and cardiovascular risk in prehypertension subjects from Mlati, Sleman District, Yogyakarta Special Region, Indonesia. A total 143 samples that met to the inclusion and exclusion criteria were subsequently randomized into two groups. Group I was given 2 x 100 g/day of soursop and Group II was without soursop. A laboratory examination from both groups was conducted including potassium, total cholesterol, low density lipoprotein (LDL), high density lipoprotein(HDL), and triglyceride levels at weeks 0; 7; and 13. Regular soursop consumption was evaluated every 2 weeks for 3 months. Data analysis was performed using an independent t test, a nonparametric Mann-Whitney test, and a chi-square test. No significantly different in serum potassium levels between the soursop and non-soursop groups at week 7 and 13 (p=0.073 and p=0.108) was observed. Furthermore, no significantly different in total cholesterol (p=0.254 and p=0.932), LDL (p=0.221 and p=0.710), HDL (p=0.400 and p=0.960), triglycerides (p=0.423 and p=0.580) of both groups was also obsereved. However, in subjects with hypercholesterolemia and hypertriglyceridemia, the mean cholesterol and triglyceride levels decreased compared to no soursop consumption at week 7 and 13. In conclusion, consumption of a soursop fruit supplement of 2 x 100 g/ day for 13 weeks does not affect the serum potassium levels of prehypertension subjects. Moreover, the consumption of a soursop fruit supplement is not significantly different compared to those without soursoup in improving cardiovascular risk. ABSTRAK Pasien penyakit ginjal kronik cenderung mengalami hiperkalemia. Mereka khawatir konsumsi buah karena takut kalium darahnya naik, oleh karena itu perlu restriksi diet kalium. Buah sirsak (Annona muricata Linn.) diduga bermanfaat untuk penyakit ginjal kronik dan risiko kardiovaskular. Penelitian ini dilakukan untuk mengkaji pengaruh pemberian minuman suplemen buah sirsak terhadap kadar kalium darah dan risiko kardiovaskular pada subjek prehipertensi dari Mlati, Sleman, Daerah Istimewa Yogyakarta. Total 143

Management of hyperuricemia in CKD includes non pharmacology and pharmacology. Non-pharmacological with lifestyle change interventions such as exercise, weight loss, low purine meat consumption, avoid high fructose, reduce alcohol and herbs. The treatment of asymptomatic hyperuricemia in CKD is still controversial. In Japan and Korea given uric acid-lowering drugs when the serum uric acid level (SUA)> 8 mg / dl but in America and Europe are not given drugs for fear of side effects. Soursop fruit consumption can be an alternative treatment for hyperuricemia in CKD both asymptomatic and symptomatic. The recommended drugs for hyperuricemia in CKD are allopurinol and febuxostat. Allopurinol is excreted through the kidneys so it is necessary to adjust the dose in CKD, starting from 50-100 mg / day, increasing it to 200-300 mg / day every 2-5 weeks until SUA <6 mg / dl. The dose may be> 300 mg / day if the patient is notified and the monitor may be toxic. In America, Europe and Japan recommend febuxostat only for the treatment of hyperuricemia.