PERBANDINGAN PENGARUH ANTARA L-ARGININE DENGAN NIFEDIPIN TERHADAP KADAR KREATININ SERUM TIKUS SPRAGUE-DAWLEY YANG DIBERI MEDIA KONTRAS IOPAMIDOL INTRAVENA

Abstract

Comparison of L-arginine and Nifedipine Effects on Serum Creatinine Level in Sprague-Dawley Rats Administered by Intravenous Radiological Contrast Iopamidol Henny Adriani Puspitasari1), Hermina Sukmaningtyas2) Background: Iopamidol may cause renal disfunction reflected by the increase of serum creatinine. Renal disfunction developed from renal ischaemia and renal tubular epithelial cell damages Ischemia is a result of the increase of adenosine, endothelin-1, calcium ions and the decrease of nitric oxide and prostaglandin so that renal vasoconstriction may be happened. Epithelial cell damage caused by toxicity and release of free . Combination of such events is known as contrast nephropathy. L-arginine is natural precursor of nitric oxide and nifedipine disrupts the role of calcium ions in smooth muscles so their administration might prevent contrast nephropathy by blocking vasoconstriction. Objectives: To investigate the effects of iopamidol administration on serum creatinine level, L-arginine and nifedipine pre-administration effects on serum creatinine level also to compare both effects. Methods: This was a post test only control group design experimental study using 24 male aged eight weeks Sprague-Dawley rats which were randomly allocated into four groups. They were K- group, which were not given any treatments; K+ group given iopamidol, P1 group given 8,4%(W/V) of L-arginine mixed in their drink 7 days before iopamidol administration and P2 group given 0,2 mg single dose of nifedipine orally 24 hours before iopamidol administration. Samples were given free access to tap water and standard rat chow. Dose of iopamidol used was 0,63 cc per 200 grams body weight of rats. On day 9, blood samples were taken and serum creatinine level was measured. Results: The average of serum creatinine level for K- group is 0,352±0,022, K+ group is 0,408±0,041, P1 group is 0,387±0,007 and P2 group is 0,347±0,041. Based on ANOVA test, no significant differences were found among groups with p=0,117. Conclusion: Serum creatinine level was not significantly higher 24 hours after administration of iopamidol. Serum creatinine level of L-arginin pre-administered group and nifedipin pre-administered group had no significant difference compared to other groups. L-arginine and nifedipine had no significant difference to serum creatinine levels after iopamidol administration. Keywords: iopamidol, creatinine, L-arginine, nifedipine Perbandingan Pengaruh antara L-arginin dengan Nifedipin terhadap Kadar Kreatinin Serum Tikus Sprague-Dawley yang Diberi Media Kontras Iopamidol Intravena Henny Adriani Puspitasari1), Hermina Sukmaningtyas2) Latar Belakang: Iopamidol dapat menyebabkan penurunan fungsi ginjal berupa kenaikan kadar kreatinin serum akibat iskemia ginjal dan kerusakan sel epitel tubulus. Iskemi terjadi karena peningkatan adenosin, endotelin-1, ion kalsium dan penurunan nitrit oksida serta prostaglandin sehingga terjadi vasokonstriksi. Kerusakan sel epitel terjadi karena pelepasan radikal bebas dan toksisitasnya. Kombinasi kejadian tersebut menimbulkan contrast nephropathy. L-arginin adalah prekursor nitrit oksida sedangkan nifedipin menghambat kerja ion kalsium pada otot polos pembuluh darah, pemberiannya diharapkan dapat menghambat vasokonstriksi dan mencegah contrast nephropathy. Tujuan: Mengetahui pengaruh pemberian iopamidol, pengaruh pemberian L-arginin dan nifedipin sebelum injeksi iopamidol terhadap kadar kreatinin serum tikus Sprague-Dawley serta membandingkan pengaruh antara keduanya. Metode: Desain penelitian eksperimental ini adalah post test only control group,menggunakan 24 ekor tikus strain Sprague-Dawley jantan berumur delapan minggu yang dibagi secara acak menjadi empat kelompok. Kelompok K- tanpa perlakuan, kelompok K+ diinjeksi iopamidol, kelompok P1 diberi L-arginin dengan dosis 8,4% (W/V) dalam air minum 7 hari sebelum injeksi iopamidol, dan kelompok P2 diberi nifedipin 0,2 mg dosis tunggal per oral 24 jam sebelum injeksi iopamidol. Iopamidol disuntikkan pada vena ekor dengan dosis 0,63 cc per 200 gramBB. Seluruh sampel mendapat pakan standar dan minum ad-libitum. Pada hari ke-9, sampel darah diambil untuk diukur kadar kreatinin serum. Hasil: Rerata kadar kreatinin serum kelompok K- sebesar 0,352±0,022; K+ sebesar 0,408±0,041, P1 sebesar 0,387±0,007 dan P2 sebesar 0,347±0,041. Dengan uji ANOVA, didapatkan perbedaan kadar kreatinin serum yang tidak bermakna antar semua kelompok dengan p=0,117. Kesimpulan: Kadar kreatinin serum 24 jam setelah pemberian iopamidol lebih tinggi secara tidak bermakna. Kadar kreatinin serum kelompok yang diberi L-arginin dan yang diberi nifedipin tidak lebih rendah bermakna dibandingkan dengan kelompok lain. Pengaruh antara L-arginin dan nifedipin terhadap kadar kreatinin serum setelah pemberian iopamidol tidak berbeda bermakna. Kata kunci: Iopamidol, Kreatinin, L-arginin, Nifedipin