PERBANDINGAN PENGARUH ANTARA L-ARGININ DENGAN NIFEDIPIN TERHADAP GAMBARAN HISTOPATOLOGI GINJAL TIKUS SPRAGUE-DAWLEY YANG DIBERI MEDIA KONTRAS IOPAMIDOL INTRAVENA

Abstract

Comparison of L-arginine and Nifedipine Effects on Kidney’s Histopatological Appearance in Sprague-Dawley Rats Administered by Intravenous Radiological Contrast Iopamidol Matrissya Hermita1), Hermina Sukmaningtyas2) Background: Iopamidol may cause Contrast Nephropathy (CN) as a result from direct tubular epithelial cell toxicity and ischemia. Tubular epithelial cell has a low tolerability from both anoxia and toxic. Ischemia results from vasoconstriction caused by alterations in the NO level and calcium ions overload. L-arginine increases NO level. Nifedipine disrupts the role of calcium ions in smooth muscles. Objectives: To investigated the effects of iopamidol administration, L-arginine and nifedipine pre-administration on kidney’s histological appearance in Sprague-Dawley rats also to compare the effects between L-arginine and nifedipine Methods: This research was an experimental study, with post test only control group design. Research samples were 24 male aged 8 weeks Sprague-Dawley rats, were randomly divided into 4 groups. K(-) group, didn’t receive any treatments; K(+) group, received iopamidol; P1 group, received 8,4% (W/V) L-arginine on their drink during the 1st 7 days, P2 group received 0,2 mg nifedipine orally on the day 7. Dose of iopamidol used was 0,63 cc/200gr body weight given on the day 8. On day 9, the decapitations were done and the kidneys were proceeding with HE staining. Within group differences of data were analyzed by ANOVA. Difference among groups was analyzed by Post Hoc Test Bonferroni. Results: The averages of the percentages of the proximal tubules’s edemas on K(-) was 23.02±0.79%; K(+) group was 62.57±0.78%; P1 group was 54.53±1.37%; P2 group was 44.65±1.66%. And there was a significant difference between all groups, p=0.001. Conclusion: Iopamidol caused the edemas of proximal tubules. L-arginine and nifedipine decreased the percentages of the proximal tubules’s edema caused by iopamidol and there was significant differences in effects between L-arginine and nifedipine. Keywords: iopamidol, the edemas of proximal tubules, L-arginine, nifedipine Perbandingan Pengaruh antara L-arginin dengan Nifedipin terhadap Gambaran Histopatologi Ginjal Tikus Sprague-Dawley yang Diberi Media Kontras Iopamidol Intravena Matrissya Hermita1), Hermina Sukmaningtyas2) Latar Belakang: Injeksi iopamidol akan menyebabkan Contrast Nephropathy (CN) yang disebabkan oleh toksisitas direk sel epitel tubulus dan iskemik ginjal. Sel epitel tubulus merupakan sel yang rentan terhadap anoksi dan toksin. Iskemi timbul akibat vasokonstriksi karena turunnya kadar NO dan meningkatnya kadar ion kalsium darah. L-arginin meningkatkan kadar NO, nifedipin menghambat kerja ion kalsium pada otot polos pembuluh darah Tujuan: Mengetahui pengaruh pemberian iopamidol, mengetahui serta membandingkan pengaruh antara L-arginin dan nifedipin sebelum injeksi iopamidol terhadap gambaran histopatologi ginjal tikus Sprague-Dawley. Metode: Penelitian ini merupakan eksperimental murni dengan rancangan The Post-Test Only Control Group Design. Sampel penelitian adalah 24 ekor tikus Sprague-Dawley jantan berumur 8 minggu, dibagi secara acak menjadi 4 kelompok. Kelompok K(-) tidak diberi perlakuan, kelompok K(+) diinjeksi iopamidol, kelompok P1 diberi 8.4% L-arginin dalam air minum selama 7 hari sebelum injeksi iopamidol, dan kelompok P2 diberi nifedipin 0,2 mg dosis tunggal per oral 24 jam sebelum injeksi iopamidol. Dosis iopamidol yang digunakan adalah 0,63 cc/200 gramBB. Pada hari ke-9, tikus didekapitasi, diambil ginjalnya untuk diproses dengan pengecatan HE. Dilakukan uji ANOVA untuk melihat adanya perbedaan pada keempat kelompok perlakuan. Besarnya perbedaan masing-masing kelompok perlakuan dianalisis dengan Post Hoc Test Bonferroni. Hasil: Rerata persentase edem tubulus proksimal pada kelompok K(+) sebesar 62.57±0.78%; kelompok P1 54.53±1.37%; kelompok P2 44.65±1.66%; kelompok K(-) sebesar 23.02±0.79%. Didapatkan perbedaan bermakna antara semua kelompok dengan p=0.001. Kesimpulan: Iopamidol menyebabkan edema tubulus proksimal. L-arginin dan nifedipin menurunkan persentase edem tubulus proksimal yang disebabkan karena iopamidol dan di antara keduanya terdapat perbedaan pengaruh yang bermakna. Kata kunci: Iopamidol, Edema Tubulus Proksimal, L-arginin, Nifedipin