Efek Ekstrak Etanol Daun Kelor terhadap Kadar Kreatinin Serum dan Superoksida Dismutase Tikus Model 5/6 Subtotal Nefrektomi

Raden Alif Kuncorojati; Haniy Thri Afifaningrum; Anis Swastika; Afifah Afifah

doi:10.22435/jki.v13i1.6248

Raden Alif Kuncorojati Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Jenderal Soedirman, Purwokerto, Indonesia
Haniy Thri Afifaningrum Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Jenderal Soedirman, Purwokerto, Indonesia
Anis Swastika Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Jenderal Soedirman, Purwokerto, Indonesia
Afifah Afifah Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Jenderal Soedirman, Purwokerto, Indonesia

DOI: https://doi.org/10.22435/jki.v13i1.6248

Keywords: Moringa oleifera, Chronic kidney disease, Superoxide dismutase, Serum creatinine, Subtotal nephrectomy

Abstract

Chronic Kidney Disease (CKD) is still a major problem in the health sector in the world, including in Indonesia. One of the main pathomechanisms in CKD is oxidative stress. Superoxide dismutase (SOD) is an enzyme that plays a role in fighting oxidative stress. Oxidative stress can be overcome with antioxidants both from inside the body and from the outside obtained from natural materials. Moringa leaves (Moringa oleifera L.) have the potential to prevent the progressivity of CKD because of their flavonoid content which has an antioxidant effect. This study aimed to analyze the effect of Moringa leaf ethanol extract (MLEE) on serum creatinine and SOD levels in rat model 5/6 subtotal nephrectomy. This research is an experimental study with a post-test only with a control group design. A total of 30 male white rats were randomly divided into 5 groups. Group A: sham control, B: subtotal nephrectomy, C, D, and E: treatment groups with MLEE of 200, 400, and 800 mg/kg BW, respectively. On the 15th day after the administration of extracts or aqua dest, sham surgery was carried out in group A, and 5/6 of subtotal nephrectomy in groups B, C, D, and E continued to administer extracts and aqua dest until the 21st day. A blood sample is taken on the 22nd day after surgery, checked serum creatinine levels and SOD. Data were analyzed using One-way ANOVA. The results showed that there was a significant difference in the average serum creatinine levels (p<0.001) and SOD (p<0.001) between groups. The treatment group showed lower serum creatinine levels and higher SOD compared to the nephrectomy subtotal group. Administration of MLEE for 35 days may prevent elevated serum creatinine levels and decreased SOD levels in rat model 5/6 subtotal nephrectomy

References

Cheung AK, Chang TI, Cushman WC, Furth SL, Hou FF, Ix JH, et al. KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney Int. Maret 2021;99(3):1–87.

Lukela J, Harrison RV, Jimbo M, Mahallati A, Saran R, Sy AZ. Management of Chronic Kidney Disease. UMHS Chronic Kidney Disease Guideline. Univ Mich. 2019;1–27.

Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, dkk. Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis. Remuzzi G, editor. PLOS ONE. 2016;11(7):1-18.

Kementerian Kesehatan RI. Riset Kesehatan Dasar 2018 [Internet]. Indonesia: Kementerian Kesehatan RI; 2018 : 59-62

Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2021 [Internet]. United Stated of America: Centers for Disease Control and Prevention; hlm. 4. https://www.cdc.gov/kidneydisease/publications-resources/ckd-national-facts.html

Tandah MR, Ihwan I, Diana K, Zulfiah Z, Ambianti N. Analisis biaya pengobatan penyakit ginjal kronik rawat inap dengan hemodialisis di rumah sakit umum daerah undata palu. LINK. 2019;15(2):1–7.

Azalea M, Andayani T, Satibi. Inap Dengan Hemodialisis Di Rumah Sakit Cost Analysis of Inpatient Hemodialysis in the Treatment of Chronic. Jurnal Manajemen dan Pelayanan Farmasi. 2016;6(2):141–50.

Fauziah F, Wahyono D, Budiarti LE. Cost illnes dari chronic kidney disease dengan tindakan hemodialisis. Jurnal Manajemen dan Pelayanan Farmasi. 2015;5(3):149-58.

Mutsaers HAM, Stribos EGD, Glorieux G, Vanholder R, Olinga P. Chronic Kidney Disease and Fibrosis: The Role of Uremic Retention Solutes. Front Med. 2015; 2(60):1-7.

Ling XC, Kuo KL. Oxidative stress in chronic kidney disease. Ren Replace Ther. 2018;4(53):1-9.

Younus H. Therapeutic potentials of superoxide dismutase. Int J Health Sci. 2018;12(3):88-93.

Katzung B, Masters S, Trevor A. Farmakologi Dasar & Klinik. Vol. 14. EGC; 2018.

Sulastri E, Zubair MS, Anas NI, Abidin S, Hardani R, Yulianti R, et al. Total Phenolic, Total Flavonoid, Quercetin Content and Antioxidant Activity of Standardized Extract of Moringa oleifera Leaf from Regions with Different Elevation. Pharmacogn J. 2018;10(6):104–8.

Duranti G, Maldini M, Crognale D, Horner K, Dimauro I, Sabatini S, et al. Moringa oleifera Leaf Extract Upregulates Nrf2/HO-1 Expression and Ameliorates Redox Status in C2C12 Skeletal Muscle Cells. Molecules. 2021;26(16):1-16

Al-Malki AL, El Rabey HA. The Antidiabetic Effect of Low Doses of Moringa oleifera Lam. Seeds on Streptozotocin Induced Diabetes and Diabetic Nephropathy in Male Rats. BioMed Res Int. 2015;2015:1–13.

Afifah A, Muflikhah K, Lestari T, Sutrisna E, Kirana A, Prastiwi SD. The protective effect of celery (Apium graveolens L.) ethanol extract on anemia in 5/6 subtotal nephrectomy rat model. Universa Med. 2020;39(1):12–8.

Afifah A, Pribadi FW, Salsabiela A, Anggara DH, Komara ZM, Al Fauzy R. The protective effect of celery ethanol extract on oxidative stress in chronic kidney disease rat model. Universa Med. 2022;41(2):114–20.

Singh D, Arya P, Aggarwal V, Gupta R. Evaluation of Antioxidant and Hepatoprotective Activities of Moringa oleifera Lam. Leaves in Carbon Tetrachloride-Intoxicated Rats. Antioxidants. 2014;3(3):569–91.

Aekthammarat D, Pannangpetch P, Tangsucharit P. Moringa oleifera leaf extract lowers high blood pressure by alleviating vascular dysfunction and decreasing oxidative stress in L-NAME hypertensive rats. Phytomedicine. 2019;54:9–16.

Villarruel-López A, López-de la Mora DA, Vázquez-Paulino OD, Puebla-Mora AG, Torres-Vitela MR, Guerrero-Quiroz LA, dkk. Effect of Moringa oleifera consumption on diabetic rats. BMC Complement Altern Med. 2018;18(1):127.

Liu D, Lv LL. New Understanding on the Role of Proteinuria in Progression of Chronic Kidney Disease. Dalam: Liu BC, Lan HY, Lv LL, editor. Renal Fibrosis: Mechanisms and Therapies [Internet]. Singapore: Springer Singapore; 2019;1165:487-500

Chen TK, Knicely DH, Grams ME. Chronic Kidney Disease Diagnosis and Management: A Review. JAMA. 2019;322(13):1294-1304.

Arief H, Widodo MA. Peranan Stres Oksidatif pada Proses Penyembuhan Luka. J Ilm Kedokt Wijaya Kusuma. 2 Maret 2018;5(2):22-29.

Fitzmaurice SD, Sivamani RK, Isseroff RR. Antioxidant Therapies for Wound Healing: A Clinical Guide to Currently Commercially Available Products. Skin Pharmacol Physiol. 2011;24(3):113–26.

Alfaridz F, Amalia R. Review jurnal : klasifikasi dan aktivitas farmakologi dari senyawa aktif flavonoid. Farmaka. 2018;16(3):1-9.

Retnaningsih C, Darmono D, Widiarnoko B, Muis SF. Peningkatan Aktivitas Antioksidan Superoksida Dismutase pada Tikus Hiperglikemi dengan Asupan Tempe Koro Benguk (Mucuna pruriens L.). AGRITECH. 2013;33(2):154-61.

Abdel-Daim MM, Khalil SR, Awad A, Abu Zeid EH, El-Aziz RA, El-Serehy HA. Ethanolic Extract of Moringa oleifera Leaves Influences NF-κB Signaling Pathway to Restore Kidney Tissue from Cobalt-Mediated Oxidative Injury and Inflammation in Rats. Nutrients. 2020;12(4):1-20.