Pengaruh Inflamasi Mikro terhadap Penyakit Ginjal pada Pasien Diabetes Melitus Tipe-2
DOI:
https://doi.org/10.35790/msj.v4i1.44682Abstract
Abstract: Diabetic nephropathy is a microvascular damage as a complication of type 2 diabetes mellitus (T2DM) and becomes one of the most frequent causes of chronic renal failure worldwide. This study aimed to determine the effect of micro-inflammation on renal impairment in T2DM patients. This was a literature review study and data were searched using three database sources, namely ClinicalKey, Pubmed, and Google Scholar. The results obtained 10 articles to be reviewed. All reviewed articles stated various increases in inflammatory mediators namely NGAL, NLR, serum cystatin-C, urinary IgG, transferrin, hs-CRP, IL-8, TSA, TLR-4, TLR-2, monocyte ratio CD14+CD16+, pro-inflammatory cytokines Th1 TNF-α, IFN-γ, IL-6, IL-1β, IL-4, and eotaxin, and decreased levels of uromodulin and TNFR1. This occurred due to some components of the body in a state of hyperglycemia wouldl be able to activate the infiltration of hematopoietic cells, especially macrophages in the kidneys, which would further secrete proinflammatory cytokines and reactive oxygen species (ROS). Inflammatory cells present in the kidney are a response to tissue damage, but can also increase cell injury and the progression of DN in its early stages. In conclusion, there is an influence of immune and inflammatory mechanisms on the development of diabetic nephropathy in patients with type 2 diabetes mellitus.
Keywords: type 2 diabetes mellitus; micro inflammation; diabetic kidney disease
Abstrak: Nefropati diabetik (ND) adalah kerusakan mikrovaskuler sebagai komplikasi DMT2 dan menjadi salah satu penyebab tersering gagal ginjal kronis di seluruh dunia. Penelitian ini bertujuan untuk mengetahui pengaruh inflamasi mikro terhadap penyakit ginjal pada pasien DMT2. Penelitian ini menggunakan metode literature review dengan pencarian data melallui tiga sumber database yaitu ClinicalKey, Pubmed, dan Google Scholar. Hasil penelitian mendapatkan 10 artikel yang di-review yang melaporkan berbagai peningkatan mediator inflamasi, yaitu NGAL, NLR, serum cystatin-C, IgG urin, transferin, hs-CRP, IL-8, TSA, TLR-4, TLR-2, rasio monosit CD14+CD16+, sitokin proinflamasi Th1 TNF-α, IFN-γ, IL-6, IL-1β, IL-4, dan eotaksin, serta penurunan kadar uromodulin dan TNFR1. Hal ini terjadi karena beberapa komponen pada keadaan DMT2 dapat mengaktifkan infiltrasi sel hematopoietik, terutama makrofag pada ginjal, yang akan mengeluarkan sitokin proinflamasi dan reactive oxygen species (ROS). Masuknya sel inflamasi ke dalam ginjal pasien merupakan respon terhadap kerusakan jaringan, tetapi juga dapat meningkatkan cedera sel serta progresifitas ND pada tahap awal. Simpulan penelitian ini ialah terdapat pengaruh mekanisme kekebalan dan inflamasi dalam perkembangan nefropati diabetik pada pasien diabetes mellitus tipe 2.
Kata kunci: diabetes melitus tipe 2; inflamasi mikro; penyakit ginjal diabetes
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