ANALYSIS OF KIDNEY FUNCTION PARAMETERS ON THE RENOPROTECTIVE EFFECTS OF ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH CHRONIC KIDNEY FAILURE
Abstract
The renoprotective effect in chronic kidney disease (CKD) patients can be induced by antihypertensive therapy, which provides a vasodilatory effect on the blood vessels leading to the kidneys. This resulting renoprotective function is considered to slow the decrease in kidney function in CKD patients. The purpose of this study was to examine the effectiveness of antihypertensive therapy as renoprotective agents through the analysis of kidney function parameters in CKD patients. A descriptive design with a cross-sectional method was used, and the study sample used data from patient medical records, specifically focusing on kidney function parameters of CKD patients during the January-June 2023 treatment period at RSUD Sultan Abdul Aziz Syah Peureulak. Of the 134 respondents, there were two groups of patients receiving antihypertensive therapy: ACE-Inhibitors (ACEIs) and (angiotensin receptor blockers) ARBs. After conducting the Wilcoxon test, there were significant changes in kidney function parameters (Urea, creatinine, and eGFR) between before and after antihypertensive therapy, with a p value <0.05. In the ACEI group, the mean urea level was 72.4 ± 48.3 mg/dL, creatinine 4.8 ± 4.3 mg/dL, and eGFR 30.6 ± 30.8 mL/min. In the ARB group, mean urea was were 85.2 ± 48.7 mg/dL, creatinine 6.1 ± 4.2 mg/dL, and eGFR 21.6 ± 26.7 mL/min. These findings indicate that ACEI and ARB antihypertensive therapies are effective as renoprotective agents in CKD patients.
Keywords: ACE-Inhibitor, antihypertensive, ARB, reno-protective effect
References
1. Tirtasari, Silviana, Kodim, Nasrin. Prevalensi dan Karakteristik Hipertensi Pada Usia Dewasa Muda di Indonesia. Tarumanagara Med J. 2019;1(2):395–402.
2. WHO. World health statistics 2022 (Monitoring health of the SDGs) [Internet]. Monitoring health of the SDGs. 2022. 1–131 p. Available from: http://apps.who.int/bookorders.
3. Riskesdas. Laporan Nasional Riskesdas 2018. 2018th ed. Badan Penelitian dan Pengembangan Kesehatan. Jakarta; 2018. p. 152–5.
4. Tim Riskesdas. Laporan Provinsi Aceh Riskesdas 2018. Riskesdas. Jakarta: Badan Penelitian dan Pengembangan Kesehatan (LPB); 2019. p. 128–30. (1; vol. 6).
5. Arfah A. Pengaruh Penyakit Hipertensi Terhadap Kualitas Fungsi Ginjal (Studi Literatur). J Heal Qual Dev. 2021;1(2):74–8.
6. Lestari EFA, Susilowati S, Hermawatiningsih OD. Evaluasi Efektivitas Antihipertensi Pada Pasien Hipertensi Dengan Gagal Ginjal Kronis Di Rawat Inap Rsud Kota Madiun. Duta Pharma J. 2021;1(2):25–31.
7. Fandinata SS, Darmawan R, Utami PR, Ulfa NM. Monitoring Kidney Function Through the Use of Candesartan, Telmisartan or Valsartan Antihypertensive Therapy towards Patients CKD. Media Kesehat Masy Indones [Internet]. 2022 Mar 31;18(1 SE-Articles):1–9. Available from: https://journal.unhas.ac.id/index.php/mkmi/article/view/17780
8. Zhao M, Wang R, Yu Y, Chang M, Ma S, Zhang H, et al. Efficacy and Safety of Angiotensin-Converting Enzyme Inhibitor in Combination with Angiotensin-Receptor Blocker in Chronic Kidney Disease Based on Dose: A Systematic Review and Meta-Analysis. Front Pharmacol. 2021;12:638611.
9. Rachmaini F, Amalia L, Rahayu C. Profil Terapi Antihipertensi dan Antihiperlipidemia Terhadap Fungsi Ginjal Pasien Diaabetes Melitus Tipe 2 dengan Komplikasi Penyakit Ginjal Kronis di RSUP Dr. Hasan Sadikin. Pharm Sci Res. 2020;7(1):17–27.
10. Nurchayati S, Sansuwito T, Damanik S. Gambaran Deteksi Dini Penyakit Gagal Ginjal Kronik Pada Masyarakat Kecamatan Tambang, Kabupaten Kampar Propinsi Riau. Indonesia. 2018 Sep 1;9:8.
11. Ariyani H, Hilmawan RG, S. BL, Nurdianti R, Hidayat R, Puspitasari P. Gambaran Karakteristik Pasien Gagal Ginjal Kronis di Unit Hemodialisa Rumah Sakit Umum Dr. Soekardjo Kota Tasikmalaya. Keperawatan & Kebidanan. 2019;3 No 2(November):1–6.
12. Abyuta Wiksa Pranandhira R, Yudha Rahman E, Khatimah H. Karakteristik Pasien Chronic Kidney Disease Yang Dilakukan Hemodialisis Di Rsud Ulin Banjarmasin Selama Pandemi Covid-19. Homeostasis. 2023;6(1):69.
13. Weldegiorgis M, Woodward M. The impact of hypertension on chronic kidney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis. BMC Nephrol. 2020 Nov;21(1):506.
14. Sugahara M, Pak WLW, Tanaka T, Tang SCW, Nangaku M. Update on diagnosis, pathophysiology, and management of diabetic kidney disease. Nephrology (Carlton). 2021 Jun;26(6):491–500.
15. Kumar M, Dev S, Khalid MU, Siddenthi SM, Noman M, John C, et al. The Bidirectional Link Between Diabetes and Kidney Disease: Mechanisms and Management. Cureus. 2023 Sep;15(9):e45615.
16. Setiati S, Sudoyo A, Stiyohadi B, Syam A. Hipertensi dalam Buku Ajar Ilmu Penyakit Dalam. In: III. Jakarta: Interna Publishing; 2019. p. 80–7.
17. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DEJ, Colvin MM, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of Ame. Circulation. 2017 Aug;136(6):e137–61.
18. Agrawal A, Kamila S, Reddy S, Lilly J, Mariyala MS. Effect of telmisartan on kidney function in patients with chronic kidney disease: an observational study. J drug Assess. 2016;5(1):24–8.
19. 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 [Internet]. 2021 Mar 1;99(3):S1–87. Available from: https://doi.org/10.1016/j.kint.2020.11.003
20. Clase CM, Carrero JJ, Ellison DH, Grams ME, Hemmelgarn BR, Jardine MJ, et al. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2020;97(1):42–61.
21. Schmidt M, Mansfield KE, Bhaskaran K, Nitsch D, Sørensen HT, Smeeth L, et al. Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study. BMJ [Internet]. 2017 Mar 9;356:j791. Available from: https://www.bmj.com/content/356/bmj.j791.abstract
22. Pethő ÁG, Tapolyai M, Csongrádi É, Orosz P. Management of chronic kidney disease: The current novel and forgotten therapies. J Clin Transl Endocrinol [Internet]. 2024;36:100354. Available from: https://www.sciencedirect.com/science/article/pii/S2214623724000255
23. Chen TK, Knicely DH, Grams ME. Chronic kidney disease diagnosis and management: a review. Jama. 2019;322(13):1294–304.
24. Maritha I, Ratnawati R, Dewi O. Analisis Parameter Fungsi Ginjal Dan Efektivitas Antihipertensi Pada Pasien Rawat Inap Hipertensi Di RSUD Kota Madiun. Duta Pharma J. 2021;1(1).
25. Anggriani A, Herawati I, Budiastuti J. Evaluasi Penggunaan Obat Hipertensi Golongan Angiotensin Reseptor Bloker pada Pasien yang Intoleransi ACE Inhibitor. J Farm Galen. 2017;4(1):20–5.
26. Burnier M, Lin S, Ruilope L, Bader G, Durg S, Brunel P. Effect of angiotensin receptor blockers on blood pressure and renal function in patients with concomitant hypertension and chronic kidney disease: a systematic review and meta-analysis. Blood Press [Internet]. 2019 Nov 2;28(6):358–74. Available from: https://doi.org/10.1080/08037051.2019.1644155
2. WHO. World health statistics 2022 (Monitoring health of the SDGs) [Internet]. Monitoring health of the SDGs. 2022. 1–131 p. Available from: http://apps.who.int/bookorders.
3. Riskesdas. Laporan Nasional Riskesdas 2018. 2018th ed. Badan Penelitian dan Pengembangan Kesehatan. Jakarta; 2018. p. 152–5.
4. Tim Riskesdas. Laporan Provinsi Aceh Riskesdas 2018. Riskesdas. Jakarta: Badan Penelitian dan Pengembangan Kesehatan (LPB); 2019. p. 128–30. (1; vol. 6).
5. Arfah A. Pengaruh Penyakit Hipertensi Terhadap Kualitas Fungsi Ginjal (Studi Literatur). J Heal Qual Dev. 2021;1(2):74–8.
6. Lestari EFA, Susilowati S, Hermawatiningsih OD. Evaluasi Efektivitas Antihipertensi Pada Pasien Hipertensi Dengan Gagal Ginjal Kronis Di Rawat Inap Rsud Kota Madiun. Duta Pharma J. 2021;1(2):25–31.
7. Fandinata SS, Darmawan R, Utami PR, Ulfa NM. Monitoring Kidney Function Through the Use of Candesartan, Telmisartan or Valsartan Antihypertensive Therapy towards Patients CKD. Media Kesehat Masy Indones [Internet]. 2022 Mar 31;18(1 SE-Articles):1–9. Available from: https://journal.unhas.ac.id/index.php/mkmi/article/view/17780
8. Zhao M, Wang R, Yu Y, Chang M, Ma S, Zhang H, et al. Efficacy and Safety of Angiotensin-Converting Enzyme Inhibitor in Combination with Angiotensin-Receptor Blocker in Chronic Kidney Disease Based on Dose: A Systematic Review and Meta-Analysis. Front Pharmacol. 2021;12:638611.
9. Rachmaini F, Amalia L, Rahayu C. Profil Terapi Antihipertensi dan Antihiperlipidemia Terhadap Fungsi Ginjal Pasien Diaabetes Melitus Tipe 2 dengan Komplikasi Penyakit Ginjal Kronis di RSUP Dr. Hasan Sadikin. Pharm Sci Res. 2020;7(1):17–27.
10. Nurchayati S, Sansuwito T, Damanik S. Gambaran Deteksi Dini Penyakit Gagal Ginjal Kronik Pada Masyarakat Kecamatan Tambang, Kabupaten Kampar Propinsi Riau. Indonesia. 2018 Sep 1;9:8.
11. Ariyani H, Hilmawan RG, S. BL, Nurdianti R, Hidayat R, Puspitasari P. Gambaran Karakteristik Pasien Gagal Ginjal Kronis di Unit Hemodialisa Rumah Sakit Umum Dr. Soekardjo Kota Tasikmalaya. Keperawatan & Kebidanan. 2019;3 No 2(November):1–6.
12. Abyuta Wiksa Pranandhira R, Yudha Rahman E, Khatimah H. Karakteristik Pasien Chronic Kidney Disease Yang Dilakukan Hemodialisis Di Rsud Ulin Banjarmasin Selama Pandemi Covid-19. Homeostasis. 2023;6(1):69.
13. Weldegiorgis M, Woodward M. The impact of hypertension on chronic kidney disease and end-stage renal disease is greater in men than women: a systematic review and meta-analysis. BMC Nephrol. 2020 Nov;21(1):506.
14. Sugahara M, Pak WLW, Tanaka T, Tang SCW, Nangaku M. Update on diagnosis, pathophysiology, and management of diabetic kidney disease. Nephrology (Carlton). 2021 Jun;26(6):491–500.
15. Kumar M, Dev S, Khalid MU, Siddenthi SM, Noman M, John C, et al. The Bidirectional Link Between Diabetes and Kidney Disease: Mechanisms and Management. Cureus. 2023 Sep;15(9):e45615.
16. Setiati S, Sudoyo A, Stiyohadi B, Syam A. Hipertensi dalam Buku Ajar Ilmu Penyakit Dalam. In: III. Jakarta: Interna Publishing; 2019. p. 80–7.
17. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DEJ, Colvin MM, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of Ame. Circulation. 2017 Aug;136(6):e137–61.
18. Agrawal A, Kamila S, Reddy S, Lilly J, Mariyala MS. Effect of telmisartan on kidney function in patients with chronic kidney disease: an observational study. J drug Assess. 2016;5(1):24–8.
19. 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 [Internet]. 2021 Mar 1;99(3):S1–87. Available from: https://doi.org/10.1016/j.kint.2020.11.003
20. Clase CM, Carrero JJ, Ellison DH, Grams ME, Hemmelgarn BR, Jardine MJ, et al. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2020;97(1):42–61.
21. Schmidt M, Mansfield KE, Bhaskaran K, Nitsch D, Sørensen HT, Smeeth L, et al. Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study. BMJ [Internet]. 2017 Mar 9;356:j791. Available from: https://www.bmj.com/content/356/bmj.j791.abstract
22. Pethő ÁG, Tapolyai M, Csongrádi É, Orosz P. Management of chronic kidney disease: The current novel and forgotten therapies. J Clin Transl Endocrinol [Internet]. 2024;36:100354. Available from: https://www.sciencedirect.com/science/article/pii/S2214623724000255
23. Chen TK, Knicely DH, Grams ME. Chronic kidney disease diagnosis and management: a review. Jama. 2019;322(13):1294–304.
24. Maritha I, Ratnawati R, Dewi O. Analisis Parameter Fungsi Ginjal Dan Efektivitas Antihipertensi Pada Pasien Rawat Inap Hipertensi Di RSUD Kota Madiun. Duta Pharma J. 2021;1(1).
25. Anggriani A, Herawati I, Budiastuti J. Evaluasi Penggunaan Obat Hipertensi Golongan Angiotensin Reseptor Bloker pada Pasien yang Intoleransi ACE Inhibitor. J Farm Galen. 2017;4(1):20–5.
26. Burnier M, Lin S, Ruilope L, Bader G, Durg S, Brunel P. Effect of angiotensin receptor blockers on blood pressure and renal function in patients with concomitant hypertension and chronic kidney disease: a systematic review and meta-analysis. Blood Press [Internet]. 2019 Nov 2;28(6):358–74. Available from: https://doi.org/10.1080/08037051.2019.1644155
Published
2025-12-31
How to Cite
MOURISA, Cut; SUKATENDEL, Firya Nadine Chalishny.
ANALYSIS OF KIDNEY FUNCTION PARAMETERS ON THE RENOPROTECTIVE EFFECTS OF ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH CHRONIC KIDNEY FAILURE.
Medika Kartika : Jurnal Kedokteran dan Kesehatan, [S.l.], v. 8, n. 4, p. 412-422, dec. 2025.
ISSN 2655-6537.
Available at: <http://medikakartika.unjani.ac.id/medikakartika/index.php/mk/article/view/1301>. Date accessed: 07 jan. 2026.
Section
Articles
