Pemakaian Nikotinamide Dalam Penanganan Hiperfosfatemia Pada Pasien Hemodialisis

51

LAMPIRAN 1

Universitas Sumatera Utara

52

LAMPIRAN 2

LEMBARAN PENJELASAN

Assalamualaikum wr.wb,
Salam sejahtera bagi Bapak/Ibu,
Terima kasih atas kesediaan Bapak/Ibu meluangkan waktu untuk
membaca dan mengisi surat persetujuan ini, sebelumnya, perkenankan saya
memperkenalkan diri. Nama saya dr. Meivina Ramadhani Pane, Peserta Program
Pendidikan Dokter Spesialis Ilmu Penyakit Dalam di Fakultas Kedokteran
Universitas Sumatera Utara (FK-USU). Saya sedang melakukan pengumpulan
data penelitian tugas akhir sebagai salah satu syarat menyelesaikan pendidikan di
FK-USU. Adapun judul penelitian saya adalah ―Efikasi dan keamanan

nikotinamide dalam penanganan hiperfosfatemia pada pasien hemodialisis‖
Penelitian ini bertujuan untuk mengetahui efektivitas dan keamanan
penggunaan Nikotinamide dalam menurunkan kadar fosfat darah pada pasien cuci
darah dengan harga yang relatif lebih murah dibandingkan dengan obat yang
sudah ada sebelumnya di pasaran.
Penelitian ini dimulai dengan pengambilan sampel darah vena sebanyak ±
2 sendok makan yang dilakukan sebelum hemodialisis dimulai. Sampel darah ini
digunakan untuk pemeriksaan darah rutin, LFT, RFT, fosfat, kalsium, albumin,
dan profil lipid. Kemudian apabila kadar serum fosfat pasien ≥ 5.5 mg/dl, maka
akan diberikan kapsul nikotinamide 250 mg 2 kali sehari pada pagi dan petang
hari pada saat makan. Kemudian setelah 4 minggu dan 8 minggu dilakukan
pengambilan darah kembali untuk menilai darah rutin, fosfat, kalsium, fungsi hati,
fungsi ginjal dan profil lipid.

Universitas Sumatera Utara

53

Penelitian ini tidak berbahaya, pada saat pengambilan darah dapat timbul
lebam pada bekas tempat pengambilan yang akan hilang sendiri dalam satu atau

dua hari. Sementara nikotinamide berdasarkan pengalaman selama ini belum
pernah menunjukkan bahaya yang serius. Beberapa efek samping yang mungkin
terjadi dari pemberian obat ini adalah diare, penurunan kadar trombosit dan
kemerahan pada wajah. Namun efek samping tersebut akan hilang jika dosis obat
dikurangi. Efek samping obat tersebut biasanya terjadi jika diberikan dengan dosis
tinggi, sedangkan pada penelitian ini dosis obat yang diberikan adalah 500 mg per
hari. Segala biaya pemeriksaan laboratorium, penyediaan obat dan biaya
penanganan yang diperlukan bila timbul efek samping akan menjadi tanggung
jawab peneliti.
Terimakasih atas keikutsertaan Bapak/Ibu. Apabila ada hal-hal yang
terjadi selama penelitian dan ada keterangan yang saya berikan masih belum jelas
atau yang ingin ditanyakan, Bapak/Ibu dapat menghubungi saya :
Nama

: dr. Meivina Ramadhani Pane

Alamat

: Jl. Suka Ramai No.4 Medan


No Telp

: 081260297727

Atas perhatian Bapak/Ibu saya ucapkan terima kasih.

Hormat saya,

dr. Meivina Ramadhani Pane

Universitas Sumatera Utara

54

LAMPIRAN 3
LEMBAR PERSETUJUAN SETELAH PENJELASAN
(INFORMED CONSENT)
=======================================================
No. Peserta :
Saya yang bertanda tangan di bawah ini :

Nama

:

Umur

:

Jenis Kelamin

: Laki-laki / Perempuan *

Alamat

:

No. Telepon

:


tahun

Setelah mendapat penjelasan dari peneliti tentang kebaikan dan keburukan
prosedur penelitian ini, menyatakan bersedia untuk ikut dalam penelitian tentang :
―EFIKASI DAN KEAMANAN NIKOTINAMIDE DALAM PENANGANAN
HIPERFOSFATEMIA PADA PASIEN HEMODIALISIS‖.
Demikian surat pernyataan bersedia ikut dalam penelitian ini saya perbuat
untuk dapat digunakan seperlunya.
Medan,

2013

Peneliti,

Pasien,

( dr. Meivina Ramadhani Pane )

(.......................................)
Saksi,


(................................)

Universitas Sumatera Utara

55

LAMPIRAN 4

KERTAS KERJA PROFIL PESERTA PENELITIAN

I. IDENTITAS PRIBADI
Nama

:

Umur

:


Jenis Kelamin

: pria/wanita

Riwayat penyakit

: DM/hipertensi/batu ginjal/kista

HD sejak

:

tahun

II. HASIL PEMERIKSAAN LABORATORIUM
Parameter

Sebelum

Minggu ke-4


Minggu Ke-8

Fosfat (mg/dl)
Kalsium (mg/dl)
Fosfat x kalsium
(mg2/dl2)
Trombosit (x103/mm3)
SGOT (U/L)
SGPT (U/L)
HDL (mg/dl)
LDL (mg/dl)
III. EFEK SAMPING YANG TIMBUL (sebutkan)
.................................

Universitas Sumatera Utara

56

LAMPIRAN 5

Data Penelitian Sebelum Pemberian Nikotinamide
Pasien

Umur
(THN)

JK

Fosfat
(mg/dl)

Kalsium
(mg/dl)

CaxP
(mg2/dl2)

Trombosit
(103/mm3)


SGOT
(U/L)

SGPT
(U/L)

HDL
(mg/dl)

LDL
(mg/dl)

1
2
3
4
5
6
7
8

9
10
11
12
13
14
15
16
17

54
55
38
70
40
53
43
46
41
59
43
35
38
44
42
32
54

P
P
L
L
L
L
L
L
L
L
L
L
L
L
P
L
P

7
7
7.2
6.3
7.9
6.3
11.3
8.1
9.2
9.5
9.5
9
7.3
9.9
7.4
9.5
6.2

9.2
10.3
8.6
9.8
9.1
9.9
9
9.6
10.3
9.6
10.3
10
10.6
9.1
8.8
9.3
11.5

64.4
72.1
61.9
61.74
71.89
62.37
101.7
77.76
94.76
91.2
97.85
90
77.38
90.09
65.12
88.35
71.3

179
186
147
160
340
157
130
123
213
284
331
173
263
167
230
165
237

23
31
45
51
23
34
20
18
65
71
16
34
19
18
31
37
41

22
45
16
37
15
49
50
13
11
45
10
43
14
17
29
48
51

43
38
33
35
23
34
37
38
33
50
49
37
64
56
54
28
49

131
83
64
101
123
99
60
138
113
99
99
78
143
110
109
88
69

Data Penelitian Setelah Minggu ke-4 Pemberian Nikotinamide
Pasien

Umur
(THN)

JK

Fosfat
(mg/dl)

Kalsium
(mg/dl)

CaxP
(mg2/dl2)

Trombosit
(103/mm3)

SGOT
(U/L)

SGPT
(U/L)

HDL
(mg/dl)

LDL
(mg/dl)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17

54
55
38
70
40
53
43
46
41
59
43
35
38
44
42
32
54

P
P
L
L
L
L
L
L
L
L
L
L
L
L
P
L
P

9.7
8
5.5
5.7
8
5.7
10.6
7.6
8.3
6.6
8.1
5.6
7
10.2
6.5
9.3
5.8

8.6
10.6
8.7
9.8
8.4
8.2
7.5
8.8
10
9
10.2
8.6
10.7
8.9
8.3
8.2
10.7

83.42
84.8
47.85
55.86
67.2
46.74
79.5
66.88
83
59.4
82.62
48.16
74.9
90.78
53.95
76.26
62.06

146
221
172
165
228
166
125
129
198
246
243
170
283
195
200
282
215

28
23
23
38
22
18
44
12
20
33
20
35
19
17
32
45
27

20
41
40
35
25
30
63
22
17
35
13
44
13
17
35
55
23

41
41
34
37
27
25
44
35
38
44
35
38
53
56
20
38
27

123
68
77
98
149
105
63
112
116
110
70
81
98
104
97
90
86

Universitas Sumatera Utara

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Data Penelitian Setelah Minggu ke-8 Pemberian Nikotinamide
Pasien

Umur
(THN)

JK

Fosfat
(mg/dl)

Kalsium
(mg/dl)

CaxP
(mg2/dl2)

Trombosit
(103/mm3)

SGOT
(U/L)

SGPT
(U/L)

HDL
(mg/dl)

LDL
(mg/dl)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17

54
55
38
70
40
53
43
46
41
59
43
35
38
44
42
32
54

P
P
L
L
L
L
L
L
L
L
L
L
L
L
P
L
P

7.8
7.9
5.2
3.4
6.9
5.1
9.6
5.3
7.2
5.1
8.5
5.5
7.9
9.9
6.3
9.1
2.7

8.2
10.9
8.8
9.6
8.7
8.5
8.8
8.6
10
8.7
9.7
8.3
10
8.2
8.5
9.1
11.7

63.96
86.11
45.76
32.64
60.03
43.35
84.48
45.58
72
44.37
82.45
45.65
70
81.18
53.55
82.81
31.59

258
251
165
160
348
170
167
159
189
230
252
161
287
158
232
249
155

34
21
22
28
20
20
12
13
16
30
18
34
19
27
32
23
35

23
31
35
21
23
28
19
20
10
40
10
37
13
55
33
29
27

41
39
35
41
30
30
42
40
45
48
30
37
37
76
39
26
35

120
64
78
95
139
97
76
125
110
125
75
75
124
103
146
79
77

Keterangan:
P : Perempuan
L : Laki-laki

Universitas Sumatera Utara

58

LAMPIRAN 6

OUTPUT ANALISIS
Jk

Valid

L
P
Total

Frequency
13
4

Percent
76,5
23,5

Valid Percent
76,5
23,5

17

100,0

100,0

Cumulative
Percent
76,5
100,0

Penyebab

Valid

Batu ginjal
DM
DN
GNC
HN
Total

Umur
Lama HD (tahun)
Ca1
Ca2
Ca3
Fosfat1
Fosfat2
Fosfat3
CaxFosfat1
CaxFosfat2
CaxFosfat3
Trombosit1
Trombosit2
Trombosit3
SGOT1
SGOT2
SGOT3
SGPT1
SGPT2
SGPT3
HDL1
HDL2
HDL3
LDL1
LDL2
LDL3

Frequency
1
1
3
1
11

Percent
5,9
5,9
17,6
5,9
64,7

Valid Percent
5,9
5,9
17,6
5,9
64,7

17

100,0

100,0

Cumulative
Percent
5,9
11,8
29,4
35,3
100,0

Case Processing Summary
Cases
Valid
Missing
N
Percent
N
Percent
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%
17
100,0%
0
0,0%

Total
N
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17

Percent
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%
100,0%

Universitas Sumatera Utara

59

Descriptives
Umur

Mean
95% Confidence Interval for
Mean

Statistic
46,2941
Lower Bound

41,2409

Upper Bound

51,3474

5% Trimmed Mean

45,7712

Median

43,0000

Variance

96,596

Std. Deviation

Lama HD (tahun)

9,82831

Minimum

32,00

Maximum

70,00

Range

38,00

Interquartile Range

15,00

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

,835
,512
4,2453
2,9773

Upper Bound

5,5133

5% Trimmed Mean

4,1798

Median

4,0000

Variance

2,46622

Minimum

,67

Maximum

9,00

Range

8,33

Interquartile Range

Ca1

Lower Bound

4,25
,448
-,760
9,7059
9,3218

Upper Bound

10,0900

5% Trimmed Mean

9,6676

Median

9,6000

Variance

,74705

Minimum

8,60

Maximum

11,50

Range

2,90

Interquartile Range

Ca2

,550
1,063
,18119

,558

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
,59815

6,082

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Std. Error
2,38371

Lower Bound

1,20
,690
,484
9,1294
8,6157

Upper Bound

9,6432

5% Trimmed Mean

9,1327

Median

8,8000

,550
1,063
,24235

Universitas Sumatera Utara

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Variance

,998

Std. Deviation

,99923

Minimum

7,50

Maximum

10,70

Range

3,20

Interquartile Range

Ca3

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

1,75
,412
-1,059
9,1941
8,6830

Upper Bound

9,7052

5% Trimmed Mean

9,1101

Median

8,8000

Variance

,988

Std. Deviation

,99403

Minimum

8,20

Maximum

11,70

Range

3,50

Interquartile Range

Fosfat1

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

1,35
1,300
1,211
8,1529
7,3836

Upper Bound

8,9223

5% Trimmed Mean

8,0866

Median

7,9000

Variance

1,49629

Minimum

6,20

Maximum

11,30

Range

5,10

Interquartile Range

Fosfat2

Lower Bound

2,50
,432
-,708
7,5412
6,6741

Upper Bound

8,4082

5% Trimmed Mean

7,4846

Median

7,6000

Variance

1,68636

Minimum

5,50

Maximum

10,60

Range

5,10

Interquartile Range

Fosfat3

,550
1,063
,40900

2,844

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for

,550
1,063
,36290

2,239

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
,24109

Lower Bound

3,05
,414
-1,010
6,6706
5,5964

,550
1,063
,50670

Universitas Sumatera Utara

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Mean

Upper Bound

6,7118

Median

6,9000

Variance

4,365

Std. Deviation

2,08919

Minimum

2,70

Maximum

9,90

Range

7,20

Interquartile Range

CaxFosfat1

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

3,05
-,219
-,693
78,8182
71,7393

Upper Bound

85,8972

5% Trimmed Mean

78,4958

Median

77,3800

Variance

13,76813

Minimum

61,74

Maximum

101,70

Range

39,96

Interquartile Range
Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

25,89
,207
-1,479
68,4341
60,9060

Upper Bound

75,9622

5% Trimmed Mean

68,3979

Median

67,2000

Variance

214,383

Std. Deviation

46,74

Maximum

90,78

Range

44,04

Interquartile Range

CaxFosfat3

Lower Bound

27,91
-,143
-1,428
60,3241
50,5796

Upper Bound

70,0687

5% Trimmed Mean

60,4879

Median

60,0300

Variance
Std. Deviation

,550
1,063
3,55116

14,64183

Minimum

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
3,33926

189,561

Std. Deviation

CaxFosfat2

7,7447

5% Trimmed Mean

,550
1,063
4,59669

359,203
18,95265

Minimum

31,59

Maximum

86,11

Range

54,52

Interquartile Range

36,84

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Trombosit1

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

,015
-1,503
205,00
170,85

Upper Bound

239,15

5% Trimmed Mean

202,06

Median

179,00

Variance

4410,375

Std. Deviation

66,411

Minimum

123

Maximum

340

Range

217

Interquartile Range

Trombosit2

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

92
,883
-,194
199,06
174,44

Upper Bound

223,68

5% Trimmed Mean

198,51

Median

198,00

Variance

47,886

Minimum

125

Maximum

283

Range

158

Interquartile Range

Trombosit3

Lower Bound

70
,238
-,670
211,24
181,85

Upper Bound

240,62

5% Trimmed Mean

189,00

Variance

3265,441

Std. Deviation

57,144

Minimum

155

Maximum

348

Range

193

Interquartile Range

SGOT1

Lower Bound

91
,872
,148
33,94
25,50

Upper Bound

42,38

5% Trimmed Mean

32,88

Median

31,00

Variance
Std. Deviation
Minimum

,550
1,063
13,859

206,76

Median

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
11,614

2293,059

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
16,107

,550
1,063
3,983

269,684
16,422
16

Universitas Sumatera Utara

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Maximum

71

Range

55

Interquartile Range

SGOT2

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

24
1,039
,435
26,82
21,87

Upper Bound

31,78

5% Trimmed Mean

26,64

Median

23,00

Variance

92,779

Std. Deviation

9,632

Minimum

12

Maximum

45

Range

33

Interquartile Range

SGOT3

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

15
,568
-,577
23,76
19,95

Upper Bound

27,58

5% Trimmed Mean

23,79

Median

22,00

Variance

7,421

Minimum

12

Maximum

35

Range

23

Interquartile Range

SGPT1

Lower Bound

13
,121
-1,172
30,29
22,01

Upper Bound

38,58

5% Trimmed Mean

29,00

Variance

259,596

Std. Deviation

16,112

Minimum

10

Maximum

51

Range

41

Interquartile Range

SGPT2

,550
1,063
3,908

30,27

Median

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
1,800

55,066

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
2,336

Lower Bound

32
,049
-1,931
31,06
23,63

Upper Bound

38,49

5% Trimmed Mean

30,29

Median

30,00

,550
1,063
3,505

Universitas Sumatera Utara

64

Variance

208,809

Std. Deviation

14,450

Minimum

13

Maximum

63

Range

50

Interquartile Range

SGPT3

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

22
,708
-,039
26,71
20,78

Upper Bound

32,63

5% Trimmed Mean

26,06

Median

27,00

Variance

132,971

Std. Deviation

11,531

Minimum

10

Maximum

55

Range

45

Interquartile Range

HDL1

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

15
,649
,917
41,24
35,65

Upper Bound

46,82

5% Trimmed Mean

38,00

Variance

118,191

Std. Deviation

10,872

Minimum

23

Maximum

64

Range

41

Interquartile Range

HDL2

Lower Bound

16
,461
-,323
37,24
32,43

Upper Bound

42,04

5% Trimmed Mean

37,15

Median

38,00

Variance

9,351

Minimum

20

Maximum

56

Range

36

Interquartile Range

HDL3

,550
1,063
2,268

87,441

Std. Deviation

Skewness
Kurtosis
Mean
95% Confidence Interval for

,550
1,063
2,637

40,98

Median

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
2,797

Lower Bound

12
,182
,191
39,47
33,79

,550
1,063
2,679

Universitas Sumatera Utara

65

Mean

Upper Bound

38,19

Median

39,00

Variance

122,015

Std. Deviation

11,046

Minimum

26

Maximum

76

Range

50

Interquartile Range

LDL1

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

9
2,331
7,628
100,41
87,62

Upper Bound

113,21

5% Trimmed Mean

99,00

Variance

619,257

Std. Deviation

24,885

Minimum

60

Maximum

143

Range

83

Interquartile Range
Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

Lower Bound

38
,047
-,753
96,88
85,53

Upper Bound

108,24

5% Trimmed Mean

98,00

Variance

487,610

Std. Deviation

22,082

Minimum

63

Maximum

149

Range

86

Interquartile Range

LDL3

32
,507
,494
100,47
Lower Bound

87,25

Upper Bound

113,69

5% Trimmed Mean

99,97

Median

97,00

Variance
Std. Deviation

,550
1,063
6,236

661,140
25,713

Minimum

64

Maximum

146

Range

,550
1,063
5,356

95,87

Median

Skewness
Kurtosis
Mean
95% Confidence Interval for
Mean

,550
1,063
6,035

100,29

Median

LDL2

45,15

5% Trimmed Mean

82

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66

Interquartile Range

48

Skewness
Kurtosis

,299
-1,276

Tests of Normality
Kolmogorov-Smirnova
Statistic
df
Sig.
Umur
,181
17
,144
Lama HD (tahun)
,164
17
,200*
Ca1
,118
17
,200*
Ca2
,199
17
,073
Ca3
,242
17
,009
Fosfat1
,163
17
,200*
Fosfat2
,143
17
,200*
Fosfat3
,124
17
,200*
CaxFosfat1
,167
17
,200*
CaxFosfat2
,141
17
,200*
CaxFosfat3
,191
17
,101
Trombosit1
,201
17
,067
Trombosit2
,126
17
,200*
Trombosit3
,235
17
,013
SGOT1
,159
17
,200*
SGOT2
,184
17
,130
SGOT3
,129
17
,200*
SGPT1
,207
17
,051
SGPT2
,133
17
,200*
SGPT3
,097
17
,200*
HDL1
,205
17
,055
HDL2
,129
17
,200*
HDL3
,233
17
,015
LDL1
,124
17
,200*
LDL2
,090
17
,200*
LDL3
,210
17
,045
*. This is a lower bound of the true significance.
a. Lilliefors Significance Correction

Statistic
,935
,953
,955
,908
,856
,930
,919
,962
,907
,925
,905
,901
,962
,856
,888
,941
,941
,845
,937
,958
,958
,964
,771
,968
,969
,917

Shapiro-Wilk
df
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17
17

,550
1,063

Sig.
,268
,503
,549
,091
,013
,220
,142
,674
,089
,179
,083
,072
,673
,013
,044
,335
,332
,009
,279
,600
,588
,715
,001
,787
,798
,131

Wilcoxon Signed Ranks Test
Ranks
N
Ca2 - Ca1

Ca3 - Ca1

Negative Ranks
Positive Ranks
Ties

13a
3b

Total

17
14d
3e
0f

Negative Ranks
Positive Ranks
Ties
Total

Ca3 - Ca2

Negative Ranks
Positive Ranks
Ties
Total

a. Ca2 < Ca1
b. Ca2 > Ca1
c. Ca2 = Ca1
d. Ca3 < Ca1

Mean Rank
9,73
3,17

Sum of Ranks
126,50
9,50

9,79
5,33

137,00
16,00

8,25
8,75

66,00
70,00

c

1

17
8g
8h
1i
17

e. Ca3 > Ca1
f. Ca3 = Ca1
g. Ca3 < Ca2
h. Ca3 > Ca2

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67

i. Ca3 = Ca2
Test Statistics
Ca2 - Ca1
Z
-3,029b
Asymp. Sig. (2-tailed)
,002
a. Wilcoxon Signed Ranks Test
b. Based on positive ranks.
c. Based on negative ranks.

a

Ca3 - Ca1
-2,875b
,004

Ca3 - Ca2
-,104c
,917

Friedman Test
Ranks
Mean Rank
Fosfat sebelum pemberian
Niacinamide, mg/dl
Fosfat setelah pemberian
Niacinamide 4 minggu,
mg/dl
Fosfat setelah pemberian
Niacinamide 8 minggu,
mg/dl

2,56
2,12
1,32

Test Statisticsa
N
Chi-Square
df
Asymp. Sig.
a. Friedman Test

17
13,522
2
,001

General Linear Model
Within-Subjects Factors
Measure: MEASURE_1
Fosfat
Dependent Variable
1
Fosfat1
2
Fosfat2
3
Fosfat3

a

Effect
Fosfat

Pillai's Trace
Wilks' Lambda
Hotelling's Trace
Roy's Largest Root
a. Design: Intercept
Within Subjects Design: Fosfat
b. Exact statistic

Multivariate Tests
Value
F
Hypothesis df
,521
8,142b
2,000
,479
8,142b
2,000
1,086
8,142b
2,000
1,086
8,142b
2,000

Error df
15,000
15,000
15,000
15,000

Sig.
,004
,004
,004
,004

Universitas Sumatera Utara

68

Mauchly's Test of Sphericitya
Measure: MEASURE_1
Epsilonb
Within
Subjects
Approx. ChiGreenhouseEffect
Mauchly's W
Square
df Sig.
Geisser
Huynh-Feldt
Lower-bound
Fosfat
,814
3,093
2 ,213
,843
,931
,500
Tests the null hypothesis that the error covariance matrix of the orthonormalized transformed dependent
variables is proportional to an identity matrix.
a. Design: Intercept
Within Subjects Design: Fosfat
b. May be used to adjust the degrees of freedom for the averaged tests of significance. Corrected tests are
displayed in the Tests of Within-Subjects Effects table.

Tests of Within-Subjects Effects
Measure: MEASURE_1
Source
Fosfat

Error(Fosfat)

Sphericity Assumed
Greenhouse-Geisser
Huynh-Feldt
Lower-bound
Sphericity Assumed

Type III Sum of
Squares
18,867
18,867
18,867
18,867
29,559

Greenhouse-Geisser
Huynh-Feldt
Lower-bound

df
2
1,686
1,863
1,000
32

Mean Square
9,434
11,191
10,130
18,867
,924

29,559

26,974

1,096

29,559

29,800

,992

29,559

16,000

1,847

F
10,213
10,213
10,213
10,213

Tests of Within-Subjects Contrasts
Measure: MEASURE_1
Source
Fosfat
Error(Fosfat)

Fosfat
Linear
Quadratic
Linear

Type III Sum of
Squares
18,678
,190
20,132

Quadratic

9,427

df
1
1
16

Mean Square
18,678
,190
1,258

16

,589

Tests of Between-Subjects Effects
Measure: MEASURE_1
Transformed Variable: Average
Type III Sum of
Source
Squares
Df
Mean Square
Intercept
2834,354
1
2834,354
Error
121,600
16
7,600

F
372,942

F
14,844
,322

Sig.
,001
,578

Sig.
,000

Universitas Sumatera Utara

Sig.
,00
,00
,00
,00

69

Estimated Marginal Means
Fosfat
Estimates
Measure: MEASURE_1
Fosfat
1
2
3

Mean
8,153
7,541
6,671

95% Confidence Interval
Lower Bound
Upper Bound
7,384
8,922
6,674
8,408
5,596
7,745

Std. Error
,363
,409
,507

Pairwise Comparisons
Measure: MEASURE_1
Mean Difference
(I) Fosfat
(J) Fosfat
(I-J)
Std. Error
1
2
,612
,333
3
1,482*
,385
2
1
-,612
,333
*
3
,871
,259
3
1
-1,482*
,385
*
2
-,871
,259
Based on estimated marginal means
*. The mean difference is significant at the ,05 level.
b. Adjustment for multiple comparisons: Bonferroni.

Sig.b
,255
,004
,255
,012
,004
,012

95% Confidence Interval for
Differenceb
Lower Bound
Upper Bound
-,279
1,503
,454
2,511
-1,503
,279
,179
1,562
-2,511
-,454
-1,562
-,179

Multivariate Tests
Value
F
Hypothesis df
Error df
Pillai's trace
,521
8,142a
2,000
15,000
Wilks' lambda
,479
8,142a
2,000
15,000
Hotelling's trace
1,086
8,142a
2,000
15,000
Roy's largest root
1,086
8,142a
2,000
15,000
Each F tests the multivariate effect of Fosfat. These tests are based on the linearly
independent pairwise comparisons among the estimated marginal means.
a. Exact statistic

Sig.
,004
,004
,004
,004

General Linear Model
Within-Subjects Factors
Measure: MEASURE_1
Dependent
KalsiumxFosfat
Variable
1
CaxFosfat1
2
CaxFosfat2
3
CaxFosfat3

Effect
KalsiumxFosfat

Pillai's Trace
Wilks' Lambda
Hotelling's Trace
Roy's Largest Root

Multivariate Testsa
Value
F
,596
11,069b
,404
11,069b
1,476
11,069b
1,476
11,069b

Hypothesis df
2,000
2,000
2,000
2,000

Error df
15,000
15,000
15,000
15,000

a. Design: Intercept
Within Subjects Design: KalsiumxFosfat

Universitas Sumatera Utara

Sig.
,001
,001
,001
,001

70

b. Exact statistic
Mauchly's Test of Sphericity

a

Measure: MEASURE_1
Epsilonb
Within Subjects
Approx. ChiGreenhouseEffect
Mauchly's W
Square
df Sig.
Geisser
Huynh-Feldt
Lower-bound
KalsiumxFosfat
,803
3,300
2 ,192
,835
,921
,500
Tests the null hypothesis that the error covariance matrix of the orthonormalized transformed dependent variables
is proportional to an identity matrix.
a. Design: Intercept
Within Subjects Design: KalsiumxFosfat
b. May be used to adjust the degrees of freedom for the averaged tests of significance. Corrected tests are
displayed in the Tests of Within-Subjects Effects table.
Tests of Within-Subjects Effects
Measure: MEASURE_1
Source
KalsiumxFosfat

Error(KalsiumxFosfat)

Sphericity Assumed
Greenhouse-Geisser
Huynh-Feldt
Lower-bound
Sphericity Assumed

Type III Sum of
Squares
2921,928
2921,928
2921,928
2921,928
3065,571

2
1,670
1,842
1,000
32

Mean Square
1460,964
1749,487
1586,448
2921,928
95,799

Greenhouse-Geisser

3065,571

26,723

114,718

Huynh-Feldt

3065,571

29,469

104,027

Lower-bound

3065,571

16,000

191,598

df

F
15,250
15,250
15,250
15,250

Sig.
,000
,000
,000
,001

Tests of Within-Subjects Contrasts
Measure: MEASURE_1
Source
KalsiumxFosfat
Error(KalsiumxFosfat)

KalsiumxFosfat
Linear
Quadratic
Linear
Quadratic

Type III Sum of
Squares
2907,275
14,653
2057,088

df

1008,483

Tests of Between-Subjects Effects
Measure: MEASURE_1
Transformed Variable: Average
Type III Sum of
Source
Squares
df
Mean Square
Intercept
244165,283
1
244165,283
Error
9144,786
16
571,549

F
427,199

1
1
16

Mean Square
2907,275
14,653
128,568

16

63,030

Sig.
,000

Universitas Sumatera Utara

F
22,613
,232

Sig

71

Estimated Marginal Means
KalsiumxFosfat
Estimates
Measure: MEASURE_1
KalsiumxFosfat
1
2
3

Mean
78,818
68,434
60,324

Std. Error
3,339
3,551
4,597

95% Confidence Interval
Lower Bound
Upper Bound
71,739
85,897
60,906
75,962
50,580
70,069

Pairwise Comparisons
Measure: MEASURE_1
(I)
Kalsium
xFosfat
1

Mean Difference
(J) KalsiumxFosfat
(I-J)
Std. Error
*
2
10,384
3,480
3
18,494*
3,889
2
1
-10,384*
3,480
3
8,110*
2,564
3
1
-18,494*
3,889
2
-8,110*
2,564
Based on estimated marginal means
*. The mean difference is significant at the ,05 level.
b. Adjustment for multiple comparisons: Bonferroni.

Sig.b
,026
,001
,026
,018
,001
,018

95% Confidence Interval for
Differenceb
Lower Bound
Upper Bound
1,081
19,687
8,098
28,890
-19,687
-1,081
1,256
14,964
-28,890
-8,098
-14,964
-1,256

Multivariate Tests
Value
F
Hypothesis df
Error df
Sig.
Pillai's trace
,596
11,069a
2,000
15,000
,001
Wilks' lambda
,404
11,069a
2,000
15,000
,001
Hotelling's trace
1,476
11,069a
2,000
15,000
,001
Roy's largest root
1,476
11,069a
2,000
15,000
,001
Each F tests the multivariate effect of KalsiumxFosfat. These tests are based on the linearly
independent pairwise comparisons among the estimated marginal means.
a. Exact statistic

Friedman Test
Ranks
Trombosit sebelum pemberian Niacinamide, mg/dl
Trombosit setelah pemberian Niacinamide 4 minggu, mg/dl
Trombosit setelah pemberian Niacinamide 8 minggu, mg/dl

Mean Rank
1,91
1,94
2,15

Test Statisticsa
N
Chi-Square
df
Asymp. Sig.
a. Friedman Test

17
,567
2
,753

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72

Friedman Test
Ranks
SGOT sebelum pemberian Niacinamide, mg/dl
SGOT setelah pemberian Niacinamide 4 minggu, mg/dl
SGOT setelah pemberian Niacinamide 8 minggu, mg/dl

Mean Rank
2,32
2,03
1,65

Test Statisticsa
N
Chi-Square
df
Asymp. Sig.
a. Friedman Test

17
4,290
2
,117

Friedman Test
Ranks
SGPT sebelum pemberian Niacinamide, mg/dl
SGPT setelah pemberian Niacinamide 4 minggu, mg/dl
SGPT setelah pemberian Niacinamide 8 minggu, mg/dl

Mean Rank
2,06
2,29
1,65

Test Statisticsa
N
Chi-Square
df
Asymp. Sig.
a. Friedman Test

17
3,815
2
,148

Friedman Test
Ranks
HDL sebelum pemberian Niacinamide, mg/dl
HDL setelah pemberian Niacinamide 4 minggu, mg/dl
HDL setelah pemberian Niacinamide 8 minggu, mg/dl

Mean Rank
2,00
1,88
2,12

Test Statisticsa
N
Chi-Square
df
Asymp. Sig.
a. Friedman Test

17
,492
2
,782

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General Linear Model
Within-Subjects Factors
Measure: MEASURE_1
LDL
Dependent Variable
1
LDL1
2
LDL2
3
LDL3
Multivariate Testsa
Value
F
Hypothesis df
,062
,492b
2,000
,938
,492b
2,000
,066
,492b
2,000
,066
,492b
2,000

Effect
LDL

Pillai's Trace
Wilks' Lambda
Hotelling's Trace
Roy's Largest Root
a. Design: Intercept
Within Subjects Design: LDL
b. Exact statistic

Error df
15,000
15,000
15,000
15,000

Sig.
,621
,621
,621
,621

Mauchly's Test of Sphericitya
Measure: MEASURE_1
Epsilonb
Within Subjects
Approx. ChiGreenhouseEffect
Mauchly's W
Square
df Sig.
Geisser
Huynh-Feldt
Lower-bound
LDL
,976
,360
2 ,835
,977
1,000
,500
Tests the null hypothesis that the error covariance matrix of the orthonormalized transformed dependent variables is
proportional to an identity matrix.
a. Design: Intercept
Within Subjects Design: LDL
b. May be used to adjust the degrees of freedom for the averaged tests of significance. Corrected tests are displayed
in the Tests of Within-Subjects Effects table.

Tests of Within-Subjects Effects
Measure: MEASURE_1
Source
LDL

Error(LDL)

Sphericity Assumed
Greenhouse-Geisser
Huynh-Feldt
Lower-bound
Sphericity Assumed

Type III Sum of
Squares
143,569
143,569
143,569
143,569
4547,765

Greenhouse-Geisser

df
2
1,954
2,000
1,000
32

Mean Square
71,784
73,486
71,784
143,569
142,118

4547,765

31,259

145,486

Huynh-Feldt

4547,765

32,000

142,118

Lower-bound

4547,765

16,000

284,235

F
,505
,505
,505
,505

Tests of Within-Subjects Contrasts
Measure: MEASURE_1
Source
LDL
Error(LDL)

LDL
Linear
Quadratic
Linear

Type III Sum of
Squares
,029
143,539
2296,471

Quadratic

2251,294

df
1
1
16

Mean Square
,029
143,539
143,529

16

140,706

F
,000
1,020

Sig.
,989
,328

Universitas Sumatera Utara

Sig.
,608
,604
,608
,487

74

Tests of Between-Subjects Effects
Measure: MEASURE_1
Transformed Variable: Average
Type III Sum of
Source
Squares
df
Mean Square
Intercept
502428,314
1
502428,314
Error
23740,353
16
1483,772

F
338,616

Sig.
,000

Estimated Marginal Means
LDL
Estimates
Measure: MEASURE_1
LDL
1
2
3

Mean
100,412
96,882
100,471

Std. Error
6,035
5,356
6,236

95% Confidence Interval
Lower Bound
Upper Bound
87,617
113,206
85,529
108,236
87,250
113,691

Pairwise Comparisons
Measure: MEASURE_1
Mean Difference
(I) LDL
(J) LDL
(I-J)
Std. Error
1
2
3,529
4,343
3
-,059
4,109
2
1
-3,529
4,343
3
-3,588
3,796
3
1
,059
4,109
2
3,588
3,796
Based on estimated marginal means
a. Adjustment for multiple comparisons: Bonferroni.

Sig.a
1,000
1,000
1,000
1,000
1,000
1,000

95% Confidence Interval for
Differencea
Lower Bound
Upper Bound
-8,079
15,138
-11,043
10,925
-15,138
8,079
-13,736
6,560
-10,925
11,043
-6,560
13,736

Multivariate Tests
Value
F
Hypothesis df
Error df
Sig.
a
Pillai's trace
,062
,492
2,000
15,000
,621
a
Wilks' lambda
,938
,492
2,000
15,000
,621
Hotelling's trace
,066
,492a
2,000
15,000
,621
Roy's largest root
,066
,492a
2,000
15,000
,621
Each F tests the multivariate effect of LDL. These tests are based on the linearly independent
pairwise comparisons among the estimated marginal means.
a. Exact statistic

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75

LAMPIRAN 7

DAFTAR RIWAYAT HIDUP

I.

Identitas Pribadi
Nama
Tempat/Tgl Lahir
Suku/Bangsa
Agama
Alamat

II. Keluarga
Suami
Anak

: dr. Meivina Ramadhani Pane
: Medan / 15 Mei 1986
: Mandailing / Indonesia
: Islam
: Jl. Suka Ramai No.4 Medan

: Lettu CKM dr. Esra Julianda Bangun
: Rafif Ravi Ahza Bangun

III. Pendidikan
SD Taman Harapan, Medan
SLTP Sutomo 1, Medan
SMU Sutomo 1, Medan
Fakultas Keddokteran USU

Tamat Tahun 1997
Tamat Tahun 2000
Tamat Tahun 2003
Tamat Tahun 2008

IV. Riwayat Pekerjaan
Dokter jaga RSU Bina kasih Medan tahun 2009

V. Perkumpulan Profesi
IDI Medan
PAPDI Sumut
VI. Journal Reading:
1. Pandit S, Chaudhuri AD, Datta SBS, Dey A, Bhanja P. Role of
pleural biopsy in etiological diagnosis of pleural effusion. Lung
India J. 2010;27:202-204
2. Lynch KE, Lynch R, Curhan GC, Brunelli SM. Prescribed dietary
phosphate restriction & survival among hemodialysis patients. Clin
J Am Soc Nephrol. 2011;6:620-629
3. Mitwalli AH, Alam AA, Wakeel JS, Isnani AC. Dyslipidemia in
dialysis patients. Saudi J Kidney Dis Transpl 2011;22:689-694

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4. De-Madaria E, Soler-Sala G, Lopez-font I, et al. Influence of fluid
therapy on the prognosis of the acute pancreatitis: a prospective
cohort study. Am J Gastroenterol. 2011;106:1843-1850
5. Zirpoli JC, Lacerda HR, Albuquerqu VMG, et al. Angina pectoris in
patients with HIV/AIDS: prevalence & risk factors. Braz J Infect
Dis. 2012;16:1-8
6. Kabadi SM, Lee BK, Liu L. Joint effects of obesity and vit D
insufficiency on insulin resistance and type 2 diabetes. Diabetes
Journal. 2012;1-6
7. Al-Amran FG, Zwain AMH, Al-Mudhaffer AM. Autonomic cerebral
vascular respone to sildenafil in diabetic patient. Diabetology &
Metabolic syndrome. 2012;4:1-7
8. Herzig K, Purhonen A, Rasanen KM, Idziak J, Juvonen P, Phillps
R, Walkowiak J. Fecal elastase-1 levels in older individuals without
known gastrointestinal diseases or diabetes melitus. BMC
geriatrics. 2011;11:1-5
9. Xiaoshan S, Hongyun L. Anticoagulan therapy in patients with
COPD in the acute exacerbation stage. 2013;5(5):1367-1370
10. Fujiyoshi A, Murad MH, Luna M, Rosario A, Ali S, Paniagua D et
al. Metabolic syndrome & its components are underdiagnosed in
cardiology clinic. J Eval Clin Pract. 2011;17(1):78-83
VII. Tulisan Ilmiah
1. Pemberian kembali OAT pada penderita hepatitis imbas obat
akibat OAT.
2. Nefritis Lupus: klinis & diagnosis.
3. Akut miokard infark dengan elevasi segmen ST.
4. Penatalaksanaan kanker gaster.
5. Koinfeksi hepatitis C pada pasien HIV/AIDS.
6. Vitamin D dan kardiovaskular.
7. Depresi pada usia lanjut.
8. Kandung kemih hiperaktif pada usia lanjut.
9. Heparin induced trombocytopenia.
10. Artritis Septik

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VIII.

Publikasi Ilmiah
1. Pane MR, Sembiring E, Marpaung S, Ginting F, Kembaren T,
Rahimi A, Ginting J. Analisis survival 24 bulan pada pasien
HIV/AIDS yang mendapatkan ARV berdasarkan CD4 awal di RS.
Haji Adam Malik Medan. Kongres Nasional PETRI XVIII, Banda
Aceh, 2012
2. Pane MR, Susilo T, Safri Z, Lubis AR. Pengaruh terapi
hemodialisis reguler terhadap kejadian hipertensi pulmonal.
Annual Meeting of Nephrology PERNEFRI, Bali, 2012.

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