End Stage Renal Disease

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PERBEDAAN KADAR MONOSIT PRE DAN POST HEMODIALISIS PADA PASIEN END STAGE RENAL DISEASE (ESRD) DI RSUD Dr. H. ABDUL MOELOEK BANDAR LAMPUNG

PERBEDAAN KADAR MONOSIT PRE DAN POST HEMODIALISIS PADA PASIEN END STAGE RENAL DISEASE (ESRD) DI RSUD Dr. H. ABDUL MOELOEK BANDAR LAMPUNG

Penurunan jumlah nefron akibat mekanisme apapun menyebabkan perubahan struktur dan fungsi dari nefron yang tersisa. Perubahan ini dimediasi oleh molekul vasoaktif terutama renin angiotensin system (RAS), sitokin dan growth factor. Ginjal akan meningkatkan aliran kapiler menuju glomerulus non sklerotik sebagai usaha untuk mempertahankan GFR. Namun terjadi hiperfiltrasi akibat hipertensi intraglomerulus dan semakin berkembangnya sklerosis pada glomerulus yang masih tersisa. Akibatnya terjadi penurunan GFR yang progresif, proteinuria, kecenderungan hipertensi, dan penyusutan ginjal. Proses ini terus berlanjut sampai ginjal tidak mampu lagi untuk melakukan filtrasi darah dari toksin dan zat-zat yang tidak diperlukan lagi oleh tubuh. Tahap terakhir ini dinamakan end-stage renal disease (ESRD) (Lewis, 2009).
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TESIS PENGARUH MOTIVATIONAL INTERVIEWING DENGAN PENDEKATAN SPIRITUAL TERHADAP KEPUTUSASAAN DAN MOTIVASI SEMBUH PASIEN END STAGE RENAL DISEASE YANG MENJALANI HEMODIALISIS REGULER

TESIS PENGARUH MOTIVATIONAL INTERVIEWING DENGAN PENDEKATAN SPIRITUAL TERHADAP KEPUTUSASAAN DAN MOTIVASI SEMBUH PASIEN END STAGE RENAL DISEASE YANG MENJALANI HEMODIALISIS REGULER

Introduction: Various problems that arise due to kidney malfunction in the client with terminal renal failure above can result in despair and decreased motivation to recover. One way to overcome this problem is by motivational interviewing with a spiritual approach (gratitude, patience and sincerity). The purpose of this research was to identify the effects of motivational interviewing with spiritual approach on despair and recovery motivation of esrd patients who have undergone regular hemodialysis. Methods: This research used quasi experiment with pre- post test and posttest only design with control group design. Technical sampling by using simple method. The research sample were 32 respondents based on the inclusion criteria. The intervention was carried out for 4 weeks with 2 meetings / week. The independent variable of this study was motivational interviewing with a spiritual approach . The independent variable were despair and recovery motivation. This research used a questionnaire instrument to measure despair and recovery motivation and the validity and reliability tests have been conducted previously. Statistical tests have used paired t test, independent t test, mann whitney and wilcoxon signed rank test. Results: The result of statistical test showed that MI with spiritual approach has effected on decrease anxiety (p=0,001) and an improvement in recovery motivation (p = 0.001). Discussions: MI intervention assists patients in identifying, evaluating and responding to their deformities and beliefs. Helping patients develop a rational mindset, engage in reality testing, and reshape form behavior by changing internal messages. Conclusion: MI interventions with spiritual approaches have an effect on reducing despair and increasing recovery motivation in ESRD patients with regular HD. Suggestion: this research can be the initial data in conducting further research on one form of cognitive intervention (MI) with a spiritual approach in dealing with various psychological problems.
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17 PENGARUH EDUKASI PENDEKATAN SPIRITUAL BERBASIS VIDEO TERHADAP KEPATUHAN PEMBATASAN CAIRAN KLIEN ESRD YANG MENJALANI HEMODIALISA

17 PENGARUH EDUKASI PENDEKATAN SPIRITUAL BERBASIS VIDEO TERHADAP KEPATUHAN PEMBATASAN CAIRAN KLIEN ESRD YANG MENJALANI HEMODIALISA

Menurut peneliti responden dengan jenis kelamin laki-laki lebih memiliki resiko yang lebih besar untuk mengalami End Stage Renal Disease karena pola dan gaya hidup laki-laki kurang baik dibandingkan dengan pola dan gaya hidup perempuan, dimana laki-laki mempunyai kebiasaan merokok, mengkonsumsi alkohol, mengkonsumsi minuman suplemen serta laki-laki memilki kadar kretinin yang lebih tinggi dari perempuan dimana hal ini dapat memperberat dari fungsi ginjal sebagai proses filtrasi, reabsorbsi, sekresi dan eksresi. Hal ini jika tidak mendapatkan perhatian khusus akan menyebabkan responden laki-laki memiliki resiko mengalami End Stage Renal Disease. Hasil penelitian ini juga menunjukkan bahwa klien yang mengalami End Stage Renal Disease yang menjalani terapi hemodialisa dilihat dari distribusi frekuensi tingkat pendidikan responden sebagian besar responden tingkat pendidikannya rendah yakni 12 klien (54,5%) sedangkan yang berpendidikan tinggi yakni 10 klien (45,5%).Hasil penelitian ini sejalan dengan penelitian yang dilakukan oleh Hanum, dkk (2015) dengan judul pengaruh pendidikan kesehatan secara individual tentang pembatasan asupan cairan terhadap pengetahuan pembatasan cairan dan IDWGklien hemodialisa. Dimana responden dengan tingkat pendidikan rendah berjumlah 24 (80%) sedangkan responden dengan tingkat pendidikan tinggi berjumlah 6 (20%).Secara umum seseorang yang memiliki tingkat pendidikan tinggi akan mempunyai pengetahuan luas dibandingkan dengan seseorang yang tingkat pendidikannya lebih rendah. Keyakinan biasanya diperoleh secara turun temurun dan tanpa adanya pembuktian terlebih dahulu, keyakinan ini dapat mempengaruhi pengetahuan seseorang baik keyakinan yang sifatnya positif maupun negatif (Notoadmojo, 2012).
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Gambaran Pasien Rawat Inap Diabetic Kidney Disease Di Rumah Sakit Immanuel Bandung Periode Oktober 2010 - September 2011.

Gambaran Pasien Rawat Inap Diabetic Kidney Disease Di Rumah Sakit Immanuel Bandung Periode Oktober 2010 - September 2011.

Tujuan dari karya tulis ilmiah ini adalah mengetahui prevalensi DKD dan ESRD (end stage renal disease) serta gambaran tipe diabetes, kolesterol total, LDL, tekanan darah, HbA1c, indeks massa tubuh (IMT), dan stadium nefropati pada pasien diabetes rawat inap di Rumah Sakit Immanuel Bandung periode Oktober 2010 – September 2011.

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Cost Effectiveness Analysis Between Hemodialysis and Peritoneal Dialysis

Cost Effectiveness Analysis Between Hemodialysis and Peritoneal Dialysis

The number of patients with End Stage Renal Disease (ESRD) in Indonesia is growing. Increasing prevalence of hypertension and diabe- tes mellitus contributes to higher prevalence of ESRD. The majority of patients (94%) with ESRD are undertaking hemodialysis (HD) at public and private hospitals. However, continuous ambulatory Peritoneal Dialysis (PD) has been prescribed to small portion of patients with ESRD. The aim of this study was to examine the cost effectiveness between HD and PD on ESRD patients. This study compared 78 HD patients at Hospital X in Bogor and 10 PD patients at Hospital Y in Jakarta. Patient’s quality of life (QoL) was measured using SF 36 questionnaires. The costs were measured by direct medical costs using CBGs prices, direct non-medical costs (transportation, food for patient and family), and indirect medical costs (opportunity costs). The study found that the HD cost per year per patient was IDR 133.4 million and the comparative cost for PD was IDR 81.7 million. The study found lower QoL of HD patients (46.2%) com- pared to QoL of PD patients (90%). In addition, PD patients had significant better quality of physical activities, emotional states, social function, and sanity. The study found the incremental costs for to HD to reach similar emotional states was IDR 2.0 million compared to PD and IDR 1.8 million for extra physical role gained. It is concluded that PD was more cost-effective than HD in achieving a certain level of quality of life among patients with ESRD in two hospitals in Indonesia.
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Hubungan Kadar High-Sensitivity C-Reactive Protein Dengan Gangguan Tidur Dan Depresi Pada Penderita Nyeri Punggung Bawah

Hubungan Kadar High-Sensitivity C-Reactive Protein Dengan Gangguan Tidur Dan Depresi Pada Penderita Nyeri Punggung Bawah

Bilgic, A., Ibis, A., Tutal, E., Koc, S., Sezer, S. and Ozdemir, N. 2012. Association of Nutritional Status with Depression and Sleep Disorders in Elderly End Stage Renal Disease Patients - Does Chronic Inflammation Cause It All? Turkish Nephrology, Dialysis and Transplantation Journal. 21(2): 148-155

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Pemberian Ekstrak Etanol Daun Salam untuk Menurunkan Ekspresi Laminin Mesangial Tikus Sprague Dawley DM - Diponegoro University | Institutional Repository (UNDIP-IR)

Pemberian Ekstrak Etanol Daun Salam untuk Menurunkan Ekspresi Laminin Mesangial Tikus Sprague Dawley DM - Diponegoro University | Institutional Repository (UNDIP-IR)

32. Bonke VT, Lindschau C, Rizkalla B, et al. Attenuation of extracellular matrix accumulation in diabetic nephropathy by the advanced glycation end product cross-link breaker ALT-711 via a protein kinase C- α dependent pathway . Diabetes. 2004 : 2921-2930.

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Directory UMM :Data Elmu:jurnal:A:Atherosclerosis:Vol154.Issue1.Jan2001:

Directory UMM :Data Elmu:jurnal:A:Atherosclerosis:Vol154.Issue1.Jan2001:

All patients and control subjects were included in the computations regardless of renal function, which was considered by adjustment for estimated creatinine clear- ance [23] in the statistical analysis. Unpaired compari- sons were tested by the Mann – Whitney U-test. The relationship between pairs of variables was tested by linear regression analysis and/or multiple regression analysis. Adjustments for age, gender, estimated crea- tinine clearance and/or homocysteine as well as the influence of diseases, gender or smoking on methionine metabolites were tested by multifactorial analysis (ANOVA). P-values B 0.05 were considered signifi- cant. These tests were performed with the software package Student SYSTAT 1.0 for windows (SYSTAT Inc., Evanston, IL, USA). Logistic regression analysis (odds ratio (OR)) was performed using the PROC PROBIT procedure with the SAS software package. Unless indicated otherwise values are expressed as the medians (95% range).
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Calcific Uremic  pada Endstage Renal Disease | Rakhmadhan | Cermin Dunia Kedokteran 1 SM

Calcific Uremic pada Endstage Renal Disease | Rakhmadhan | Cermin Dunia Kedokteran 1 SM

Calcific uremic arteriolopathy (CUA) merupakan salah satu komplikasi end-stage renal disease (ESRD), yang dapat meningkatkan morbiditas dan mortalitas. Faktor risiko CUA antara lain jenis kelamin (wanita), diabetes melitus, hiperfosfatemia, ESRD, gangguan mineral dan tulang, obesitas, warfarin, dan etnis Kaukasia. Gold standard diagnosis adalah penemuan patognomonik histopatologis spesimen biopsi kulit. Tatalaksana meliputi penanganan umum, perawatan luka, koreksi abnormalitas biokimia, sodium tiosulfat, dan beberapa terapi potensial seperti bisfosfonat, low- molecular-weight heparin, dan agen trombolitik. CUA berpotensi fatal, diagnosis sedini mungkin dan tatalaksana yang tepat dapat memperbaiki kondisi dan memberikan hasil memuaskan.
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Perbedaan estimasi LFG dan kesesuaian dosis antibiotik pasien rawat inap RSUD Panembahan Senopati berdasarkan formula MDRD dan CKD-EPI.

Perbedaan estimasi LFG dan kesesuaian dosis antibiotik pasien rawat inap RSUD Panembahan Senopati berdasarkan formula MDRD dan CKD-EPI.

Abstrak : Penilaian akurat terhadap fungsi ginjal adalah suatu hal penting dalam dunia kesehatan salah satunya dalam penentuan dosis obat-obatan. Fungsi ginjal dapat dilihat melalui nilai estimasi Laju Filtrasi Glomerulus (eLFG). Besarnya nilai eLFG ini dapat dihitung berdasarkan 2 formula yaitu Modification of Diet in Renal Disease (MDRD) dan Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Obat antibiotik merupakan salah satu obat yang banyak digunakan di masyarakat. Beberapa antibiotik dieliminasi di ginjal dan memerlukan penyesuaian dosis. Penelitian ini bertujuan untuk melihat perbedaan nilai eLFG dari kedua formula ini serta perbedaan proporsi kesesuaian dosisnya. Terdapat 290 pasien dengan 394 data serum kreatinin dan 573 peresepan antibiotik. Penelitian ini merupakan jenis observasional analitik dengan rancangan cross- sectional. Terdapat 23 (9,31%) kasus peresepan antibiotik memiliki dosis belum tepat berdasarkan nilai eLFG formula MDRD dan 24 (9,72%) peresepan berdasarkan nilai eLFG formula CKD-EPI. Uji Mann Whitney pada 394 data eLFG didapatkan bahwa tidak ada perbedaan antara nilai eLFG yang dihitung berdasarkan formula MDRD dan CKD-EPI (p=0,93). Uji Chi-Square (p=0,878) menunjukkan tidak ada perbedaan bermakna proporsi kesesuaian dosis antara 2 formula. Hasil ini bermakna bahwa klinisi dapat menggunakan formula MDRD atau CKD-EPI karena keduanya memiliki hasil eLFG dan kesesuaian dosis antibiotika yang sama.
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Nephrology Services Operational Policy

Nephrology Services Operational Policy

For hospitals without resident nephrologists and health clinics with affiliated satellite haemodialysis units, the general medical care of the nephrology and dialysis patients shall be supervised by the Physician/Family Medicine Specialist/medical officer of the hospital/clinic and he/she shall liaise with the senior nephrologist in the state on any matter relating to the clinical care of renal patients. The state nephrologist (or the national advisor in states without nephrologists) shall arrange for a nephrologist to periodically visit the district hospitals and health clinics without nephrologist to review patients. Hospital Directors/Family Medicine Specialists shall appoint a medical officer to be responsible for the day-to-day care of dialysis patients, including the provision of emergency coverage.
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Correlation between cystasin C to disease severity of cirrhosis on model of end stage liver disease score | Gunadi | Acta Interna: The Journal of Internal Medicine 3864 11519 1 PB

Correlation between cystasin C to disease severity of cirrhosis on model of end stage liver disease score | Gunadi | Acta Interna: The Journal of Internal Medicine 3864 11519 1 PB

B a c k g r o u n d : T h e p re v a l e n c e o f osteoarthritis (OA) in the community is high. This disease is the second most common cause of physical disability worldwide. Pain in OA is caused by several factors, such as inflammation. Non steroidal anti-inflammatory drugs (NSAIDs) were the most common drugs given worldwide to reduce pain in OA. NSAIDs were also associated with a high incidence of gastrointestinal side effects. An alternative to manage this problem is by using the combination of Curcuma xantorrhyza Roxb. (commonly known as temulawak) extract, ginger (Zingiber officinale) extract, soybean (Glycine max), and shrimp shell. Curcuma xantorrhyza contains curcumin which has anti-inflammatory effect by suppressing cyclo-oxygenase (COX-2) enzyme activity, suppressing lipo-oxygenase enzyme activity, and play a role as a free radical scavenger. Ginger can inhibit COX-2 activity in PGE-2 production. Shrimps shell contains glucosamine and chondroitin which can increase proteoglycan in articular chondrocytes and inhibit COX-2 synthesis. Isoflavone in soybean can inhibit articular cartilage degradation and COX-2 synthesis.
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Analisis pengobatan antihipertensi pada geriatri berdasarkan laju filtrasi glomerulus dengan formula Modification of Diet in Renal Disease (MDRD) di rumah sakit Kabupaten Bantul periode 2009 - USD Repository

Analisis pengobatan antihipertensi pada geriatri berdasarkan laju filtrasi glomerulus dengan formula Modification of Diet in Renal Disease (MDRD) di rumah sakit Kabupaten Bantul periode 2009 - USD Repository

Sica (cit., Nasution, 2001) mengemukakan beberapa penelitian yang menunjukkan OAH yang seluruhnya dieliminasi melalui ginjal akan menumpuk pada penderita dengan gangguan fungsi ginjal, sehingga akan lebih memperberat fungsi ginjal, oleh karena itu diperlukan penyesuaian dosis, sedangkan OAH yang tidak seluruhnya dieliminasi melalui ginjal dapat bersifat lebih renoprotektif. Dalam penelitian tentang Atherosclerotic Renal Artery Stenosis (ARAS), 108 pasien yang beresiko ARAS yang menerima pengobatan antihipertensi berupa ACE inhibitor mengalami kenaikan kreatinin serum sebesar 20% (Mactier, 2006).
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Survival of borderline tumors of the ovary and its prognostic factors at Dr. Cipto Mangunkusumo hospital from 1990 to 1999

Survival of borderline tumors of the ovary and its prognostic factors at Dr. Cipto Mangunkusumo hospital from 1990 to 1999

Sixty-two patients with borderline tumors of ovary were historical cohort analyzed for survival characteristics. There were 9 patients with FIGO stage IA, 9 with stage IC, 3 with stage IIIA, 2 with stage IIIB, 4 with stage IIIC, 1 with stage IV and 34 with inadequate stage tumors. Twenty one patients had surgical staging with radical surgery, 10 patient had at least a total abdominal hysterectomy and bilateral salpingo-oophorectomy, 6 patient had surgical staging with conservative surgery, 24 patient had at least a unilateral salphingo-oophorectomy or ovarian cystectomy and 1 patient had biopsy. Sixteen patients received cisplatin-based combination chemotherapy, that were 8 with inadequate stage tumors, 7 with stage III tumors and 1 with stage IV tumor. Follow-up range from 0.02 to 10.48 years, with a median of 3.5 years. Fifty nine patient were alive. Three patients died, all of disease. Recurrence were found in 4 patients. The overall 2-years survival rate was 96% and 10-years survival rate was 94%. In log rank test, residual disease and histology type were significant predictor of survival. (Med J Indones 2002; 11:222-9)
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Predictors of end stage lung disease in a cohort of patients with scleroderma

Predictors of end stage lung disease in a cohort of patients with scleroderma

echocardiographic features, with resting peak pulmonary arterial pressure above 30 mm Hg (plus right atrial pressure) and associated reduction in T lco to <70% predicted. In many cases the diagnosis was further confirmed by right heart catheterisation, with resting or exercise associated mean pulmonary arterial pressure above 25 or 30 mm Hg, respectively. Isolated pulmonary hypertension was determined by these changes in the absence of significant lung fibrosis. Vital status at the end of December 1997 was determined for all patients. Two reviewers (CMB, AJS) inspected the death certificates obtained from the UK National Health Service Central Register. Patient death was attributed to a
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Gambaran Tekanan Darah Pasien Saat Menjalani Hemodialisis di RSUP Haji Adam Malik Medan

Gambaran Tekanan Darah Pasien Saat Menjalani Hemodialisis di RSUP Haji Adam Malik Medan

United States Renal Data System (USRDS). (2011). Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases , Bethesda, MD, 201

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Korelasi Kadar Albumin dengan Indeks Massa Tubuh pada Penderita Gagal Ginjal Kronik di RSUP H. Adam Malik Medan Tahun 2014

Korelasi Kadar Albumin dengan Indeks Massa Tubuh pada Penderita Gagal Ginjal Kronik di RSUP H. Adam Malik Medan Tahun 2014

Espahbodi, F., Khoddad, T., Esmaeili, L., 2014. Evaluation of Malnutrition and its Association With Biochemical Parameters in Patients With End Stage Renal Disease Undergoing Hemodialysis Using Subjective Global Assessment. Nephro Urol Mon., 6(3): e16385.

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Prevalensi dan Faktor Risiko Penyakit Ginjal Kronis Yang Menjalani Hemodialisa di RSUP Haji Adam Malik Medan Periode 2014-2015.

Prevalensi dan Faktor Risiko Penyakit Ginjal Kronis Yang Menjalani Hemodialisa di RSUP Haji Adam Malik Medan Periode 2014-2015.

18. Chen Wei, Lm Q, Wang H, Chen Weiqmg, Johnson RJ, Dong X, Li H, Ba S, Tan J, Luo N. He H, Yu H. Prevalence and risk faktor of chronic kidney disease : a population study in the Tibetan population. Nephrol dial transplant, October 12, 2010.

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Comparison of Estimated Glomerular Filtration Rate Mean Value of HARUS 15-30-60, HADI, and ASIAN Fomula Accuracy in Diabetes Mellitus Type 2 | Rachmayati | International Journal of Integrated Health Sciences 403 1272 1 PB

Comparison of Estimated Glomerular Filtration Rate Mean Value of HARUS 15-30-60, HADI, and ASIAN Fomula Accuracy in Diabetes Mellitus Type 2 | Rachmayati | International Journal of Integrated Health Sciences 403 1272 1 PB

Methods: The Kidney Dialysis Outcome Quality Initiative (KDOQI) has published a guideline to measure renal function, which is based on glomerular filtration rate (GFR). This procedure is complicated and expensive, therefore an estimated GFR (eGFR) has been proposed. The modification of diet in renal disease (MDRD) study prediction equation is the most frequently eGFR used. This method still have a weakness in accuracy, so the chronic kidney disease epidemiology collaboration (CKD-EPI) formula is developed. Since CKD-EPI is not practical for daily use, the MDRD is published for Asian population that includes Ch-E, Jp-E, and Th-E. In Indonesia, the MDRD formula has not been validated using any gold standard, therefore 2 new formulas have been developed, i.e. HARUS 15-30-60 and HADI formulas. In this study, we analyzed 102 medical records of Diabetes Mellitus Type 2 (DMT2) patients who visited Dr. Hasan Sadikin General Hospital, Bandung during the period of 2012 to 2013. We analyzed the data using HARUS 15-30-60, HADI, Asian formulas, and then compared them to CKD-EPI to see the accuracy. Statistical analysis used was paired t-test in SPSS-17 program.
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Gagal ginjal stadium akhir End Stage Ren

Gagal ginjal stadium akhir End Stage Ren

Pada gagal ginjal akut, dokter akan berusaha memperbaiki aliran darah ke ginjal (prerenal), menghentikan penggunaan obat-obatan yang merusak ginjal (renal) atau mengangkat sumbatan pada saluran kencing pasien (postrenal). Jika diperlukan, mungkin dokter akan menyarankan untuk melakukan cuci darah untuk membuang zat-zat sisa metabolisme yang tertimbun di dalam tubuh.

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