Pengaruh Pemberian Curcumin Terhadap Perbaikan Gangguan Pendengaran pada Pasien Penyakit Ginjal Kronik Hemodialisis Reguler Ditinjau dari Pemeriksaan Otoacoustic Emission, Audiometri Nada Murni dan Kadar Indoxyl Sulfate di RSUP H. Adam Malik Medan

Abstract

Introduction: Chronic kidney disease (CKD) is a disorder of kidney structure or function that occurs for >3 months and has an impact on health. Waste products of metabolism by the kidneys cause the circulation of these toxic materials in the body. This can cause damage to tissues and organ systems including the hearing system. Uremic toxins which are commonly found in CKD patients can cause oxidative stress and cause complications of CKD. Curcumin has antioxidant, anti-inflammatory, and antiapoptotic effects that have the potential to be used to protect against complications of CKD. Methods: This study was conducted on 48 chronic kidney failure patients who were divided into 3 groups, namely the placebo group, the group of subjects given 500 mg curcumin and the group of subjects given 1000 mg curcumin given for 12 weeks. Each group consisted of 16 patients. OAE and pure tone audiometry examinations were carried out at the Haji Adam Malik General Hospital, Medan, while Indoxyl sulfate level examinations will be carried out at the Integrated Lab of the USU Faculty of Medicine. Data analysis was performed using univariate analysis by looking at the mean and standard deviation for each group. Results: There was a significant decrease in Indoxyl sulfate levels in the 500 mg curcumin group (P = 0.008) and the placebo group (P = 0.019). In the hearing function results, there was a significant decrease in the SNR results of the 500 mg curcumin group at three frequencies of 2 kHz (P = 0.003), 8 kHz (0.018), 10 kHz (P = 0.042) and the 1000 mg curcumin group at 4 frequencies of 1.5 kHz (P = 0.023), 2 kHz (P = 0.019), 3 kHz (P = 0.009), 10 kHz (P = 0.028). There was a significant increase in hearing threshold in all three treatment groups (P = 0.001) with the lowest median increase of 0.21 dB in the 500 mg group. Conclusion: Curcumin can play a role in preventing the deterioration of hearing function in PGK patients as seen from the SNR value and hearing threshold by reducing Indoxyl sulfate levels.