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KARYA TULIS AKHIR
PENGARUH PEMBERIAN EKSTRAK KUNCUP BUNGA ROSELA
(Hibiscus sabdariffa) TERHADAP PENCEGAHAN KERUSAKAN
TUBULUS GINJAL TIKUS PUTIH STRAIN WISTAR (Rattusnorvegicus
strain wistar) MODEL BATU GINJAL
Oleh:
YULFIA DWI WIGDA ARUMSARI
201610330311083
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2020
ii
HASIL PENELITIAN
PENGARUH PEMBERIAN EKSTRAK KUNCUP BUNGA ROSELA
(Hibiscus sabdariffa) TERHADAP PENCEGAHAN KERUSAKAN
TUBULUS GINJAL TIKUS PUTIH STRAIN WISTAR (Rattusnorvegicus
strain wistar) MODEL BATU GINJAL
KARYA TULIS AKHIR
Diajukan kepada
Universitas Muhammadiyah Malang untuk memenuhi
salah satu persyaratan dalam menyelesaikan
Program Sarjana Fakultas Kedokteran
Oleh:
YulfiaDwiWigdaArumsari
201610330311083
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH MALANG
2020
iii
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KATA PENGANTAR
Assalamu’alaikum Warahmatullahi Wabarakatuh
Puji syukur saya panjatkan kepada Tuhan Yang Maha Esa, karena atas
rahmat dan hidayah-Nya saya telah berhasil menyelesaikan Karya Tulis Akhir
yang berjudul “PENGARUH PEMBERIAN EKSTRAK KUNCUP ROSELA
(Hibiscus sabdariffa) TERHADAP PENCEGAHAN KERUSAKAN TUBULUS
GINJAL TIKUS PUTIH STRAIN WISTAR (Rattus norvergicus strain wistar)
MODEL BATU GINJAL”.
Penulis menyadari bahwa penyusunan Karya Tulis Akhir ini jauh dari kata
sempurna, meskipun demikian penulis telah berusaha semaksimal mungkin dan
juga mendapatkan bantuan dan bimbingan dari Dosen Pembimbing dalam rangka
penyusunannya. Tanpa bantuan, dorongan dan doa dari berbagai pihak, tidaklah
Karya Tulis Akhir ini terselesaikan.
Akhir kata, penulis mengucapkan terima kasih kepada semua pihak yang
telah berperan dalam penyusunan Karya Tulis Akhir ini. Semoga Allah SWT
senantiasa meridhoi. Aamiin.
Wassalamu’alaikum Warahmatullahi Wabarakatuh
Malang, 17 Juni 2020
Penulis
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UCAPAN TERIMAKASIH
1. Dr. dr. Meddy Setiawan, Sp.PD, FINASIM selaku Dekan Fakultas
Kedokteran Universitas Muhammadiyah Malang.
2. dr. Mochammad Ma’roef, Sp.OG selaku Wakil Dekan I Fakultas Kedokteran
Universitas Muhammadiyah Malang
3. dr. Sri Adila Nurainiwati, Sp.KK selaku Wakil Dekan II Fakultas Kedokteran
Universitas Muhammadiyah Malang
4. dr. Indra Setiawan, Sp. THT-KL selaku Wakil Dekan III Fakultas Kedokteran
Universitas Muhammadiyah Malang
5. Dr. dr. Fathiyah Safithri, M. Kes. selaku dosen pembimbing I yang telah
memberikan waktu, kesabaran dan masukan selama bimbingan yang sangat
membantu dalam menyelesaikan tugas akhir ini dengan baik.
6. dr. Yoyok Subagio, Sp. BS selaku dosen pembimbing II yang telah
meluangkan waktu dan kesabaran selama bimbingan serta motivasi yang
sangat membantu dalam menyelesaikan tugas akhir ini dengan baik.
7. dr. Dian Yuliartha Lestari, Sp.PA selaku dosen penguji yang telah
meluangkan waktu dan memberikan banyak masukan untuk menyelesaikan
tugas akhir ini.
8. Kedua orang tua tercinta yang telah memberikan doa, dukungan, semangat
dan kasih sayang yang tiada henti sepanjang hidup, semangat dan doa untuk
kelancaran dalam perkuliahan dan proses pengerjaan tugas akhir ini.
9. Dosen pengajar FK UMM yang telah memberikan bekal ilmu pengetahuan
dan nasehat dunia dan akhirat.
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10. Dosen pengajar FK UMM yang telah memberikan bekal ilmu pengetahuan
dan nasehat dunia dan akhirat.
11. Kepada teman-teman PULMO yang sudah mendukung dan banyak membantu
dalam penyelesaian tugas akhir ini.
12. Anggota grup HAMPERS 2020 yang selalu menyemangati dan menghibur
tiap lelah menghampiri.
13. Wahyu Estu Septyah Margowati yang sabar dan semangat mengajari cara
pakai microsoft word, excel, dan SPSS.
13. Marisa Devina Agustin dan Windya Hartasih sejak SMP selalu menginspirasi.
14. Nadia Ramadhani dan Rizki Akbar Fahmi yang sudah turut membantu tiap
detail penelitian selama 35 hari.
xi
DAFTAR ISI
LEMBAR PENGESAHAN ................................................................................. iii
SURAT PERNYATAAN ORISINILITAS .......................................................... iv
LEMBAR PENGUJIAN ...................................................................................... v
KATA PENGANTAR ........................................................................................ vi
UCAPAN TERIMA KASIH .............................................................................. vii
ABSTRAK ......................................................................................................... ix
ABSTRACT .......................................................................................................... x
DAFTAR ISI ...................................................................................................... xi
DAFTAR TABEL ............................................................................................ xiv
DAFTAR GAMBAR ......................................................................................... xv
DAFTAR SINGKATAN .................................................................................. xvi
DAFTAR LAMPIRAN .................................................................................... xvii
BAB 1 ................................................................................................................. 1
PENDAHULUAN ............................................................................................... 1
1.1 Latar Belakang....................................................................................... 1
1.2 Rumusan Masalah .................................................................................. 2
1.3 Tujuan Penelitian ................................................................................... 2
1.3.1 Tujuan Umum ............................................................................. 2
1.3.2 Tujuan Khusus ............................................................................ 3
1.4 Manfaat Penelitian ................................................................................. 3
1.4.1 Manfaat Akademik ..................................................................... 3
1.4.2 Manfaat Klinik ............................................................................ 3
1.4.3 Manfaat Masyarakat.................................................................... 3
BAB 2 ................................................................................................................. 4
TINJAUAN PUSTAKA....................................................................................... 4
2.1 Batu ginjal ............................................................................................. 4
2.2 Komplikasi Batu Ginjal ......................................................................... 9
2.3 Anatomi Ginjal ...................................................................................... 9
2.4 Histologi Ginjal ................................................................................... 13
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2.5 Fisiologi Ginjal .................................................................................... 16
2.6 Respon Seluler ..................................................................................... 20
2.6.1 Jejas Sel .................................................................................... 20
2.6.2 Adaptasi Sel .............................................................................. 21
2.6.3 Kematian Sel ............................................................................ 22
2.7 Hibiscus Sabdariffa .............................................................................. 24
2.7.1 Taksonomi ................................................................................ 24
2.7.2 Morfologi ................................................................................. 25
2.7.3 Persebaran ................................................................................ 26
2.7.4 Nilai Nutrisi .............................................................................. 26
2.7.5 Kandungan Bio-aktif ................................................................. 27
2.7.6 Kegunaan .................................................................................. 27
2.8 Induksi Tikus Model Batu Ginjal ......................................................... 29
2.8.1 Etilen Glikol ............................................................................. 29
2.8.2 Efek Klinis ................................................................................ 30
2.8.3 Interaksi Ginjal dan Etilen Glikol .............................................. 30
BAB 3 ............................................................................................................... 31
KERANGKA KONSEP DAN HIPOTESIS ....................................................... 31
3.1 Kerangka Konsep Penelitian ................................................................ 31
3.2 Hipotesis .............................................................................................. 33
BAB 4 ............................................................................................................... 34
METODOLOGI PENELITIAN ......................................................................... 34
4.1 Jenis Penelitian .................................................................................... 34
4.2 Lokasi dan Waktu Penelitian ................................................................ 34
4.3 Populasi dan Sampel Penelitian............................................................ 34
4.3.1 Populasi .................................................................................... 34
4.3.2 Sampel ...................................................................................... 34
4.3.3 Jumlah Besar Sampel ................................................................ 34
4.3.4 Teknik Pengambilan Sampel ..................................................... 36
4.3.5 Karakteristik Sampel Penelitian ................................................ 36
4.3.6 Variabel Penelitian .................................................................... 36
4.3.7 Definisi Operasional ................................................................. 37
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4.4 Alat dan Bahan .................................................................................... 37
4.4.1 Alat ........................................................................................... 37
4.4.2 Bahan ....................................................................................... 38
4.5 Prosedur Penelitian .............................................................................. 39
4.5.1 Aklimatisasi .............................................................................. 39
4.5.2 Identifikasi dan Pembuatan Ekstrak Etanol Kuncup Bunga Rosela
39
4.5.3 Dasar Penentuan Dosis Ekstrak Etanol Kuncup Bunga Rosela .. 39
4.5.4 Perlakuan Hewan Coba ............................................................. 40
4.5.5 Proses Anestesi dan Pembedahan Hewan Coba ......................... 41
4.5.6 Pembuatan Preparat Histologi ................................................... 41
4.6 Alur Penelitian ..................................................................................... 45
4.7 Analisis Data ....................................................................................... 46
4.8 Jadwal Penelitian ................................................................................. 47
BAB 5 ............................................................................................................... 48
HASIL PENELITIAN DAN ANALISIS DATA ................................................ 48
5.1 Hasil Penelitian .................................................................................... 48
5.2 Analisis Data ....................................................................................... 50
BAB 6 ............................................................................................................... 55
PEMBAHASAN ................................................................................................ 55
BAB 7 ............................................................................................................... 58
KESIMPULAN DAN SARAN .......................................................................... 58
7.1 Kesimpulan.......................................................................................... 58
7.2 Saran ................................................................................................... 58
Daftar Pustaka ................................................................................................... 59
LAMPIRAN ...................................................................................................... 67
xiv
DAFTAR TABEL
Nomor Judul Tabel Halaman
Tabel 4.1 Definisi Operasional 37
Tabel 4.2 Jadwal Penelitian 47
Tabel 5.1 Rerata Jumlah Nekrosis Tubulus Ginjal 50
xv
DAFTAR GAMBAR
Nomor Judul Gambar Halaman
Gambar 2.1 Posisi Ginjal dalam Rongga Peritoneal 11
Gambar 2.2 Kortek Renalis dan Medula Renalis 12
Gambar 2.3 Struktur Nefron 13
Gambar 2.4 Histologi Ginjal 14
Gambar 2.5 Histologi Kortek dan Medula Ginjal 15
Gambar 2.6 Korpuskulum Ginjal 16
Gambar 2.7 Jejas Nekrotik 24
Gambar 2.8 Hibiscus sabdariffa 25
Gambar 2.9 Sel Nekrosis dan Dilatasi Tubulus Ginjal 31
Gambar 5.1 Foto Mikroskopis Tubulus Ginjal Tiap
Perlakuan
49
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DAFTAR SINGKATAN
ACE : Angiotensin Converting Enzyme
AKI : Acute Kidney Injury
CaOx : Calcium Oxalat
COD : Calcium Oxalat Dehydrate
COM : Calcium Oxalat Monohydrate
CSA : Cyclosporine A
DNAse : Deoksiribonuklease
iNOS : Nitric oxide synthase
Lyso PC : Lysophosphatidylcholine
MEG : Monoethylene Glycol Gas
mPTP : Mitochondrial permeability transition pore
NADPH : Nikotinamid Adenin Dinukleotid Phosphate
ROS : Reactive Oxygen Species
SOR : Spesies Oksigen Reaktif
xvii
DAFTAR LAMPIRAN
Nomor Judul Gambar Halaman
Lampiran 1 Dokumentasi Kegiatan Penelitian 67
Lampiran 2 Uji Normalitas Saphiro-Wilk 67
Lampiran 3 Uji Kruskal-Wallis 68
Lampiran 4 Uji Post Hoc Man Whitney 68
Lampiran 5 Uji Regresi Linier 70
Lampiran 6 Surat Ijin Penelitian 71
Lampiran 7 Surat Layak Etik 72
Lampiran 8 Hasil Deteksi Plagiasi 73
Lampiran 9 Kartu Konsultasi 74
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