KARYA TULIS AKHIR

PENGARUH PEMBERIAN MINUMAN BERENERGI SUBAKUT

TERHADAP GAMBARAN HISTOLOGI GINJAL TIKUS PUTIH STRAIN

WISTAR

Oleh :

UTARI PRASETYANINGRUM

08020124

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH MALANG

2012

ii

PENGARUH PEMBERIAN MINUMAN BERENERGI SUBAKUT

TERHADAP GAMBARAN HISTOLOGI GINJAL TIKUS PUTIH STRAIN

WISTAR

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh :

UTARI PRASETYANINGRUM

08020124

FAKULTAS KEDOKTERAN

UNIVERSITAS MUHAMMADIYAH MALANG

2012

iii

LEMBAR PENGESAHAN

LAPORAN HASIL PENELITIAN

Telah disetujui sebagai hasil penelitian

untuk memenuhi persyaratan

Pendidikan Sarjana Program Pendidikan Dokter

Universitas Muhammadiyah Malang

Tanggal : 20 Maret 2012

Pembimbing I

dr. Diah Hermayanti, Sp.PK

Pembimbing II

dr. Abi Noor Wahyono, Sp.An, M.Kes

Mengetahui,

Fakultas Kedokteran

Dekan,

dr. Irma Suswati, M.Kes

NIP : 11395010320

iv

LEMBAR PENGUJIAN

Karya Tulis Akhir oleh Utari Prasetyaningrum

Telah diuji dan dipertahankan di depan Tim Penguji

Pada tanggal 20 Maret 2012

Tim Penguji

dr. Diah Hermayanti, Sp.PK Ketua

dr. Abi Noor Wahyono, Sp.An, M.Kes Anggota

dr. Hawin Nurdiana, M.Kes Anggota

v

KATA PENGANTAR

Assalamualaikum Wr.Wb

Syukur alhamdulillah kehadirat Allah SWT yang telah melimpahkan

rahmat dan hidayah-Nya, sehingga penulis dapat menyelesaikan Karya Tulis

Akhir dengan judul “Pengaruh Pemberian Minuman Berenergi Subakut Terhadap

Gambaran Histologi Ginjal Tikus Putih Strain Wistar”.

Dalam terwujudnya Karya Tulis Akhir ini penulis ingin mengucapkan

terima kasih terutama kepada:

1. Allah SWT atas segala rahmat dan karunia-Mu sehingga hamba mampu

menyelesaikan tugas akhir ini dengan baik dan sholawat serta salam

senantiasa tercurahkan kepada Rasulullah SAW yang membawa

kebenaran.

2. Kedua orang tua dan kakak penulis yang selalu memberikan kasih sayang,

doa yang tak henti, dukungan dan selalu mengingatkan penulis. Insya

Allah penulis akan selalu berusaha membuat kalian bangga.

3. dr.Irma Suswati, M.Kes selaku Dekan Fakultas Kedokteran Universitas

Muhammadiyah Malang.

4. dr. Diah Hermayanti, Sp.PK selaku dosen pembimbing I dalam penulisan

Karya Tulis Akhir ini.

5. dr. Abi Noor Wahyono, Sp.An, M.Kes selaku dosen pembimbing II dalam

penulisan Karya Tulis Akhir ini.

6. dr. Hawin Nurdiana, M.Kes selaku dosen penguji dalam penulisan Karya

Tulis Akhir ini.

7. dr. Soebarkah Basuki, Sp.PA selaku pembaca hasil penelitian yang telah

memberikan ilmu dan bimbingan dalam pengamatan hasil penelitian

8. Untuk Resa, Mega, Irna, Dewi, Qoyum, Ega, Tita, Rezky, Manyun, Diki,

Apip dan semua teman-teman angkatan 2008 di Fakultas Kedokteran

Universitas Muhammadiyah Malang.

9. Seluruh Dosen yang telah memberikan ilmunya dan Staf Pengajar dan TU

Fakultas Kedokteran Universitas Muhammadiyah Malang.

Penulis menyadari bahwa penelitian ini masih jauh dari sempurna,

sehingga penulis membuka diri untuk segala kritik dan saran yang bersifat

membangun. Akhirnya penulis berharap semoga Karya Tulis Akhir ini dapat

bermanfaat bagi masyarakat, khususnya dalam bidang kesehatan.

Wassalamualaikum Wr.Wb

Malang, 12 Maret 2012

Penulis

vi

ABSTRAK

Prasetyaningrum, Utari. 2012. Pengaruh Pemberian Minuman Berenergi Subakut

Terhadap Gambaran Histologi Ginjal Tikus Putih Strain Wistar. Tugas

Akhir, Fakultas Kedokteran, Universitas Muhammadiyah Malang.

Pembimbing: (1) Diah Hermayanti (2) Abi Noor Wahyono

Pendahuluan : Konsumsi minuman berenergi semakin meningkat sejak pertama

kali munculnya minuman Red Bull pada tahun 1997. Kandungan utamanya adalah

kafein yang merupakan antagonis reseptor adenosin A2a yang dapat

meningkatkan aktivasi polymorphonuclear cell dan resiko inflamasi yang

menyebabkan perubahan progresif lambat terhadap gambaran histologi ginjal.

Tujuan : Membuktikan adanya pengaruh pemberian minuman berenergi subakut

terhadap gambaran histologi ginjal tikus putih strain wistar.

Metode : Eksperimen laboratoris dengan rancangan the post test only control

group design. Sampel dibagi dalam 4 kelompok. Kelompok I (K) tanpa pemberian

minuman berenergi, kelompok II. III dan IV (P1, P2, P3) diberikan minuman

berenergi 72 mg, 216 mg dan 360 mg. Analisis data menggunakan One Way

Anova, uji Tukey, uji korelasi dan uji regresi.

Hasil : Hasil uji One Way Anova dan uji Tukey didapatkan nilai sig=0,000

(p<0,05) artinya terdapat pengaruh yang signifikan antara perlakuan dengan

jumlah sel nekrosis dan terdapat perbedaan yang bermakna antar kelompok. Hasil

uji korelasi dan regresi didapatkan r=0,988 dan R2=0,976 artinya semakin tinggi

dosis akan diikuti oleh peningkatan jumlah sel nekrosis.

Kesimpulan : Minuman berenergi dapat meningkatkan jumlah sel nekrosis pada

sel epitel tubulus proksimal ginjal.

Kata kunci : Minuman berenergi, kafein, histologi ginjal, nekrosis sel epitel

tubulus proksimal ginjal

vii

ABSTRACT

Prasetyaningrum, Utari. 2012. The Effect of Orally Energy Drinks Subacute to

The Kidney Histological Appearance in White Rat Strain Wistar. Final

Assignment, Medical Faculty, University of Muhammadiyah Malang,

Adviser: (1) Diah Hermayanti (2) Abi Noor Wahyono

Introduction : Energy drink consumption has continued to gain popularity since

the 1997 debut of Red Bull. The key ingredient is caffeine which is an antagonist

Adenosine A2a receptor can increase activation of polymorphonuclear cells and

the risk of inflammation that causes a slow progressive changes of histological

kidney.

Objective : To prove the effect of orally energy drinks subacute to the kidney

histological appearance in white rat strain wistar.

Method : Laboratory experiment by using the post test only control group design.

The sample was divided into 4 groups. Group I (K) without energy drink, group

II, III and IV (P1, P2, P3) with 72 mg, 216 mg and 360 mg of energy drink. Data

analysis used One Way Anova, Tukey test, correlation test and regression test.

Result : One Way Anova test and tukey test result’s obtained value sig=0,000

(p<0,05) means there is a significant effect between treatments with a number of

cell necrosis and there are significant differences between groups. The correlation

test and regression test result of value r=0,988 and R2=0,976 which means the

higher the dosage will be followed by an increase in number of cell necrosis.

Conclusion : Energy drinks can increase number of cell necrosis in renal

proximal tubular epithelial cells.

Keywords : Energy drinks, caffeine, renal histology, necrosis of renal proximal

tubular epithelial cells

viii

DAFTAR ISI

HALAMAN JUDUL ....................................................................................... i

LEMBAR PENGESAHAN ............................................................................. iii

LEMBAR PENGUJIAN .................................................................................. iv

KATA PENGANTAR ..................................................................................... v

ABSTRAK ....................................................................................................... vi

ABSTRACT ..................................................................................................... vii

DAFTAR ISI .................................................................................................... viii

DAFTAR TABEL ............................................................................................ xi

DAFTAR GAMBAR ....................................................................................... xii

DAFTAR SINGKATAN ................................................................................. xiii

DAFTAR LAMPIRAN .................................................................................... xiv

BAB 1 PENDAHULUAN .............................................................................. 1

1.1 Latar Belakang................................................................................. 1

1.2. Rumusan Masalah ........................................................................... 4

1.3. Tujuan .............................................................................................. 4

1.3.1. Tujuan umum ......................................................................... 4

1.3.2. Tujuan khusus ........................................................................ 4

1.4. Manfaat Penelitian ........................................................................... 4

1.4.1 Manfaat akademis ................................................................... 4

1.4.2 Manfaat klinis ......................................................................... 5

1.4.3 Manfaat masyarakat................................................................ 5

BAB 2 TINJAUAN PUSTAKA ...................................................................... 6

2.1 Minuman Berenergi ......................................................................... 6

2.1.1 Definisi minuman berenergi .................................................. 6

2.1.2 Target sasaran minuman berenergi ........................................ 7

2.1.3 Kandungan minuman berenergi ............................................. 7

2.1.3.1 Kafein ......................................................................... 7

2.1.3.1 Taurin ......................................................................... 12

2.1.3.3 Ginseng ...................................................................... 14

2.1.3.4 Vitamin B kompleks .................................................. 15

ix

2.1.4 Efek minuman berenergi pada tubuh ...................................... 17

2.2 Ginjal ............................................................................................... 19

2.2.1 Anatomi ginjal ....................................................................... 19

2.2.2 Fisiologi ginjal ........................................................................ 21

2.2.3 Histologi ginjal ....................................................................... 24

2.3 Jejas Sel ............................................................................................ 29

2.3.1 Jejas reversibel ....................................................................... 30

2.3.2 Jejas ireversibel ...................................................................... 31

2.4 Pengaruh minuman berenergi terhadap kerusakan ginjal ................. 35

BAB 3 KERANGKA KONSEP DAN HIPOTESIS ........................................ 38

3.1 Kerangka Konsep ........................................................................... 38

3.2. Hipotesis ........................................................................................ 40

BAB 4 METODE PENELITIAN .................................................................... 41

4.1 Rancangan Penelitian ...................................................................... 41

4.2 Tempat dan Waktu Penelitian ......................................................... 41

4.3 Populasi dan Sampel ....................................................................... 41

4.3.1 Populasi .................................................................................. 41

4.3.2 Sampel .................................................................................... 41

4.3.3 Besar sampel ........................................................................... 41

4.3.4 Karakteristik sampel penelitian .............................................. 43

4.4 Variabel Penelitian .......................................................................... 43

4.4.1 Variabel bebas ........................................................................ 43

4.4.2 Variabel terikat ....................................................................... 44

4.4.3 Variabel kontrol ...................................................................... 44

4.4.4 Definisi operasional ................................................................ 44

4.5 Alat dan Bahan ................................................................................. 46

4.5.1 Alat ......................................................................................... 46

4.5.2 Bahan ...................................................................................... 47

4.6 Alur penelitian .................................................................................. 47

4.7 Prosedur Penelitian ........................................................................... 47

4.7.1 Adaptasi hewan percobaan ..................................................... 47

4.7.2 Penentuan dosis ...................................................................... 48

x

4.7.3 Penyiapan larutan uji .............................................................. 48

4.7.4 Percobaan ............................................................................... 49

4.8 Analisis data ..................................................................................... 51

BAB 5 HASIL DAN ANALISIS PENELITIAN ............................................ 52

5.1 Hasil Penelitian ................................................................................. 52

5.1.1 Hasil pengamatan preparat tubulus proksimal ginjal tikus

putih strain wistar ................................................................... 52

5.1.2 Penelitian jumlah sel nekrosis pada sel epitel tubulus

proksimal ginjal tikus putih strain wistar ............................... 53

5.2 Analisis Data .................................................................................... 55

5.2.1 Uji asumsi data ....................................................................... 55

5.2.2 Analisis one – way ANOVA .................................................. 57

5.2.3 Pengujian berganda (multiple comparisons) .......................... 58

5.2.4 Pengujian korelasi dan regresi ................................................ 61

BAB 6 PEMBAHASAN .................................................................................. 65

BAB 7 KESIMPULAN DAN SARAN ........................................................... 71

7.1 Kesimpulan ....................................................................................... 71

7.2 Saran ................................................................................................. 71

DAFTAR PUSTAKA ...................................................................................... 73

xi

DAFTAR TABEL

Tabel 4.1 Konversi dosis antar spesies ............................................................ 47

Tabel 5.1 Hasil penelitian jumlah sel nekrosis pada sel epitel tubulus

proksimal ginjal tikus putih strain wistar ........................................ 54

Tabel 5.2 Uji kesamaan ragam dengan uji levene ........................................... 57

Tabel 5.3 Tabel ringkasan hasil uji anova ....................................................... 58

Tabel 5.4 Tabel uji pembandingan berganda tukey ......................................... 59

Tabel 5.5 Uji korelasi ....................................................................................... 61

xii

DAFTAR GAMBAR

Gambar 2.1 Struktur kimia kafein ................................................................... 8

Gambar 2.2 Stuktur kimia taurin ..................................................................... 13

Gambar 2.3 Struktur umum histologis ginjal ................................................... 24

Gambar 2.4 Struktur korpuskulus ginjal .......................................................... 26

Gambar 2.5 Glomerulus ginjal normal ............................................................ 27

Gambar 2.6 Mekanisme jejas sel ..................................................................... 30

Gambar 2.7 Sel tubulus ginjal normal dan nekrosis ........................................ 34

Gambar 5.1 Gambaran mikroskopis ginjal dengan perbesaran 400x .............. 52

Gambar 5.2 Grafik jumlah sel nekrosis pada sel epitel tubulus

proksimal ginjal tikus putih strain wistar ..................................... 55

Gambar 5.3 Grafik jumlah sel nekrosis pada sel epitel tubulus

proksimal ginjal tikus putih strain wistar ..................................... 60

Gambar 5.4 Grafik linieritas ............................................................................ 63

xiii

DAFTAR SINGKATAN

ADH : Anti Diuretic Hormone

ADP : Adenosine Diphosphate

AMP : Adenosine Monophosphate

ATP : Adenosine Triphosphate

cAMP : cyclic Adenosine Monophosphate

DNA : Deoxyribose Nucleic Acid

LD : Lethal Dose

NAD : Nicotinamide Adenine Dinucleotide

NADH : Nicotinamide Adenine Dinucleotide Hydrogen

NADP : Nicotinamide Adenine Dinucleotide Phosphate

NADPH : Nicotinamide Adenine Dinucleotide Phosphate Hydrogen

PKC : Protein Kinase C

PMN : Polymorphonuclear Cells

RNA : Ribo Nucleic Acid

ROS : Reactive Oxygen Species

xiv

DAFTAR LAMPIRAN

Lampiran 1 Hasil Analisis Data Jumlah Sel Nekrosis Ginjal .......................... 80

xv

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