Profil Keamanan dan Efek Samping Obat Antihipertensi pada Pasien Gagal Ginjal Kronis: Tinjauan Sistematis Berbasis Real-World Evidence dan Farmakovigilans Global

Denda Dhea Vanesa Engelika, Dwi Sugma Putri, Muhammad Faisal

Abstract


Pasien gagal ginjal kronis (GGK) berisiko tinggi mengalami reaksi obat yang merugikan (ADRs) akibat penggunaan antihipertensi. Penelitian ini bertujuan mensintesis bukti mengenai profil keamanan antihipertensi serta kontribusi Real-World Evidence (RWE) dan farmakovigilans global. Penelitian menggunakan Systematic Literature Review berdasarkan pedoman PRISMA 2020 dengan sumber data Google Scholar, Scopus, DOAJ, Elicit, Scite.ai, dan SciSpace. Artikel yang diinklusi merupakan penelitian asli, tinjauan sistematik, dan meta-analisis periode 2016–2025. Hasil menunjukkan bahwa ACE inhibitor dan ARBs memberikan efek renoprotektif, tetapi meningkatkan risiko hiperpotasemia, peningkatan kreatinin serum, dan cedera ginjal akut. Penghambat saluran kalsium, penghambat beta, dan diuretik memiliki profil efek samping yang berbeda, terutama edema perifer, bradikardia, hipotensi, dan gangguan elektrolit. Integrasi RWE dan farmakovigilans memperkuat deteksi sinyal keamanan obat sehingga mendukung pemilihan terapi antihipertensi yang lebih individual serta meningkatkan keselamatan pasien GGK.


Keywords


Gagal ginjal kronis; obat antihipertensi; efek samping obat;

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References


Albasri, A., Hattle, M., Koshiaris, C., Dunnigan, A., Paxton, B., Fox, S. E., Smith, M., Archer, L., Levis, B., Payne, R. A., Riley, R. D., Roberts, N., Snell, K. I. E., Lay-flurrie, S., Usher-smith, J., Stevens, R., Hobbs, F. D. R., Mcmanus, R. J., & Sheppard, J. P. (2021). Association between antihypertensive treatment and adverse events : systematic review and meta-analysis. https://doi.org/10.1136/bmj.n189

Bill, F., & Foundation, M. G. (2017). Global , regional , and national burden of chronic kidney disease , 1990 – 2017 : a systematic analysis for the Global Burden of Disease Study 2017. https://doi.org/10.1016/S0140-6736(20)30045-3

Burnier, M., Lin, S., Ruilope, L., Bader, G., Durg, S., & Brunel, P. (2019). Effect of angiotensin receptor blockers on blood pressure and renal function in patients with concomitant hypertension and chronic kidney disease: a systematic review and meta-analysis. Blood Pressure, 28(6), 358–374. https://doi.org/10.1080/08037051.2019.1644155

Cheung, A. K., Chang, T. I., Cushman, W. C., Furth, S. L., Hou, F. F., Ix, J. H., Knoll, G. A., Muntner, P., Pecoits-filho, R., Sarnak, M. J., Tobe, S. W., Tomson, C. R. V, Lytvyn, L., Craig, J. C., Tunnicliffe, D. J., Howell, M., Tonelli, M., Cheung, M., Earley, A., & Mann, J. F. E. (2021). Pressure in Chronic Kidney Disease. Kidney International, 99(3), 559–569. https://doi.org/10.1016/j.kint.2020.10.026

Febyolla, C. L., Pardilawati, C. Y., Junando, M., & Damayanti, E. (2025). ARTICLE REVIEW : FAKTOR RISIKO TERJADINYA GAGAL GINJAL KRONIK DI INDONESIA Article Review : Risk Factors for Chronic Kidney Failure in Indonesia. ARTICLE REVIEW: FAKTOR RISIKO TERJADINYA GAGAL GINJAL KRONIK DI INDONESIA Article, 3, 50–57. https://doi.org/10.63004/jfs.v3i1.646

Hernawan, J. Y. (2023). Profil Tekanan Darah dan Pola Pemberian Terapi Antihipertensi pada Pasien Gagal Ginjal kronik yang Menjalankan Hemodialisis di Klinik PMI Gamping Yogyakarta Blood Pressure Profile and Pattern of Antihypertension Therapy in Chronic Kidney Failure Patients . Profil Tekanan Darah Dan Pola Pemberian Terapi Antihipertensi Pada Pasien Gagal Ginjal Kronik Yang Menjalankan Hemodialisis Di Klinik PMI Gamping Yogyakarta.

Lee, H., Lee, H., Townsend, R. R., Kim, D., Park, S., & Kim, H. C. (2022). Cardiovascular Implications of the 2021. 79(17). https://doi.org/10.1016/j.jacc.2022.02.040

Mhmndar, M. A., Singh, T., Fatima, I., Shehryar, A., & Zaidi, M. R. (2025). Comparative Efficacy and Safety of Angiotensin- Converting Enzyme Inhibitors , Angiotensin Receptor Blockers , and Calcium Channel Blockers in Hypertensive Patients With Chronic Kidney Disease : A Systematic Review. 17(2). https://doi.org/10.7759/cureus.78845

Mishima, E., Haruna, Y., & Arima, H. (2019). Renin-angiotensin system inhibitors in hypertensive adults with non-diabetic CKD with or without proteinuria : a systematic review and meta-analysis of randomized trials. Hypertension Research, 469–482. https://doi.org/10.1038/s41440-018-0116-3

Negara, A., Kedua, P., Institusi, A., Negara, A., & Barat, S. (2024). Karakteristik Faktor Risiko Pasien Chronic Kidney Desease ( CKD ) Yang Menjalani Hemodialisa. Jurnal Manajemen Asuhan Keperawatan, 8(2), 59–63. https://doi.org/10.33655/mak.v8i1.194

Page, M. J., Mckenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-wilson, E., Mcdonald, S., … Moher, D. (2021). The PRISMA 2020 statement : an updated guideline for reporting systematic reviews Systematic reviews and Meta-Analyses. https://doi.org/10.1136/bmj.n71

Pitt, B., Ruilope, L. M., Rossing, P., Kolkhof, P., Ph, D., Nowack, C., Schloemer, P., Ph, D., & Joseph, A. (2020). Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. 2219–2229. https://doi.org/10.1056/NEJMoa2025845

Prevalence, A. R., Factors, R., Burnier, M., & Egan, B. M. (2019). Compendium on the Pathophysiology and Treatment of Hypertension Adherence in Hypertension. 1124–1140. https://doi.org/10.1161/CIRCRESAHA.118.313220

Salsabila, A. Z., & Sulistyaningsih, D. R. (2025). Essentia : Journal of Medical Practice and Research Hubungan Tekanan Darah dan Lama Menderita dengan Laju Filtrasi Glomerulus Pasien Hipertensi. Hubungan Tekanan Darah Dan Lama Menderita Dengan Laju Filtrasi Glomerulus Pasien Hipertensi, 1(2).

Tangri, N. (2023). The association between dual RAAS inhibition and risk of acute kidney injury and hyperkalemia in patients with diabetic kidney disease : a systematic review and meta-analysis. Nephrology Dialysis Transplantation, 38(June), 2503–2516. https://doi.org/10.1093/ndt/gfad101

Wang, L., Maxfield, K., Guinn, D., Madabushi, R., Zineh, I., & Schuck, R. N. (2021). A Systematic Assessment of US Food and Drug Administration Dosing Recommendations For Drug Development Programs Amenable to Response-Guided Titration. Clinical Pharmacology & Therapeutics, 109(1), 123–130. https://doi.org/https://doi.org/10.1002/cpt.2068

Wanner, C., Hui, M., Alpesh, Z., & Luca, N. A. (2025). Guideline ‑ Recommended Disease ‑ Modifying Therapies for Patients with Cardiorenal Disease : A Call ‑ to ‑ Action Narrative Review. Advances in Therapy, 42(7), 3141–3157. https://doi.org/10.1007/s12325-025-03228-1

Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., Depalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., Maclaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., … Gentile, F. (2018). Clinical Practice Guideline 2017 ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Guideline for the Prevention , Detection , Evaluation , and Management of High Blood Pressure in Adults A Report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. https://doi.org/10.1161/HYP.0000000000000065

Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., Kahan, T., Mahfoud, F., Redon, J., Ruilope, L., Zanchetti, A., Kerins, M., Kjeldsen, S. E., Kreutz, R., Laurent, S., … Desormais, I. (2018). 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European Heart Journal, 39(33), 3021–3104. https://doi.org/10.1093/eurheartj/ehy339

Xu, R., Wu, F., Lan, J., & Duan, P. (2021). Real-world comparison of direct-acting oral anticoagulants and vitamin K antagonists in chronic kidney disease: a systematic review and meta-analysis. Expert Review of Hematology, 14(5), 493–502. https://doi.org/10.1080/17474086.2021.1920012


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