ABSTRAK
Latar Belakang
Methylcobalamin adalah metabolit aktif dari cyanocobalamin.Methylcobalamin sangat penting untuk sintesis DNA selular, menurunkan homocystein, co-faktor untuk sintesis methyonin, berperan dalam metabolisme asam folat.Sehingga, pemberian methylcobalamin diharapkan bisa menurunkan kejadian aterosklerosis pada gagal ginjal kronik stadium V yang ditandaidenganpenurunan ICAM danHsCRP.
Tujuan Penelitian
Penelitian ini bertujuan membuktikan dan mengetahui pengaruh pemberian methylcobalamin  terhadap kadar ICAM dan HsCRP pada pasien penyakit ginjal kronik stadium V di RSUD dr.Moewardi Surakarta.
Metode Penelitian
Penelitian ini adalah eksperimental Randomized Control Trial. Subjek penelitian yang mengikuti hingga selesai 30 pasien Penyakit Ginjal Kronik Stadium V  (15 methylobalamin ;15 placebo). Kadar ICAM dan HsCRP serum menggunakan ELISA. Analisis statistik menggunakan mann whitney test, t test, wilcoxon,dengan signifikansi p<0.05.
Hasil Penelitian
Pada kelompok kontrol dan perlakuan sesudah perlakuan didapatkan variabel ICAM 320,86 + 151,45 ng/ml pada kelompok kontrol dan 215,55 + 102,23 ng/ml pada perlakuan, t=2,232, P=0,034.Sedangkan variabel HsCRP 4,32 + 4,27 mg/l pada kelompok kontrol dan 1,80 + 0,88 mg/l pada perlakuan,t=2,241, P=0,033. Perbandingan ICAM dan HsCRP sebelum dan sesudah perlakuan pada kelompok perlakuan didapatkan variabel ICAM sebelum 291,25 + 105,36 ng/ml dan sesudah 215,55 + 102,22 ng/ml, t=4,319,P=0,001. Sedangkan variabel HsCRP sebelum 6,75 + 4,32 mg/l dan sesudah 1,80 + 0,88 mg/l, t=4,691,  P=0,001.
Perbandingan delta-ICAM dan delta HsCRP pada kelompok kontrol dan perlakuan.Delta-ICAM pada kontrol 20,61 + 118,91ng/ml dan perlakuan 75,70 ¬+ 67,88 ng/ml, Z= -2,758, P=0,005. Sedangkan delta HsCRP pada kontrol -0,48 ¬+ 5,83 mg/l dan perlakuan 4,95 + 4,09 mg/l, t=-2,957, P=0,006.
Kesimpulan
Pemberian methylcobalamin menurunkan kadar ICAM dan HsCRP pada  pasien  penyakit ginjal kronis stadium V yang menjalani hemodialisis secara bermakna.
Kata kunci: Methylcobalamin,ICAM,HsCRP,Penyakit Ginjal Kronis stadium V
ABSTRACT
Background
Methylcobalamin is active metabolic of cyanocobalamin. Methylcobalamin is most important for cellular DNA synthesize to diminish homocysteine, co-factor of methyonin synthesize. It has a role of folic acid metabolism. There for, giving Methylcobalamin will reduce atherosclerosis accident on patient with chronic kidney disease stage V. it will be shown with reduction of ICAM and HsCRP
Objectives
This study aims to prove and determine the effect of methylcobalamin on the levels of ICAM and HsCRP in patient with chronic kidney disease stage V
Methods
This study was a randomized double-blind experimental Control Trial. Subjects completed the study were followed up 30 patients with chronic kidney disease stage V (15 methylobalamin ;15 placebo). ICAM and HsCRP levels in serum using ELISA.Statistical analysis using the Mann Whitney test, t test, Wilcoxon, with significance p <0.05.
Results    
After treatment on control group and treatment group, ICAM variable calculated at 320,86 + 151,45 ng/ml at control group and 215,55 + 102,23 ng/ml at treatment group, t=2,232, P=0,034. While HsCRP variable 4,32 + 4,27 mg/l at control group and 1,80 + 0,88 mg/l at treatment group, t=2,241, P=0,033. Comparison of ICAM and HsCRP before and after treatment on treatment group resulted on ICAM variable before at 291,25 + 105,36 ng/ml and after at 215,55 + 102,22  ng/ml, t=4,319,P=0,001. While HsCRP variable at 6,75 + 4,32 mg/l before and 1,80 + 0,88 mg/l, t=4,691,  P=0,001.
Comparison of delta-ICAM on control and treatment group resulted at 20,61 + 118,91 ng/ml on control group and 75,70 ¬+ 67,88 ng/ml on treatment group, Z = -2,758, P = 0,005. While delta HsCRP at -0,48 ¬+ 5,83 mg/l on control group and 4,95 +4,09 mg/l at treatment group, t = -2,957, P=0,006.
Conclusion
Methylcobalamin supplementation reduce the levels of ICAM and HsCRP in patient with chronic kidney disease stage V with adequate hemodialysis.
Keywords: Methylcobalamin,ICAM,HsCRP, chronic kidney disease stage V