Chronic Kidney Disease (CKD) is a pathophysicological process with various causes, resulting in the decline of progressive kidney function and in kidney failure. Currently, CKD cases are rising quickly particularly in developing countries and have become the main health problem worldwide because it has been the risk factor of cardiovascular diseases. CKD can cause failure of organs due to the increased toxin level. The increase of blood ureum level could harm all cells, including neuron cells. One of the therapies of CKD is hemodyalisis. This study aimed to obtain the ratio of cognitive function before and after undergoing hemodyalisis among CKD patients. This was a descriptive study using the primary data obtained directly from the patients undergoing hemodyalisis at the hemodyalisis unit, Department of Internal Diseases Prof. Dr. R. D. Kandou Hospital, Manado. The population in this study was patients who had undergone hemodyalisis more than 208 times or for 2 years and had met the inclusion criteria. The results showed that CDK male patients were 43,3% and female patients 56,7%. Before undergoing hemodialysis, the average ureum level was 124.7, and after undergoing hemodyalisis, the average ureum level was 97.3 with 20.4% Urea Reduction Rate (URR). Before undergoing hemodialysis, the average cognitive function was 27.6, and after hemodialysis, the average rate was 28,6. Conclusion: There was a significant decrease of average blood ureum level and a significant increase of cognitive function among CKD patients who had undergone hemodyalisis.Keywords: chronic kidney disease, hemodyalisis, ureum, cognitive functionAbstrak: Penyakit Ginjal Kronik (PGK) adalah suatu proses patofisiologi dengan penyebab yang beragam, mengakibatkan penuruan fungsi ginjal yang progresif, dan biasanya berakhir dengan gagal ginjal. Kasus Penyakit Ginjal Kronik saat ini meningkat dengan cepat terutama di negara-negara berkembang dan telah menjadi masalah utama kesehatan di seluruh dunia karena merupakan faktor resiko terjadinya penyakit jantung dan pembuluh darah. PGK dapat mengakibatkan peningkatan kadar ureum dalam tubuh yang dapat merusak semua sel termasuk sel neuron. Penelitian ini bertujuan untuk mengetahui perbandingan fungsi kognitif sebelum dan sesudah dialisis pada pasien PGK. Penelitian ini mengguakan metode deskriptif berdasarkan data primer yang didapatkan secara langsung dari pasien yang menjalani terapi hemodialisis di Unit Hemodialisis Bagian Ilmu Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado. Populasi penelitian yaitu pasien PGK yang telah menjalani terapi hemodialisis. Hasil penelitian menunjukkan bahwa pasien PGK berjenis kelamin laki-laki sebesar 43,3% dan perempuan sebesar 56,7%. Sebelum menjalani hemodialisis nilai rerata ureum 124,7 dan sesudah nilai rerata ureum menjadi 97,3 dengan rerata Urea Reduction Rate (URR) 20,4%. Sebelum menjalani hemodialisis rerata fungsi kognitif 27,6 dan sesudah hemodialisis rerata menjadi 28,6. Simpulan: Terjadi penurunan bermakna dari nilai rerata ureum serta terjadi peningkatan bermakna dari nilai rerata fungsi kognitif sesudah pasien PGK menjalani hemodialisis.Kata kunci: penyakit ginjal kronik, hemodialisis, ureum, fungsi kognitif
Diabetes mellitus is still increasing in number in the future. Type 2 diabetes mellitus type 2 (T2DM) often appears in adults and the cause is due to a shortage of the hormone insulin on a relative basis, generally appears slowly and gradually worsens. One of the parameters to control blood sugar level is HbA1c. The high HbA1c increases the risks and complications in T2DM patients. This study aimed to obtain the relationship between HbA1c level and GFR among T2DM patients. This was an analytical study using the patient's medical record data. This study was conducted at the Endocrine Clinic and Heart and Hypertension Clinic with a total samples of 65 patients. The results showed that of the 65 subjects, there were 40 male patients and 25 female patients. The Pearson correlation test showed that the relationship of the HbA1c level and GFR had a p value = 0.05 > 0.462 and the correlation r = 0.093. Conclusion: There was no significant relationship between HbA1c level and GFR in type 2 DM patients. Keywords: HbA1c, GFR, type 2 DM Abtsrak: Diabetes merupakan suatu penyakit tidak menular yang akan terus meningkat jumlahnya di masa datang. Diabetes Melitus tipe 2 (DMT2) sering muncul pada orang dewasa dan penyebabnya oleh karena kekurangan hormon insulin secara relatif , umumnya muncul perlahan dan secara bertahap akan bertambah berat. Salah satu parameter kontrol kadar gula darah ialah HbA1c. Jika HbA1c meningkat terjadi pula peningkatan resiko komplikasi. Penelitian ini bertujuan untuk mengetahui hubungan kadar HbA1c dengan eLFG pada pasien DMT2. Jenis penelitian ini analitik dengan mengevaluasi data rekam medik pasien. Penelitian dilakukan di Poliklinik Endokrin dan Poliklinik Jantung dan Hipertensi dengan jumlah subyek penelitian 65 pasien DMT2. Hasil penelitian ini menunjukkan bahwa dari 65 orang subjek terdapat 40 laki-laki dan 25 perempuan. Untuk mengetahui adanya hubungan kadar HbA1c dengan LFG digunakan analisis bivariat Pearson correlation yang mendapatkan nilai p hitung = 0,462> 0,05 dengan kekuatan korelasi r = 0,093. Simpulan: Tidak terdapat hubungan bermakna antara kadar HbA1c dengan eLFG pada pasien DM tipe 2.Kata kunci: HbA1c, eLFG, DM tipe 2
Background CKD Patients on routine hemodialysis (HD) are prone to medical complications and conditions that are potentially detrimental to the quality of life (QoL), such as anemia, malnutrition, low body mass index (BMI), HD shift time, and HD adequacy measured by Kt/V. CKD patients undergoing routine HD mostly have lowered QoL and are at higher risk for malnutrition, inflammation, hospitalization, and mortality, compared to the general population. This study intends to find out whether there is a correlation between these factors and the quality of life of patients undergoing routine hemodialysis. Methods The design of this study is a cross-sectional analysis of observational data. Hemodialysis patients from general hospital Prof. dr. R. D. Kandou Manado for 3 months from August to October 2017 were included. Fifty-two patients meet the inclusion and exclusion criteria. The correlation between quality of life with anemia, serum albumin, BMI, adequacy of HD, using Pearson correlation test (if normality test fulfilled) or Spearman correlation test (if the normality test not fulfilled) and Independent Samples T-test to assess the quality of life with HD shift time. Results This study found no correlation between hemoglobin levels (p=0.244, r=-0.098), BMI (p=0.473, r=-0.010), HD timing (p=0.082) and quality of life of the patients, but a significant correlation between serum albumin (p=0.020, r=0.286), HD adequacy measured by Kt/V (p=0.030, r=0.257) and subjects' quality of life. Conclusion This study showed that serum albumin and Kt/V values had a significant correlation with quality of life, while hemoglobin, BMI and dialysis shift time are not related to the quality of life.
Chronic kidney disease (CKD) is a pathophysiological process with a diverse etiology that causes progressive decrease of renal function and is generally ended with renal failure. Patients with CKD are given low-protein and low-water diets that can affect their nutritional status and immune system. This study was aimed to determine the relationship between nutritional status and cellular immune system in patients with stage V CKD that had hemodialysis perfomed on them at the Installation of Hemodialysis of Prof. Dr. R. D. Kandou Hospital Manado. This was a descriptive analytical study with a cross sectional design. Variables were age, gender, lymphocyte count, body mass index (BMI), and upper arm circumference. There were 30 samples in this study; males (56.7%) were more dominant. The age range was 36-76 years; lymphocyte count range was 1000-4131; IMT range was 16-28.1; and upper arm circumference range was 17-28.50. The Spearman parametric test of the relationship between nutritional status and cellular immune system based on BMI and lymphocyte count obtained a P-value of 0.111 meanwhile the relationship between nutritional status based on upper arm circumference and lymphocytes obtained a P-value of 0.309. Conclusion: There was no relationship between nutritional status (BMI and arm circumference) and cellular immune system (lymphocyte count) in stage V CKD patients that had hemodialysis perfomed on them. Keywords: CKD V-HD, nutritional status, cellular immune systemAbstrak: Penyakit ginjal kronik (PGK) adalah suatu proses patofisiologis dengan etiologi beragam yang mengakibatkan penurunan fungsi ginjal secara progesif dan umumnya berahir dengan gagal ginjal. Pasien PGK diberikan terapi rendah protein dan air sehingga dapat berdampak pada status gizi dan sistem imun pasien. Penelitian ini bertujuan untuk mengetahui hubungan status gizi dengan sistem imun seluler pada subyek PGK stadium V hemodialisis di Instalasi Tindakan Hemodialisis RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Variabel penelitian ialah usia, jenis kelamin, hasil hitung limfosit, hitung IMT, dan ukuran lingkar lengan atas (LILA). Hasil penelitian mendapatkan 30 sampel dengan jumlah terbanyak ialah laki-laki 17 orang (56,7%), cengan rentang usia 36-76 tahun. Kisaran nilai untuk limfosit ialah 1000-4131; IMT 16-28,1; dan LILA 17-28,50. Uji parametrik Spearman terhadap hubungan antara status gizi berdasarkan IMT dan limfosit mendapatkan P=0,111 sedangkan antara status gizi berdasarkan LILA dan limfosit mendapatkan P=0,309. Simpulan: Tidak terdapat hubungan antara status gizi (IMT dan LILA) dengan limfosit (sistem imun) pada pasien PGK V yang menjalani hemodialisis.Kata kunci: PGK V-HD, status gizi, sistem imun seluler
Chronic kidney disease (CKD) is a pathological process with various etiology that causes a progressive reduction in kidney and generally ended with renal failure. In chronic renal failure, there are usually chronic complications such as anemia and bone disease with low level of calcium serum, high level of phosphorus serum, and high paratyroid hormone. This study was aimed to obtain the description of the levels of calcium and phosphorus serum in CKD patients at the hemodialysis unit in Prof. R. D. Kandou Hospital Manado. This was a descriptive study based on patient medical records. Of the 75 patients, the majority of them were males (41 patients; 54.7%), aged > 60 years (27 patients; 36%), and had calcium serum level in normal limit (40 patients; 53.3%) and phosphorus serum level as hyperphosphatemia (61 patients; 81.3%).Keywords: CKD, calcium serum, phosphorus serum, hemodialysis Abstrak: Penyakit ginjal kronik (PGK) adalah suatu proses patofisiologi dengan etiologi beragam yang mengakibatkan penurunan fungsi ginjal secara progresif, dan umumnya berakhir dengan gagal ginjal. Pada gagal ginjal kronik, biasanya terdapat komplikasi kronik meliputi anemia serta penyakit tulang, biasanya dengan kadar kalsium rendah, fosfat tinggi dan hormon paratiroid tinggi. Penelitian ini bertujuan untuk mengetahui gambaran hasil produk kalsium dan fosfat pada pasien penyakit ginjal kronik stadium V di ruang hemodialisis. Jenis penelitian ialah deskriptif dengan menggunakan data rekam medik dan dikelompokkan berdasarkan jenis kelamin, umur, kadar kalsium, dan kadar fosfor serum, hasil produk kalsium dan fosfat. Dari 75 sampel, didapatkan terbanyak ialah pasein berjenis kelamin laki-laki sebanayak 41 orang (54,7%), rentang umur >60 sebanyak 27 orang (36%), dengan kadar kalsium serum normal sebanyak 40 orang (53,3%) dan kadar fosfor serum hiperfosfatemia yaitu 61 orang (81,3%). Kata kunci: penyakit ginjal kronik, hemodialisis, kalsium serum, fosfor serum.
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