Gambaran status besi pada pasien penyakit ginjal kronik stadium 5 dengan anemia yang menjalani hemodialisis reguler

Abstract

Chronic kidney disease (CKD) is a pathological condition with a variety of etiology, resulting in progressively decreased renal function which is often ended with kidney failure. Chronic kidney disease has a global prevalence of 800 per million of population and the incidence of end-stage renal disease ranges from 150 to 200 per million of population. Complications often occur at the end-stage renal disease inter alia anemia with a rate of 80-90%. This study was aimed to obtain the profile of stage-5 CKD patients with anemia and regular hemodialysis was performed on them. This was a descriptive-retrospective study using data of medical records at Prof. Dr. R. D. Kandou General Hospital from January 2015 to October 2016. There were six observed variables as follows: age, gender, serum iron (SI), total iron binding capacity (TIBC), transferrin saturation, and ferritin. The results showed that of the 48 CKD patients with anemia, there were 24 males and 24 females. The majority were aged 60-69 years (33%) and had normal SI level in 30 patients (67%); decreased TIBC in 35 patients (75%); normal transferrin saturation in 26 patients (54%); and increased ferritin level in 38 patients (81%). Conclusion: Majority of the patients were 60-69 years old and had normal level of SI, decreased TIBC, normal transferrin saturation, and increased levels of ferritin. There was no difference in case number of both sexes.Keywords: serum iron, total iron binding capacity, transferrin saturation, ferritin Abstrak: Penyakit Ginjal Kronik (PGK) adalah suatu keadaan patologis dengan etiologi yang beragam, terjadi penurunan fungsi ginjal secara progresif, dan biasanya berakhir dengan gagal ginjal. Penyakit ginjal kronik merupakan salah satu masalah kesehatan di dunia dengan prevalensi 800 per juta populasi dan insidensi end-stage renal disease (ESRD) 150-200 per juta populasi di dunia. Komplikasi sering terjadi pada PGK stadium akhir antara lain anemia dengan persentase mencapai 80-90%. Penelitian ini bertujuan untuk mendapatkan profil pasien PGK stadium 5 dengan anemia dan menjalani hemodialisis reglular. Jenis penelitian ialah deskriptif-retrospektif menggunakan data sekunder dari catatan rekam medik periode Januari 2015 – Oktober 2016 di RSUP Prof. Dr. R. D. Kandou Manado dengan enam variabel penelitian, yaitu usia, jenis kelamin, serum iron (SI), total iron binding capacity (TIBC), saturasi transferin, dan feritin. Dari 48 data rekam medik pasien yang memenuhi kriteria inklusi ditemukan bahwa mayoritas pasien berumur 60-69 tahun (33%), laki-laki maupun perempuan berjumlah sama, mayoritas pasien memiliki kadar SI normal berjumlah 30 pasien (67%), kadar TIBC menurun berjumlah 35 pasien (75%), saturasi transferin normal berjumlah 26 pasien (54%), dan kadar feritin meningkat berjumlah 38 pasien (81%). Simpulan: Mayoritas pasien PGK stadium 5 yang menjalani hemodialisis reguler berusia 60-69 tahun, laki-laki dan perempuan berjumlah sama, serta memiliki kadar SI normal, penurunan TIBC, saturasi transferin normal, dan peningkatan kadar feritin. Kata kunci: serum iron, total iron binding capacity, saturasi transferin, feritin

Karakteristik Feritin Serum Pada Pasien Penyakit Ginjal Kronik Yang Menjalani Hemodialisis Di Rsup Prof. Dr. I.G.N.G. Ngoerah

“…Hal ini sesuai dengan penelitian Bryan J. Silaban dkk berdasarkan feritin serum, didapatkan kadar feritin mengalami peningkatan pada 39 pasien (81%). 18 Peningkatan kadar feritin pada PGK merupakan hasil dari inflamasi sistemik yang mendasari karena sintesis feritin responsif terhadap sitokin peradangan. Kondisi ini berhubungan dengan penyakit anemia kronik karena peningkatan feritin mengakibatkan penahanan besi dalam sel.…”

Karakteristik Pasien Anemia pada End Stage Renal Disease (ESRD) dengan Hemodialisis di Instalasi Hemodialisis RSUD Dr. Soetomo

“…Pada penelitian oleh Nuryati et al, tahun 2015 di RS UGM, Yogyakarta yaitu terdapat 5 subjek penelitian dengan nilai ST < 20% dan 28 subjek dengan nilai ST normal (20 -50%) (Nuryati, 2016). Pada penelitian yang dilakukan oleh Silaban et al, pada periode januari 2015oktober 2016 di RSUP Prof. Dr. R. D. Kandou Manado didapatkan subjek penelitian sebagian besar memperlihatkan nilai ST normal yaitu sebanyak 26 subjek (54%) (Silaban, Sugeng, & Waleleng, 2016).…”

Role of soluble transferrin receptor – An Iron marker in hemodialysis patients

“…[ 1 ] The prevalence of anemia in Manado, Indonesia, was as high as 80%–90% in 2016 and increased as CKD worsened. [ 2 ] Additionally, it was shown to be associated with an increased risk of cardiovascular complications and a reduced quality of life. [ 1 ] The common cause of anemia in CKD is depletion of erythropoietin production by the kidneys, which is often exaggerated by iron deficiency.…”

“…[ 1 ] The common cause of anemia in CKD is depletion of erythropoietin production by the kidneys, which is often exaggerated by iron deficiency. [ 2 3 ] Iron deficiency in patients with CKD and on hemodialysis (HD) is usually caused by occult gastrointestinal bleeding, blood trapping in an HD dialyzer or line, bleeding at HD access, and an inflammatory state that can decrease iron absorption and availability. [ 2 ] Iron deficiency results in a suboptimal response to an erythropoiesis-stimulating agent (ESA).…”

“…[ 2 3 ] Iron deficiency in patients with CKD and on hemodialysis (HD) is usually caused by occult gastrointestinal bleeding, blood trapping in an HD dialyzer or line, bleeding at HD access, and an inflammatory state that can decrease iron absorption and availability. [ 2 ] Iron deficiency results in a suboptimal response to an erythropoiesis-stimulating agent (ESA). ESA therapy in an iron deficiency state should involve iron supplementation simultaneously.…”