“HUBUNGAN ANTARA KOMBINASI HEMODIALISIS (HD)
/ HEMOPERFUSI (HP) DENGAN STATUS NUTRISI
(
7 POINT
SUBJECTIVE GLOBAL ASSESSMENT
(SGA) DAN
ALBUMIN SERUM)
PASIEN HEMODIALISIS REGULER”
Dwi Bayu Wikarta, Alwi Thamrin Nasution, Abdurrahim Rasyid Lubis Divisi Nefrologi dan Hipertensi - Departemen Ilmu Penyakit Dalam
Fakultas Kedokteran Universitas Sumatera Utara Medan
ABSTRAK
Latar Belakang: Malnutrisi pada pasien hemodialisis reguler sering terjadi dan merupakan faktor independen yang mempengaruhi morbiditas dan mortalitas. Hal ini berkaitan dengan tingkat bersihan molekul kecil, sedang dan molekul besar racun uremik saat proses hemodialisis yang kurang optimal. Aplikasi klinis kombinasi hemodialisis dengan hemoperfusi (HD/HP) menunjukkan tingkat efektifitas pembersihan molekul racun uremik yang optimal. Kidney Disease Outcomes Quality Initiative (KDOQI) merekomendasikan penilaian status nutrisi pasien hemodialisis reguler dengan kombinasi alat penilaian yang valid salah satunya yaitu 7-point SGA(Subjective Global Assesment) dan albumin.
Tujuan: Untuk mengetahui hubungan kombinasi HD/HP dengan status nutrisi pasien hemodialisis reguler.
Metode: Penelitian kohort prospektif dari bulan Desember 2013 hingga Maret 2014 terhadap 20 pasien hemodialisis reguler dan dilakukan anamnesis, pengukuran tinggi badan, berat badan, indeks massa tubuh, penilaian status nutrisi dengan 7-point SGA dan pemeriksaan albumin serum.
Hasil: Dari 20 subjek yang diamati 1 subjek keluar dari penelitian. Terdapat perbedaan bermakna antara rerata skor 7-point SGA sebelum dengan sesudah kombinasi Hemodialisis/Hemoperfusi(p<0,05). Terdapat perbedaan bermakna antara rerata albumin sebelum dan Albumin setelah kombinasi HD/HP pertama(p<0,05). Terdapat perbedaan Body Mass Index(BMI) setelah kombinasi berdasarkan jenis kelamin(p<0,05). Terdapat hubungan yang kuat antara 7-point
SGA setelah kombinasi dengan BMI setelah kombinasi(r=0,636;p<0,01).
Kesimpulan: Kombinasi HD/HP merupakan aplikasi klinis yang cukup baik untuk penanganan malnutrisi pada pasien hemodialisis reguler. Penilaian rutin status nutrisi pasien hemodialisis reguler sangat diperlukan, dengan kombinasi alat penilaian yang valid(7-point SGA,albumin) diharapkan dapat membantu menurunkan morbiditas dan mortalitas.
Kata kunci: Hemodialisis, hemoperfusi, 7-point SGA, albumin.
“ THE CORRELATION BETWEEN
COMBINATION HEMODIALYSIS (HD) / HEMOPERFUSION
(HP) WITH NUTRITION STATUS (7 POINT SUBJECTIVE
GLOBAL ASSESMENT (SGA) AND ALBUMIN)
ON REGULAR HEMODIALYSIS”
Dwi Bayu Wikarta, Alwi Thamrin Nasution, Abdurrahim Rasyid Lubis Division of Nephrology and Hypertension - Department of Internal Medicine
Faculty of Medicine University of Sumatera Utara Medan
ABSTRACT
Background: Malnutrition in hemodialysis patients is common and it’s a regular independent factors affecting morbidity and mortality. This relates to the level of small molecule, medium and large molecule clearance uremic toxins during the process of hemodialysis is less than optimal. Clinical Application hemoperfusion combination with hemodialysis (HD/HP) demonstrated the optimal clearance of molecular uremic toxins. Kidney Disease Outcomes Quality Initiative (KDOQI) recommends assessment nutritional status of regular hemodialysis patients with a combination of valid assessment tools, such as 7-point SGA (Subjective Global Assessment) and albumin.
Objective: To determine correlation between the combination of HD/HP with the nutritional status of regular hemodialysis patients.
Methods: This prospective cohort study from December 2013 to March 2014 on 20 regular hemodialysis patient and do history, measurements of height, weight, body mass index, nutritional status assessment by 7-point SGA and examination of serum albumin.
Results: At the end of observation, 20 subjects were observed one subject out of the study. There is a significant difference between the mean of score 7-point SGA before and after combination hemodialysis/hemoperfusion (p<0.05). There is a significant difference between the mean albumin before and after combination Albumin HD / HP first (p<0.05). There are differences in body mass index (BMI) after combination by sex (p<0.05). There is a strong relationship between the 7-point SGA with BMI after combination (r=0.636,p<0.01).
Conclusion: The combination of HD / HP is good clinical application for the treatment of malnutrition in regular hemodialysis patients. Regular assessment of nutritional status of regular hemodialysis patients is necessary, with a combination of a valid assessment tool (7-point SGA, albumin) is expected to help decrease morbidity and mortality.
Keywords: Hemodialysis, haemoperfusion, 7-point SGA, albumin.
