i
“
HUBUNGAN ANTARA KOMBINASI HEMODIALISIS (HD) /
HEMOPERFUSI (HP) DENGAN TOTAL BODY WATER
(TBW), EXTRA CELLULAR WATER (ECW) DAN INTRA
CELLULAR WATER (ICW) PASIEN HEMODIALISIS
REGULER
”
Faisal Sinurat, Abdurrahim Rasyid Lubis
Divisi Nefrologi dan Hipertensi - Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Sumatera Utara Medan
ABSTRAK
Latar Belakang: Air merupakan komponen utama tubuh dan merupakan medium
esensial dalam tubuh. Dalam keadaan normal keseimbangan volume cairan tubuh intra dan ekstra seluler dipertahankan tetap konstan oleh ginjal. Aplikasi klinis kombinasi hemodialisis dengan hemoperfusi (HD/HP) menunjukkan tingkat efektifitas pembersihan molekul racun uremik yang optimal. Kombinasi HD/HP bermanfaat terhadap bersihan toksin uremik berat molekul menengah dan berat molekul besar pada pasien-pasien hemodialisis reguler
Tujuan: Untuk mengetahui hubungan antara kombinasi hemodialisis /
hemoperfusi dengan TBW, ECW, ICW pada BIA pada pasien hemodialis 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 cairan tubuh dengan menggunakan alat BIA.
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, BIA, TBW, ECW, ICW.
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“ THE CORRELATION BETWEEN
COMBINATION HEMODIALYSIS (HD) / HEMOPERFUSION (HP) WITH
TOTAL BODY WATER (TBW), EXTRA CELLULAR
WATER (ECW) DAN INTRA CELLULAR WATER (ICW)
ONREGULAR HEMODIALYSIS”
Faisal Sinurat, 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, BIA, TBW, ECW, ICW.
