Background: Hemodialysis is one of the main therapies for patients with end-stage renal disease. Quality of life is essential in the management of chronic kidney disease (CKD) patients undergoing hemodialysis. Factors that influence the quality of life in hemodialysis patients must be identified. Purpose: This research evaluated the quality of life in CKD patients undergoing hemodialysis and determined factors affecting the quality of life. Patients and Methods: This study used an analytical survey method with a cross-sectional design. The Subjective Global Assessment (SGA) questionnaire was used to evaluate nutritional status, and the KDQOL-SF TM questionnaire was used to evaluate quality of life. The bivariate statistical test applied was the Student's t-test or the Mann-Whitney U-test. Multivariate analysis was done using logistic regression. Results: The total number of hemodialysis patients in the study was 124. Their median age was 44 years. The patients consisted of 66 (53%) men and 58 (47%) women. Overall, 84 patients had good quality of life (67.7%), and 40 (32.3%) reported poor quality of life. Our study showed a relationship between economic status and quality of life (p = 0.029) and between the number of comorbid factors and quality of life (p = 0.014). No relationship was found between nutritional status and quality of life (p = 0.121). Multivariate analysis using logistic regression analysis showed that the number of comorbidities was a significant factor in quality of life (p = 0.004, ). Conclusion:The majority of hemodialysis patients had good quality of life. Logistic regression analysis found that the number of comorbidities was a significant factor in the quality of life of hemodialysis patients. Comorbidities in hemodialysis patients must be managed to improve their quality of life.

Introduction. Chronic kidney disease (CKD) is associated with high mortality rates, mainly as a result of cardiovascular complications. Meanwhile, recent studies have suggested a role of a homodimer protein called activin A in chronic kidney disease-mineral and bone disorder (CKD-MBD) conditions that may exist in the vascular calcification and osteolytic process. Ultrasound examination of the carotid intima-media thickness (cIMT) is a noninvasive method to assess vascular calcification. This study aimed to analyze the relationship between the activin A serum level and cIMT in patients with CKD at Mohammad Hoesin Hospital, Palembang, Indonesia. Methods. We conducted a hospital-based, cross-sectional study of consecutive CKD patients at the Department of Internal Medicine, Mohammad Hoesin Hospital, from July to November 2019. The level of activin A was measured by enzyme-linked immunosorbent assay. Meanwhile, cIMT measurements were collected by B-mode ultrasound imaging. Results. A total of 55 patients with CKD were included in this investigation. The median serum activin A level in these patients was 236.17 (116.33–283) pg/mL, while the median cIMT was 0.8 (0.6–1.45) mm. A relationship between the serum activin A level and cIMT (r  =  0.449; p = 0.001 ) was observed. During multivariate analysis with linear regression, triglyceride p = 0.049 , phosphate p = 0.005 , and activin A p = 0.020 serum levels were factors associated with cIMT. Conclusion. In this study, a relationship between the activin A serum level and cIMT in patients with CKD was identified. Vascular calcification should be screened for in all CKD patients by the measurement of cIMT.

Kidney disease affects 800 million children and adults worldwide, and the numbers keep increasing. A better understanding of the pathogenesis in kidney diseases, especially on a biomolecular level, is much needed to identify novel biomarkers and therapeutic targets for kidney diseases. The glomerular filtration barrier comprises endothelial cells, the glomerular basement membrane, and podocytes. The podocyte has a central role in part of the glomerular filtration barrier. The normal functioning of podocytes is particularly important in preventing the heavy proteinuria seen in nephrotic syndrome or diabetic nephropathy, or in the disease process of focal segmental glomerulosclerosis. The podocyte is injured by circulating factors, which finally results in deranged podocyte motility. Soluble urokinase-type plasminogen activator receptor (suPAR) is a circulating form of glycosyl-phosphatidylinositol uPAR domain membrane protein and is known to play a role in the pathogenesis in kidney diseases, specifically focal segmental glomerulosclerosis and diabetic nephropathy. suPAR binds to αvβ3 integrin on podocyte foot processes and causes podocyte structure disorganization leading to glomerular filtration disruption and hence proteinuria. suPAR is also a potential biomarker to predict the incidence of CKD.

Kidney disease affects 800 million children and adults worldwide, and the numbers keep increasing. A better understanding of the pathogenesis in kidney diseases, especially on a biomolecular level, is much needed to identify novel biomarkers and therapeutic targets for kidney diseases. The glomerular filtration barrier comprises endothelial cells, the glomerular basement membrane, and podocytes. The podocyte has a central role in part of the glomerular filtration barrier. The nor­mal functioning of podocytes is particularly important in preventing the heavy proteinuria seen in nephrotic syndrome or diabetic nephropathy, or in the disease process of focal segmental glomerulosclerosis. The podocyte is injured by circulating factors, which final­ly results in deranged podocyte motility. Soluble uro­kinase-type plasminogen activator receptor (suPAR) is a circulating form of glycosyl-phosphatidylinositol uPAR domain membrane protein and is known to play a role in the pathogenesis in kidney diseases, specifi­cally focal segmental glomerulosclerosis and diabetic nephropathy. suPAR binds to αvβ3 integrin on podo­cyte foot processes and causes podocyte structure dis­organization leading to glomerular filtration disruption and hence proteinuria. suPAR is also a potential bio­marker to predict the incidence of CKD.

Chronic kidney disease (CKD) is associated with high mortality rates related to cardiovascular complications. Atherosclerosis, arteriosclerosis and vascular calcification conditions are often found in CKD patients. Carotid intima media thickness (cIMT) thickening is one of the parameters of vascular disorders. A cross sectional study was conducted on patients with chronic kidney disease in the hospital. Mohammad Hoesin Palembang. Patients' blood samples were examined in the hospital laboratory. CIMT thickening was examined using echocardiography. A total of 55 patients with stage 3-5 chronic kidney disease were examined. The median cIMT is 0.8 (0.6-1.45) mm. Spearman's correlation analysis showed a significant correlation between triglyceride levels and thickening of cIMT (r = 0.303, p = 0.025). A significant correlation was also shown between phosphate levels and cIMT thickening (r = 0.290, p = 0.032). There is a significant correlation of triglyceride levels and phosphate levels to cIMT thickening in patients with chronic kidney disease in Palembang