Background: Hemodialysis is one of renal replacement therapy for patients with chronic renal failure (CRF). The quality of hemodialysis is largely determined by the recommended dose of hemodialysis. Biological and psychological changes are often faced by patients undergoing hemodialysis, which can affect their quality of life. Family support is an important factor that serves as a support system for the patients to face the health problems. This study aimed to determine the association between hemodialysis adequacy, family support, and quality of life in chronic renal failure patients. Subjects and Method: This was an analytic observational study with cross sectional design. It was conducted at Kasih Ibu Hospital, Surakarta, Central Java. A total sample of 102 patients with chronic renal failure who underwent hemodialysis were selected for this study using random sampling. The dependent variable was quality of life. The independent variables were hemodialysis adequacy and family support. The quality of life was assessed using the WHOQoL questionnaire. The hemodialysis adequacy was measured by Ureum Reduction Rate (URR) formula. Family support was measured by family support questionnaire. The data were analyzed using Chi Square test, Mann Whitney test, and logistic regression Results: Patients with chronic renal failure had better quality of life if they underwent adequate hemodialysis (OR= 5.34; 95% CI= 2.20 to 12.98; p= 0.001) and received strong family support (OR= 7.74; 95% CI= 3.13 to 19.13; p= 0.001). Conclusion: Quality of life of the patients with chronic renal failure is determined by hemodialysis adequacy and family support.
Background: Inflammation plays an important role in the pathogenesis of COVID-19 and can be an important factor in the prognosis. The innate immune response to a respiratory infection is characterised by an influx of neutrophils to the lungs, particularly the alveoli. A sustained release of anti-inflammatory cytokines may lead to widespread apoptosis of lymphocytes, resulting in lymphopenia. Hs-CRP is an indicator of COVID-19 inflammation. The aim of this study was to analyse Neutrophilto-Lymphocyte Ratio (NLR) and Hs-CRP in order to predict mortality in COVID-19 patients. Research methods: This research was conducted at Moewardi Hospital in July 2020. The subjects were COVID-19 patients. NLR is neutrophils divided by lymphocytes using a haematology analyser. The examination of Hs-CRP was conducted utilizing the ELISA method. Statistical test with an independent T-test and cox proportional hazard analysis with p <0.05 was also used. Results: The results showed that Hs-CRP and NLR increased in COVID-19 patients who later died and obtained lower levels of surviving (p = 0.001 and p = 0.11). Hs-CRP increased the risk of death for COVID-19 patients (p = 0.18; HR = 1.036) and NLR also increased the risk of death for COVID-19 patients (p = 0.08; HR = 1.34) Conclusion: Neutrophil-to-Lymphocyte Ratio and Hs-CRP predicted mortality in COVID-19 patients
Kanamisin adalah obat untuk terapi tuberkulosis resistan obat (TB RO) yang menimbulkan efek samping gangguan pendengaran, gangguan fungsi ginjal, dan gangguan elektrolit terutama hipokalemia. Penelitian bertujuan menilai kesintasan waktu timbulnya efek samping dan pengaruh faktor risiko usia, riwayat terapi streptomisin serta berat badan terhadap efek samping akibat pemberian kanamisin pasien TB RO. Penelitian kohort retrospektif dari data rekam medis pasien TB RO dari Januari 2011 sampai April 2017 di RSUD Dr. Moewardi Surakarta. Analisis pengaruh faktor risiko terhadap efek samping menggunakan uji cox regression. Dari 238 pasien didapatkan gangguan pendengaran 143 pasien, gangguan fungsi ginjal 147 pasien, dan hipokalemia 169 pasien. Usia lebih dari 40 tahun hazard ratio (HR) 2,419
ABSTRAKPendahuluan. Dialisis merupakan modalitas terapi pengganti ginjal (TPG) yang rutin dilakukan di Indonesia, terdiri dari hemodialisis (HD) dan continuous ambulatory peritoneal dialysis (CAPD). Peningkatan jumlah pasien penyakit ginjal kronik (PGK) tiap tahunnya mengakibatkan kebutuhan akan dialisis juga meningkat. Kondisi malnutrisi, efek samping terapi, stres psikis, dan keadaan komorbid yang menyertai seringkali memengaruhi kualitas hidup pasien PGK. Tujuan dari penelitian ini yaitu untuk mengetahui perbedaan kualitas hidup dan status nutrisi antara pasien PGK yang mendapat terapi HD dan CAPD.Metode. Penelitian ini merupakan observasional analitik yang dilakukan pada bulan Agustus-September 2019 di Rumah Sakit Dr. Moewardi, Surakarta. Subjek penelitian yaitu pasien PGK yang mendapat terapi dialisis (30 pasien HD dan 30 pasien CAPD). Instrumen penelitian berupa kuesioner yaitu kidney disease quality of life short form-36 TM (KDQOL-36 TM ) untuk evaluasi kualitas hidup serta kuesioner subjective global assesment (SGA) untuk mengetahui keadaan nutrisi pasien PGK. Hasil penelitian dianalisis dengan uji T tidak berpasangan dan chi square serta dilanjutkan dengan analisis multivariat, nilai p < 0,05 dinilai signifikan secara statistik.Hasil. Rerata usia subjek penelitian yaitu 49,23 (simpang baku [SB] 12,25) tahun pada kelompok HD dan 41,13 (SB 12,10) tahun pada kelompok CAPD. Hasil analisis kualitas hidup menunjukkan kelompok CAPD memiliki keadaan fisik (p = 0,003) dan mental (p = 0,047) yang lebih baik dibandingkan dengan pasien HD. Gejala sistemik pada PGK didapatkan lebih berat pada kelompok pasien HD (p = 0,037). Selain itu, efek penyakit ginjal yang diderita pasien dinilai lebih memperburuk kualitas hidup pasien yang menjalankan terapi HD (p = 0,018). Namun, beban penyakit ginjal antara kedua kelompok tidak berbeda secara signifikan. Status nutrisi menunjukkan pasien CAPD memiliki status nutrisi yang lebih baik dibandingkan dengan pasien HD (p = 0,016). Hasil analisis multivariat menunjukkan bahwa variabel yang memiliki perbedaan signifikan terhadap HD dan CAPD adalah komponen kesehatan mental (p = 0,016) dan kesehatan fisik (p = 0,003).Simpulan. Hasil penelitian ini menunjukkan kualitas hidup dan status nutrisi pasien PGK stadium akhir dengan terapi CAPD lebih baik dibandingkan dengan pasien PGK yang menjalani terapi HD. Namun, penelitian lebih lanjut dengan subjek yang lebih luas serta menggunakan kuesioner yang berbeda masih diperlukan. Kata Kunci: Continous ambulatory peritoneal dialysis, hemodialisis, kualitas hidup, nutrisi, penyakit ginjal kronik ABSTRACT Introduction. Dialysis is a common procedure routinely used in Indonesia which consist of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). Increasing number of CKD patients lead to higher dialysis requirement. Malnutrition, adverse effect of therapy, psychological stress, and comorbid conditions may affect quality of life (QoL) in CKD patients. We aimed to investigate comparison of QoL and nutritional status between CKD pati...
Latar belakang: Pengendalian Infeksi Tuberkulosis Laten (ITBL) penting dalam program End TB Strategy. Prevalensi ITBL dan reaktivasi menjadi tuberkulosis aktif meningkat pada kondisi imunodefisiensi salah satunya adalah pasien hemodialisis. Diagnosis ITBL dilakukan dengan pemeriksaan Tuberculin Skin Test (TST) dan Immunoglobulin Gamma Release Assay (IGRA). Penelitian ini merupakan uji diagnostik ITBL yang bertujuan mengetahui tingkat kesesuaian pemeriksaan TST dan T-SPOT.TB, ketepatan pemeriksaan T-SPOT.TB, serta korelasi antara jumlah sel T cluster of differentiation 4 (CD4+) dengan pemeriksaan TST dan TSPOT.TB.
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