Factors affecting hemodialysis adequacy in patients undergoing hemodialysis: a cross-sectional study

Abstract

Hemodialysis is the most preferred renal replacement therapy for patients with chronic kidney failure worldwide. The indicator of the success of hemodialysis therapy is the fulfillment of the adequacy of the hemodialysis dose as measured by Kt/V. Many factors affect the adequacy of hemodialysis, including internal factors and external factors of the patient. This study aimed to analyze the factors that affect the adequacy of hemodialysis in patients undergoing hemodialysis at Indramayu Hospital. Research design using a cross-sectional approach. The sample in this study was 44 respondents who were taken based on purposive sampling. The result showed that the average Kt/V was 1.71 with the lowest Kt/V value being 0.76 and the highest Kt/V being 2.33. Of 44 respondents, 24 (54.5 %) found adequacy achieved, and 20 (45.5 %) respondents did not achieve adequacy. Factors related to hemodialysis adequacy are gender (p=0.000; OR=4.0), dry weight (p=0.006; OR=7.286), dialyzer reuse (p=0.005; OR=8.000), and quick of blood (p=0.38; OR=4.5). Suggestions for hemodialysis nurses to be able to evaluate, especially the use of dialyzer reuse no more than 4 times, and maintain a quick blood speed of at least 250 ml/minute to achieve adequacy.

Hubungan Penerimaan Diri dengan Kepatuhan Pembatasan Cairan pada Pasien Gagal Ginjal

“…Selain itu faktor lain yang dapat mempengaruhi adekuasi hemodialisis adalah berat badan kering. Semakin tinggi berat badan maka akan semakin tinggi nilai V dan membuat perhitungan Kt/v menjadi semakin kecil (Ladesvita & Sukmarini, 2019;Wayunah et al, 2023) Pelaksanaan hemodialisis di Instalasi hemodialisis yaitu dengan memberikan dosis Qb pada rentang 200-300, Qd minilai 500 mL/menit, jadwal HD 2x seminggu dan waktu dialisis 4-6 jam per sesi HD. hal ini sesuai dengan rekomendasi panduan Nephrologist et al ( 2024) & Marugan (2020) yang merekomendasikan kecepatan aliran darah minimal 200-300 mL/menit, durasi waktu minimal 12 jam per minggu untuk mayoritas dua atau tiga kali seminggu.…”