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"[ABSTRAKLatar Belakang. Pendekatan holistik di bidang Psikosomatik menekankan faktor spiritualitas dan dukungan pada sisi spiritualitas dapat meningkatkan pelayanan serta memperbaiki kondisi psikologis pada pasien. Selama prosedur hemodialisis respon inflamasi akan meningkat dibuktikan dengan peningkatan konsentrasi interleukin-6 (IL- 6). Aspek spiritual yang dapat menurunkan respon inflamasi masih perlu diteliti.Tujuan. Untuk mengetahui gambaran aspek spiritual pasien yang menjalani hemodialisis kronik dan untuk mengetahui korelasi aspek spiritual dengan kadar IL-6 serum pada pasien yang menjalani hemodialisis kronik.Metode. Penelitian ini merupakan studi cross sectional dilakukan pada 51 pasien hemodialisis kronik di unit Hemodialisis RSUP. H. Adam Malik dan RSU. Dr. Pirngadi Medan mulai bulan Juli-Agustus 2014. Pemeriksaan kadar IL-6 serum diukur dengan metode quantitative enzyme-linked immunosorbent assay (ELISA) dilakukan pengambilan sampel darah dan pengukuran spiritual dilakukan dengan pengisian kuesioner FACIT Sp-12 pada pagi hari 30 menit sebelum hemodialisis berlangsung.Hasil. Skor subskala meaning (makna) 10.67 (SB 2.66), peace (damai) 9.63 (SB 2.19) dan faith (iman) 11.47 (SB 2.91). Nilai median kadar IL-6 serum pada penelitian ini adalah adalah 5,63 (1,48-28,88) pg/mL. Nilai median FACIT Sp-12 adalah 30,00 (18-48). Hasil uji korelasi antara tingkat spiritual dengan kadar IL-6 serum menunjukkan koefisien korelasi -0,330 dengan nilai p = 0,018 yang secara statistik menunjukkan korelasi negatif yang lemah.Simpulan. Spiritual pada pasien hemodialisis kronik tinggi. Terdapat korelasi negatif yang lemah antara aspek spiritual dengan kadar IL-6 pada pasien hemodialisis kronik.

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ABSTRACTBackground: Holistic approach in psychosomatic focus on spirituality factor and spiritual support is expected to improve services and psychological condition of the patients. Inflammatory response during haemodialysis procedure hence increased with the evidence of increasing level of serum interleukin-6 (IL-6). Further research is still needed to see the spiritual factors that can decrease the inflammatory factors.Objective: To assess spiritual aspect of chronic haemodialysis patients and to assess correlation between serum IL-6 level and spiritual aspect in chronic haemodialysis patients.Methods: Cross sectional study on 51 chronic haemodialysis patients at RSUP. H. Adam Malik and RSU dr. Pirngadi Medan between July-August 2014. Serum IL-6 was measured using quantitative enzyme-linked immunosorbent assay (ELISA) methods. Blood samples and spiritual aspect assessment by handing out FACITSp-12 questionnaire to patients were taken in the morning, 30 minutes before haemodialysis.Results: . Subscale meaning 10.67 (SB 2.66), peace 9.63 (SB 2.19) and faith 11.47 (SB 2.91). Median serum IL-6 level is 5,63 ( 1,48-28,88 ) pg/mL. Median FACIT Sp-12 is 30,00 (18-48). Correlation test between serum IL-6 level and spiritual aspect have shown statistically weak negative correlation (correlation coefficient -0,330, p = 0.018).Conclusion: spirituality level in chronic hemodialysis patients are higher. Weak negative correlation between serum IL-6 level and spiritual level on chronic haemodialysis patients was found in this study.;Background: Holistic approach in psychosomatic focus on spirituality factor and spiritual support is expected to improve services and psychological condition of the patients. Inflammatory response during haemodialysis procedure hence increased with the evidence of increasing level of serum interleukin-6 (IL-6). Further research is still needed to see the spiritual factors that can decrease the inflammatory factors.Objective: To assess spiritual aspect of chronic haemodialysis patients and to assess correlation between serum IL-6 level and spiritual aspect in chronic haemodialysis patients.Methods: Cross sectional study on 51 chronic haemodialysis patients at RSUP. H. Adam Malik and RSU dr. Pirngadi Medan between July-August 2014. Serum IL-6 was measured using quantitative enzyme-linked immunosorbent assay (ELISA) methods. Blood samples and spiritual aspect assessment by handing out FACITSp-12 questionnaire to patients were taken in the morning, 30 minutes before haemodialysis.Results: . Subscale meaning 10.67 (SB 2.66), peace 9.63 (SB 2.19) and faith 11.47 (SB 2.91). Median serum IL-6 level is 5,63 ( 1,48-28,88 ) pg/mL. Median FACIT Sp-12 is 30,00 (18-48). Correlation test between serum IL-6 level and spiritual aspect have shown statistically weak negative correlation (correlation coefficient -0,330, p = 0.018).Conclusion: spirituality level in chronic hemodialysis patients are higher. Weak negative correlation between serum IL-6 level and spiritual level on chronic haemodialysis patients was found in this study., Background: Holistic approach in psychosomatic focus on spirituality factor and spiritual support is expected to improve services and psychological condition of the patients. Inflammatory response during haemodialysis procedure hence increased with the evidence of increasing level of serum interleukin-6 (IL-6). Further research is still needed to see the spiritual factors that can decrease the inflammatory factors.Objective: To assess spiritual aspect of chronic haemodialysis patients and to assess correlation between serum IL-6 level and spiritual aspect in chronic haemodialysis patients.Methods: Cross sectional study on 51 chronic haemodialysis patients at RSUP. H. Adam Malik and RSU dr. Pirngadi Medan between July-August 2014. Serum IL-6 was measured using quantitative enzyme-linked immunosorbent assay (ELISA) methods. Blood samples and spiritual aspect assessment by handing out FACITSp-12 questionnaire to patients were taken in the morning, 30 minutes before haemodialysis.Results: . Subscale meaning 10.67 (SB 2.66), peace 9.63 (SB 2.19) and faith 11.47 (SB 2.91). Median serum IL-6 level is 5,63 ( 1,48-28,88 ) pg/mL. Median FACIT Sp-12 is 30,00 (18-48). Correlation test between serum IL-6 level and spiritual aspect have shown statistically weak negative correlation (correlation coefficient -0,330, p = 0.018).Conclusion: spirituality level in chronic hemodialysis patients are higher. Weak negative correlation between serum IL-6 level and spiritual level on chronic haemodialysis patients was found in this study.]"

"Hemodialisis merupakan salah satu terapi untuk pasien gagal ginjal kronik. Hemodialisis selain memiliki efek terapeutik juga menimbulkan dampakjangka panjang yang menurunkan kualitas hidup pasien. Beberapa faktor yang diduga berpengaruh terhadap kualitas hidup pasien hemodialisis yaitu depresi, tingkat spiritual, dan dukungan sosial. Penelitian ini bertujuan untuk mengetahui hubungan depresi, tingkat spiritual, dan dukungan sosial dengan kualitas hidup pasien hemodialisis di RSAU Dr. Esnawan Antariksa. Penelitian ini menggunakan desain cross sectional, dengan jumlah sampel 119 orang pasien di unit hemodialisis. Analisis data menggunakan uji korelasi, independent t-test dan one way anova. Hasil penelitian menunjukkan terdapat hubungan yang signifikan antara kualitas hidup dengan dukungan sosial p-value 0,009, r=0,240, tingkat spiritual p-value 0,000 dan depresi p-value 0,000. Faktor yang paling berpengaruh terhadap kualitas hidup yaitu depresi. Penelitian ini merekomendasikan kepada perawat untuk melakukan pengkajian depresi sebagai screening awal untuk menentukan intervensi keperawatan guna meningkatkan kualitas hidup.

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Hemodialysis is one of the treatment of chronic renal failure. Beside its therapeutic effects, hemodialysis cause long term impact that decrease quality of life. There are several factors considered have influences quality of life of hemodialysis patients, which are depression, spiritual level and social support. The aim of this study is to determine relationship between depression, spiritual level and social support with quality of life of hemodialysis patient in RSAU Dr. Esnawan Antariksa. This study was a cross sectional design, involved 119 hemodialysis patients Data were analysed using correlation test, independent t test, and one way anova. The results showed there was a significant relationship between quality of life and social support p value .009, r .240, spiritual level p value .000 and depression p value .000 . The most influential factor quality of life is depression. This study recommends that nurses should assess depression level in hemodialysis patient as early screening to determine nursing intervention that can improve quality of life."

"Latar Belakang: Penurunan kapasitas latihan dan kekuatan otot merupakan gambaran yang umum dijumpai pada pasien hemodialisis (HD) kronik. Perbaikan kadar hemoglobin (Hb) tidak memperbaiki secara optimal kapasitas latihan. Prevalensi kalsifikasi arteri tinggi pada pasien HD. Hal ini menyebabkan berkurangnya elastisitas pembuluh darah sehingga meningkatkan kekakuan arteri. Terdapat bukti klinis bahwa kekakuan arteri sentral memengaruhi kapasitas latihan pada pasien penyakit ginjal kronik (PGK). Kapasitas latihan dapat diprediksi dengan menilai kekuatan otot perifer. Tujuan: Mengetahui korelasi kekakuan arteri sentral dengan kekuatan genggam tangan pada pasien yang menjalani HD kronik. Metode: Penelitian ini merupakan penelitian potong lintang dengan subyek pasien HD kronik yang diambil dengan teknik consecutive sampling dengan rentang usia 18 – 59 tahun.  Analisis bivariat dilakukan untuk menilai korelasi kekakuan arteri sentral (dengan menilai central pulse wave velocity/cPWV) dengan kekuatan genggam tangan (KGT), kemudian dilakukan korelasi parsial terhadap variabel perancu (usia, dialysis vintage, Hb, dan aktivitas fisik). Hasil: Terdapat 45 pria dan 40 wanita dengan median usia masing-masing 47 (19-59) dan 47 (18-59) tahun. Kedua kelompok mempunyai tingkat aktivitas fisik sedang. Tidak terdapat korelasi antara cPWV dengan KGT baik pada  pria (r = -0,046, p = 0,763) maupun wanita (r = -0,285, p = 0,113). Analisis stratifikasi pada wanita yang memiliki tinggi badan (TB) >150 cm menunjukkan korelasi negatif derajat sedang antara cPWV dengan KGT (r = -0,466; r² = 0,217; p = 0,016). Nilai cPWV berperan sebesar 21,7% terhadap KGT, dan 78,3% diduga dipengaruhi oleh faktor perancu. Kelompok KGT rendah memiliki nilai cPWV yang meningkat pada semua kategori usia. Simpulan: Kekakuan arteri sentral tidak berhubungan dengan kekuatan genggam tangan pada pasien yang menjalani HD kronik. Terdapat kecenderungan peningkatan nilai cPWV pada subjek yang memiliki KGT rendah.

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Background: Exercise intolerance and muscle weakness are the common features in hemodialysis patients. However, correction of renal anemia by eritropoetin does not optimize the exercise capacity. The prevalence of arterial calcification among the hemodialysis patient is high. It thereby decreased the elasticity of the vessels and increased the arterial stiffness. Clinical evidence showed that central arterial stiffness affects the exercise capacity in chronic kidney disease (CKD). Exercise capacity can be predicted by assessing peripheral muscle strength.

Objective: To investigate the correlation between central arterial stiffness and handgrip strength in chronic hemodialysis patients.

Methods: This study use cross-sectional design which perform in chronic HD patients aged between 18 and 59 years old by consecutive sampling. Bivariate analysis was done to determine the correlation between central arterial stiffness (assessed using central pulse wave velocity /cPWV) and handgrip strength (HGS). Afterwards, partial correlation of confounding variables (age, dialysis vintage, Hb and physical activity) were also be analyzed.

Results: There were 45 men and 40 women with the median age of 47 (19-59) and 47 (18-59) years old, respectively. Both groups have moderate level of physical activity. There was no correlation between cPWV and HGS in men (r = -0.046, p = 0.763) and women (r = -0.285, p = 0.113). Stratified analysis in women with height over 150 cm showed a moderate negative correlation between cPWV and HGS (r = -0,466; r² = 0,217; p = 0,016). cPWV accounted for 21.7% of HGS, while 78.3% were suggested to be influenced by the confounding factors. The group with low HGS had an increased cPWV in all age categories.

Conclusion: Central artery stiffness was not associated with HGS in chronic HD patient. There was a tendency of increased central arterial stiffness in the group of subjects who had low HGS."

"Pendahuluan: Kekakuan arteri merupakan prediktor mortalitas pasien hemodialisis. Hemodialisis merupakan proses yang menginduksi inflamasi, ditandai dengan peningkatan penanda inflamasi, Pentraxin 3 (PTX3), intradialisis. Rerata kekakuan arteri pada pasien HD dua kali seminggu di Indonesia menunjukkan hasil yang lebih rendah daripada literatur. Tujuan: Mengetahui faktor risiko kekakuan arteri pada pasien hemodialisis kronik dengan berfokus pada frekuensi hemodialisis dan PTX3.Metode: Penelitian ini merupakan penelitian potong lintang di RS Cipto Mangunkusumo, RS Fatmawati, dan RS Medistra pada pasien yang menjalani hemodialisis minimal 1 tahun dengan frekuensi dua dan tiga kali seminggu. Kekakuan arteri diukur dengan carotid-femoral pulse wave velocity. Pemeriksaan PTX3 dilakukan sebelum hemodialisis dimulai.Hasil: Penelitian dilakukan pada 122 subjek, 82 subjek diantaranya menjalani hemodialisis dua kali seminggu. Tidak ada perbedaan kekakuan arteri antara pasien HD 2x dan 3x seminggu. PTX3 > 2,3 ng/ml berhubungan dengan kekakuan arteri (p=0,021). Pada analisis multivariat, PTX3 berhubungan dengan kekakuan arteri (adjusted OR 5,18; IK 95% 1,07-24,91), demikian juga penyakit kardiovaskular (adjusted OR 3.67; IK 95% 1.40-10.55), kolesterol LDL (adjusted OR 3.10; IK 95% 1.04-9.24), dan dialysis vintage (adjusted OR 2.72; IK 95% 1.001-7.38).Simpulan: PTX >2,3 ng/ml berhubungan dengan kekakuan arteri. Tidak terdapat perbedaan kekakuan arteri antara pasien HD dua kali dan tiga kali seminggu.

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Introduction: Arterial stiffness is a mortality predictor in hemodialysis patients. Hemodialysis induces inflammation, marked by intradialysis increment of inflammatory marker, Pentraxin 3 (PTX3). The mean arterial stiffness in twice-weekly hemodialysis patients in Indonesia is lower than studies done in thrice-weekly patients.

Objective: To determine factors associated with arterial stiffness in hemodialysis patients, focusing on the role of hemodialysis frequency and PTX3.

Methods: This study is a cross-sectional study conducted in Cipto Mangunkusumo Hospital, Fatmawati Hospital, and Medistra Hospital Jakarta in twice- and thrice-weekly hemodialysis patients. Arterial stiffness is measured by carotid-femoral pulse wave velocity.

Results: The study is conducted in 122 subjects, 82 of them undergo twice-weekly hemodialysis. There is no difference in arterial stiffness between twice- and thrice-weekly subjects. PTX3>2.3 ng/ml is associated with arterial stiffness (p= 0.021). In multivariate analysis, PTX3 is associated with arterial stiffness (adjusted OR 5.18; 95% CI 1.07-24.91), as well as cardiovascular disease (adjusted OR 3.67; 95% CI 1.40-10.55), LDL cholesterol (adjusted OR 3.10; 95% CI 1.04-9.24), and dialysis vintage (adjusted OR 2.72; 95%CI 1.001-7.38).

Conclusions: Predialysis PTX3 level above 2.3 ng/ml is associated with arterial stiffness. There is no difference in arterial stiffness between twice- and thrice-weekly hemodialysis patients."

"Latar Belakang: Puasa ramadan menurunkan petanda inflamasi pada individu sehat. pasien PGK (Penyakit ginjal kronik) yang menjalanin hemodialisis rutin meskipun dianjurkan tidak berpuasa sebagian besar masih tetap berpuasa ramadan. PGK merupakan kondisi inflamasi kronik dengan petanda inflamasi IL-6 yang tinggi, IL-6 berkorelasi kuat dengan skor inflamasi malnutrisi dan menjadi prediktor mortalitas pasien PGK yang menjalanin HD rutin. Saat ini belum diketahui pengaruh puasa ramadan pada pasien PGK yang menjalanin HD rutin apakah akan juga mempengaruhi petanda inflamasi seperti individu sehat. Tujuan: Mengetahui pengaruh puasa Ramadan pada pasien dengan hemodialisis rutin terhadap inflamasi.Metode: Penelitian dengan desain kohort prospektif yang dikerjakan pada ramadan tahun 2022 (April-Mei) pada pasien hemodialisis rutin di 3 unit HD, dibagi menjadi 2 kelompok (berpuasa/tidak berpuasa) dimana subjek dengan kondisi infeksi, dalam terapi steroid, edema pulmo, diabetes yang tidak terkontrol, disabilitas, tuli pendengaran serta memiliki penyakit kardiovascular berat dikeluarkan dalam penelitian ini. Kadar IL-6 dan skor MIS dinilai sebelum menjalankan proses HD di minggu pertama dan terkhir ramadan. Analisis dilakukan dengan menghitung median dari tiap variable dependen.Hasil: Total 70 subjek diikutsertakan pada penelitian ini. Sebagian besar subjek penelitian adalah laki-laki (54,3%), berusia lebih dari 45 tahun (52,9%), berasal dari rumah sakit PMI (42,9%) dengan jenis dialiser LF (Lowflux) 78,6%. Durasi lama puasa lebih dari sama dengan 15 hari adalah 70%, tidak menjalankan ibadah puasa saat HD 71,4% dengan lama menjalani hemodialisis lebih dari 5 tahun 48,6% dan komorbid hipertensi 64,3%. Delta kadar IL-6 Kel berpuasa 6,1 pg/mL, kel tidak berpuasa 13,6 pg/mL dengan p=0,828. Delta MIS kel berpuasa 1 point dan kel tidak berpuasa 2 point dengan p=0,376.Simpulan: Pasien hemodialisis rutin yang berpuasa ramadan menunjukan peningkatan kadar IL-6 dan skor MIS lebih rendah dibandingkan dengan yang tidak berpuasa walaupun secara statistik tidak bermaknaBackground and Objectives Ramadan fasting reduces sign of inflammation in healthy individuals. CKD patients who undergo routine hemodialysis, although those patients are not recommended to fast, most of them were still fasting. CKD is a chronic inflammation condition which indicated by high level of IL-6. Level of IL-6 is strongly correlated with Malnutrition- Inflammatory Score (MIS) and is a mortality predictor in PGK patients who undergo routine dialysis. Currently, there is no information on the effect of Ramadan fasting on CKD patients who undergo dialysis and whether it has similar effect on inflammation index compared to healthy individuals. Materials and Methods: The study employed prospective cohort design which was done during Ramadan 2022 (April – May) on routine hemodialysis patients in 3 hemodialysis unit. The subject was divided into two groups (i.e. fasting/ non- fasting) where subjects with infection conditions, undergoing steroid therapy, pulmonary edema, uncontrolled diabetes, disability, hearing impaired, and cardiovascular disease are excluded from this study. Level of IL-6 and MIS score was taken before undergo hemodialysis in the first and last week of Ramadan. Data analysis was done by calculating median to every dependent variable.Results: A total of 70 subjects were included in this study. Most of the subjects are male (54.3%), aged more than 45 years old (52.9%), taken from PMI hospital (42.9%), and with low-flux membrane dialyzers (LF) (78.6%). The duration of fasting was more or equal to 15 days (70%), undergo hemodialysis without fasting (71.4%), have been undergo hemodialysis for more than five years (48.6%) and comorbidity of hypertension (64.3%). The change of IL-6 level in fasting group was 6.1 pg/mL; not fasting group was 13.6 pg/mL with p value= 0.828. The difference in MIS in fasting group was 1 point and non-fasting group was 2 points with p value=0.376. Conclusion: Patients undergo routine hemodialysis in fasting group showed increase in IL-6 levels and MIS score lower compared to non-fasting group, although statistically insignificant. "

"Penelitian ini adalah penelitian deskriptif potong lintang pada pasien remaja di RSCM Jakarta pada bulan Juni 2018. Tujuannya adalah untuk mengetahui gambaran masalah psikososial dan hubungannya dengan kepatuhan berobat remaja dengan infeksi HIV perinatal yang diukur dengan kuesioner. Terdapat 46 remaja usia 11-17 tahun yang mengikuti penelitian. Kebanyakan subyek masih bersekolah. Lebih dari setengah 58,7 sudah mengetahui status infeksi HIV mereka, dan 47,8 dianggap mandiri minum obat oleh orangtua atau pengasuhnya. Kebanyakan subyek memiliki setidaknya satu masalah di rumah, sekolah, kebiasaan makan, penggunaan obat/zat adiktif, atau keamanan diri, sementara 8,7 memiliki masalah seksualitas. Gejala emosional didapatkan pada 8,7 subyek, masalah perilaku pada 6,5 , hiperaktivitas pada 6,5 , masalah teman sebaya 6,5 , dan masalah total kesulitan pada 8,7 . Delapan puluh sembilan persen subyek memiliki skor perilaku prososial normal. Kepatuhan berobat tinggi pada 39,1 , sedang pada 37 , dan rendah pada 23,9 . Tidak ada hubungan signifikan antara pengetahuan status infeksi atau masalah psikososial dan kepatuhan berobat.

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This is a descriptive, cross sectional study in adolescent patients of RSCM Jakarta done in June 2018. The aim was to describe psychosocial problems and the associations with medication adherence in perinatally infected adolescents, measured by questionnaires. Forty six adolescents enrolled in this study. Most subjects still study at school. More than half 58.7 already know their HIV status, and 47.8 were considered independently adherent to their medication by parents or caregivers. Most subjects had at least one home, school, eating habit, drug substance use, or safety problems, and 8.7 had sexuality problems. Emotional symptoms were found in 8.7 subjects, conduct problems in 6.5 , hyperactivity in 6.5 , peer relationship problems in 6.5 , and total difficulties problems in 8.7 . Eighty nine percent subjects scored normal prosocial behavior. Medication adherence were high in 39.1 subjects, medium in 37 , and low in 23.9 . There were no significant associations between knowledge of infection status or psychosocial problems and medication adherence."

"Adekuasi hemodialisis tercapai dengan terpenuhinya dosis sesuai kebutuhan pasien untuk mendukung pasien mampu hidup secara optimal. Penelitian bertujuan untuk mengetahui hubungan dosis dengan adekuasi pada pasien yang menjalani hemodialisis di RSUD Serang Banten. Penelitian ini menggunakan desain deskriptif korelasi melibatkan 46 pasien hemodialisis dengan tehnik purposive sampling. Variabel penelitian ini meliputi durasi HD, quick of blood, dan adekuasi dengan perhitungan rumus Kt/V. Hasil penelitian ini menunjukkan adanya hubungan yang bermakna antara durasi HD dengan adekuasi hemodialisis. Rerata adekuasi hemodialisis pasien 1,6. Seluruh pasien menjalani hemodialisis dengan frekuensi 2 kali per minggu dengan durasi HD 4-5 jam, quick of blood 200-265 ml/mt. Hasil pemodelan menunjukan durasi HD berkontribusi paling besar terhadap adekuasi setelah dikontrol oleh jenis kelamin, ukuran tubuh, lama menjalani terapi, akses vaskuler, dan dialiser pengunaan ulang. Perawat perlu memperhatikan pengaturan durasi HD untuk mencapai adekuasi hemodialisis yang optimal.

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The adequacy of hemodialysis can be achieved by meeting the needs of hemodialysis patients given, in order that the patients able to life optimally. The purpose of this research was to identify the correlation between dose with adequacy on patients undergoing hemodialysis at RSUD Serang Banten.

Description correlation involved 46 patients hemodialysis with technical purposive sampling. This study observed the duration of hemodialysis, quick of blood, and adequacy with Kt/V formula.

There was significant corelation between the duration of hemodialysis and adequacy. The average of hemodialysis adequacy patients 1,6, twice per week by 4 - 5 hours, quick of blood 200-265 ml/mt.

The modelling result that duration of hemodialysis the most contributed to the adequacy after being controlled by sex, body size, vintage of hemodialysis therapy, vascular access, and dialyzer reuse. The nurses need to pay attention to the duration to achieve optimal adequacy hemodialysis."

"Latar Belakang: Angka kematian pasien penyakit ginjal tahap akhir (PGTA) akibat penyakit kardiovaskular (PKV) sangat tinggi, khususnya pada pasien hemodialisis kronik (HDK), PKV juga dipengaruhi oleh kondisi malnutrisi dan inflamasi. Malnutrition Inflammation Score (MIS) dipakai sebagai prediktor morbiditas dan mortalitas pasien HDK. Asymmetric dimethylarginine (ADMA) dan symmetric dimethylarginine (SDMA) adalah hasil dari proteolisis protein termetilasi yang merupakan penanda inflamasi dan malnutrisi dan ditemukan meningkat pada pasien hemodialisis.Tujuan: Mencari korelasi rasio ADMA/SDMA terhadap MIS pada pasien Penyakit ginjal kronik (PGK) yang menjalani HDK 2x seminggu. Metode: Penelitian dengan desain potong lintang yang dikerjakan pada bulan Juli 2022 pada pasien HDK > 3 bulan. Kadar ADMA, SDMA, dan MIS diambil dan dicatat saat sebelum pasien memulai sesi hemodialisis. Analisis bivariat dilakukan dengan analisis Spearman dan Mann – Whitney dan analisis multivariat dengan regresi linier.Hasil: Sebanyak 23 sampel adalah laki-laki (48,9%) dengan rerata usia 51,2 tahun. Median Albumin adalah 4,0 g/dl dan median TIBC adalah 220 mcg/dl. Median ADMA adalah 82ng/ml, median SDMA 599 ng/ml, rasio ADMA/SDMA 0,14, dan skor MIS 4 (3-6). Skor MIS >5 adalah sebesar 34% dengan <5 sebesar 66%. Dalam analisis bivariat dan multivariat setelah dikontrol penggunaan penghambat ACE, tidak ditemukan hubungan antara rasio ADMA/SDMA dengan MIS (p=0,154).Simpulan: Tidak ditemukan korelasi antara rasio ADMA/SDMA terhadap MIS pada pasien PGK yang menjalani HDK 2x seminggu. 

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Background: The mortality rate of patients with nd tageidney isease (ESKD) due to cardiovascular disease (CVD) is very high, especially in chronic hemodialysis (HD) patients. CVD is also affected by malnutrition and inflammatory conditions. Malnutrition Inflammation Score (MIS) is used as a predictor of morbidity and mortality in HD patients. Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) are the results of proteolysis of methylated proteins which are markers of inflammation and malnutrition and are found to be increased in hemodialysis patients.

Objective: To find a correlation between the ratio of ADMA/SDMA to MIS in chronic kidney disease (CKD) patients who underwent HD 2x a week.

Methods: A cross-sectional study conducted in July 2022 in HD patients > 3 months. ADMA, SDMA, and MIS levels were taken and recorded before the patient started the hemodialysis session. Bivariate analysis was performed using Spearman and Mann-Whitney analysis and multivariate analysis using linear regression.

Results: A total of 23 samples were male (48.9%) with an average age of 51.2 years. The median Albumin is 4.0 g/dl and the median TIBC is 220 mcg/dl. The median ADMA was 82 ng/ml, the median SDMA was 599 ng/ml, the ADMA/SDMA ratio was 0.14, and the MIS score was 4 (3-6). MIS score > 5 is 34% with < 5 is 66%. In bivariate and multivariate analysis after adjusted for the use of ACE inhibitors, no relations were found between the ADMA/SDMA ratio and MIS (p=0.154).

Conclusion: No correlation was found between the ratio of ADMA/SDMA to MIS in CKD patients who underwent HD 2x a week."