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"ABSTRAKPenyakit ginjal kronik (PGK) telah menjadi penyakit epidemik global dan prevalensinya di Indonesia terus meningkat. Hemodialisis (HD) merupakan terapi pengganti ginjal yang paling sering dilakukan pada pasien PGK stadium akhir. Pasien PGK yang menjalani HD rutin rentan mengalami protein energy wasting (PEW) sehingga memengaruhi status gizi. Lingkar otot lengan atas (LOLA) merupakan indeks yang dapat menggambarkan total protein tubuh dan massa otot. Terapi medik gizi komprehensif diperlukan untuk menghindarkan pasien dari PEW dan memperbaiki kualitas hidup pasien. Pemantauan terhadap empat pasien berusia 32-61 tahun dengan proporsi jenis kelamin sama, didiagnosis PGK stadium akhir dan menjalani HD rutin. Berdasarkan kriteria The American Society for Parenteral and Enteral Nutrition seluruh pasien mengalami malnutrisi. Dua pasien telah menderita PEW, dua lainnya berisiko PEW. Terapi medik gizi diberikan sesuai dengan keadaan klinis pasien dengan target protein yaitu 1,1-1,4 g/kgBB/hari. Asupan energi dan protein pada dua pasien telah lebih dari 35 kkal/kgBB/hari dan 1,2 kkal/kgBB/hari sejak awal, sedangkan dua pasien lainnya rendah pada awal pengkajian namun mengalami peningkatan di akhir pemantauan. Seluruh pasien memiliki nilai LOLA yang rendah dan diduga mengalami deplesi otot, namun dua pasien mengalami peningkatan LOLA di akhir pemantauan.

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ABSTRACTChronic kidney disease has become a global epidemic disease and the prevalence is increasing in Indonesia. Hemodialysis (HD) is the most common treatment for end stage renal disease (ESRD) patients. Patients who undergoing HD routinely are vulnerable to increase protein energy wasting (PEW) so nutritional status must be monitored closely. Mid upper arm muscle circumference (MUAMC) can be use to show total body protein and muscle mass. Medical nutrition therapy is needed to prevent patients from PEW and improve the quality of life. Four patients age range 32-61 years and same sex ratio, diagnosed with ESRD undergoing HD. Based on The American Society for Parenteral and Enteral Nutrition s criteria all patients were malnutrition. Two patients experienced PEW and the other had risk of PEW. Medical nutritional therapy is given according to clinical condition of each patient with target protein from 1.1-1.4 g/kgBW/day. Energy and protein intake in two patients was more than 35 kcal/kgBW/day and 1.2 kcal/kgBW/day at first assessment. Unfortunately the others patient intake were low at the first assessment but incresed at the end of monitoring. All patients had low MUAMC scores which indicate muscle depletion. Two patients had increased MUAMC at the end of monitoring."

"Latar Belakang: Penyakit ginjal kronik (PGK) menunjukkan peningkatan signifikan dalam prevalensi dan angka kematian. Pasien PGK yang menjalani hemodialisis (HD) kronik rentan mengalami kejadian hipoglikemia intradialisis. Kejadian ini jarang dilaporkan karena tidak bergejala dan memiliki ambang batas yang bervariasi, terutama pada pasien diabetes melitus (DM). Tujuan: Penelitian ini bertujuan untuk mengidentifikasi faktor prediksi kejadian hipoglikemia intradialisis pada pasien PGK yang menjalani HD kronik.Metode: Penelitian kohort prospektif ini melibatkan 156 pasien PGK yang menjalani HD di Unit HD, Divisi Ginjal-Hipertensi, FKUI-RSUPN-CM, Jakarta, pada bulan Juni 2024. Analisis bivariat dan multivariat digunakan untuk mengidentifikasi faktor prediksi kejadian hipoglikemia intradialisis.Hasil: Hipoglikemia intradialisis terjadi pada 29,5% pasien. Faktor prediksi signifikan termasuk hipotensi intradialisis (OR 6,78; 95% CI 2,47-18,59; p = 0,000), lama menjalani HD ≤ 1 tahun (OR 4,75; 95% CI 1,72-13,09; p = 0,003), inadekuasi HD (OR 3,54; 95% CI 1,38-9,06; p = 0,009), dan diabetes melitus tipe 2 (OR 2,62; 95% CI 1,07-6,43; p = 0,036). Persamaan model prediksi, logit(p) = -2,94 + 1,91 × hipotensi intradialisis + 1,56 × lama menjalani HD + 1,26 × adekuasi HD + 0,96 × diabetes tipe 2 dikembangkan menjadi sistem skoring dengan total skor 5. Skor yang lebih tinggi menunjukkan probabilitas hipoglikemia yang lebih tinggi. Model ini menunjukkan kalibrasi baik (Hosmer-Lemeshow p = 0,37) dan diskriminasi kuat (AUC = 0,83 IK 95% 0,75-0,91).Kesimpulan: Faktor-faktor yang memprediksi terjadinya hipoglikemia intradialisis adalah hipotensi intradialisis, lama menjalani HD, adekuasi HD, dan DM tipe 2. Model prediksi yang dihasilkan menunjukkan performa statistik yang baik.

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Background: Chronic kidney disease (CKD) shows a significant increase in prevalence and mortality rates. Patients with CKD undergoing chronic hemodialysis (HD) are prone to experience intradialytic hypoglycemia. This condition is rarely reported due to its asymptomatic nature and varying thresholds, especially among diabetic patients.

Objective: This study aims to identify predictors of intradialytic hypoglycemia in CKD patients undergoing chronic HD.

Methods: A prospective cohort study was conducted with 156 CKD patients receiving HD at hemodialysis unit, Division of Nephrology-Hypertension, FKUI-RSUPN-CM, Jakarta, in June 2024. Bivariate and multivariate analyses were used to identify significant predictors of intradialytic hypoglycemia.

Results: Intradialytic hypoglycemia occurred in 29.5% of patients. Significant predictors included intradialytic hypotension (OR 6.78; 95% CI 2.47-18.59; p = 0.000), HD duration ≤ 1 year (OR 4.75; 95% CI 1.72-13.09; p = 0.003), HD inadequacy (OR 3.54; 95% CI 1.38-9.06; p = 0.009), and type 2 diabetes mellitus (OR 2.62; 95% CI 1.07-6.43; p = 0.036). The predictive model, logit(p) = -2.94 + 1.91 × intradialytic hypotension + 1.56 × HD duration + 1.26 × HD adequacy + 0.96 × type 2 diabetes was developed into a scoring system with a total score of 5. Higher scores indicated a higher probability of hypoglycemia. The model showed strong calibration (Hosmer-Lemeshow p = 0.37) and discrimination (AUC = 0.83 95% CI 0.75-0.91).

Conclusion: The factors that predict the occurrence of intradialytic hypoglycemia include intradialytic hypotension, duration of HD, HD adequacy, and type 2 diabetes mellitus. The predictive model developed exhibits strong statistical performance."

"Latar belakang: Penyakit ginjal kronis (PGK) merupakan penyakit kronis yang menjadi masalah kesehatan global. Hemodialisis (HD) adalah salah satu terapi pengganti ginjal pada PGK stadium akhir yang bersifat katabolik. Pasien PGK dengan HD rutin rentan mengalami protein energy wasting (PEW) apabila tidak mendapatkan asupan energi dan protein yang adekuat. Terapi medik gizi yang komprehensif dan holistik diperlukan untuk mencegah terjadinya atau bertambahnya progresivitas PEW yang memengaruhikualitas hidup pasien. Kasus: Empat orang perempuan berusia 24-52 tahun dengan diagnosis PGK stadium akhir yang rutin menjalani HD. Selama menjalani HD, seluruh pasien memiliki riwayat asupan energi total <25 kkal/kg BB dengan protein <1 g/kg BB. Kekuatan genggam tangan pada seluruh pasien <18 kg dan kadar albumin tiga pasien <3,8 g/dL. Tiga pasien telah mengalami PEW dan satu lainnya berisiko PEW. Terapi medik gizi diberikan sesuai kondisi klinis masing-masing pasien dengan target protein 1,2-1,4 g/kgBB/hari.Hasil: Asupan energi dan protein pada seluruh pasien meningkat pada akhir pemantauan. Rerata pasien dapat mencapai 90% KET dengan protein mencapai 1,3 g/kg BB/hari selama pemantauan. Kekuatan genggam tangan, kadar albumin, hemoglobin, dan komposisi tubuh pasien PGK dengan HD rutin yang mendapatkan terapi medik gizi mengalami perbaikan.Kesimpulan:Terapi medik gizi yang adekuat mendukung perbaikan klinis serta parameterlaboratorium pada pasien PGK dengan HD rutin sehingga dapat mencegah terjadinya atau bertambahnya progesivitas PEW.

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Background: Chronic kidney disease (CKD) is a chronic disease that has become global health problem. One of renal replacement therapy in end-stage CKD is hemodialysis (HD) which is a catabolic procedure. CKD patients on maintenance HD (MHD) is susceptible to develop protein energy wasting (PEW) if they get inadequate energy and protein intake. Comprehensive and holistic nutritional medical therapy is needed to prevent development or rapid progression of PEW which affects the quality of life of patients.

Case:

Four women aged 24-52 years with end-stage CKD on MHD. All patients had total energy intake <25 kcal / kg BW with protein intake <1 g / kg body weight. Handgrip strength in all patients were less than 18 kg and three of them have albumin levels less than 3.8 g/dL. Three patients experienced PEW and the other had risk of PEW. Nutritional medical therapy is given according to the clinical conditions of each patient with target of protein from 1.2-1.4 g / kg BW / day.

Results: All patient showed increment intake of energy and protein. The average of energy intake patient can reach 90% total energy requirement with protein intake reached 1.3 g / kg / day during monitoring. Handgrip strength, albumin, hemoglobin levels, and body composition in CKD patient on MHD who received nutritional medical therapy were improved.

Conclusion: Adequate nutritional medical therapy supports improvement of clinical condition and laboratory parameters in CKD patients on MHD with the purposes of preventing development or rapid progression of PEW."

"Hipertensi intradialitik merupakan komplikasi yang paling sering terjadi pada pasien yang menjalani hemodialisis dengan prevalensi kejadian sebesar 38%, kejadian hipertensi intradialitik yang tidak diatasi dapat meningkatkan morbiditas dan mortalitas pasien. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan kejadian hipertensi intradialitik pada pasien gagal ginjal kronik yang menjalani terapi hemodialisis. Desain penelitian ini adalah analitik cross sectional dengan jumlah sampel 57 orang. Analisis data menggunakan Chi-square dan Regresi Logistik. Hasil penelitian menunjukkan adanya hubungan antara transfusi darah saat hemodialiasis (p= 0,001), interdialytic weight gain (IDWG) (p= 0,002), laju ultrafiltrasi (UFR) (p= 0,037) dan pemberian erythropoetin stimulating agents (ESA) (p= 0,048). Hasil analis multivariat regresi logistik berdasar nilai Odd Ratio menunjukkan IDWG ≥ 3% dan transfusi darah saat hemodialisis merupakan faktor yang paling berhubungan dengan kejadian hipertensi intradialitik pasien gagal ginjal kronis yang menjalani terapi hemodialisis. Berdasarkan hasil penelitian ini, perlu dilakukan intervensi keperawatan terkait pembatasan cairan pada pasien hemodialisis sebagai salah satu upaya pencegahan kejadian hipertensi intradialitik.

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Intradialytic hypertension is the most common complication in patients undergoing hemodialysis with a prevalence of 38%, untreated intradialytic hypertension can increase patient morbidity and mortality. This study aims to analyze the factors associated with the incidence of intradialytic hypertension in patients with chronic renal failure undergoing hemodialysis therapy. The design of this research is analytic cross sectional with a sample size of 57 people. Data analysis using Chi-square and Logistic Regression. The results showed that there was a relationship between blood transfusion during hemodialysis (p= 0.001), interdialytic weight gain (IDWG) (p= 0.002), ultrafiltration rate (UFR) (p= 0.037) and the administration of erythropoetin stimulating agents (ESA) (p= 0.048). ). The results of multivariate logistic regression analysis based on Odd Ratio values ​​showed IDWG 3% and blood transfusion during hemodialysis was the most associated factor with the incidence of intradialytic hypertension in patients with chronic renal failure undergoing hemodialysis therapy. Based on the results of this study, it is necessary to carry out nursing interventions related to fluid restriction in hemodialysis patients as an effort to prevent the incidence of intradialytic hypertension."

"[ABSTRAKPasien penyakit ginjal kronik derajat 5 mengalami suatu keadaan di mana ginjal sama sekali tidak dapat mempertahankan homeostasis metabolisme tubuh sehingga membutuhkan terapi pengganti ginjal. Terapi pengganti ginjal yang paling sering dipilih oleh pasien PGK derajat 5 adalah hemodialisis. Perubahan metabolik pada PGK derajat 5 dengan hemodialisis dapat disebabkan oleh gangguan fungsi ginjal dan proses hemodialisis. Perubahan metabolik tersebut antara lain gangguan keseimbangan cairan, dan asam basa serta gangguanmetabolisme protein, karbohidrat, dan lemak. Dibutuhkan terapi terintegrasi pada pasien PGK yang terdiri atas terapi farmakologi, terapi pengganti ginjal, terapi nutrisi dan dukungan psikologis. Peran nutrisi dalam menurunkan komplikasi dan meningkatkan kualitas hidup sangat penting dalam tatalaksana pasien PGK. Pemberian nutrisi pada pasien PGK dengan hemodialisis bertujuan untuk mengatasi gejala akibat gangguan ginjal dan mencegah komplikasi akibat progresivitas kerusakan ginjal. Pemberian nutrisi yang tepat dapat dilakukan dengan memahami patofisiologi yang terjadi pada pasien PGK dan proseshemodialisis yang dipilih sebagai terapi pengganti ginjal. Berdasarkan hal tersebut, dilaporkan empat serial kasus pada pasien PGK derajat 5 dengan hemodialisis rutin. Diberikan terapi nutrisi sesuai panduan yaitu energi 30-35 kkal per kg berat badan, protein 1,2 g per kg berat badan, lemak 25-30% energi total, dan karbohidrat 60-65% energi total. Diketahui bahwa penyebab asupan tidak terpenuhi adalah keadaan klinis yaitu sesak, penurunan kesadaran, dan gangguan saluran cerna yaitu mual dan muntah.

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ABSTRACTStage 5 of chronic kidney disease represents total inability of kidneys to maintain body homeostasis normally. At this stage, it is necessary to use methods that substitute kidney function such as hemodialysis, peritoneal dialysis, or kidney transplantation. The most used method is hemodialysis. Metabolic changes in stage 5 of chronic kidney disease can be caused by kidney disease itself and also hemodialysis treatment. Metabolic complications of chronic kidney disease and hemodialysis include changes in acid-base balance and metabolism of proteins,carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complication and to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are to overcome the symtoms and to prevent the complication that caused by kidney disease. Nutrition therapy can be done properly by understand the pathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney disease with hemodialysis are reported here. The nutrition which is given consist of energy 30-35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid 25-30 % total energy, and carbohydrate 60-65 % total energy. There is inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit. Stage 5 of chronic kidney disease represents total inability of kidneys to maintain body homeostasis normally. At this stage, it is necessary to use methods thatsubstitute kidney function such as hemodialysis, peritoneal dialysis, or kidney transplantation. The most used method is hemodialysis. Metabolic changes in stage 5 of chronic kidney disease can be caused by kidney disease itself and also hemodialysis treatment. Metabolic complications of chronic kidney disease and hemodialysis include changes in acid-base balance and metabolism of proteins, carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complication and to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are to overcome the symtoms and to prevent the complication that caused by kidney disease. Nutrition therapy can be done properly by understand the pathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney disease with hemodialysis are reported here. The nutrition which is given consist of energy 30-35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid 25-30 % total energy, and carbohydrate 60-65 % total energy. There is inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit., Stage 5 of chronic kidney disease represents total inability of kidneys to maintainbody homeostasis normally. At this stage, it is necessary to use methods thatsubstitute kidney function such as hemodialysis, peritoneal dialysis, or kidneytransplantation. The most used method is hemodialysis. Metabolic changes instage 5 of chronic kidney disease can be caused by kidney disease itself and alsohemodialysis treatment. Metabolic complications of chronic kidney disease andhemodialysis include changes in acid-base balance and metabolism of proteins,carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complicationand to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are toovercome the symtoms and to prevent the complication that caused by kidneydisease. Nutrition therapy can be done properly by understand thepathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney diseasewith hemodialysis are reported here. The nutrition which is given consist ofenergy 30–35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid25–30 % total energy, and carbohydrate 60–65 % total energy. There isinadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit.]"

"Penyakit ginjal kronis pada anak merupakan kondisi kerusakan ginjal yang permanen pada struktur atau fungsi ginjal anak. Hemodialisis merupakan salah satu terapi pengganti ginjal sebagai jembatan sebelum tindakan transplantasi ginjal dilakukan, untuk dapat meningkatkan kondisi klinis anak. Penerimaan diri terhadap penyakit merupakan fase penting yang akan menentukan keberhasilan program terapi. Tujuan penulisan karya ilmiah ini untuk melakukan analisis terhadap penerapan teori kenyamanan Kolcaba dalam asuhan keperawatan anak dengan penyakit ginjal kronis tahap akhir yang menjalani hemodialisis. Penulis melakukan analisis terhadap lima kasus anak yang menjalani hemodialisis dan telah diberikan asuhan keperawatan menggunakan pendekatan teori kenyamanan Kolcaba. Aplikasi teori kenyamanan Kolcaba terbukti efektif memberikan kenyamanan pada anak yang menjalani hemodialisis. Acceptance of Illness Scale (AIS) berbasis sistem informasi yang digunakan dalam penilaian penerimaan penyakit terbukti valid dan reliabel. Proyek inovasi menggunakan AIS berbasis sistem informasi pada anak dengan penyakit ginjal kronis yang menjalani hemodialisis efektif dilakukan untuk menilai penerimaan penyakit anak. Edukasi suportif yang diberikan juga terbukti berpengaruh pada peningkatan penerimaan penyakit anak.

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Chronic disease in children is a condition of permanent kidney damage to the structure or function of the child's kidneys. Hemodialysis is one of the renal replacement therapies as a bridge before a kidney transplant is carried out, to improve the clinical condition of children. Self-acceptance of the disease is an important phase that will determine the success of program therapy. The purpose of writing this scientific paper is to analyze the application of Kolcaba's theory of comfort in the care of children with end-stage chronic diseases undergoing hemodialysis. The author conducted an analysis of five cases of children who underwent hemodialysis and were given nursing care using the Kolcaba comfort approach. The application of Kolcaba's theory of comfort has proven to be effective in providing comfort to children undergoing hemodialysis. The Information System-based Disease Acceptance Scale (AIS) used in the assessment of disease acceptance has been proven to be valid and reliable. An innovation project using AIS based on an information system in children with chronic diseases undergoing effective hemodialysis was carried out to assess the acceptance of children's disease. The supportive education provided has also been shown to have an effect on increasing the acceptance of children's illnesses."

"Kepatuhan manajemen terapi hemodialisis berpengaruh terhadap kejadian komplikasi yang mungkin dapat muncul, kualitas hidup dan angka mortalitas pada pasien. Salah satu faktor yang berpengaruh terhadap tingkat kepatuhan tersebut adalah persepsi penyakit. Tujuan penelitian ini adalah untuk mengetahui hubungan antara persepsi penyakit dengan kepatuhan manajemen terapi hemodialisis pada pasien penyakit ginjal kronik. Desain penelitian yang digunakan adalah analitik korelatif dengan jumlah sampel 103 responden yang dipilih berdasarkan teknik purposive sampling pada pasien hemodialisis. Data dikumpulkan melalui Brief Illness Perception Questionnaire B-IPQ untuk persepsi penyakit dan modifikasi End-Stage Renal Disease Adherence Questionnaire ESRD-AQ untuk kepatuhan manajemen terapi hemodialisis. Data tersebut diolah dengan menggunakan SPSS versi 23. Hasil penelitian ini menunjukkan ada hubungan antara persepsi penyakit dengan kepatuhan manajemen terapi hemodialisis r= -0.244; p value= 0.007 . Akan tetapi, jika ditinjau per-dimensi maka hanya kontrol personal r= 0.329; p value= 0.000 dan respon emosi r= -0.292; p value= 0.001 yang berhubungan dengan kepatuhan manajemen terapi hemodialisis. Dengan sebab itu, tenaga kesehatan perlu memperhatikan persepsi penyakit pada pasien untuk meningkatkan kepatuhan manajemen terapi hemodialisis pada pasien.

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The adherence of hemodialysis therapy management influenced occurence rate of complication that might be appear, quality of life, and mortality rate in patient. One of the factors that affect adherence of hemodialysis therapy management is illness perception. This research aimed to identify the relation between illness perception and adherence of hemodialysis therapy management in patient with chronic kidney disease. Correlation analytic with purposive sampling technique was used for this research with 103 patients in hemodialysis as a sample. Data were collected by Brief Illness Perception Questionnaire B IPQ for illness perception and End Stage Renal Disease Adherence Questionnaire ESRD AQ for adherence of management hemodialysis therapy. Data were analyzed by SPSS ver. 23. Result shows that illness perception affect adherence to therapy management r 0.244 p value 0.007 . Yet, only control personal r 0.329 p value 0.000 and emotional response r 0.292 p value 0.001 that influence adherence to therapy management. Therefore, it is recommend to assess patient view of their illness to increase adherence rate to hemodialysis."

"Latar Belakang: Kematian pasien Penyakit Ginjal Kronik (PGK) pada usia dewasa yang menjalankan hemodialisis setelah tiga bulan adalah jarang. Namun, masih mungkin terjadi. Padahal layanan hemodialisis dibutuhkan seumur hidup.Tujuan: Mengetahui faktor – faktor risiko yang berhubungan dengan kematian pasien PGK usia dewasa yang menjalankan hemodialisis reguler.Metode: Kasus kontrol tanpa pencocokkan (matching) dengan perbandingan 1:2. Uji statistik yang digunakan adalah regresi logistik.Hasil: Faktor risiko yang berhubungan terhadap kematian adalah riwayat gagal jantung (OR = 2,3; IK 95% = 1,2 – 4,4; nilai p = 0,009), riwayat obstruksi pasca ginjal (OR = 3,5; IK 95% = 1,6 – 7,6; nilai p = 0,002), glukosa sewaktu ≥140 mg/dl (OR = 2,1; IK 95% = 1,2 – 3,6; nilai p = 0,011), Gangguan Ginjal Akut (GGA) (OR = 6,5; IK 95% = 3,8 – 11,1; nilai p = 0,000), dan Indeks Massa Tubuh (IMT) <18,5 kg/mm2 (OR = 3,0; IK 95% = 1,2 – 7,6; nilai p = 0,019).Kesimpulan: Faktor – faktor risiko yang berhubungan dengan kematian pasien PGK pada usia dewasa yang menjalankan hemodialisis reguler adalah riwayat gagal jantung, riwayat obstruksi pasca ginjal, glukosa sewaktu ≥140 mg/dl, GGA, dan IMT <18,5 kg/mm2

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Background: Mortality of Chronic Kidney Disease (CKD) patients in adults undergoing hemodialysis after three months is rare. However, it is still possible. Even though hemodialysis services are needed for life.

Objective: To determine the risk factors associated with the death of adult CKD patients undergoing regular hemodialysis.

Method: Unmatched control case with a ratio of 1:2. The statistical test used was logistic regression.

Results: Risk factors were history of heart failure (OR = 2.3; CI 95% = 1.2 – 4.4; p value = 0.009), history of obstruction post renal (OR = 3.5; CI 95% = 1.6 – 7.6; p value = 0.002), random glucose ≥140 mg/dl (OR = 2.1; CI 95% = 1.2 – 3.6; p value= 0.011), Acute Kidney Injury (AKI) (OR = 6.5; CI 95% = 3.8 – 11.1; p value = 0.000), and Body Mass Index <18.5 kg/mm2 (OR = 3.0; CI 95% = 1.2 – 7.6; p value = 0.019).

Conclusion: Risk factors associated with mortality in adult CKD patients undergoing regular hemodialysis are a history of heart failure, a history of post-renal obstruction, random glucose ≥140 mg/dl, AKI, and IMT <18.5 kg/mm2."