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"Lebih dari 16% populasi dunia dipengaruhi oleh Penyakit Ginjal Kronis (PGK), dimana 19,3% akan berkembang menjadi Penyakit Ginjal Tahap Akhir (PGTA) dengan angka mortalitas 50% dalam 24 bulan. Prognosis PGTA yang buruk dan biaya perawatannya yang sangat tinggi, sehingga masih diperlukan pengkajian untuk mengidentifikasi faktor- faktor yang menyebabkan insidensi PGTA. Penelitian ini bertujuan untuk mengidentifikasi determinan yang behubungan dengan kejadian PGTA di RSUD dr. Soedarso Kota Pontianak. Penelitian kuantitatif ini merupakan studi analitik case control menggunakan data primer wawancara dan rekam medis pasien selama bulan Mei – Juni 2023. Analisis regresi logistik berganda dilakukan untuk mengetahui determinan terhadap kejadian PGTA. Hasil analisis multivariat menunjukkan terdapat empat variabel yang berhubungan dengan kejadian PGTA, diantaranya: Hipertensi (OR 5,54, 95% CI: 2,59 – 11,80), Diabetes Melitus (OR 4,24, 95% CI: 1,79 – 9,98), riwayat keluarga PGK (OR 4,37, 95% CI: 1,02 – 18,73), dan merokok 310 batang/hari (OR 1,44, 95% CI: 0,56 – 3,74). Faktor prediktor dominan kejadian PGTA adalah variabel Hipertensi. Penapisan yang lebih ketat berupa pemeriksaan laboratorium kadar kreatinin dan protein urin tiap satu tahun sekali diperlukan untuk mendeteksi PGK stadium awal, terutama pada pasien berisiko tinggi yang memiliki riwayat Hipertensi, Diabetes Melitus, riwayat keluarga PGK, dan merokok untuk mencegah terjadinya PGTA.

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More than 16% of the world's population is affected by Chronic Kidney Diseases (CKD), of which 19.3% will develop End Stage Kidney Disease (ESRD) with a mortality rate of 50% within 24 months. It has a poor prognosis and requires high costs therapy, so its important to identify the factors that cause the incidence of ESRD. This study aims to identify the determinants associated with the incidence of ESRD in RSUD Dr. Soedarso Pontianak. This quantitative research is an analytic case control study using primary data from interviews and medical records of patients from May to June 2023. Multiple logistic regression analysis was carried out to determine the determinants of the incidence of ESRD. The results of the multivariate analysis showed that there were four variables associated with the incidence of ESRD, including: Hypertension (OR 5.54, 95% CI: 2.59 – 11.80), Diabetes Mellitus (OR 4.24, 95% CI: 1.79 – 9.98), family history of CKD (OR 4.37, 95% CI: 1.02 – 18.73), and smoking 310 cigarettes/day (OR 1.44, 95% CI: 0.56 – 3.74). The dominant predictor factor for the incidence of ESRD is Hypertension. More stringent screening in the form of laboratory tests for urine protein and creatinine levels every once a year is needed to detect the early stages of CKD, especially in high-risk patients who have a history of Hypertension, Diabetes Mellitus, a family history of CKD, and smoking to prevent ESRD."

"Latar Belakang: Hipertensi merupakan kasus terbanyak pada pasien hemodialisis HD . Tekanan nadi sentral merupakan prediktor yang kuat terhadap mortalitas dengan penyebab apa pun, banyak faktor yang mempengaruhi tekanan nadi sentral, baik secara langsung maupun tidak langsung, di antaranya adalah interdialytic weight gain IDWG . IDWG dikatakan berhubungan dengan mortalitas akibat penyebab apa pun, namun belum jelas mekanismenya. Tujuan: Mengetahui tekanan nadi sentral dan korelasinya dengan IDWG pada pasien penyakit ginjal tahap akhir PGTA yang menjalani HD di RSCM. Metode: Penelitian ini merupakan studi potong lintang pada pasien PGTA yang menjalani HD di RSCM. Dilakukan pemeriksaan tekanan nadi sentral dengan alat sfigmokor, dan dihitung IDWG dalam satu bulan terakhir, selanjutnya dikorelasikan. Hasil: Didapatkan 67 subyek yang memenuhi kriteria inklusi. Median usia 53.0 rentang inter-kuartil [RIK] 44.0-62.0 tahun, subyek dengan jenis kelamin perempuan lebih banyak ditemukan. Lamanya menjalani HD median 51,3 RIK 23,8-88,8 bulan. Median tekanan nadi sentral 45 RIK 32,67-56,67 mmHg. Rerata IDWG adalah 2,71 simpang baku [SB] 1,08 kg atau 5,04 SB 1,88 . Tekanan nadi sentral tidak berkorelasi dengan IDWG dengan r = 0,088 p=0,478. Simpulan: Tekanan nadi sentral pada pasien PGTA yang menjalani HD di RSCM mediannya sebesar 45 RIK 32,67-56,67 mmHg. Tekanan nadi sentral tidak berkorelasi dengan IDWG.

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Background: Hypertension is the most prevalent case in patients undergoing hemodialysis HD . Central pulse pressure is a strong predictor of mortality of any cause. Many factors are related to central pulse pressure, either directly or indirectly, including interdialytic weight gain IDWG. IDWG are said to be associated with mortality of any cause in HD patients, but the mechanism underlying that association remained unclear.

Objective: To find central pulse pressure and its correlation with IDWG in end stage renal disease ESRD patients undergoing HD in Rumah Sakit Cipto Mangunkusumo, Indonesia.

Methods: Cross sectional study on all ESRD patients undergoing HD in Rumah Sakit Cipto Mangunkusumo. Central pulse pressure was measured using Sphygmocor. IDWG of patients within the last month were obtained, and then a correlation analysis was conducted on both variables.

Results: This study included 67 subjects that met inclusion criteria. The median range age of participants was 53.0 44.0 62.0 years old, with more female subjects present. The median range of duration of HD was 51.3 23.8 88.8 months. Median range of central pulse pressure was 45 32,67 56,67 mmHg. The mean of IDWG was 2.71 standard deviation SD 1.08 kg or 5.04 SD 1.88. This study found that there were no correlation between central pulse pressure and IDWG, r 0.088 p 0.478.

Conclusions: Median range of central pulse pressure in ESRD patients undergoing HD in CMGH was 45 32,67 56,67 mmHg. Central pulse pressure had no correlation with IDWG. "

"Tujuan penelitian ini adalah mengetahui hubungan derajat hidronefrosis dan leukosit urin dengan kejadian komplikasi demam dan retropulsi pada pasien batu non-opaque yang menjalani URS. Penelitian ini bersifat prospektif, deskriptif analitik di RSUD dr. Fauziah Bireun Aceh selama Oktober-Desember 2016. Terdapat 42 pasien dengan didominasi laki-laki 73,8 , rata-rata berusia 47 tahun, 61,9 dengan batu di ureter proksimal, dan 76,2 diantaranya mengalami hidronefrosis sedang serta 28,5 mengalami leukosit urin ge;15/LPB. Komplikasi demam terjadi pada 11,9 pasien dan retropulsi batu sebanyak 7,1 . Derajat hidronefrosis dan leukosit urin merupakan faktor yang mempengaruhi terjadinya demam paska operasi. Kadar leukosit urin tidak mempengaruhi kejadian retropulsi.

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The purpose of this research is to know the relationship between degree of hydronephrosis, urinary leukocytes with incidence of fever and retropulsion as complication of non opaque stone patients underwent URS. This was prospective, analytical descriptive research in dr.Fauziah Bireun Hospital Aceh during October December 2016. From 42 patients, 73.8 were male with mean age 47y.o, 61.9 had proximal ureter stone, 76.2 had moderate hydronephrosis, 28.5 had urinary leucocytes ge 15 HPF. Fever occurred in 11.9 and retropulsion in 7.1 patients. Degree of hydronephrosis and urine leukocyte affect the incidence of post operative fever significantly. Urine leukocyte levels do not affect the incidence of retropulsion."

"ABSTRAK Analisis Praktik Residensi Keperawatan Medikal Bedah Pada Pasien Gangguan Sistem Perkemihan Dengan Kasus Gagal Ginjal Kronik Stage V Menggunakan Pendekatan Model Keperawatan Adaptasi Roy Di Rumah Sakit Umum Pusat Nasional RSUPN dr. Cipto Mangunkusumo Jakarta. Diana Rhismawati Djupri2017 AbstrakPraktek klinik Ners Spesialis Keperawatan Medikal Bedah Sistem Perkemihan adalah untuk mampu melakukan dan menganalisa asuhan keperawatan pada pasien Gagal Ginjal Kronik Stage V dan 30 pasien lain yang mengalami gangguan pada sistem perkemihan. Selain itu mampu menerapkan Evidence Based Nursing Practice EBNP dan sebagai inovator di ruang perawatan maupun di ruang rawat jalan. Peran pemberi asuhan keperawatan menggunakan Model Adaptasi Roy. Perilaku adaptasi fisiologi yang banyak mengalami gangguan adalah cairan dan masalah keperawatan yang banyak muncul adalah hipervolemia, sehingga intervensi yang diberikan adalah pencatatan secara akurat intake dan output, edukasi pembatasan cairan. Penerapan EBNP yang dilakukan adalah dengan melakukan identifikasi tingkat fatigue pada pasien Gagal Ginjal Kronik Stage V dengan menggunakan instrumen FACIT-F, sehingga dapat diketahui tingkat fatigue pasien dan dapat dilakukan asuhan keperawatan yang komprehensif. Program inovasi yang dilakukan adalah Range of Motion pada pasien intrahemodialisis untuk meningkatkan adekuasi hemodialisis dikaitkan dengan tingkat fatigue menggunakan instrumen FACIT-F Kata Kunci : fatigue, ROM exercise, gagal ginjal kronik, hemodialysis, FACIT-FABSTRACT Analysis of Medical Surgical Nursing Residency Practice on UrinarySystem Disorders with Chronic Kidney Disease CKD STAGE V Cases Using Roy Adaptation Model Approach at Cipto Mangunkusumo Hospital in Jakarta Diana Rhismawati Djupri2017 Abstract Ners Specialist Urinary System is to be able to perform and analyze nursing care in patients with Chronic Kidney Desease CKD Stage V and 30 other patients with urinary system disorders. It is also capable of implementing Evidence Based Nursing Practice EBNP and as an innovator in the treatment room as well as in the outpatient room. The role of nursing care providers uses the Roy Adaptation Model. Behavioral adaptation of many disordered physiology is fluid and nursing problems that many appear is hypervolemia, so that intervention given is accurate recording intake and output, fluid restriction education. Implementation of EBNP is done by identifying fatigue level in patients with Chronic Kidney Desease CKD Stage V using FACIT F instrument, so that can know fatigue level of patient and can be done comprehensive nursing care. The innovation program performed was the Range of Motion in intrahemodialysis patients to improve the hemodialysis adequacy associated with fatigue levels using the FACIT F instrument. Keywords fatigue, ROM exercise, Chronic Kidney Desease, hemodialysis, FACIT F"

"[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.]"

"ABSTRAKInsomnia merupakan gangguan tidur yang paling banyak dialami pasien Penyakit Ginjal Tahap Akhir PGTA yang menjalani. Pengukuran kecukupan dosis hemodialisis pada pasien PGTA di Indonesia menunjukkan bahwa lebih banyak yang tidak mencapai ketidakadekuatan hemodialisis. Tujuan dari penelitian ini mengetahui hubungan antara adekuasi hemodialisis dengan kejadian insomnia pada pasien PGTA yang menjalani hemodialisis serta faktor lainnya yang mempengaruhi insomnia. Penelitian ini mengevaluasi sebanyak 125 responden dengan desain cross-sectional dan perhitungan adekuasi dengan rumus Daurgidas Kt/V serta kuesioner Insomnia Severity Index ISI untuk penilaian kejadian insomnia. Prevalensi insomnia ditemukan sebanyak 56 dan 71,2 responden mencapai adekuasi hemodialisis Kt/V ge;1,2. Hasil uji statistik menemukan bahwa tidak terdapat hubungan yang signifikan antara adekuasi hemodialisis dengan insomnia p value= 0,352. Faktor depresi p value = 0,001 dan lama hemodialisis p value = 0,042 menjadi faktor yang berhubungan dengan insomnia pada penelirian ini. Pemantauan terhadap capaian adekuasi hemodialisis minimal satu bulan sekali dan pengkajian tingkat depresi diawal hemodialisis dilakukan untuk mengurangi atau mencegah kejadian insomnia.Kata Kunci: PGTA, Insomnia dan Adekuasi Hemodialisis.

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ABSTRACTInsomnia is the most common sleep disorder experienced by patients with end stage renal disease ESRD. Measurement of sufficiency of hemodialysis dose in ESRD patients in Indonesia shows that more do not reach the inadequacy of hemodialysis. The purpose of this study was to know the relationship between hemodialysis adequation with the case of insomnia in ESRD patients which undergoing hemodialysis and other factors that affect insomnia. This study evaluated 125 respondents with cross sectional design and calculation of adequacy with Daurgidas formula Kt V and Insomnia Severity Index ISI questionnaire for the assessment of insomnia event. The prevalence of insomnia was found to be 56 and 71.2 of respondents attained hemodialysis adequacy Kt V ge 1,2. The results of statistical tests found that there was no significant relationship between hemodialysis adequation with insomnia p value 0.352 . Depression factors p value 0.001 and duration of hemodialysis p value 0.042 were factors associated with insomnia in this study. Monitoring on the achievement of hemodialysis adunasi at least once a month and assessment of depression levels at the beginning of hemodialysis done to reduce or prevent the incidence of insomnia."

"Latar Belakang: Penyakit ginjal tahap akhir (PTGA) memiliki mortalitas dan morbiditas yang utamanya disebabkan oleh gangguan kardiovaskular. Salah satu penyebab gangguan kardiovaskular tersebut adalah kekakuan arteri. Hemodialisis merupakan salah satu intervensi pada pasien PTGA. Namun, faktor-faktor yang memengaruhi kekakuan arteri pada pasien PTGA yang menjalani hemodialisis masih belum banyak diteliti.Tujuan: Mengetahui proporsi kekakuan arteri pada pasien PGTA yang menjalani hemodialisis dua kali seminggu dan faktor-faktor yang mempengaruhinya.Metode: Studi observasional dengan desain potong lintang dilakukan di Unit Hemodialisis Divisi Ginjal-Hipertensi Rumah Sakit Umum Pusat dr. Cipto Mangunkusumo (RSUPN-CM) pada bulan April-Mei 2019. Pasien penyakit ginjal tahap akhir yang menjalani hemodialisis dua kali per minggu minimal selama 3 bulan terakhir diikutsertakan dalam penelitian. Pasien yang mengalami penyakit akut atau tidak kooperatif dieksklusi dari penelitian. Kekakuan arteri dinilai dalam bentuk Pulse Wave Velocity (PWV) menggunakan alat SphygmoCor dengan cutoff PWV 10 m/s.Hasil: Sebanyak 83 subyek penelitian yang terdiri dari 22 (26,5%) subyek dengan kekakuan arteri dan 61 (73,5%) subyek tanpa kekakuan arteri diikutsertakan dalam studi. Faktor-faktor yang berhubungan secara indenden dengan kekakuan arteri adalah kadar gula darah puasa (odds ratio 6,842 (IK95% 1,66-28,24)) dan kadar LDL (odds ratio 4,887 (IK95% 1,59-16,58)).Simpulan: Proporsi kekakuan arteri pada pasien PGTA yang menjalani hemodialisis dua kali seminggu adalah sebesar 26,5%. Faktor-faktor yang berhubungan dengan kekakuan arteri pada pasien PGTA dengan hemodialisis kronik dua kali per minggu adalah kadar gula darah puasa dan kadar LDL.

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Introduction: End stage renal disease (ESRD) mortalities and morbidities are mainly occurred in association with cardiovascular disease. One of which is arterial stiffness. Hemodialysis is one of the intervention for ESRD patients. However, factors affecting arterial stiffness in ESRD patients having hemodialysis have not been studied much in Indonesia.Aim: Investigating the proportion of arterial stiffness in ESRD patients having hemodialysis two times a week and factors affecting it.Methods: An observational study with cross-sectional design was performed in Hemodialysis Unit, Kidney and Hypertension Division, National General Hospital Cipto Mangunkusumo (RSUPN-CM) on April to May, 2019. ESRD patients having hemodialysis two times a week for at least 3 months were included in the study. Patients with acute disease or uncooperative were excluded from the study. Arterial stiffness was measured as pulse wave velocity (PWV) using SphygmoCor® with PWV cutoff of 10m/s.Results: There were 83 study samples included in this study, 22 (26,5%) of which were patients with arterial stiffness and 61 (73,5%) of which were patients without arterial stiffness. Factors independently affecting arterial stiffness were fasting glucose level (odds ratio 6,842 (CI95% 1,66-28,24)) and LDL level (odds ratio 4,887 (CI95% 1,59-16,58)).Conclusion: The proportion of arterial stiffness in ESRD patients having hemodialysis two times a week was 26,5%. Factors affecting arterial stiffness in ESRD patients were fasting glucose level and LDL level."

"Latar Belakang: Periostin memainkan peran sebagai mediator proses inflamasi termasuk inflamasi dan fibrosis ginjal. Namun, data signifikansi periostin pada acute kidney injury terbatas. Kami meneliti korelasi kadar periostin urin dengan fungsi ginjal pada pasien keganasan yang mendapat terapi cisplatin dosis tinggi. Metode: Penelitian kohort prospektif ini dilakukan di n ruang rawat HOM lantai 8 gedung A, di RSCM dari November 2019 hingga jumlah sampel minimal terpenuhi dengan cara consecutive sampling. Data dianalisis menggunakan SPSS versi 23.0 sesuai tujuan penelitian. Hasil: Dari 37 responden diketahui 70,3% laki-laki, 29,7% berusia 41-50 tahun, 59,5% menderita KNF, serta 64,9% memiliki Skor Karnofsky 80. Kadar ureum dan kreatinin darah responden meningkat dari pra kemoterapi hingga 1 minggu paska kemoterapi I. Begitu juga dengan nilai eGFR yang makin menurun. Perubahan kadar periostin menurun selama kemoterapi I dan II, naik kembali 1 minggu paska kemoterapi III dengan nilai p>0,05. Pada uji korelasi kadar periostin urin dengan variabel fungsi ginjal lainnya tidak didapatkan domain yang signifikan bermakna (p>0,05) dengan nilai koefisien korelasi lemah (r = 0,017-0,254) dan beberapa domain memiliki arah korelasi negatif. Simpulan: Tidak didapatkan korelasi bermakna kadar periostin urin dengan kadar ureum darah, kreatinin darah serta laju filtrasi glomerulus pasien keganasan dengan terapi cisplatin dosis tinggi.

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Background: Periostin plays role as mediator of inflammatory processes including inflammation and kidney fibrosis. However, data on the significance of periostin in acute kidney injury are limited. We investigated the correlation of urine periostin levels with kidney function in malignant patients receiving high-dose cisplatin therapy.

Methods: This prospective cohort study was conducted in the 8th floor HOM care room in building A, in the RSCM from November 2019 until the minimum sample size was fulfilled by consecutive sampling. Data were analyzed using SPSS version 23.0 according to the purpose of study.

Results: Of the 37 respondents known to be 70.3% male, 29.7% aged 41-50 years, 59.5% suffer from NPC, and 64.9% have Karnofsky score of 80. Urea levels and blood creatinine of respondents increased from pre-chemotherapy to 1 week after chemotherapy I. Likewise, the eGFR value decreases. Changes in periostin levels decreased during chemotherapy I and II, rising again 1 week after chemotherapy III with a p value> 0.05. In the correlation test of urinary periostin levels with other kidney function variables, no significant domain was found (p> 0.05) with a weak correlation coefficient (r = 0.017-0.254) and some domains had a negative correlation direction.

Conclusion: No significant correlation was found in urine periostin levels with blood urea levels, blood creatinine and glomerular filtration rates of malignant patients with high-dose cisplatin therapy."

"Latar Belakang : Fistula arteriovena (FAV) merupakan akses vaskular yang paling banyak digunakan oleh pasien-pasien Penyakit Ginjal Tahap Akhir (PGTA) yang menjalani hemodialisis rutin di Indonesia. FAV dapat mengalami disfungsi sebelum digunakan untuk inisiasi hemodialisis, yang disebut kegagalan primer. Klopidogrel merupakan antiagregasi trombosit yang dilaporkan dapat mengurangi kejadian kegagalan primer pada FAV dibandingkan antiagregasi trombosit lainnya. Hingga saat ini belum ada panduan yang merekomendasikan penggunaan klopidogrel karena kurangnya bukti ilmiah.Tujuan: Mengetahui pengaruh pemberian klopidogrel terhadap kejadian kegagalan primer FAV dan risiko perdarahan pada pasien-pasien PGTA.Metode: Penelusuran literatur Randomized Control Trial pada pangkalan data Medline / Pubmed, EbscoHost, Embase, Proquest, Scopus dan Cochrane Library berdasarkan kriteria eligibilitas sesuai PICO tanpa batasan bahasa sejak tahun 1987. Penilaian risiko bias menggunakan aplikasi Risk of Bias 2 Cochrane.Hasil: Penelitian ini melibatkan 3 penelitian Randomized Control Trial berdasarkan kriteria yang telah ditentukan. Ketiga penelitian mendapatkan hasil bahwa pemberian klopidogrel dapat mengurangi risiko kegagalan primer FAV. Meta-analisis tidak dapatdilakukan karena adanya heterogenitas klinis dan metodologis. Penilaian risiko bias dengan Risk of Bias 2 Cochrane mendapatkan 2 literatur berisiko bias ringan, dan 1 berisiko sedang. Penilaian dengan uji regresi Egger ( p = 1,00) dan uji korelasi Rank (p = 0,446) tidak terdapat indikasi bias publikasi. Prevalensi perdarahan tidak berbeda pada kelompok perlakuan dibandingkan kelompok kontrol.Simpulan: klopidogrel dapat mengurangi kejadian kegagalan primer FAV dengan kejadian perdarahan yang tidak berbeda dengan kelompok kontrol.

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Background: Arteriovenous fistula (FAV) is the most widely used vascular access for end-stage renal disease also called end-stage kidney disease or kidney failure (CKD) patients undergoing routine hemodialysis in Indonesia. However, FAV can become dysfunctional before it is used for the initiation of hemodialysis, a condition known as primary failure. Clopidogrel is an anti-platelet aggregation that has been reported to reduce the incidence of primary failure in FAV compared to other anti-platelet aggregation agents. To date, the guideline does not suggest the use of clopidogrel monotherapy for prevention arteriovenous fistula primary failure due to low quality of evidence.

Objective: To assess the association of clopidogrel to the incidence of primary FAV failure and the risk of bleeding in End Stage Kidney Disease patients.

Methods: A literature search was carried out to obtain Randomized Control Trial studies conducted since 1987 from Medline / Pubmed, EbscoHost, Embase, Proquest, Scopus, and Cochrane Libraries without language restrictions. Risk of bias assessment was performed with the Cochrane Risk of Bias 2 application.

Results: This study involved 3 studies based on determined criteria. The risk of bias assessment with Cochrane's Risk of Bias 2 obtained a mild degree. All of the studies found that clopidogrel may reduce the risk of primary AVF failure. Meta-analysis was not performed due to clinical and methodological heterogeneity. Risk of bias assessment found 2 literature with mild risk bias and 1 literature with low risk bias. Assessment with Egger regression test (p = 1.00), and Rank correlation test (p = 0.446) showed no indication of publication bias. In addition, the prevalence of bleeding did not differ between the treatment and control groups"