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Abstrak :
Pasien ESRD yang menjalani hemodialisis merupakan kelompok yang rentan terkena infeksi di masa pandemi ini. Ketika pasien terkonfirmasi COVID-19, pasien harus menjalani isolasi dan hemodialisis di unit khusus COVID-19. Akan muncul berbagai respon dan dampak bagi pasien. Tujuan penelitian ini adalah untuk mengeksplorasi secara mendalam tentang pengalaman pasien yang menjalani hemodialisis dan terkonfrimasi COVID-19. Penelitian ini menggunakan pendekatan fenomenologi dengan metode wawancara mendalam. Partisipan berjumlah 15 orang dari RS Universitas Hasanuddin yang dipilih melalui teknik purposive sampling. Terdapat 5 tema yang dihasilkan dalam penelitian ini yaitu respon emosi saat terkonfirmasi COVID-19, dampak yang dialami pasien saat terkonfirmasi COVID-19 dan menjalani isolasi, perbedaan yang dialami saat menjalani isolasi dan HD COVID-19, support system dan harapan terhadap ruang perawatan isolasi dan HD COVID-19. Temuan tersebut menunjukkan bahwa pasien yang menjalani hemodialisis dan terkonfirmasi COVID-19 memerlukan bantuan dan dukungan dari penyedia layanan kesehatan di unit hemodialisis khususnya unit hemodialisis khusus COVID-19 untuk mengatasi berbagai masalah dan dampak akibat terkonfirmasi. Perawat perlu berperan aktif untuk melakukan pengkajian secara holistik dan evaluasi secara terus menerus dan berkelanjutan agar dapat memberikan asuhan keperawatan yang komprehensif dalam memenuhi kebutuhan pasien ......Hemodialysis patients were a susceptible group to get infection during pandemic. When a patient was confirmed COVID-19, the patient must undergo isolation and hemodialysis in a special COVID-19 unit. There would be various responses and impacts for the patient. The purpose of this study was to explore in depth the experiences of patients undergoing hemodialysis and confirmed COVID-19. This study used a phenomenological approach with in-depth interviews. There were 15 participants from Hasanuddin University Hospital who were selected through purposive sampling technique. There are 5 themes generated in this study, emotional responses when confirmed COVID-19, the impact experienced by patients when confirmed COVID-19 and undergoing isolation, differences experienced when undergoing isolation and HD COVID-19, support system and expectations for the isolation room.and HD COVID-19. These findings indicate that patients undergoing hemodialysis and confirmed COVID-19 require assistance and support from health care providers in the hemodialysis unit, especially in the COVID-19 hemodialysis unit for to overcome various problems and impacts of being confirmed. Nurses need to play an active role in conducting holistic assessments and evaluations continuously in order to provide comprehensive nursing care in meeting patient needs.

Abstrak :

Latar Belakang: Steal syndrome yang terjadi karena akses vaskular adalah komplikasi yang paling ditakutkan setelah pembuatan suatu fistula arteriovena, untuk itu perlu dikembangkan suatu bentuk pemeriksaan untuk deteksi awal. Hand ischemia questionnaire dan pengukuran peak systolic velocity arteri radialis dan arteri ulnaris merupakan bentuk pemeriksaan subyektif dan obyektif yang dipakai untuk mendeteksi steal syndrome

Tujuan: Untuk mengetahui korelasi antara hand ischemia questionnaire dengan peak systolic velocity pada arteri radialis dan arteri ulnaris pada pasien hemodialisa dengan akses fistula native lengan atas untuk mendeteksi gejala steal syndrome.

Metode: Desain yang digunakan adalah desain potong lintang. Penelitian ini dilakukan di RSUPN Dr. Cipto Mangunkusumo selama periode Maret hingga Mei 2019 pada pasien yang menjalani hemodialisis dengan menggunakan akses native fistula lengan atas dengan atau tanpa gejala iskemia pada tangan, metode pengisian kuesioner dengan cara wawancara termpimpin, kemudian dilanjutkan dengan pengukuran peak systolic velocity arteri radialis dan arteri ulnaris distal dari fistula arteriovena.

Hasil: Total sampel 80, sampel terbanyak berjenis kelamin wanita 43 (53,8%) sedangkan pria sebanyak 37 orang (46,2%). Sebanyak 91,2% sampel dengan FAV BC Sinistra, dengan median usia 53 tahun. Total skor HIQ yang didapat, minimum 0, maksimum 70, dengan nilai median 3. Nilai PSV arteri radialis minimum 20 cm/detik, maximum 79 cm/detik, median 40 cm/detik. Nilai PSV arteri ulnaris minimum 16 cm/detik, maksimum 70 cm/detik, median 41 cm/detik. Terdapat korelasi yang bermakna (p<0,001) antara hand ischemia questionnaire dengan peak systolic velocity arteri radialis dan arteri ulnaris pada pasien dengan native fistula lengan atas, namun setelah dilakukan uji diagnostik didapatkan sensitivitas hanya sebesar 15% dan spesifisitas 100%

Simpulan: Terdapat korelasi yang signifikan antara hand ischemia questionnaire dengan nilai peak systolic velocity arteri radialis dan arteri ulnaris pada pasien dengan native fistula lengan atas, namun karena didapatkan sensitifitas yang rendah sehingga hand ischemia questionnaire tidak dapat digunakan sebagai pemeriksaan awal untuk mendeteksi steal syndrome pada pasien dengan tanpa gejala iskemia tangan sebelumnya.

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Background: Dialysis access steal syndrome is the most feared complication after making arteriovenous fistulas, for which a form of examination for early detection needs to be developed. Hand ischemia questionnaire and measurement of peak systolic velocity of the radial artery and ulnar artery distal of the arteriovenous fistula are forms of subjective and objective examination used to detect steal syndrome

Objective: To determine the correlation between hand ischemia questionnaire with peak systolic velocity in the radial artery and ulnar artery in hemodialysis patients using native upper arm arteriovenous fistula to detect symptoms of steal syndrome.

Method: The design used is a cross-sectional design. This research was conducted at RSUPN Dr. Cipto Mangunkusumo during the period March to May 2019 in patients undergoing hemodialysis using native upper arm arteriovenous fistula access with or without symptoms of ischemia in the hand, the method of filling in the questionnaire by guided interview, then followed by measurements of the radial and ulnar artery peak stystolic velocity distal to the arteriovenous fistula

Results: The total sample was 80, the most samples were female 43 (53.8%) while men were 37 (46.2%). 91.2% of the samples had av fistula BC Sinistra, with a median age of 53 years. The total HIQ score obtained is  with a minimum value of 0, a maximum of 70, with a median value of 3. The radial arterial PSV value is with a minimum value of 20 cm/second, a maximum of 79 cm/second, a median of 40 cm/second. The ulnar arterial PSV value is at least 16 cm/second, maximum 70 cm/second, median 41 cm/second. There was a significant correlation (p <0.001) between the hand ischemia questionnaire and the peak systolic velocity of the radial and ulnar artery in patients with native upper arm arteriovenous fistula, but after a diagnostic test the sensitivity was only 15% with 100% specificity.

Conclusion: There was a significant correlation between the hand ischemia questionnaire and the value of the peak systolic velocity of the radial and ulnar arteries in patients with native upper arm fistula, but because of the low sensitivity that the hand ischemia questionnaire could not be used as an initial examination to detect steal syndrome in patients without previous symptoms of hand ischemia.

Abstrak :
Efektifitas hemodialisis dapat dilihat dari penurunan kadar ureum dan kreatinin pasca hemodialisis. Agar efektifitas ini tercapai maka diperlukan pemantauan dan pengaturan dalam proses hemodialisis, salah satunya adalah pengaturan dan pemantauan kecepatan aliran darah (Quick of blood/ Qb) selama proses hemodialisis. Penelitian ini bertujuan mengetahui hubungan antara quick of blood dengan penurunan nilai ureum kreatinin post hemodialisis pada pasien CKD yang menjalani hemodialisis di Unit Hemodialisis Rumah Sakit Umum Daerah Raden Mattaher Jambi. Penelitian ini menggunakan desain deskriptif analitik dengan pendekatan cross sectional. Jumlah sampel pada penelitian ini adalah 32 responden. Hasil penelitian menunjukkan bahwa pasien pria lebih banyak dari wanita yaitu sebesar 66%, umur rata-rata adalah 51 tahun dengan umur termuda adalah 26 tahun dan umur tertua 73 tahun. Penelitian juga menunjukkan Qb rata-rata adalah 190,586 ml/menit. Nilai ureum predialisis rata-rata adalah 132,8 mg/dl, setelah dilakukan hemodialisis terjadi penurunan ureum rata-rata sebesar 71,3 mg/dl (53,7%), adapun nilai kreatinin predialisis ratarata adalah 10,54 mg/dl, setelah dilakukan hemodialisis terjadi penurunan kreatinin rata-rata sebesar 5,65 mg/dl. Hasil penelitian menunjukkan bahwa tidak ada hubungan antara nilai Qb dengan penurunan ureum post hemodialisis pada pasien CKD yang menjalani hemodialisis (p=0,799), tidak ada hubungan antara nilai Qb dengan penurunan kreatinin post hemodialisis pada pasien CKD yang menjalani hemodialisis (p=0,100). Kesimpulan penelitian adalah tidak ada hubungan antara nilai Qb dengan penurunan ureum dan kreatinin post hemodialisis pada pasien CKD yang menjalani hemodialisis. Rekomendasi dari penelitian ini adalah Rumah Sakit perlu membuat prosedur tetap tentang pengaturan Qb pasien dengan aturan yang baku mengacu pada berat badan pasien atau dialser yang digunakan. Rekomendasi lain adalah perlu dilakukan penelitian tentang cara pengaturan Qb yang tepat agar meningkatkan adekuasi hemodialisis dan pengaruh pengaturan Qb terhadap adekuasi hemodialisis.

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Haemodialysis effectivity could be shown by the decrease of ureum and creatinine level post hemodialysis. Observation and regulation in haemodialysis process should be done to reach those effectivity, one of them observation and regulation the speed of blood flow rate (Quick of blood/ Qb) during process hemodialisis. The purpose of the research is to know the relation between quick of blood with the decrease of ureum and kreatinin post hemodialysis of CKD patient in haemodialysis unit of Raden Mattaher Hospital Jambi. Descriptive analytic design with cross sectional approach has been used in this research. The total samples were 32 respondens. The research found that male more than female patients (66%) with average 51 years old, youngest is 26 years old and the oldest 73 years old. The Qb average was 190,586 ml/minute. Predialysis ureum average was 132,78 ml/dl, and it ecrease 71,3 ml/dl (53,7%) post haemodialysis. Predialisis creatinine average was 10,54 ml/dl decrease 5,65 ml/dl post haemodialysis. The research showed there were no relation between Qb and decrease of ureum post haemodialysis in CKD patients who treated by haemodialysis (p=0,799), and no relation between Qb and decrease of creatinine post haemodialysis in CKD patients who treated by haemodialysis (p=0,100). In conclusion, there were no relation between Qb and decrease of ureum and creatinin post haemodialysis in CKD patient who treated by haemodialysis. As recommendation to the hospital, they should make the true procedures in patient with haemodialysis process by Qb regulation based on body weight or dialzer. The future research should do about regulation method of Qb and its affect to increase haemodialysis adequation.

Abstrak :
Background: the prevalence of chronic kidney disease (CKD) and dialysis patients is increasing every year in Indonesia. The impact of CKD and dialysis on patient quality of life (QOL) has been recognized as an important outcome measure in the management of CKD. The Kidney Disease Quality of Life (KDQOL-36) has been validated and is widely used as a measure of QOL for CKD and dialysis patients in many countries, but not in Indonesia. The aim of this study is to determine the reliabity and validity of the Indonesian version of KDQOL-36 on hemodialysis patients in Indonesia. Methods: the KDQOL-36 was translated into Indonesian language by a certified translator and then it was back-translated into English. The translated questionnaire was further reviewed by an expert panel. The final questionnaire was administered to hemodialysis patients in Hemodialysis Unit at Hasan Sadikin General Hospital. Validity was measured using Pearson's correlation between the kidney disease-targeted scores, generic dimensions (SF-12) scores and each scale score in KDQOL-36. The internal consistensy was assessed using Cronbach's Alpha and reliability was examined using test-retest. Results: out of 103 patients, we found that most subjects were male (52.4%) with median age of 51 (22-75) years. The duration of hemodialysis was 3.4 (SD 2.1) years. The validity test showed a significant correlation (p<0.001) on kidney disease-targeted total score, SF-12 and each score of the scale within it. All of the KDQOL-36 scales showed good test-retest reliability. Internal consistency reliability values were acceptable, with Cronbach's Alpha >0,7 for all scales. Conclusion: the Indonesian version of the KDQOL-36 questionnaire is valid and reliable for evaluating QOL in reguler hemodialysis patients.

Abstrak :
AV fistula allows external vascular access for hemodialysis patients. Because hemodialysis patients experience puncture wounds and stabbing pain approximately 300 times a year, development of methods to decrease pain intensity are of great importance. Some techniques, such as the Valsalva maneuver, are known to reduce pain. This study aims to assess the effect of the Valsalva maneuver on decreasing the intensity of AV fistula pain in patients receiving hemodialysis. The quasi-experimental research of pre and post without control applying consecutive sampling to get as many as 63 respondents. Pain intensity was measured by using the Numerical Pain Rating Scale (NPRS). The Valsalva maneuver was performed during insertion of the AV fistula needle for 16–20 seconds. The results showed significant differences in pain intensity between before and after the intervention with the difference in mean that is 1.35 (SD = 0.54), t = 19.70, p = 0.001. The Valsalva maneuver is effective in reducing the pain of AV fistula insertion because it stimulates the vagus nerve to induce an antinociceptive effect. Nurses are highly recommended to teach the Valsalva maneuver to patients undergoing routine hemodialysis.

Abstrak :
Background: arterial stiffness is a mortality predictor in hemodialysis patients, hemodialysis induces inflammation, marked by an intradialysis increase in the inflammatory marker pentraxin 3 (PTX3). Arterial stiffness in twice-weekly hemodialysis patients in Indonesia is lower than has been found in studies of thrice-weekly patients. This study therefore aims to determine the factors associated with arterial stiffness, focusing on the role of hemodialysis frequency and PTX3. Methods: a cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Fatmawati Hospital, and Medistra Hospital involving patients with twice- and thrice-weekly hemodialysis. Arterial stiffness was measured by carotid-femoral pulse wave velocity after hemodialysis, and blood samples for PTX3 testing were taken before hemodialysis. Bivariate and multivariate analyses were performed using chi-squared tests and logistic regression. Results: out of 122 subjects, 82 underwent twice-weekly hemodialysis. There was no difference in arterial stiffness between patients with twice- and thrice-weekly hemodialysis. In bivariate analysis, PTX3, cardiovascular disease, dialysis vintage had p values of <0.05, while the subsequent multivariate analysis showed that PTX3>2.3 ng/ml was 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 (adjusted OR 3.10; 95% CI 1.04–9.24), and dialysis vintage (adjusted OR 2.72; 95% CI 1.001–7.38). Conclusion: predialysis PTX3 levels above 2.3 ng/ml were associated with arterial stiffness. There was no difference in arterial stiffness between patients with twice- and thrice-weekly hemodialysis.

Abstrak :
Pada pasien hemodialisis (HD), banyak penelitian di negara maju membuktikan hubungan yang erat antara inflamasi, komplikasi kardiovaskular, malnutrisi, dan mortalitas yang tinggi. Inflamasi yang ditandai dengan meningkatnya IL-6 dan CRP, serta berkurangnya sitokin anti-inflamasi IL-10, mempunyai peran utama dalam terjadinya berbagai komplikasi pada pasien HD di Indonesia, terdapat perbedaan pelaksanaan HD, yaitu HD yang lebih jarang (2 kali seminggu), banyak menggunakan dialiser selulosal diasetat, proses ulang, low flux, dan tanpa air yang sangat murni, yang kesemuanya menyebabkan risiko respons inflamasi yang tinggi. Pada kenyataannya, prevalensi inflamasi dan nilai rata-rata CRP di Indonesia lebih rendah. Polimorfisme gen IL-6-174G>C dan gen IL-10-1082G>A telah dibuktikan mempengaruhi tingkat produksi IL-6 dan CRP. Perbedaan proporsi alel G, C pada IL-6-174, dan alel G, A pada IL-1082, berbagai bangsa dan ras, mungkin menjadi penyebab perbedaan di atas. Sindrom inflamasi malnutrisi (SIM) pada pasien HD berbeda dengan malnutrisi pada populasi. Pada SIM, faktor inflamasi, uremia dan katabolisme protein lebih berperan. Hal ini memerlukan cara penilaian status malnutrisi yang berbeda. Penelitian ini dilakukan untuk mendapatkan frekuensi polimorfisme gen IL-6-174 dan IL-10-1082, mengetahui faktor yang berperan dalam SIM, mengetahui perbedaan prevalensi inflamasi pada pasien dengan malnutrisi dan sebagai validitas penilaian SGA. Telah dilakukan penelitian pada pasien yang menjalani HD 2 kali seminggu, 5 jam per kali HD, tanpa komplikasi penyakit lainnya, dan semua memakai dialiser selulosa diasetat yang diproses ulang. Dari 64 pasien yang diperiksa, didapatkan gen IL-6-74GG 95,31%, CC 3,13% dan GC 1,56%. Gen IL-1082AA 89,06%, GA 10,94%, dan GG tidak didapatkan. Proporsi alel ini hampir sama seperti yang didapatkan di Korea, Jepang dan Cina, berbeda dengan yang didapat di AS, ras Kaukasia, Amerika-Afrika, Hispanik dan Eropa (Kaukasia). Selain perbedaan pada proporsi gen, kami mendapatkan konsenlrasi CRP (6,23±5,57 mg/L), frekuensi malnutrisi (24,7%), dan skor MIS (6,7) yang lebih rendah dibanding dengan data dari AS dan Eropa. Mengingat sedikitnya alel C pada gen IL-6-174 dan alel G pada gen IL-10-1082, analisis statistik yang dilakukan tidak dapat memperlihatkan pengaruh perbedaan alel terhadap manifestasi klinik. Inflarnasi kronik mempengaruhi terjadinya malnutrisi (PR 3,03; 1K 95% 1,53-6,06; P = 0,012). Penilaian dengan skala SGA berkorelasi balk dengan parameter antropometri (IMT, LLA, LOLA, HGS), dan albumin serum. Albumin serum sebagai parameter inflamasi kronik berkorelasi balk dengan parameter nutrisi yang lain, sedangkan CRP tidak. Didapatkan kesan yang kuat bahwa pada pasien HD, gen IL-174GG bersifat protektif, sedangkan gen IL-1082AA tidak begitu berperan. Selain itu dibuktikan adanya pengaruh inflamasi terhadap malnutrisi dan SGA terbukti merupakan penilaian sindrom malnutrisi inflamasi yang cukup baik.

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Many studies on HD patients in developed countries have conferred strong evidence of closed correlation between inflammation, cardiovascular complication and high mortality rates. Inflammation, indicated by high levels of CRP and IL-6, has a major role in initiating and sustaining complications. Adapting to high cost, HD in Indonesia is conducted in a little different ways. Patients are dialyzed twice a week, 5 hours each, using reprocessed cellulose/diacetate membrane dialyzer, and without ultrapure water. All of these contribute to a high risk of inflammation, but in fact the prevalence of inflammation in Indonesia is relatively low. IL-6-174G>C and IL-10-1082G>A polymorphic gene have been proven to influence the production of IL-6 and CRP. The difference in the proportion of allele G, C in IL-6-174, allele G, A in IL-1082 in a variety of people's races might cause the difference in the prevalence and the level of inflammation. Malnutrition inflammation syndrome (MIS) on HD patients is different from malnutrition in general population. In MIS, the inflammatory factors, uremia, and protein catabolism of protein are more dominant. These matters probably require a different assessment method of malnutrition status. The purpose of this study was to obtain the frequency of polymorphic gene IL-6-174 and IL-10-1082 to find out the prominent factors in MIS, and to find out the difference in the inflammation prevalence in patients with malnutrition and to serve as validity of SGA assessment. A study on patients who were on hemodialysis twice a week, 5 hours each session has been conducted. The subjects had no other co-morbidities and all of them used reprocessed diasetat cellulose dialyzers. Out of 64 patients examined, IL-6-174GG was obtained 95.31%, CC 3.13% and GC 1.56%, IL-1082AA 89.06%, GA 10.94%, but absence of GG genotype. The proportion of these alleles was almost similar to that obtained in Korea, Japan and China, but it was different from that obtained in the US for the Caucasian race, African Americans, Hispanic people, and the Caucasian people in Europe_ Besides the difference in gene proportion, it was obtained that CRP (6.23±5.57 mg/L), malnutrition (24.7%), and malnutrition inflammation score (6.7) were lower compared with the data from Europe and the United States. Considering the scanty amount of allele C in IL-6-174 gene and G allele in IL-10-1082 gene, based on the statistic analysis performed it did not revealed the influence of the difference in allele on the clinical manifestation. It was found that chronic inflammation influenced the occurrence of malnutrition (PR 3.03; CI 95% 1.53-6.06; P = 0,012). The scoring by the...

Abstrak :
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. ......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.

Abstrak :
Banyak dampak dan perubahan akibat pandemi COVID-19 yang dapat dialami pasien gagal ginjal terminal yang menjalani hemodialisis. Hal ini dapat mempengaruhi kepatuhan mereka dalam menjalani proses hemodialisis yang nantinya dapat berpengaruh terhadap kualitas hidup pasien hemodialisis. Tujuan penelitian ini adalah untuk mengeksplorasi secara mendalam tentang pengalaman pasien yang menjalani hemodialisis di Indonesia di era pandemi COVID-19. Penelitian ini menggunakan pendekatan deskriptif kualitatif dengan metode wawancara mendalam. Partisipan berjumlah 15 orang dari RS Wahidin Sudirohusodo dan RS Universitas Hasanuddin yang dipilih melalui teknik purposive sampling. Terdapat 3 tema yang dihasilkan dalam penelitian ini yaitu munculnya berbagai respon pada awal pandemi, timbulnya berbagai dampak yang dialami selama pandemi, dan adanya strategi koping yang dibangun selama pandemi. Temuan tersebut menunjukkan bahwa pasien gagal ginjal terminal yang menjalani hemodialisis telah berupaya untuk membangun strategi koping yang adaptif di era pandemi COVID-19 tetapi mereka tetap memerlukan dukungan dari penyedia layanan kesehatan di unit hemodialisis untuk mengatasi berbagai masalah dan dampak akibat pandemi COVID-19 ini. Perawat hemodialisis diharapkan dapat melakukan pengkajian secara holistik dan evaluasi secara terus menerus agar dapat memberikan asuhan keperawatan yang komprehensif dalam memenuhi kebutuhan pasien hemodialisis di era pandemi COVID-19 ini. ......Many effects and changes due to COVID-19 pandemic experienced by patients with end-stage renal disease undergoing hemodialysis. This can affect their compliance to have hemodialysis treatment that will affect their quality of life. The aim of this study is to deeply explore the experience of patients with end-stage renal disease who were undergoing hemodialysis during COVID-19 pandemic. This study takes qualitative descriptive approach with in-depth interviews. The participants were 3 themes, as: the emergence of various responds in an early pandemic, the effects that were experienced during pandemic and the coping strategy built during the pandemic. These findings showed that patients with end-stage renal disease have been implementing adaptif coping strategy during the pandemic, but they still need a support from the health care providers in the hemodialysis unit to overcome various problems and impacts during COVID-19 pandemic. The role of nurses is needed to conduct holistic assessments and continuous evaluations in order to provide comprehensive nursing care for the needs of hemodialysis patients in this era of the COVID-19 pandemic.

Abstrak :
Pendahuluan : Klien gagal ginjal kronis yang menjalani hemodialisa mengalami banyak perubahan dalam hidupnya. Dalam proses adaptasi yang dilakukan muncul kebutuhan spiritual untuk mencari makna dalam kehidupan yang membuat mereka dapat bertahan dalam penderitaan. Tujuan : memperoleh gambaran mengenai pengalaman spiritual klien gagal ginjal kronis yang menjalani hemodialisa. Metode : pendekatan kualitatif fenomenologi deskriptif. Sampel penelitian sebanyak 9 partisipan diambil menggunakan purposive sampling. Metode pengumpulan data menggunakan indepth interview. Analisa data menggunakan metode Collaizzi. Hasil : penelitian mendapatkan 4 tema utama : respon yang terjadi saat awal diagnosa GGK dan harus menjalani hemodialisa, respon yang terjadi selama menjalani hemodialisa, upaya mendapatkan dukungan spiritual, upaya memaknai sakit dan merangkai ulang kejadian (reframing). Rekomendasi : hasil penelitian ini diharapkan dapat menjadi data dasar bagi pengembangan asuhan keperawatan berbasis spiritual pada klien gagal ginjal kronis dengan hemodialisa. ......Introduction : Chronic kidney disease patients have many changes in their life. During their adaptation process, spiritual need becomes important to make them struggle in suffering from the disease. Objectives : to give overview of spiritual experience experienced by chronic kidney disease patients undergoing hemodialysis treatment in PKU Muhammadiyah Gombong Hospital Central Java. Methods : this is a qualitative descriptive research using phenomenological approach. The samples consist of 9 participants taken by using purposive sampling technique. The data analysis technique is Collaizzi?s method. Results : 4 themes can be illustrated in the study results : responses happened at the first time they were diagnosed as chronic kidney diseases and hemodialysis patients, responses happened during their hemodialysis process, effort of looking for spiritual sources and effort of looking for the meaning of being sick and reframing. Recommendation : The results of this study can be used to improve the holistic nursing process implementation based on spiritual needs for chronic kidney disease patients undergoing hemodialysis treatment.