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Latar Belakang: Penyakit Ginjal Kronik (PGK) adalah kondisi serius dengan morbiditas dan mortalitas tinggi, ditandai oleh kerusakan ginjal selama lebih dari tiga bulan. Hemodialisis adalah tatalaksana umum untuk PGK lanjut, yang dijalani oleh 19,33% pasien di Indonesia. Risiko Penyakit Kardiovaskular (PKV) pada PGK stadium 4-5 mencapai 50%, dengan 40% kematian terkait PKV. Padahal sebanyak 12,5% pasien CKD ditemukan pada pasien yang sudah memiliki penyakit kardiovaskular. Maka biomarker seperti Pentraxin-3 (PTX3) penting untuk diagnosis dan prognosis, terutama karena telah ditemukan lebih efektif daripada C-Reactive Protein (CRP) dan biomarker inflamasi lain. PTX3 juga bersifat kardioprotektif dan dapat memprediksi kejadian Major Adverse Cardiovascular Events (MACE) tetapi belum pernah ada penelitian yang memprediksi MACE pada pasien PGK. Penelitian ini termasuk dalam penelitian CARE-CKD di Rumah Sakit Cipto Mangunkusumo (RSCM) dan menganalisis kemampuan PTX3 dalam memprediksi MACE pada pasien PGK.

Tujuan: Mengetahui kadar, nilai potong, dan kemampuan PTX3 dalam memprediksi MACE pada pasien PGK yang menjalani HD di RSCM, dengan kalibrasi dan diskriminasi baik setelah dikontrol faktor jenis kelamin, usia, IMT dan infeksi.

Metode: Penelitian ini menggunakan desain kohort retrospektif. Data sekunder dari pasien PGK yang menjalani hemodialisis dianalisis untuk melihat hubungan kadar PTX3 dengan kejadian MACE selama satu tahun. Analisis statistik menggunakan SPSS versi 26.

Hasil:

Pada 74 pasien PGK yang menjalani HD di RSCM, kadar PTX–3 median adalah 0,9 ng/mL. Dari mereka, 11 pasien mengalami MACE dengan PTX–3 median 1,324 ng/mL. Analisis ROC menunjukkan AUC 0,630. PTX–3 dapat memprediksi MACE, dengan cut-off 1,317 ng/mL.

Simpulan: Pentraxin 3 dapat menjadi prediktor MACE pada pasien PGK yang menjalani HD yang baik setelah dikontrol oleh variable perancu.

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Background: Chronic Kidney Disease (CKD) is a serious condition with high morbidity and mortality, characterized by kidney damage for over three months. Hemodialysis is a common treatment for advanced CKD, undertaken by 19.33% of patients in Indonesia. The risk of Cardiovascular Disease (CVD) in CKD stages 4-5 reaches 50%, with 40% of deaths related to CVD. Therefore, biomarkers like Pentraxin-3 (PTX3) are crucial for diagnosis and prognosis, as PTX3 has been found to be more effective than C-Reactive Protein (CRP) and other inflammatory biomarkers. PTX3 also has cardioprotective properties and can predict Major Adverse Cardiovascular Events (MACE), though no studies have yet predicted MACE in CKD patients. This research is part of the CARE-CKD study at Cipto Mangunkusumo Hospital and will analyze PTX3's ability to predict MACE in CKD patients.

Objective: To determine the levels, cut-off value, and predictive ability of PTX3 for Major Adverse Cardiovascular Events (MACE) in Chronic Kidney Disease (CKD) patients undergoing hemodialysis at Cipto Mangunkusumo Hospital, with good calibration and discrimination after controlling for gender, age, BMI, and infection factors.

Methods: This study utilized a retrospective cohort design. Secondary data from CKD patients undergoing hemodialysis were analyzed to examine the relationship between PTX3 levels and MACE occurrences over one year. Statistical analysis was conducted using SPSS version 26.

Results: In 74 CKD patients undergoing HD at Cipto Mangunkusumo Hospital, the median PTX-3 level was 0.9 ng/mL. Among them, 11 patients experienced MACE with a median PTX-3 level of 1.324 ng/mL. ROC analysis indicated an AUC of 0.630. PTX-3 can predict MACE, with a cut-off of 1.317 ng/mL.

Conclusions: Pentraxin 3 could be a predictor of MACE in CKD patients undergoing HD after calibration of confounding factors."

"ABSTRAKPendahuluan: 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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ASBTARCTIntroduction: 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."

"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."