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"ABSTRAKProses hemodialisis juga sering menimbulkan dampak kesakitan seperti terjadinya kram otot saat intradialisis. Tujuan penelitian ini untuk mengidentifikasi dampak meningkatnya frekuensi pernapasan terhadap kram otot intradialisis. Penelitian ini menggunakan metode kuantitatif dengan desain analitik cross sectional. Penelitian ini dilakukan di ruang hemodialisis RSUD Panembahan Senopati Bantul. Subyek penelitian ini diambil secara accidental sampling. Keseluruhan subyek penelitian ini adalah 91 responden. Peneliti mengukur frekuensi pernapasan predialisis dan mengkaji kram otot intradialisis. Penelitian ini menggunakan analisa bivariabel Chi-Square. Hasil analisa Chi-Square menunjukkan nilai p sebesar 0,020 yang berarti terdapat hubungan yang signifikan antara frekuensi napas predialisis terhadap kram otot intradialisis. Kram otot yang terjadi selama proses hemodialisis dapat terjadi karena adanya stress oksidatif selama intradialisis. Observasi frekuensi pernapasan dapat mengantisipasi adanya risiko stres oksidatif yang mungkin akan terjadi.ABSTRACTEffect of Predialysis Respiration Rate on Intradialysis Muscle Cramps at Regional Hospital Panembahan Senopati Bantul. Hemodialysis process often causes painful impact such as muscle cramps during intradialysis. The objective of this research was to identify the increased between respiratory rate and intradialysis muscle cramps. The method of this research was analytical survey method. This research is descriptif quantitative with cross sectional design. This research conducted in hemodialysis unit in Panembahan Senopati General Hospital in Bantul. The subjects of the research taken using accidental sampling. The total research subjects were 91 respondents. The researchers measured the relationship between predialysis respiratory rate and assesed the intradialysis muscle cramps. The data analyzed with bivariate chi square. The Chi-Square analysis results showed that the p value is 0,020, meaning that there was a significant relationship between predialysis respiratory rate and intradialysis muscle cramps. Muscle cramps during hemodialysis process may occur due to oxidative stress during intradialysis. Observing respiratory rate can anticipate the risks of oxidative stress that may occur. "

"Prevalensi penyakit ginjal kronik pada anak selalu meningkat dan dapat menyebabkan malnutrisi hingga gagal tumbuh. Penelitian ini bertujuan mengidentifikasi gambaran status gizi dan mencari hubungan status gizi dengan faktor yang berhubungan pada anak dengan PGK fase pradialisis dengan desain cross-sectional. Data diambil di Poliklinik Nefrologi RSCM Jakarta. Analisis data menggunakan metode ANOVA, independent sample t-test, spearman, dan mann-whitney dengan SPSS Versi 25. Rerata status gizi berdasarkan IMT/U didapatkan bergizi baik, yakni -1,02. Rerata perawakan berdasarkan TB/U didapatkan perawakan pendek dengan z-score -2,71. Terdapat 8 subjek berusia di bawah 10 tahun dengan median z-score BB/U di rentang berat badan kurang, yakni -2,77. Analisis bivariat antara BB/U, IMT/U, dan TB/U dengan stadium penyakit ginjal kronik, jenis kelamin, faktor etiologi primer, hipertensi, anemia, usia, status ekonomi keluarga, durasi penyakit, dan tingkat pendidikan orangtua tidak menunjukkan hubungan signifikan (p>0,05). Analisis bivariat antara BB/U dan IMT/U dengan gangguan mineral tulang tidak berhubungan signifikan (p>0,05). Namun, analisis bivariat TB/U dengan gangguan mineral tulang (p=0,005) memiliki hubungan signifikan. Penelitian ini menyimpulkan bahwa rerata status gizi anak PGK stadium 3—5 fase pradialisis memiliki berat badan kurang, perawakan pendek, tetapi bergizi baik. Terdapat hubungan antara status gizi anak dengan gangguan mineral tulang tetapi tidak berhubungan dengan faktor lainnya.

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The prevalence of pediatric chronic kidney disease is increasing annually and can lead to malnutrition to failure to thrive. This study aims to identify the nutritional status of children with chronic kidney disease and its related factors using cross-sectional design held at Pediatric Nephrology Clinic RSCM Jakarta. Data were analyzed using ANOVA, independent sample t-test, spearman, and mann-whitney with SPSS Version 25. Nutritional status based on BMI-for-age showed the subjects had good nutrition with a mean z-score of -1.02. Stature based on height-for-age showed a mean z-score of -2,71, classified as stunted. There were 8 subjects under the age of 10 with a median z-score -2,77, classified as underweight based on the weight-for-age. Bivariate analysis between weight-for-age, height-for-age, and BMI-for-age with CKD stage, gender, primary etiological factor, hypertension, anaemia, age, family economic status, duration of illness, and parental education level did not show a significant association (p>0.05). Bivariate analysis between weight-for-age and BMI-for-age with mineral and bone disorder was also not significantly related (p>0.05). However, bivariate analysis of height-for-age with CKD-MBD (p=0.005) had a significant association. This study concluded that children with CKD stage 3-5 in the predialysis phase were underweight, stunted, but well-nourished. There was a significant association between nutritional status and CKD-MBD but no association with other factors."

"Latar Belakang: Prevalensi penyakit arteri perifer PAP pada pasien dengan penyakit ginjal kronik PGK terlihat meningkat sejak stadium 3. Alat diagnostik nilai indeks ankle brachial ABI cukup akurat dalam mendeteksi PAP pada populasi normal. Pada PGK yang sering terjadi kalsifikasi pembuluh darah dimana nilai ABI dapat menjadi normal atau tinggi meski sudah ada stenosis pembuluh darah. Kalsifikasi pada ibu jari jarang terjadi membuat pemeriksaan nilai indeks toe brachial TBI mempunyai kelebihan dalam menilai PAP pada PGK.Tujuan: Untuk mendapatkan proporsi PAP berdasarkan nilai ABI dan TBI serta informasi mengenai profil PAP pada PGK predialisis dan faktor yang diduga berhubungan. Metode: Penelitian potong lintang pada pasien PGK di poliklinik Ilmu Penyakit Dalam, poliklinik Ginjal Hipertensi, poliklinik Kardiologi dan poliklinik Kardiologi Pusat Jantung Terpadu RSCM periode Oktober 2015-Maret 2016. Data didapatkan dari hasil wawancara, pemeriksaan fisik, nilai ABI dan TBI, serta pemeriksaan laboratorium. Studi deskriptif dilakukan dengan melihat proporsi PAP berdasarkan nilai ABI dan TBI, proporsi variabel dan penentuan nilai rerata dan median. Hasil: Terdapat 75 pasien yang memenuhi kriteria penelitian. Proporsi PAP berdasarkan nilai ABI dan TBI 60 IK 95 49 -; 71. Nilai ABI. 0,9 dan TBI. 0,7 digunakan sebagai cut off dalam diagnosis PAP. Proporsi PAP pada tiap stadium ginjal mulai terlihat besar. Pasien dengan PAP lebih banyak laki-laki 51,1 dan rerata IMT 23,57 3,5 kg/m2. Median usia pasien 64 tahun 33-74 tahun. Nilai median ABI 1,04 0,7-1,26 dan TBI 0,61 0,31-0,74. Sebagian besar tidak merokok 53,3, mempunyai komorbiditas hipertensi 84, diabetes melitus 64, penyakit jantung koroner 57 dan dislipidemia 40. Nilai median laju filtrasi glomerulus 31,6 6,3-57,6, nilai median albuminuria 153 mg/g kreatinin 7,9-10767,3, nilai median kalsium. mg/dL 7,2-9,8 mg/dL, nilai median fosfat 3,9 mg/dL 1,9-5,7 mg/dL, rerata nilai produk CaxPO4 33,7 6,5 mg2/dL2 dan nilai median hsCRP 1,3 mg/L 0,1-19,19 mg/L. Proporsi pasien dengan hipertensi lebih besar pada pasien dengan PAP. Sementara proporsi DM tidak terkontrol lebih besar dibandingkan yang terkontrol 44. 20. Simpulan: Proporsi PAP pada pasien PGK predialisis berdasarkan nilai ABI dan TBI sebesar 60. PAP pada PGK predialisis lebih banyak pada subjek dengan komorbiditas, diabetes melitus yang tidak terkontrol, stadium. klasifikasi Fontaine dan kecenderungan albuminuria yang meningkat.

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Background The prevalence of peripheral artery disease PAD in chronic kidney disease patients is increasing in CKD stage. or higher. Ankle brachial index is an accurate diagnostic tool in population without CKD. Higher prevalence of arterial calcification in CKD can lead to. normal or high ABI in stenotic vessel. Toe vessels are less susceptible to calcification, therefore toe brachial index TBI measurement can be more useful for PAD assessment in CKD population.

Objectives: The aim of the study is to determine the profile of PAD based on ankle brachial index and toe brachial index in predialysis CKD patients.

Methods: cross sectional study was conducted in outpatient clinics of Dr. Cipto Mangunkusumo hospital from October 2015 to March 2016. The data were obtained by interview, ABI and TBI measurement, and analyzing the laboratories values.

Results: In 75 patients ABI and TBI measurement were conducted simultaneously. ABI 0.9 and or TBI 0.7 had been used as cut off values for diagnosing PAD. PAD proportion based on ABI and TBI in CKD predialysis is 60 IK 95 49 - 71. PAD proportion in every CKD stage are high. Most of the subject are male 51.1 and the mean body mass index value is 23.57 3.5 kg m2. The age median is 64 year old 33 74 year old. The median value of ABI is 1.04 0.7 1.26 and TBI 0.61 0.31 0.74. Most of the patients are non smoker 53.3, had hypertension 84, diabetic 64, coronary artery disease 57 and dyslipidemia 40. Median value of glomerulus filtration rate is 31.6 ml menit 1.73 m2 6.3 57.6 ml menit 1.73 m2, median value of albuminuria 153 mg. kreatinin 7.9 10767.3 median value of calcium. mg dL 7.2 9.8 mg dL, median value of phosphate 3.9 mg dL 1.9 5.7 mg dL, mean value of CaxPO4 product is 33.7 6.5 mg2 dL2 and median value of hsCRP 1.3 mg. 0.1 19.19 mg.. Most patient with PAD had. greater proportion of hypertension. The proportion of uncontrolled diabetes are higher in patient with PAD 44 vs 20.

Conclusion PAD proportion based on ABI and TBI is 60 IK 95 49 - 71. Most of the patients with PAD in CKD predialyis are with uncontrolled diabetes, stage II of Fontaine classification, increased albuminuria. "