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Abstrak :
[Penyakit Arteri Perifer (PAP) merupakan sumbatan aliran darah arteri selain koroner dan intrakranial. PAP dihasilkan dari proses atherosklerosis, emboli, trombus, dan inflamasi yang mengarah ke stenosis arteri. PAP asimptomatik menempati 3-10% populasi dunia, dan meningkat hingga 15-20% pada 70 tahun ke atas. Divisi kami mencatat 18,1-24,7% pasien kaki diabetik dengan PAP mengalami amputasi pada kurun waktu 3 tahun terakhir. Evaluasi ultrasonografi Doppler pada arteri utama ekstremitas bawah diharapkan mampu mendeteksi secara dini apakah pasien akan diamputasi atau tidak baik mayor maupun minor. Metode yang diambil adalah analitik komparatif kategorik independen dengan disain penelitian kohort retrospektif. Selama Januari 2010 hingga Desember 2011 didapatkan 24 pasien yang masuk kriteria inklusi. Arteri yang diperiksa a.femoralis, a.poplitea, a.tibialis posterior, dan a.dorsalis pedis dengan tampilan spektral mulai dari monofasik, bifasik, atau trifasik terutama dengan pelebaran spektral. Ultrasonografi salah satu modalitas ?operator dependent?, untuk mengurangi bias, peneliti menggunakan operator ultrasonografi adalah peneliti sendiri, trainee atau konsultan divisi kami. Hasil didapatkan spektral bifasik hingga monofasik pada a.femoralis 25,0%, a.poplitea 58,3%, a.tibialis posterior 41,6%, a.dorsalis pedis 45,8%, angka amputasi mayor dan minor masing-masing 4%. Perhitungan statistik didapatkan untuk a.femoralis p=0,054 (95% CI), a.poplitea p=0,006 (95% CI), a.tibialis posterior p=0,010 (95% CI), dan a.dorsalis pedis p=0,021 (95% CI). Secara statistik, prediksi amputasi dapat bermakna pada ultrasonografi Doppler pada a.poplitea, a.tibialis posterior, dan a.dorsalis pedis. Dapat ditarik kesimpulan pemeriksaan ultrasonografi Doppler penting dilakukan pada setiap pasien PAP untuk mengevaluasi secara khusus keadaan empat arteri utama ekstremitas bawah pasien dan untuk prediktor amputasi ...... Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss., BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.]

Abstrak :
Latar Belakang Hemodialisa membutuhkan suatu akses vaskuler yang fungsional dan adekuat untuk mendapatkan hasil terbaik, bagi Negara berkembang seperti Indonesia tingginya biaya perawatan dan tenaga ahli masih merupakan hal yang harus ditanggapi serius oleh semua pihak. NKF-KDOQI menetapkan tiga Tujuan utama suatu unit hemodialisa antara lain meningkatkan pemakaian AV Fistula, Mengurangi pemakaian kateter hingga 10% dan Deteksi dini dari disfungsi akses vaskuler. Hingga saat ini belum ada gambaran akses vaskular yang terdapat di unit hemodialisa RSUPN Ciptomangunkusumo sehingga dapat dibandingkan dengan guideline, dan diharapkan mendapat masukan untuk pelayanan terbaik bagi pasien. Metode Penelitian ini berupa deskriptif retrospektif, Populasi penelitian adalah pasien gagal ginjal kronik yang menjalani hemodialisa dengan akses vaskuler fistula AV dan kateter vena sentral di Rumah Sakit Cipto Mangunkusumo pada bulan Mei – Desember 2012. Data dari rekam medis penderita diketahui mengenai tanggal hemodialisa pertama kali, tanggal pembuatan akses vaskuler pertama kali, jenis akses vaskuler yang digunakan pertama kali serta konversi yang mengikutinya, serta lokasi akses vaskuler tersebut. Hasil Didapatkan 234 data pasien yang aktif menjalani hemodialisa di unit hemodialisa RSUPN Ciptomangunkusumno Jakarta dari bulan Mei – juni 2012, terdiri dari 146 laki laki dan 88 perempuan , rerata umur 49.04 tahun dengan rentang umur 11 tahun sampai 78 tahun. Diantara pasien tersebut , 122 (52.1%) pasien dengan AV fistula, dan pasien yang membuat AV Fistula sebelum hemodialisa pertama hanya pada 7 pasien (1.2%) 1 pasien menggunakan graft PTFE, dengan lokasi tersering untuk AV Fistula adalah Radiocephalica sebanyak 29.4%, 48 pasien menggunakan central venous catheter, dimana 28 pasien dengan longterm catheter (12%) dan sisanya dengan shortterm catheter (8.5%). Direct Puncture digunakan oleh pasien sebagai cara yang dipakai pertama kali melakukan hemodialisa, sebanyak 49.6%. dari keseluruhan pasien yang pernah menjalani pemasangan AV fistula mengalami primary failure sebanyak 10.65%, dan secondary failure sebanyak 7.37%. Kesimpulan Masalah pada suatu unit hemodialisa tidaklah sederhana dan untuk mencapai suatu hasil yang terbaik diperlukan kerjasama dari sebuah tim multidisiplin vaskular akses yang terdiri dari ahli ginjal hipertensi, ahli bedah vaskular, ahli radiologi, dan perawat dialisa. Dengan seorang koordinator yang berdedikasi tinggi yang selalu memperbaharui data base pasien dan update terbaru dari perkembangan akses vaskuler. ......Background A vascular access that mantained to be functioning and adequate is a must to achieve the best result in haemodialysis procedure. For a developing country like Indonesia, a high cost and expertise in vascular access maintenance reluctantly a serious issues. NKF-KDOQI has established three primary goals for a haemodialysis unit to achieve, to increase the placement of native fistulas as vascular access at initiation of hemodialysis procedure until 65 %, to discourage catheter insertion until 10% and early detection of vascular access dysfunction. Recently at Cipto Mangunkusumo hospital, there are no profile of vascular access in haemodialysis unit to figure out the condition and compare with guideline. Method This is a descriptive retrospective study with a CRF (Chronic Renal Failure) patients that undergo hemodialysis with natve fistula and catheter as their vascular access in Cipto Mangunkusumo hospital from May to December 2012. Data collected from medical record included dates when initiates their hemodialysis procedure, diagnose of CRF, creation of fistula or other vascular access, and complication that has occurred. Results From 234 patients that undergo hemodialysis procedure from May to December 2012, there werre 146 male and 81 female, with median age of 49.04 years old and distance within 11 – 78 years old. Among these patients 122(52%) with fistula an 1 patient with graft but only 7 patients (1.2%) that use native fistula to initiate their hemodialysis procedure. The most location for fistula were on left radiocephalic in 29.4% of patients, 48 patients use catheter for their vascular access that ionclude 12% long term and 8.5 % long term catheter. There were 49.6% patients with direct venous puncture to initiate their hemodialysis. From all fistulas that created there were 10.65% primary failure and 7.37% secondary failure. Conclusion Problems in hemodialysis unit is not as simple as that, and to achieve the best result require the concerted effort of multivariariate vascular access team that consist nephrologist, vascular surgeon, radiologist, and nurse with a chief coordinator that updating vascular access patients database and its development

Abstrak :
ABSTRAK
Penyebab PAD yang paling sering adalah atherosclerosis. PAD berhubungan dengan penyakit atherosklerosis lain seperti renal artery stenosis (RAS). Angka harapan hidup menurun pada pasien yang mengalami RAS, terutama yag stenosisnya diatas 60% namun belum sampai ke tahap gagal ginjal kronik. Dengan penatalaksanaan yang holistik diharapkan angka harapan hidup pasien semakin meningkat. Tujuan: Untuk mengetahui prevalensi RAS pada pasien PAD serta melihat hubungan antara Angio Score, riwayat hipertensi dan diabetes melitus terhadap derajat RAS yang terjadi. Metode: Desain yang digunakan adalah desain potong lintang. Penelitian ini dilakukan di RSUPN Dr. Cipto Mangunkusumo selama periode Februari hingga Mei 2019. Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dengan diagnosis lower extremity PAD dan dari pemeriksaan CT Angiografi didapatkan stenosis pada pembuluh darah tungkai, serta tampak arteri renalis pada pemeriksaan CTA yang dilakukan pada pasien tersebut. Pengambilan sampel dilakukan dengan metode total sampling. Hasil: sampel terbanyak berjenis kelamin wanita (50,8%) sedangkan pria sebanyak 32 orang (49,2%). Sebanyak 90,8% pasien yang diteliti menderita diabetes sedangkan 61,5% dari sampel menderita hipertensi. RAS derajat 1 merupakan yang terbanyak ditemukan. Tidak ada hubungan ANGIO Score terhadap usia, jenis kelamin dan diabetes mellitus, namun ada terhadap hipertensi. Terdapat hubungan antara RAS dengan usia dan hipertensi, namun tidak terdapat hubungan terhadap diabetes mellitus dan jenis kelamin. ANGIO Score dan RAS terdapat hubungan yang bermakna (p<0,001). Simpulan: Perbandingan ANGIO Score berdasarkan derajat stenosis mendapatkan hasil uji Kruskall Wallis mendapatkan nilai p<0,001 dan dilanjutkan dengan uji Mann Whitney mendapatkan bahwa perbedaan sudah terjadi saat perbandingan derajat stenosis 0 dengan derajat 1 dan seterusnya (p<0,001). Semakin tinggi nilai ANGIO Score (cut off pada score 9), angka spesifitas semakin tinggi.

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ABSTRACT
Background: The most common cause of PAD is atherosclerosis. PAD is associated with other atherosclerosis diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients who experience RAS, especially those with stenosis above 60% but have not yet reached the stage of chronic renal failure. With holistic management, it is expected that the patient's life expectancy will increase. Objective: To determine the prevalence of RAS in PAD patients and to see the relationship between Angio Score, history of hypertension and diabetes mellitus to the degree of RAS that occurred. Method: The design used is a cross-sectional design. This research was conducted at RSUPN Dr. Cipto Mangunkusumo during the period February to May 2019. The study was conducted at RSUPN Dr. Cipto Mangunkusumo with a diagnosis of lower extremity PAD, which obtained an ABI score of <0.9, severe ischemia until both unilateral and bilateral limb necrosis and CT angiography examination found stenosis in the leg veins, and the appearance of the renal artery on CTA examination performed on patients that is. Sampling is done by the total sampling method. Results: the most samples were female (50.8%) while men were 32 (49.2%). As many as 90.8% of patients studied had diabetes while 61.5% of the samples suffered from hypertension. 1st degree RAS is the most found. There is no relationship between ANGIO Score with age, gender and diabetes mellitus, but there is a hypertension. There is a relationship between RAS and age and hypertension, but there is no relationship to diabetes mellitus and gender. ANGIO Score and RAS have a significant relationship (p <0.001). Conclusion: The comparison of ANGIO Score based on the degree of stenosis obtained the results of the Kruskall Wallis test obtained a p value of <0.001 and continued with the Mann Whitney test found that the difference had occurred when the ratio of stenosis degrees was 0 with degrees 1 and so on (p <0.001). The higher the ANGIO score (cut off at score 9), the higher the specificity.

Abstrak :
ABSTRAK
Latar belakangModalitas akses vaskular yang sering digunakan untuk melakukan tindakan HD pada anak adalah penggunaan tunneled double lumen catheter TDLC , yang telah meningkat penggunaannya dari 60 pada tahun 2011 sampai 78 pada tahun 2014 dari semua pilihan akses vaskuler untunneled catheter, tunneled catheter, AVF dan AVG . Belum ada data mengenai lama penggunaan kateter tersebut berhubungan dengan posisi pemasangan, lokasi ujung kateter, bakteremia yang berhubungan dengan kateter, dan status nutrisi. Penelitian ini bertujuan untuk menelaah faktor-faktor yang memengaruhi lama penggunaan kateter tersebut.MetodeStudi deskriptif dengan desain cross sectional dengan subjek penelitian anak berusia 2-18 tahun dan menderita penyakit ginjal kronik stadium 4-5 yang menjalani HD reguler di RSCM. Data berasal dari rekam medis. Berdasarkan data dari registrasi pasien didapatkan terdapat 70 pasien anak yang dipasang TLDC antara bulan Agustus 2012 sampai Agustus 2016. Semua kateter yang dipasang adalah Hemo-Cath LT diproduksi oleh Medcomp , Harleysville, PA, USA . Lima belas pasien dieksklusi karena data yang tidak lengkap. Sehingga didapatkan 55 pasien yang masuk kriteria inklusi. Analisis statistik dengan uji statistik Mann-Whitney, Kruskall-Wallis, regresi linear. Pengujian dilakukan dengan menggunakan piranti lunak SPSS version 20 for Windows.HasilSelama periode Agustus 2012 sampai Agustus 2016 didapatkan 55 subjek yang memenuhi kriteria; 32 subjek 58,2 laki laki dan 23 subjek 41,8 perempuan. Rerata lama penggunaan TDLC 125 hari. Lama penggunaan TDLC pada kelompok posisi ujung kateter di mid atrium lebih panjang dibandingkan pada kelompok posisi ujung kateter di luar mid atrium kanan 154 20-491 hari vs 86,5 35-228 hari;

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ABSTRACT BackgroundThe most common vascular access used for hemodialysis HD in children is tunneled double lumen catheter TDLC . The use of TDLC increased from 60 in 2011 to 78 in 2014 among all vascular access options untunneled catheter, tunneled cathteter, arteriovenous fistula AVF and arteriovenous graft AVG . There is no data about duration of catheter use associated with site of insertion, tip position, catheter related bacteremia, nutritional status and underlying disease. The study aimed to find out factors influencing the duration of catheter use.MethodA cross sectional descriptive study was carried out enrolling subjects of 2 18 years old with stage 4 5 chronic kidney disease undergoing regular HD in Cipto Mangunkusumo Hospital since August 2012 until August 2016. Data was collected from patients rsquo medical records at RSCM medical records department. Informations gathered included age, sex, weight, height, duration of TDLC use, site of insertion, catheter tip position based on plain thoracic photo, history of diagnosis of catheter related bacteremia, and primary disease.Review of the procedural databese for TDLC placement on pediactrics patient revealed 70 patients between August 2012 and August 2016. All of catheters were Hemo Cath LT Manufactured by Medcomp , Harleysville, PA, USA . fifteen patiens were excluded because of incomplete medical records. Therefore, the study consisted of 55 patients. Statistical analysis was performed using Mann Whitney, Kruskall Wallis, and linear regression with SPSS version 20 for windows.ResultIn period of August 2012 until August 2016 there were 55 subjects who met the criteria 32 subjects 58.2 were males and 23 subjects 41.8 were females. Median duration of catheter use was 125 days. Duration of catheter use with the tip position in the mid atrium group is longer than in those higher than mid right atrium superior vena cava 154 20 491 days vs. 86.5 35 228 days p