Kombinasi Hemodialisis/Hemoperfusi Meningkatkan Status Nutrisi yang Diukur dengan BIA (Bioelectrical Impedance Analysis) pada Pasien Hemodialisis Reguler
DOI:
https://doi.org/10.55175/cdk.v45i2.822Kata Kunci:
BIA, hemodialisis, hemoperfusi, status nutrisiAbstrak
Pasien penyakit ginjal kronik (PGK) yang menjalani hemodialisis reguler sering mengalami gangguan nutrisi akibat berbagai faktor, antara lain tingginya kadar ureum dalam darah (uremic malnutrition). Status nutrisi pasien penyakit ginjal kronis (PGK) dapat diukur dengan bioelectrical impedance analysis (BIA) yang merupakan alat pengukur body composition. Penelitian ini bertujuan untuk menilai manfaat kombinasi HD/HP terhadap bersihan (clearance) toksin uremik berat molekul menengah dan besar dengan melihat efeknya terhadap status nutrisi pasien yang diukur dengan BIA pada pasien-pasien hemodialisis reguler di Medan. Jenis penelitian adalah kohort prospektif dari bulan Desember 2013 hingga Maret 2014 pada 20 pasien hemodialisis reguler dengan membandingkan beberapa parameter BIA sebelum dan sesudah dilakukan kombinasi HD/HP. Didapatkan rerata perubahan setelah HD/HP untuk IMT, RMR, FFM, FFM (%), BCM, glikogen, fat, fat (%), protein, dan mineral secara berurutan adalah +0,03 (p=0,92), +28,42 kcal (p=0,85), +1,64 kg (p=0,74), +2,71 (p=0,02), +0,58 kg (p=0,15), +16,6 kg (p=0,05), -1,67 kg (p=0,04), -2,80 (p=0,024), -0,21 kg (p=0,34), dan -0,054 kg (p=0,42). Peningkatan komponen IMT, RMR, FFM, FFM (%), BCM, dan glikogen menunjukkan peningkatan status nutrisi.
Chronic kidney disease (CKD) patients undergoing regular hemodialysis often have nutritional deficiencies due to various factors, i.e. high levels of blood urea (uremic malnutrition). Nutritional status of chronic kidney disease (CKD) patients can be measured by bioelectrical impedance analysis (BIA) which gauges the body composition. This study wants to see the benefits of HD/HP combination for medium and large weight molecular uremic toxin clearance and to see the effects on nutritional status of patients as measured by BIA in regular hemodialysis patients in Medan. A prospective cohort study was done from December 2013 to March 2014 on 20 regular hemodialysis patients, comparing several BIA parameters before and after combination of HD/HP. The mean change before and after HD/HP for IMT, RMR, FFM, the FFM (%), BCM, glycogen, fat, fat (%), protein, and mineral were respectively +0.03 (p = 0.92), + 28,42 kcal (p = 0.85), +1,64 kg (p = 0.74), +2.71 (p = 0.02), +0,58 kg (p = 0.15), +16,6 kg (p = 0.05), -1,67 kg (p = 0.04), -2.80 (p = 0.024), -0.21 kg (p = 0.34), and -0.054 kg (p = 0.42). Increased IMT, RMR, FFM, the FFM (%), BCM, and glycogen showed nutritional status improvement.
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