Research Article

Karakteristik pasien stenosis vena sentral dengan penyakit ginjal kronik yang menjalani hemodialisa di RSUP Sanglah Denpasar, Bali, Indonesia

Nyoman Saka Ranuartha, Ketut Putu Yasa

Nyoman Saka Ranuartha
Divisi Bedah Throaks dan Kardiovaskuler, Departemen/KSM Ilmu Bedah, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia

Ketut Putu Yasa
Divisi Bedah Throaks dan Kardiovaskuler, Departemen/KSM Ilmu Bedah, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia. Email: ketut.putuyasa07@gmail.com
Online First: February 04, 2021 | Cite this Article
Ranuartha, N., Yasa, K. 2021. Karakteristik pasien stenosis vena sentral dengan penyakit ginjal kronik yang menjalani hemodialisa di RSUP Sanglah Denpasar, Bali, Indonesia. Intisari Sains Medis 12(1): 9-13. DOI:10.15562/ism.v12i1.911


Introduction: Chronic Kidney Disease is a pathophysiological process with multiple etiologies causing chronic progressive impairment of kidney function and/or structure. Renal replacement therapy or hemodialysis is the optimal therapeutic option and is widely used in various developing countries. In the last 3 years, chronic kidney disease (CKD) patients at Sanglah General Hospital with the use of hemodialysis vascular access are often followed by central venous stenosis.

Method: A retrospective descriptive study with a cross-sectional design was carried out involving patients with a stage 5 chronic kidney disease diagnosed with symptomatic central venous stenosis clinicaly and radiological finding that met the inclusion and exclusion criteria. The independent variables of this study were age, gender, and risk factors. The dependent variables of this study were the type of location, symptom onset, duration, and history of hemodialysis access.

Result: It was recorded that 40 subjects, 77.5% aged <60 years, 52.5% were male, 75% had a history of hypertension as the etiology of chronic kidney disease. The location of the most stenosis locations was in the subclavian vein (62.5%), from the duration of using hemodialysis access was 80% over 6 weeks also using of catheter more than 2 is (55%).

Conclusion: The most history of using access to hemodialysis was tunneled type of double lumen catheter (70%) and the most often locations for insertion catheter is left subclavian vein (50%). Based on the results of this study, CKD patients with central venous stenosis showed a history of using double lumen catheters more frequently and from the location of the stenosis found in the subclavian veins, the locations that were found mostly in central venous stenosis.

 

Latar belakang: Penyakit Ginjal Kronis merupakan suatu proses patofisiologis dengan etiologi yang beragam sehingga menyebabkan gangguan fungsi dan atau struktur ginjal yang bersifat kronik progresif. Terapi pengganti ginjal atau hemodialisa menjadi pilihan terapi yang optimal dan banyak digunakan di berbagai Negara berkembang. Dalam 3 tahun terakhir, pada pasien penyakit ginjal kronis (PGK) di RSUP Sanglah dengan penggunaan akses vaskular hemodialisa kerap diikuti dengan stenosis vena sentral.

Metode: Dilakukan studi deskriptif retrospektif dengan desain potong lintang melibatkan pasien penyakit ginjal kronik stadium 5 yang terdiagnosis simptomatik stenosis vena sentral secara klinis dan penunjang radiologis yang memenuhi dari kriteria inklusi dan ekslusi. Variabel independen dari penelitian ini adalah usia, jenis kelamin, faktor komorbid. Variabel dependen dari penelitian ini adalah jenis, lokasi, onset gejala, durasi serta riwayat penggunaan akses hemodialisa.

Hasil: Tercatat 40 subjek, 77,5% berusia <60 tahun, 52,5% berjenis kelamin laki-laki, 75% memiliki riwayat hipertensi sebagai faktor komorbid penyakit ginjal kronik. Letak lokasi stenosis terbanyak terdapat di vena subklavia 62,5%, dari durasi penggunaan akses hemodialisa yaitu 80% lebih dari 6 minggu dengan frekuensi penggunaan lebih dari 2 kali sebesar 55%. Riwayat penggunaan akses hemodialisa terbanyak yaitu kateter double lumen tipe tunneled sebesar 70% dengan lokasi pemasangan kateter pada vena subklavia kiri sebanyak 50%.

Simpulan: Berdasarkan hasil dari penelitian ini, pada pasien PGK dengan stenosis vena sentral menunjukkan riwayat penggunaan kateter double lumen lebih sering dijumpai serta dari lokasi stenosis didapatkan pada vena sublkavia lokasi yang banyak ditemukan pada stenosis vena sentral.

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