LOW OXYGENATION STATUS INCREASES NAUSEA-VOMITING INCIDENCE IN HEMODIALYSIS PATIENTS

Cornelia Dy Nekada,Mohamad Judha

doi:10.24990/injec.v2i1.138

Abstract

Background and Objective: Data from Indonesia Basic Health Research (2013) states that the chronic renal failure in Indonesia is increasing, especially in Yogyakarta with the prevalence of chronic renal failure of 0,3%. If the patients of chronic renal failure are in End Stage Renal Disease (ESRD), the kidney needs replacement therapy to help its function. This therapy is called Continuous Renal Replacement Therapy (CRRT) or Hemodialysis (HD). Hemodialysis therapy may influence to the imbalance of oxyhemoglobin in the blood. Patients undergoing hemodialysis may experience intradialytic nausea and vomiting. The objective of this study is to identify whether there is a relationship between pre-dialysis oxygenation status through oxygen saturation (SpO2) and respiratory rate (RR) examination and the intradialytic nausea-vomiting occurrence. Method: This research is a comparative research with analytical cross sectional design. This research was conducted in hemodialysis room in Public Hospital of Panembahan Senopati Bantul. The subject of the research was taken using total sampling, by paying attention to research ethics. The total research subjects are 183 respondents. The researchers measured the oxygen saturation and patients’ respiratory rate and examined the intradialytic nausea and vomiting complaints. Result: The analysis result of Fisher’s exact in this research shows p value of 0,000 both in bivariate analysis of oxygen saturation to the nausea and vomiting occurrence and in bivariate analysis of the respiratory rate to the nausea and vomiting occurrence. The multivariate analysis employing regression logistic shows that the OR of oxygen saturation is 73,57, this means that the measurement of the abnormal oxygen saturation has the chance of seventy three times more to the nausea and vomiting occurrence, if compared to the patients with normal oxygen saturation. Conclusion and Suggestion: Intradialytic nausea and vomiting is one of the causes of the imbalance of oxyhemoglobin. The readiness of pre-dialysis oxygenation status needs to be noticed so that the nausea and vomiting complaints can be anticipated earlier.

Highlights

Data from Indonesia Basic Health Research (2013) states that the chronic renal failure in Indonesia is increasing, especially in Yogyakarta with the prevalence of chronic renal failure of 0,3%
The chronic renal failure occurrence in the age group of 35-44 is of 0,3%, and the highest occurrence is in the age group of more than or equal to 75 years, which is of 0,6%
One of the therapies given to the patients with chronic renal failure is CRRT (Continuous Renal Replacement Therapy) or hemodialysis

Summary

Introduction

Data from Indonesia Basic Health Research (2013) states that the chronic renal failure in Indonesia is increasing, especially in Yogyakarta with the prevalence of chronic renal failure of 0,3%. If the patients of chronic renal failure are in End Stage Renal Disease (ESRD), the kidney needs replacement therapy to help its function. Moissl, Garzotto, Cruz, Clementi, Brendolan, et al (2014), suggest that the intradialytic complications that often occur are headaches, nausea and vomiting, intradialytic hypertension and hypotension, muscle cramps, hypothermia, and electrolyte imbalance syndrome Those complications commonly occur due to the high speed of hemodialysis process (Quick of Blood/QB), the high level of urea creatinine in blood, as well as other physical problems of the patients (Mujais & Ismail, 2013). From the result of the interview and observation in a prior study conducted by the researcher in Public Hospital of Panembahan Senopati Bantul, the complaint that mostly occurs in hemodialysis process is nausea and vomiting, which is 27%. The hemostatic change influences to the hemoglobin imbalance that eventually leads to the decrease of oxyhemoglobin level in the blood and perfusion problems to the gastrointestinal (Han, Oh, Hong, Yi, Noh, Lee, et al, 2016)

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