Undergoing Hemodialysis Therapy Research Articles

KEPATUHAN MENJALANI TERAPI HEMODIALISA DENGAN KUALITAS HIDUP PASIEN GAGAL GINJAL KRONIK

Chronic renal failure is a condition of decreased kidney function gradually or overall and requires kidney replacement therapy to maintain life. Hemodialysis is a therapy for patients with chronic renal failure. Compliance with hemodialysis therapy is one of the important things to note, if the patient is not compliant it can cause a buildup of harmful substances in the body that will have an impact on the quality of life of the patient. This study aimed to analyze the correlation between compliance undergoing hemodialysis therapy and life quality of patients with chronic renal failure in the hemodialysis ward of Tabanan Regional Hospital. This study was quantitative by using a descriptive correlational design method with cross sectional approach. The population in this study was chronic renal failure patients who underwent hemodialysis in the hemodialysis ward of Tabanan Regional Hospital. as many as 260 respondents. The sampling technique was by using non-probability sampling technique with purposive sampling technique with a total sample of 72 respondents. Data collection used questionnaire sheets. Lambda test results obtained p-value = 0.005 (p <0.05) then H0 was rejected, which means that there was a correlation between compliance undergoing hemodialysis therapy and life quality of patients with chronic renal failure in the hemodialysis ward of Tabanan Regional Hospital. The closeness of the correlation between variables can be seen from r-value = 0.238 which had a weak correlation.

DUKUNGAN KELUARGA DAN FAKTOR-FAKTOR YANG MEMPENGARUHI KECEMASAN PASIEN HEMODIALISA

According to Riskesdas data the highest cause of death by non-communicable diseases in Indonesia is chronic kidney disease (CKD), for CKD patients who have to undergo hemodialysis therapy for the rest of their lives must be very heavy to experience and often feel anxiety to decreased physical activity and quality of life. This research aimed to discover the effect of family support on the anxiety level of hemodialysis patients. This research was a quantitative research with used a descriptive correlation research method and used a purposive sampling technique. The number of samples was 81 respondents who were hemodialysis patients at Rumah Sakit Advent Bandar Lampung. The data collection was conducted in February 2020. To determine family support, the Family Support Scale (FSS) was used and the Hospital Anxiety and Depression Scale (HADS) were used to measure the level of anxiety. Simple linear regression test results obtained a significant value of p 0.015 < 0.05 that means Ho rejected and Ha accepted. In conclusion, there is an effect of family support on the level of anxiety of hemodialysis patients at Rumah Sakit Advent Bandar Lampung. The authors has suggested that the families to more spirit to providing support patients in undergoing hemodialysis.

Mortalidad asociada a COVID19 en pacientes con enfermedad renal crónica en Guatemala

Objetivo: determinar la prevalencia de mortalidad asociada a COVID-19 en pacientes con enfermedad renal crónica. Material y métodos: estudio descriptivo, prospectivo realizado en 151 pacientes adultos con enfermedad renal crónica que presentan infección por COVID-19 que asistieron al centro de atención permanente de enfermedades respiratorias del hospital General San Juan de Dios, se determinaron características demográficas, comorbilidades, terapia de reemplazo renal, niveles de cuerpos azoados y potasio, tiempo de diagnóstico de enfermedad renal crónica y soporte ventilatorio, se elaboró una boleta de recolección de datos con todas las variables del estudio. Resultados: del total de pacientes, 57 (37.7%) fallecieron, de estos 66.7% fueron de sexo masculino, el 35.1 % oscilaba entre las edades de 46-55 años, del total de fallecidos el 78.9% padecían de diabetes mellitus, el 89.5% de pacientes estaban con terapia en hemodiálisis, el 19.3% de los pacientes estuvieron bajo ventilación mecánica invasiva, 26 de estos pacientes (45.6%) tenían más de 11 días de no recibir terapia dialítica, en cuanto a los resultados de laboratorio el 47.4% tenía rangos de creatinina entre 9.1 a 12 mg/dL, 38.6% nitrógeno de urea entre 90.1-110 y niveles de potasio entre 5.51 a 6.5 mmol/L (35.1%). Conclusiones: la mortalidad por COVID-19 en pacientes con enfermedad renal crónica fue de 37.7%, esta población de pacientes presenta un tiempo prolongado entre cada terapia dialítica y mayor riesgo de mortalidad.

The anxiety symptoms among chronic kidney disease patients who undergo hemodialysis therapy

Unresolved anxiety can lead to some impact on which a person tends to have a negative assessment of the meaning of life, decreased quality of life, emotional changes such as chronic depression and psychosis disorders. The general objective in this research is to find out the symptoms of anxiety symptoms of chronic kidney disease patients undergo hemodialysis. This research employed cross sectional design. This study used non-probability sampling type quota sampling. Sample was calculated using the Slovin formula obtained a sample size of 171. The proportion of patient with chronic kidney disease treated with hemodialysis based on the anxiety level resulting mild anxiety (86.5%) and moderate anxiety (13.5%). There are symptoms of anxiety symptoms in patients with chronic kidney disease undergoing hemodialysis.

Hubungan Kepatuhan Hemodialisis Dengan Disfungsi Ereksi Pada Pria Usia Subur Di RSUD Ungaran

Abstract Background Hemodialysis is a program that replaces the function of the kidneys due to damage to the kidney organs (dialysis), where patients with chronic kidney failure must obedient in undergoing hemodialysis. Disobedience can cause therapy failure. Prolonged hemodialysis programs have an impact on reproductive health. It often happens, patients who undergo hemodialysis program have erectile dysfunction problems where patients who do hemodialysis will experience decreased libido, impotencei, infertility, gynecomastia. The purpose of this study was to determine the relationship between adherence to undergo hemodialysis therapy with erectile dysfunction in men of childbearing age who have chronic kidney failure. The research method used in this study is a quantitative correlation research method with a cross-sectional approach, with questionnairs as the data collection tool. The sample used in this study was determined by purposive sampling with 31 respondents of childbearing age undergoing hemodialysis. Data analysis used are descriptive analysis and bivariate test and chi-square correlation test. The resultsof this study are participants that compliance with hemodialysis in the obedient category are 30 people (97%) and erectile dysfunction in men of childbearing age in the category of erectile dysfunction are 27 people (87%). Chi-square correlation test results obtained Value = 0.573 which means greater than alpha 0.05 (0.573> 0.05) then the Ha hypothesis is rejected and Ho is accepted so it can be concluded that there is no significant relationship between adherence to undergoing hemodialysis therapy with erectile dysfunction in men of childbearing age at Ungaran District Hospital. Compliance, Erectile Dysfunction, Hemodialysis, Productive men

PEMBERDAYAAN KELUARGA DALAM MENURUNKAN TINGKAT KECEMASAN PASIEN GGK DENGAN HEMODIALISA

Chronic kidney failure (CKD) is a pathological condition in the kidney with diverse etiologies, resulting in progressive decline in kidney function, and in general must undergo hemodialysis therapy. In patients with hemodialysis therapy, anxiety often arises with the therapeutic procedures that are given so that the system needs support from the family. This study wanted to determine the effect of family empowerment on anxiety levels of chronic renal failure patients with hemodialysis. The pre-experimental design was the design in this study with a population of 36 patients and a sample size of 22 patients obtained through purposive sampling. This study used a questionnaire instrument and the data obtained were analyzed using the Wilcoxon Sign Rank Test. The measurement results on the level of anxiety before the intervention showed 63% in the level of severe anxiety and after the intervention showed 46% in the category of moderate anxiety. P-value in the statistical test shows 0.003 which means that there is an influence of family empowerment with anxiety level of CRF patients undergoing hemodialysis therapy. Family empowerment can reduce the level of anxiety for patients undergoing hemodialysis in the Hemodialysis Room of RSUD. Mardi Waluyo Blitar. Family empowerment provides assistance, solutions, support, so that it can be used to overcome the anxiety experienced by patients undergoing hemodialysis.

Circulating angiopoietin-like protein 2 levels and arterial stiffness in patients receiving maintenance hemodialysis: A cross-sectional study

Background and aimsChronic low-grade inflammation is receiving much attention as a critical pathology that induces various aging phenotypes, a concept known as “inflammaging”. Uremic patients undergoing hemodialysis therapy show vascular aging phenotypes characterized by greater arterial stiffness and calcification compared to healthy controls of the same generation. In the current study, we investigated whether levels of inflammaging markers in the circulation were associated with vascular aging phenotypes in hemodialysis patients, as estimated by the cardio-ankle vascular index (CAVI). MethodsWe conducted a multicenter cross-sectional study of 412 patients receiving hemodialysis and evaluated the relationship between circulating hs-CRP or ANGPTL2 levels, as markers of inflammaging, and CAVI. ResultsOf 412 patients, 376 were analyzed statistically. While circulating hs-CRP levels had no significant association with CAVI, generalized linear models revealed that high circulating ANGPTL2 levels were significantly associated with increasing CAVI after adjustment for classical metabolic factors and hemodialysis-related parameters [β 0.63 (95%CI 0.07–1.18)]. Exploratory analysis revealed that high circulating ANGPTL2 levels were also strongly associated with increased CAVI, particularly in patients with conditions of increased vascular mechanical stress, such elevated blood pressure [β 1.00 (95%CI 0.23–1.76)], elevated pulse pressure [β 0.75 (95%CI 0.52–0.98)], or excess body fluid [β 1.25 (95%CI 0.65–1.84)]. ConclusionsWe conclude that circulating levels of ANGPTL2 rather than hs-CRP are positively associated with CAVI in the uremic population and that ANGPTL2 could be a unique marker of progression of vascular aging in patients receiving hemodialysis.

HUBUNGAN DUKUNGAN KELUARGA DAN KEBUTUHAN SPIRITUAL DENGAN TINGKAT KECEMASAN PASIEN GAGAL GINJAL KRONIK DALAM MENJALANI TERAPI HEMODIALISIS DI RSUD BANGKINANG

The increasing incidence of kidney failure is due to the epidemiological transformation of the disease in recent years. Chronic renal failure patients undergoing hemodialysis therapy will experience anxiety caused by the threat of death, and do not know the final outcome of the therapy. This study aims to analyze the relationship between family support and spiritual needs with the level of anxiety of chronic kidney failure patients undergoing hemodialysis therapy at Bangkinang Hospital in 2020. This study used a cross sectional research design. The population in this study were 47 patients undergoing hemodialysis therapy in the hemodialysis unit at Bangkinang Hospital. The sample in this study patients who underwent hemodialysis therapy were 47 people with a total sampling technique. Collecting data through distributing questionnaires. Data processing used univariate and bivariate analysis. The results showed most respondents had low family support as many as 25 people (53.2%), most respondents had low spiritual needs as many as 29 people (61.7%), most respondents experienced high anxiety levels as many as 30 people (63, 8%). The results of the Chi-square test found that there was a significant relationship between family support and spiritual needs with the level of anxiety of chronic kidney failure patients undergoing hemodialysis therapy at Bangkinang Hospital. It is recommended that the hospital be able to provide counseling about family support and spiritual needs in order to reduce the anxiety level of chronic kidney failure patients.

Associations Among Plant-Based Diet Quality, Uremic Toxins, and Gut Microbiota Profile in Adults Undergoing Hemodialysis Therapy

The objective of the study was to evaluate associations among diet quality, serum uremic toxin concentrations, and the gut microbiota profile in adults undergoing hemodialysis therapy. This is a cross-sectional analysis of baseline data from a clinical trial involving adults receiving hemodialysis therapy. Usual dietary intake was determined using a diet history method administered by Accredited Practising Dietitians. Two approaches were used for diet quality assessment: (1) using three a priori defined plant-based diet indices-an overall plant-based diet index (PDI), a healthy PDI, and an unhealthy PDI and (2) classification of food group intake. Serum uremic toxins (p-cresyl sulfate and indoxyl sulfate (IS); free and total) were determined by ultra-performance liquid chromatography. Gut microbiota composition was established through sequencing the 16S rRNA gene in stool samples. Twenty-two adults (median age 70.5 [interquartile range: 59-76], 64% male) were included in the final analysis. Higher adherence to the PDI was associated with lower total IS levels (P=.028), independent of dialysis adequacy, urinary output, and blood albumin levels. In contrast, higher adherence to the unhealthy PDI was associated with increases in both free and total IS. Several other direct and inverse associations between diet quality with uremic toxins, microbial relative abundances, and diversity metrics were also highlighted. Diet-associated taxa showed significantly different trends of association with serum uremic toxin concentrations (P<.05). Higher adherence to the PDI was negatively associated with relative abundances of Haemophilus and Haemophilus parainfluenzae that were related to elevated total IS levels. In contrast, increased intake of food items considered unhealthy, such as animal fats, sweets and desserts, were associated with bacteria linked to higher IS and p-cresyl sulfate (total and free) concentrations. The quality of diet and food selections may influence uremic toxin production by the gut microbiota in adults receiving hemodialysis. Well-designed dietary intervention trials that adopt multi-omic technologies appropriate for the functional annotation of the gut microbiome are needed to validate our findings and establish causality.

Coping Mechanisms and Stress Adaptation in Chronic Kidney Failure Patients Underwent Hemodialysis Therapy in RSUD Waled Kabupaten Cirebon

Chronic renal failure is a disease that results in a progressive and gradual decline in renal function that requires hemodialysis therapy. In Indonesia, there were 198,575 patients chronic kidney failure in 2018. The number of undergoing hemodialysis therapy is 132,142 patients. The hemodialysis routine causes tension, anxiety, stress and depression in patient. The purpose of this study was to determine the relationship between coping mechanisms and stress adaptation in chronic renal failure patients undergoing hemodialysis therapy ant Waled Hospital. The method of this research was descriptive correlational with a cross sectional approach. This research used purposive sampling technique amounted to 79 respondents. The instrument of this research was a questionnaire Jaloweic Coping Scale (JCS) and stress adaptation questionnaire. Data analysis used the spearman rank test. Place of research at Waled Hospital, Cirebon Regency during July 2020. The result showed that most respondents had an adaptive category as many as 55 adaptation showed the results of most respondents had an adaptive category as many as 55 respondents with a percentage (69.6%). The spearman rank test showed p value &lt;α and r&lt;1, which means that there was a moderate an positive relationship between coping mechanisms and stress adaptation (p value=0,000 &lt; α=0.05 and r=0.593). The is a relationship between coping mechanisms and stress adaptation in chronic renal failure patients undergoing hemodialysis therapy. The better coping mechanism is carries out, the adaptive stress that arises will be adaptive so that the patient can adjust and be able to cope with the stress he is experiencing.

Upaya Keluarga Dalam Meningkatkan Kualitas Hidup Pasien Hemodialisa

&lt;p&gt;&lt;strong&gt;&lt;em&gt;Background:&lt;/em&gt;&lt;/strong&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;Chronic kidney failure or end-stage kidney disease is impaired kidney function. It is progressive and irreversible. One way to maintain survival with hemodialysis, dependence on hemodialysis will reduce the quality of life of patients. The purpose of this research was to describe, analyze and interpret family efforts to improve the quality of life of patients with chronic renal failure undergoing hemodialysis therapy in Dr. Achmad Mochtar Bukittinggi.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Method&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;The type of this research was qualitative with phenomenological approach. It was conducted on July 2019. Then, by using purposive sampling technique, 6 people had been chosen as the samples. The data were collected through in-depth interviews and it was by analyzed colaizzi method.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Results&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;The results of the research obtained that about the family efforts in improving the quality of life of patients described into 4 themes: 1) assisting in meeting physiological needs, 2) providing psychological support, 3) assisting in social activities, 4) assisting in solving environmental problems. In short, family efforts both in improving the quality of life of patients were viewed from physical health, psychological health, social and environmental relations.&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;strong&gt;&lt;em&gt;Conclusion&lt;/em&gt;&lt;/strong&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;: &lt;/em&gt;&lt;em&gt;Then, it is expected that families to make maximum efforts to improve the quality of life of patients.&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;&lt;br /&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;&lt;br /&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords: &lt;/strong&gt;&lt;em&gt;Quality of Life, Hemodialysis, Family Effort&lt;/em&gt;&lt;em&gt;&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;em&gt;&lt;br /&gt;&lt;/em&gt;&lt;/p&gt;

THE RELATIONSHIP OF FAMILY SUPPORT REGARDING THE PATIENTS WITH CHRONIC KIDNEY FAILURE WHO HAVE HEMODIALIZED THERAPY TREATMENT IN PMI HOSPITAL BOGOR

Chronic Renal Failure (CRF) is a disease that has occurred after various diseases that damage the kidney nephrons period up to the point the two are not capable of functioning regulatory and ekstetoriknya to maintain homeostasis. Number of patients with kidney failure in Indonesia is estimated to reach 300.000 people. As many as 12.804 patients with renal failure undergoing hemodialysis. To determine correlation family support patient compliance with chronic renal failure undergo hemodialysis therapy in RS PMI Bogor. This type of research is descriptive quantitative analytical research with cross sectional design. How sampling in this study with purposive sampling with a sample of 152 respondents. The instrument used is questionnaire while data analysis techniques using univariate and bivariate analysis using statistical test Chi-Square. Of the 152 respondents with a family to support as many as 139 respondents (91.4%), adherent patients as many as 128 respondents (84.2%) and family support with adherent patients as many as 121 respondents (79.6%). Statistical test results using Chi-square test p value value 0,007 (p &lt;0.05) and the value of OR 5.762. The conclusion of this research that, There is a correlation between family support patient compliance with chronic renal failure through hemodialysis therapy in PMI Hospital Bogor, 2016. The researchers recommend that increased family support by distributing leaflets to the patients and families about the importance of family support for compliance patients undergo hemodialysis therapy.

Trace element imbalances in patients undergoing chronic hemodialysis therapy – Report of an observational study in a cohort of Portuguese patients

IntroductionPatients with end-stage renal disease undergoing hemodialysis therapy are at risk of developing deficiencies of essential trace elements and/or overload of toxic trace elements, both of which may significantly affect their clinical status of. Those imbalances may result from the disease itself but also from the quality of the therapeutic process, namely the hemodialysis process, which has greatly evolved in the last decades. Thus, old observations that have been assumed as very well-proven have been recently questioned. In this case-control study we evaluate the current trace elements status in a group of Portuguese patients under hemodialysis therapy. Material and methodsSerum samples from patients (n = 93), collected for the routine periodic control of Al levels, were analyzed for a wide panel of trace elements (Li, Al, Mn, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Ba, Pb) using inductively coupled plasma mass spectrometry technique (hemodialysis patients’ group). For comparison purposes, samples of individuals with no evidence of renal disease according to standard laboratory analytical criteria (n = 50) were also analyzed (control group). ResultsThe results showed significant differences between the two groups, with higher values in hemodialysis patients group for Al (14.6 vs. 9.5 μg/L), Co, Ni, Sr, Mo (4.5 vs. 1.4 μg/L), Cd (0.058 vs. 0.025 μg/L) and Pb (0.55 vs. 0.30 μg/L); and lower values in hemodialysis patients group for Li (4.0 vs. 75.8 μg/L), Mn, Cu (943.5 vs. 1038.5 μg/L), Zn (943.5 vs. 1038.5 μg/L), Se (71.5 vs. 103.8 μg/L), Rb (202.4 vs. 300.3 μg/L) and Ba (0.65 vs. 8.7 μg/L). ConclusionThis study confirms that hemodialysis patients tend to present significant trace elements imbalances, which may be related to the higher morbidity and mortality observed in this specific patients’ group.

P1453THE DEVELOPMENT OF A NEW PATIENT-REPORTED OUTCOME MEASURE TO EVALUATE THE QUALITY OF DIALYSIS THERAPY

Abstract Background and Aims There is a growing interest in Patient-Reported Outcome Measures (PROMs) as evaluation tools of medical care globally, including dialysis therapy. We developed our original PROM for patients undergoing maintenance hemodialysis (MHD), which was named the Ai-POD (Ai means love in Japanese, POD stands for Patients Oriented Dialysis). The Ai-POD is composed of 20 items relating to physical symptoms (joint pain, itching, frustration, weakness, shortness of breath, constipation, difficulty getting to sleep, asleep condition), complaints during dialysis therapy (pain of cannulation, headache, drop of blood-pressure, leg crumps, fatigue after dialysis session), dietary conditions (appetite, food enjoyment, sore or dry mouth), mental health (depressive feeling, life enjoyment) and comprehensive life satisfaction. All items are rated on a Likert scale from 0 (best) to 4 (worst) except mental health. The mental health questions are yes-no closed questions converting 0 (excellent) or 4 (bad). The sum of all 20 components ranges from 0 to 80, denoting increasing of severity. We have been collecting the data of Ai -POD from all patients in our facilities for over ten years. We examined the associations between the score of Ai-POD and prospective mortality in our patients undergoing hemodialysis therapy to assess the usefulness of the Ai-POD score. Method Three hundred ninety-six patients (262 men, 134 women; age 66 ± 12years) on MHD therapy for at least three months were evaluated with Ai-POD in October 2013 and followed up for three years. We categorized the patients into the four groups according to the quartile of the Ai-POD score and compared anthropometric measurements and laboratory measurements among the groups. The four groups are as below: Grop1 (Score: 0 ∼ 10), Group 2 (11 ∼18), Group 3 (19 ∼29), and Group 4 (29 ∼). A Cox regression analysis was used to evaluate the association between the severity of the Ai-POD score and mortality risk adjusting with several factors. Kaplan-Meire analysis and Log-rank test assessed the mortality rate for comparison among the four groups. Results The average of Ai-POD score of all patients was 19.6 ± 11.7, following a normal distribution. Among the four quartile groups, we found no differences in age, dialysis vintage and diabetes ratio, but found the statistic difference in gender ratio and serum-albumin. Compared with Group 1, the multivariable-adjusted hazard ratio for mortality was significantly increased to 2.51 (95% CI 1.03 – 7.02) and 3.00 (95% CI 1.25 – 8.46) in Group 3 and Group 4, respectively. Kaplan-Meier analysis showed higher mortality in Group 3 and 4 (16.7% and 19.1% respectively) compared with Group 1 and 2 (5.6% and 6.5% respectively) significantly (p=0.0033) (Figure). Sub-analysis with each Ai-POD item indicated that frustration, appetite, food enjoyment, and overall life satisfaction were strong independent predictors of prognosis. Conclusion The score of PROM is a significant prognostic factor, suggesting the Ai-POD score could be one of the useful tools to estimate the quality of dialysis therapy. The strategies to improve the score in each item could enhance the quality of dialysis therapy.

Surgical Management of Thoracolumbar Spondylodiscitis in End-Stage Renal Disease.

In recent times due to the advancement of haemodialysis techniques, there is increase in the life span of the patients with end-stage renal disease, which tends to increase the risk of complications of bacteraemia due to skin penetration for blood access and leading to propensity for more skeletal and spinal complications. Hence, early diagnosis of spine infection and early initiation of appropriate therapy are important in ensuring successful treatment and preventing further morbidity. The study included 22 males and 12 females who were known case of end-stage renal disease undergoing haemodialysis therapy and diagnosed with spondylodiscitis based on the clinical and radiological signs. The included patients required surgical stabilization based on the instability, neurological status, and epidural abscess, and non-responsive to medical line of treatment. To measure the degree of pain, Visual Analog Scale was used and British Medical Research Council grading system was used for motor evaluation. Radiography was undertaken one immediately and later at 1, 3, 9, and 12months and at yearly interval thereafter. Fusion assessment was done by features of consolidation of graft and absence of loosening of implants in both anteroposterior and lateral views will be an indirect evidence of fusion in short-term follow-up. Average age of the patients was 62years (range 40-75years). Twenty-two patients were male (64.7%) and twelve (35.3%) were female. Sixteen patients had diabetes mellitus and fifteen patients had chronic glomerulonephritis with various underlying causes. All patients presented with back pain with a duration range from 3 to 8weeks. 13 patients gave a history of on/off fever which was mild grade and 3 patients with high-grade fever. Eighteen patients presented with neurological deficits. The most common organism isolated was Methicillin-Resistant Staphylococcus Aureus (MRSA). At the final follow-up, radiographs revealed a good interbody fusion in 30 of the 34 cases, with 3 cases showed delayed fusion. The mean hemoglobin (Hb) level was 8.8g/dl and elevated total leucocyte level with mean of 14,425; mean C-reactive protein (CRP) level was 55.6mg/dl and erythrocyte sedimentation rate (ESR) was 47.5. All patients showed improvement in back pain. Preoperatively, the VAS had a mean of 8.5; post-operatively on day 2, the mean VAS was 3.2, and on 1month follow-up mean VAS was 2.4. In end-stage renal disease patients presenting with back pain, the diagnosis and treatment of spondylodiscitis becomes difficult. Where fever may not be a presenting feature even in cases with severe destructive osteomyelitis, and at times presenting as latent infection. Hence, spinal infection should be suspected as a possible cause of back pain in patients presenting with ESRD, even if they are presenting without fever and MRI study should be performed for the early diagnosis. Surgical intervention with debridement and posterior instrumentation should be considered as a modality of treatment in all cases of spondylodiscitis, with improved clinical outcome in terms of functionality, disability, and rehabilitation and acceptable complication rates in the perioperative period which can be adjusted to the individual cases.

Kecemasan dengan kualitas hidup pasien yang menjalani hemodialisis

Chronic Kidney Failure (CRF) is a condition of chronic kidney function decline that is progressive and irreversible. One of the effective actions in handling this condition is hemodialysis. CRF patients undergoing hemodialysis therapy mostly experience anxiety and decreased quality of life. This study aims to determine the relationship of anxiety with quality of life in CRF patients undergoing hemodialysis at Rasyida Kidney Hospital Medan. The research method used correlation analytic with cross sectional approach. The study population was all patients undergoing hemodialysis with a sampling technique that was purposive sampling with a total sample of 76 people. The research instrument used the Zung Self Rating Anxiety Scale (ZSAS) and WHOQOL-BREF questionnaire. The results of the study were analyzed using the Spearmen Rank test. The results of this study indicated the anxiety of the majority of respondents with a moderate category of 49 respondents (64.5%) and the quality of life of patients undergoing majority hemodialysis with a bad category of 42 respondents (55.3%). Spearmen rank test analysis showed that there was a relationship between anxiety and the quality of life of CRF patients undergoing hemodialysis with value of p = 0.006 p

Hubungan Antara Dukungan Keluarga Dan Motivasi Dengan Kualitas Hidup Pada Pasien Yang Menjalani Terapi Hemodialisa di RSI Sultan Agung Semarang

Life quality of chronic kidney disease patients who undergoing hemodialysis therapy is still being an attractive problem for health professionals, a patient will feel worth if they get support from their family and have the motivation to undergo hemodialysis therapy. This research aims to acknowledge family support and motivation with life quality in patients undergoing hemodialysis therapy in Islamic Sultan Agung Hospital Semarang. This research is analytic observational study, using total sampling technique with 87 numbers of respondents. Data collection using a questionnaire. Data Analysis technique using a chi-square test. Chi-square test for family support and life quality discovers result p-value 0,005, meanwhile for motivation and life quality hemodialysis patients p-value 0,0001. Family support and motivation is correlated wit life quality on patients undergoing hemodialysis. The nurse has a big role to give support and motivation toward patients and family.

The Relationship of Duration Undergoing Hemodialysis Therapy and the Quality of Life of Patients with Chronic Kidney Disease at the Rasyida Kidney Hospital

The Relationship of Duration Undergoing Hemodialysis Therapy and the Quality of Life of Patients with Chronic Kidney Disease at the Rasyida Kidney Hospital

Gambaran Perubahan Tekanan Darah Pada Pasien Gagal Ginjal Kronik Yang Menjalani Terapi Hemodialisis Di Ruang Hemodialisa Rumah Sakit TK. II Pelamonia Makassar

Background: The kidneys have a very important role in maintaining a healthy body. The kidneys experience acute renal failure when the kidney cannot function suddenly. Without kidney replacement therapy, deaths from metabolic disorders can occur quickly. One kidney replacement therapy can be done is hemodialysis. Although hemodialysis is safe and beneficial for patients, it does not mean without side effects. Various complications can occur when patients undergo hemodialysis one of which is intradialisis hypertension. This complication can lead to new, more complex problems, including discomfort, increasing stress affecting the quality of life, worsening the patient's condition and even causing death. Objective To determine the description of blood pressure changes in patients with chronic renal failure undergoing hemodialysis therapy in the Hemodialysis room at TK II Pelamonia Hospital Makassar. Methods: This study used a descriptive survey method with a case study approach. Results: Research shows that patients undergoing hemodialysis therapy experience changes in blood pressure in pre and post hemodialysis. Conclusion: There is an effect of hemodialysis on changes in blood pressure in patients with kidney failure in the Hemodialysis Room of TK. II Pelamonia Hospital Makassar.

PENERAPAN LATIHAN RANGE Of MOTION (ROM) PADA PASIEN DENGAN GAGAL GINJAL KRONIK DALAM PEMENUHAN KEBUTUHAN AKTIVITAS

Chronic kidney failure (CKD) or Chronic Kidney Diseases (CKD) is a problem that occurs in the decline in kidney function because the kidneys become a vital organ in maintaining a healthy body. Decreased kidney function causes the kidneys can not maintain the balance of metabolism, fluid and electrolytes which can lead to uremia. This study aims to see the extent of the application of ROM exercises in Chronic Kidney Failure Patients in Meeting the Needs of Activities. This research is using descriptive case design with a case study approach. The results of this study are intradialysis ROM exercises in patients undergoing hemodialysis therapy can influence the level of fatigue (fatigue). This began to be seen in the treatment of the third to the sixth has changed and the value of fatigue has increased. Which means that the higher the value of fatigue, the better the quality of life of patients with chronic renal failure. But this exercise must be done continuously. Conclusion: Intradilysis ROM exercises in hemodialysis patients can affect the level of fatigue (fatigue). Keywords: Fatigue, ROM Exercise, CKD