Besar Risiko Status Nutrisi terhadap Morbiditas dan Mortalitas Pasien Hemodialisis Reguler
Risk of Nutritional Status with Morbidity and Mortality of Regular Hemodialysis Patients
DOI:
https://doi.org/10.36408/mhjcm.v9i2.753Keywords:
Status nutrisi, hemodialisis reguler, morbiditas dan mortalitasAbstract
Latar belakang : Protein energi wasting (PEW) merupakan salah satu komplikasi pasien yang menjalani hemodialisis (HD) reguler akibat malnutrisi dan inflamasi dan menjadi indikator mutu layanan HD. Penelitian ini bertujuan untuk menganalisis besar risiko status nutrisi terhadap morbiditas dan mortalitas pasien HD reguler.
Metode : Penelitian kohort prospektif selama 6 bulan (5 Mei sampai 4 November 2021), pada pasien HD reguler, berusia lebih dari 18 tahun di unit HD RSUD Sanjiwani Gianyar. Status nutrisi dinilai dengan Indeks Massa Tubuh (IMT), kadar albumin serum, Subjective Global Assesement (SGA), Malnutrition inflammation score (MIS), dan International Society of Renal Nutrition and Malnutrition (ISRNM).
Hasil : Subyek penelitian adalah 111 orang terdiri dari 61.3% laki-laki, rerata umur 53,67 tahun, rerata lama menjalani HD 44,56 bulan dengan etiologi utama yaitu hipertensi dan DKD 54%. Rerata IMT 23,41 kg/m2 dan albumin 4,05 g/dL. Analisis risiko relatif (RR) menunjukkan albumin <3,8 g/dL meningkatkan risiko morbiditas 3,25 kali (CI 95% 1,29- 8,13) p=0,01, dibandingkan albumin >/= 3,8 g/dL. Demikian juga SGA B dan C meningkatkan morbiditas 3,2 (CI 95% 1,36–7,52) kali dibandingkan SGA A dengan p=0,007, tetapi IMT, MIS dan ISRNM tidak bermakna. Analisis Kaplan Meier, menunjukkan subyek dengan status nutrisi baik mempunyai ketahanan hidup lebih lama dibandingkan dengan status nutrisi kurang, tetapi tidak bermakna secara statistik.
Simpulan : Status nutrisi kurang berdasarkan albumin dan SGA signifikan meningkatkan risiko morbiditas namun tidak meningkatkan risiko mortalitas. Parameter status nutrisi lain seperti IMT, MIS, dan ISRNM bukan faktor risiko morbiditas dan mortalitas pasien HD.
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