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The Relationship of Subjective Global Assessment (SGA) with Energy Intake, Protein, Hand Grip Strength and Body Mass Index in Chronic Kidney Disease (CKD) Patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) Adrianto, Yudhi; Hustrini, Ni Made; Kresnawan, Triyani; Amelia, Annisa Eka; Hudayani, Fitri
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
Publisher : UI Scholars Hub

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Introduction. Energy and protein intake in chronic kidney disease (CKD) with continuous ambulatory peritoneal dialysis (CAPD) therapy plays an important role in balancing hypercatabolic conditions. Unbalanced intake will result in energy and protein deficits which are increasing the risk of muscle catabolism, decreasing body mass index (BMI), and malnutrition. Subjective global assessment (SGA) as the gold standard in nutritional assessment is needed in assessing nutritional status and determining malnutrition, therefore nutritional intervention can be delivered and improve CAPD patients’ quality of life. This study was conducted to determine the relationship between SGA with energy and protein intake, hand grip strength, and body mass index on CKD patients undergoing CAPD. Methods. A cross-sectional study was conducted among 30 CKD patients undergoing CAPD which were purposively selected using total sampling. Nutritional status was assessed using SGA questionnaire, energy and protein intake was assessed through food records, and hand grip strength was measured by jamar hydraulic hand dynamometer. The normality of the data was tested using the Kolmogorov-Smirnoff test and bivariate analysis was conducted using the Chi-Square test. Results. Of a total of 30 CKD patients, most of them were aged 25-55 years (76.6%), while the age group <25 years was only>6.7%. More than 73% of patients had normal SGA nutritional status and 26% were malnourished. The average energy requirement was 1,942 (SD 277) Kcal, the lowest energy intake was 921 kcal/day and the highest was 1,959 kcal/day with an average dialysate energy intake of 404 (SD 42) kcal. The average protein intake was 54 (SD 9.5) grams, while the average protein requirement was 70.7 (SD 9.7) grams/day. Based on BMI status, 20% of subjects were underweight, 60% normal, and 20% overweight. A total of 53.3% of patients had poor hands grip strength and only 46.7% were normal with an average grip strength was 26.7 (SD 9.3) kg. Analysis showed that SGA was not related to energy intake (p<0.857), grip strength (p<0.307), and BMI (p<0.829). However, there was a relation between protein intake and SGA (p<0.048, OR: 1.233, 95% CI: 1,058 – 2,389). Conclusions. Inadequate protein intake is related to the risk of malnutrition than adequate protein intake. There is no relationship between energy intake, hands grip strength, and BMI on SGA scores.

PERAN EDUKASI GIZI TERHADAP ASUPAN ENERGI-PROTEIN DAN INDEKS MASSA TUBUH PASIEN GAGAL GINJAL KRONIS DENGAN TERAPI CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) Adrianto, Yudhi; Utari, Diah Mulyawati; Hudayani, Fitri; Kresnawan, Triyani
JURNAL RISET GIZI Vol 9, No 1 (2021): Mei (2021)
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jrg.v9i1.6670

Background: Nutrition are the essential factor to maintain body weight, body mass index and food intake in CAPD patients. Dialysis could increase nutrients lost and had to be replaced by adequate intake. Nutrition education should be needed to increase patient’s knowledge, food intake and body mass index.Objectives: To determine the role of nutrition education towards energy-protein intake and body mass index in patient with continuous ambulatory peritoneal dialysis (CAPD)Method: A cross-sectional study design with total sampling technique to obtains thirthy CAPD outpatient at RSUPN Dr. Cipto Mangunkusumo. Energy and protein intake were assessed by 3-days-food records (weekday and weekend). Nutritional status were obtained with BMI by dry body weight. Data were analyzed with independent t-test.Results: Most of subject are male outpatients, 25 – 55 years old (76.7%), had hypertension (83.3%) and normal BMI (50%). Most of subject had been undergoing peritoneal dialysis more than a year (67%), and had less than two times education per year. Energy intake were categorized as sufficient (80%) but protein intake were categorized as insufficient. There were no differences between frequency of nutrition education with energy-protein intake and nutritional status (p0.05)Conclusion: There are no differences between energy-protein intake and nutritional status with the frequency of nutrition education. Nutritional education by nutritionist and/or dietitian according to the recommendations help to maintain normal body mass index.

PERAN EDUKASI GIZI TERHADAP ASUPAN ENERGI-PROTEIN DAN INDEKS MASSA TUBUH PASIEN GAGAL GINJAL KRONIS DENGAN TERAPI CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) Adrianto, Yudhi; Utari, Diah Mulyawati; Hudayani, Fitri; Kresnawan, Triyani
JURNAL RISET GIZI Vol 9, No 1 (2021): Mei (2021)
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/jrg.v9i1.6670

Background: Nutrition are the essential factor to maintain body weight, body mass index and food intake in CAPD patients. Dialysis could increase nutrients lost and had to be replaced by adequate intake. Nutrition education should be needed to increase patient’s knowledge, food intake and body mass index.Objectives: To determine the role of nutrition education towards energy-protein intake and body mass index in patient with continuous ambulatory peritoneal dialysis (CAPD)Method: A cross-sectional study design with total sampling technique to obtains thirthy CAPD outpatient at RSUPN Dr. Cipto Mangunkusumo. Energy and protein intake were assessed by 3-days-food records (weekday and weekend). Nutritional status were obtained with BMI by dry body weight. Data were analyzed with independent t-test.Results: Most of subject are male outpatients, 25 – 55 years old (76.7%), had hypertension (83.3%) and normal BMI (50%). Most of subject had been undergoing peritoneal dialysis more than a year (67%), and had less than two times education per year. Energy intake were categorized as sufficient (80%) but protein intake were categorized as insufficient. There were no differences between frequency of nutrition education with energy-protein intake and nutritional status (p0.05)Conclusion: There are no differences between energy-protein intake and nutritional status with the frequency of nutrition education. Nutritional education by nutritionist and/or dietitian according to the recommendations help to maintain normal body mass index.

Knowledge and Behavior Change of People Living with HIV through Nutrition Education and Counseling Hudayani, Fitri; Sartika, Ratu Ayu Dewi
Kesmas Vol. 10, No. 3
Publisher : UI Scholars Hub

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HIV, AIDS, dan gizi saling berhubungan. Pada Unit Pelayanan Terpadu HIV Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, layanan edukasi dan konseling gizi disediakan secara kolaboratif untuk orang yang hidup dengan HIV. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan dan konseling gizi terhadap pengetahuan dan perilaku orang yang hidup dengan HIV. Penelitian ini dilakukan dengan desain kuasi eksperimental menggunakan kelompok perlakuan dan kontrol. Kelompok perlakuan terdiri dari 25 sampel dan 29 sampel untuk kelompok kontrol, dilakukan sebelum dan setelah perlakuan. Sampel berusia dewasa antara 18 – 50 tahun dipilih dengan menerapkan kriteria inklusi dan eksklusi. Sampel uji-t berpasangan digunakan untuk menganalisis data. Penelitian ini dilakukan pada bulan Mei – Juli 2014. Berdasarkan hasil penelitian, diketahui bahwa adanya efek berupa perubahan pengetahuan (nilai p = 0,000) dengan nilai 6,38 poin lebih rendah pada kelompok kontrol dan terdapat perbedaan yang signifikan dalam perubahan perilaku (nilai p = 0,048) untuk kelompok perlakuan setelah menerima edukasi dan konseling gizi. Penelitian ini menunjukkan bahwa edukasi dan konseling gizi menggunakan media edukasi yang lebih lengkap dan diberikan secara berkelanjutan dapat meningkatkan pengetahuan dan mengubah perilaku orang yang hidup dengan HIV. HIV, AIDS and nutrition are interconnected. In the HIV Integrated Care Unit of Dr. Cipto Mangunkusumo Public Hospital, nutrition education and counseling services are provided within a collaborative service for people living with HIV (PLWH). This study aimed to determine influence of nutrition education and counseling to knowledge and behavior of PLWH. This study was conducted with quasi experimental design using treatment and control groups. The treatment group consisted of 25 samples and 29 samples for control group. Samples were adults between 18 – 50 years old selected by applying inclusion and exclusion criteria. A pretested questionnaire was used to assess knowledge. Paired t-test sample was used to analyze data. This study was conducted on May – July 2014. Based on results of this study, there was effect in form of knowledge change (p value = 0.000) with score 6.38 point lower on the control group and any significant differences in behavior change (p value = 0.048) for the treatment group after receiving nutrition education and counseling. This study shows that nutrition and counseling using media of education which is more complete and continuously provided may improve knowledge and change behavior of PLWH.

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