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Clinical Features and Quality of Life in End Stage Renal DiseasePatients Undergoing Hemodialysis Twice A Week Compared toThrice A Week Imelda, Fitri; Susalit, Endang; Marbun, M Bonar M
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NFK-KDOQI) recommends thrice weekly hemodialysis (HD) However, in Indonesia, most patients are given HD twice a week. Therefore it is necessary to investigate the clinical features and quality of life in End Stage Renal Disease (ESRD) patients undergoing twice-weekly HD. This study aimed to identify the clinical features and the quality of life in ESRD patients undergoing hemodialysis twice a week. Methods. A cross-sectional study was conducted in ESRD patients undergoing twice-weekly HD and thrice-weekly HD at Cipto Mangunkusumo Hospital and some private hospitals in Jakarta. Blood samples were obtained for laboratory examination. Meanwhile, quality of life were assessed by using Kidney Disease Quality of Life (KDQOL-SF 36). Results. A total of 80 subjects were included in this study, most of them were male and over 50 years old. Some clinical features were significantly higher in twice-weekly HD patients compared to thrice-weekly HD patients. Those features were Interdialytic Weight Gain (IDWG) (mean 4.91% (SD 1.52) and 3.82% (SD 1.28); p= 0.002); albumin (mean 4.05 mg/dl (SD 0.26) and 3.86 mg/dl (SD 0.48); p= 0.027); transferrin saturation (median 25.5% (range 12.0 to 274.0) and 21.95% (5.8 to 84.2); p= 0.004); phosphate level (mean 5.82 mg/dl (SD 1.68) and 5.82 mg/dl (SD 1.68); p= 0.026. Meanwhile, Total Iron Binding Capacity (TIBC) was significantly higher in thrice-weekly HD patients (mean 235.20 μg/dl (SD 55.72) and 273.73 μg/dl (SD 58.29 SB); p= 0.004). Approximately, 68% of twice-weekly HD reached Kt/V >1.8 and 93.3% of thrice-weekly HD reached Kt/V >1.2. Quality of life between the two groups was not significant either on Physical Componet Score (PCS) (p= 0.227), Mental Component Score (MCS) (p= 0.247), and Kidney Disease Component Score (KDCS) (p= 0.889). Conclusions. There are statistically significant differences between clinical features of twice-weekly HD and thrice-weekly HD on examination of IDWG, albumin, transferrin saturation, and phosphate levels which are higher in twice-weekly HD. Whereas, TIBC is higher in thrice-weekly HD group. Meanwhile, the patients quality of life in both groups showed no statistically significant differences.
Tirotoksikosis Periodik Paralisis Pada Hipokalemia Refrakter : Laporan Kasus Azzahra, Yolla P.; Imelda, Fitri; Purawijaya, Handrian R.
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 3 (2025): Volume 12 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i3.17744

Abstract

Tirotoksikosis Periodik Paralisis merupakan komplikasi hipertiroid yang jarang terjadi dan ditandai dengan episode kelemahan otot (paralisis) dan hipokalemia. Peningkatan kadar tiroksin (T4) dan triiodotironin (T3) merupakan penanda diagnostik yang penting selain hipokalemia dan gejala klinis paralisis. Penelitian ini merupakan studi kasus pada pasien tirotoksikosis periodik paralisis pada hipokalemia refrakter. Pada kasus ini, Pasien mempunyai riwayat 1 bulan lalu rawat inap dengan diagnosa hipokalemia, dilakukan pemeriksaan hasil kalium : 1,8 mmol/L, hasil elektrolit urin kalium : 109 mmol/24 jam, Free T3 : 19,83 pg/mL, Free T4 : 6,19 ng/dL, pemeriksaan USG tiroid adanya gambaran struma difusa bilateral. Pemberian KCL 25-50 mEq/24 jam secara IV , b blocker non selektif seperti propanolol 1x10 mg dan tirozol 1x10 mg. Pada pasien tirotoksitosis periodik paralisis, terapi yang diberikan KCL, b blocker non selektif digunakan untuk mencegah serangan sampai tercapai kondisi eutiroid dan dapat mencegah perpindahan kalium dan fosfat dengan menghambat stimulasi hiperadrenergik dari Na+/ K+ ATPase, sehingga diharapkan terdapat adanya peningkatan kadar kalium setelah pemberian koreksi KCL dan penurunan kadar Free T3 dan Free T4.