I Gusti Ngurah Agung Tresna Erawan
Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Udayana, Sanglah General Hospital, Bali, Indonesia

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Deep Venous Thrombosis (DVT) risk assessment on routine hemodialysis patient using Padua prediction score Benny Tjan; I Gusti Ngurah Agung Tresna Erawan; Yenny Kandarini
Journal of Indonesia Vascular Access Vol. 1 No. 2 (2021): (Available Online: December 2021)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v1i2.15

Abstract

Introduction: Hemodialysis requires invasive vascular access (VA) procedure which could emerge deep venous thrombosis (DVT) complication. Apart from VA, other risk factors, either modifiable or unmodifiable, could increase DVT risk. Those factors can be assessed by Padua Prediction Score (PPS). This study aims to assess which risk factors in PPS increase the risk of developing DVT in routine hemodialysis patients at BHCC main clinic. Methods: This research is a descriptive observational study with simple random sampling. The participants were 58 routine hemodialysis patients in BHCC. The inclusion criteria of this study were the ages above 17 years old, had history hemodialysis more than one, the patient willing to become of the sample subject. The patient that incompletely fulfills the questionnaire were already treated with anticoagulation were admitted for VTE, and had a history of discontinuing hemodialysis were excluded. The data were gathered using a questionnaire according to PPS. The data was analyzed by using SPP 25.0. The descriptive data was provided in a table and pie chart. Results: Based on the results of the PPS, 11 patients (18.96%) were among the high risk, and 47 patients (81.04%) were at low risk. The most potent risk factor in increasing the risk of DVT is reduced mobility with a risk priority number (RPN) of 30 (severity=3, occurrence=10). Recent (≤one month) trauma and surgery entail on second with an RPN of 24 (severity=2, occurrence=12). The third is occupied by heart and/or respiratory failure with a RPN of 14 (severity=1, occurrence=14). Previous VTE history with a RPN of 12 (severity=3, occurrence=4) placed fourth, followed by age≥ 70 (RPN=8, severity=1, occurrence=8) and obesity (BMI>= 30) with a RPN of 4 (severity=1, occurrence=4) at fifth and sixth respectively. Conclusion: "Reduced mobility" is the most prominent risk factor to increase DVT risk in routine hemodialysis patients, followed by other risk factors. Reduced mobility and obesity are modifiable risk factors that should be eliminated by educating routine hemodialysis patients.
Association of platelet and hematocrit value with arteriovenous fistula (AVF) failure in hemodialysis patient at Bali Husada Cipta Canti, Bali, Indonesia Anak Agung Gede Oka Suta Wicaksana; I Gusti Ngurah Agung Tresna Erawan; Yenny Kandarini
Journal of Indonesia Vascular Access Vol. 2 No. 1 (2022): (Available Online: June 2022)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v2i1.16

Abstract

Introduction: Hemodialysis is one of the renal replacement therapies used for end-stage renal disease (ESRD) patients. Arteriovenous fistula (AVF) is the preferred hemodialysis access type because it has better patency rates and fewer complications than other access types. However, around 31-61% of AVF fail to mature. An early AVF failure may be due to a lack of maturation or thrombosis, and late failure defines as a failure after successful use. Some factors that make AVF fail are injury of the endothelial wall or hypercoagulation. This study aimed to determine the association between pre-operative platelet and hematocrit value with AVF failure in BHCC Clinic Denpasar. Method: This is an analytic cross-sectional study. The data were collected from medical records from all dialytic patients from January 2020-December 2020. Patients with inclusion criteria were collected. Patient with incomplete data was excluded. Data were analyzed using Chi-square analysis. Results: Our study involved 34 patients, 21(61.8%) of them were male, and the mean age was 52.62 years (±10.77 SD). The AVF failure prevalence was 32.4% (n=11). We found no association between platelet value with AVF failure, with a p-value=0.411. There was an association between hematocrit value and AVF failure in hemodialysis patients with a p-value=0.032. Most of the patient was male and aged 45-60 with ESRD from the characteristic found. Conclusion: There was an association between pre-operative hematocrit value and AVF failure in hemodialysis patients. There was no association between pre-operative platelet value with AVF failure.