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Sri Wardani, Ni Wayan
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Besar Risiko Status Nutrisi terhadap Morbiditas dan Mortalitas Pasien Hemodialisis Reguler: Risk of Nutritional Status with Morbidity and Mortality of Regular Hemodialysis Patients Sri Wardani, Ni Wayan
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (354.318 KB) | DOI: 10.36408/mhjcm.v9i2.753

Abstract

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.
Systemic Lupus Erythematosus and Rapid Progressive Glomerulonephritis with History of Hypothyroidism: A Case Report Gideon, Adolf; Sri Wardani, Ni Wayan; Asmara, Dewa Wedha
Jurnal Impresi Indonesia Vol. 4 No. 10 (2025): Jurnal Impresi Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i10.7034

Abstract

A 20 years old female presented to the ER with fever and multiple joint pain, especially in hands and feet. Patient also have dry cough without blood, and weight loss in the last few months. There were no other symptoms. Patient had a medical history of hypothyroidism with episodic thyroid enlargement since 2022. Medications were irregularly taken, and there was a relapse in 2023. After a few days of treatment. After a few days of treatment, new symptomps such as hemoptysis, dyspnea, high-grade fever and chills emerged. This was followed by vomiting, bloating, and difficulty in defecation. Laboratory examination revealed hypothyroidism, anemia, and thrombocytopenia with decreased kidney function. Complete urine test showed blood (hematuria) and protein (proteinuria) in urine. Chest X Ray indicated cardiomegaly and pneumonia with mild effusion. Subsequently, we suspected Systemic Lupus Erythematosus (SLE), and Rapid Progressive Glomerulonephritis, with confirmed diagnoses of hypothyroidism and pneumonia. ANA IF (for SLE), abdominal ultrasonography, and viral examination were performed to confirm our diagnosis. Several days later, ANA IF results returned significantly positive, confirming the diagnosis of SLE based on the ACR/EULAR 2019 criteria. This report underscores the importance of history-taking, physical examination and laboratory examination in suspected cases of systemic lupus erythematosus. Early recognition and appropriate management are crucial in achieving favorable outcomes for the patients.
Co-Authors Asmara, Dewa Wedha Gideon, Adolf