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All Journal International Journal of Advanced Multidisciplinary International Journal of Psychology and Health Science
Eka Dharma Putra, I Putu
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Decision Sciences, Operations Research & Management Earth & Planetary Sciences Economics, Econometrics & Finance Education Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Mathematics Nursing Social Sciences

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The Relationship Between Hypertension and the Occurrence of Aneurysms in AV Shunts in CKD Stage V Patients at RSU Kertha Usadha Singaraja Eka Dharma Putra, I Putu
International Journal of Advanced Multidisciplinary Vol. 3 No. 4 (2025): International Journal of Advanced Multidisciplinary (January-March 2025)
Publisher : Green Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijam.v3i4.766

Abstract

Chronic Kidney Disease (CKD) stage V patients rely on hemodialysis using arteriovenous (AV) shunts for treatment. However, aneurysms frequently occur as complications, threatening the efficacy of therapy. Hypertension, a prevalent condition in CKD patients, increases the risk of aneurysm formation through sustained high pressure on blood vessel walls. This study investigates the relationship between hypertension and aneurysm occurrence in AV shunts among CKD stage V patients. Method : This cross-sectional observational study was conducted at RSU Kertha Usadha Singaraja, involving 40 CKD stage V patients undergoing hemodialysis. Data collection included medical record reviews, blood pressure measurements, and physical examination for aneurysm detection. The association between hypertension and aneurysm incidence was analyzed using the Chi-square test. Result : Among the 40 participants, 27.5% had aneurysms, with a significant association between uncontrolled hypertension and aneurysm occurrence (p = 0.013). Patients with uncontrolled blood pressure were more likely to develop aneurysms (45%) compared to those with controlled blood pressure (10%). The findings underline the importance of blood pressure management in mitigating aneurysm risk. Conclussion : Uncontrolled hypertension significantly contributes to aneurysm formation in AV shunts among CKD stage V patients. Effective blood pressure management is essential to reduce vascular complications, ensuring better outcomes and sustainability of hemodialysis therapy.
A Patient with Vesicoureteral Reflux Due to Neurogenic Bladder with Complications of Chronic Kidney Disease Eka Dharma Putra, I Putu
International Journal of Psychology and Health Science Vol. 3 No. 1 (2025): International Journal of Psychology and Health Science (January - March 2025)
Publisher : Greenation Publisher & Yayasan Global Research National

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijphs.v3i1.752

Abstract

Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder into the upper urinary tract and is more commonly observed in children compared to adults. Adult-onset VUR is relatively rare and often linked to secondary causes such as neurogenic bladder or post-surgical complications. This case report presents a 56-year-old male patient with secondary VUR due to neurogenic bladder, complicated by chronic kidney disease (CKD) stage V. The patient exhibited symptoms including increased urinary frequency, difficulty controlling urination, and pubic pain. Diagnostic findings included severe hydronephrosis, detrusor overactivity with small bladder capacity, and lumbar spondylosis with nerve root compression. Management involved medical therapy with antimuscarinic agents and preoperative hemodialysis to optimize renal function. Surgical intervention was recommended, but the patient opted for continued regular hemodialysis. This case underscores the importance of early diagnosis and integrated. management of VUR and its complications to prevent CKD progression. Case report: A 56-year-old male presented with chronic urinary frequency and discomfort, significantly disrupting daily activities. Medical history revealed recurrent episodes over three years, worsening recently. Imaging and diagnostic evaluations showed severe hydronephrosis and evidence of neurogenic bladder due to lumbar nerve compression. Laboratory tests indicated CKD stage V, with anemia, elevated creatinine, and proteinuria. Treatment included solifenacin and preoperative hemodialysis, but the patient declined surgery. Regular dialysis was initiated as the primary management. Discussion: The etiology of adult-onset VUR is often secondary to structural or neurological abnormalities. In this case, lumbar spondylosis led to neurogenic detrusor overactivity, causing reflux and subsequent renal damage. Pathophysiology involves bladder dysfunction and intrarenal reflux, which aggravates kidney scarring. Integrated care, combining medical and potential surgical management, remains critical in mitigating disease progression. Conclusion: This case highlights the complexity of secondary VUR in adults, emphasizing the need for a multidisciplinary approach to management. Early identification and tailored treatment are pivotal in preventing severe complications like CKD.
A Patient Chronic Kidney Disease with Complication Subdural Hematome during Hemodialisis Programe Eka Dharma Putra, I Putu
International Journal of Psychology and Health Science Vol. 3 No. 1 (2025): International Journal of Psychology and Health Science (January - March 2025)
Publisher : Greenation Publisher & Yayasan Global Research National

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijphs.v3i1.753

Abstract

Subdural hematoma (SDH) is a critical neurosurgical condition often linked to chronic kidney disease (CKD) patients undergoing hemodialysis (HD). This case report presents a 56-year-old male with CKD stage V and SDH as a complication during HD therapy. The patient experienced a sudden decrease in consciousness following routine dialysis. Diagnostic evaluations revealed chronic subdural hematoma with midline shift, accompanied by chronic nephritis and anemia. Management included burr hole surgery, heparin-free dialysis, and supportive medical therapy. The patient showed significant recovery, highlighting the importance of timely intervention and a multidisciplinary approach to manage SDH in CKD patients undergoing HD. Case report: A 56-year-old male CKD stage V patient on routine HD presented with acute headache and decreased consciousness post-dialysis. CT imaging confirmed chronic SDH with a midline shift. Treatment involved burr hole drainage and heparin-free dialysis. The patient recovered well after four days of hospitalization and resumed dialysis without further complications. Discussion: The pathophysiology of SDH in HD patients involves changes in intracranial pressure and impaired hemostasis due to CKD and dialysis-related factors. The use of anticoagulants further exacerbates bleeding risks. This case underlines the need for careful monitoring, individualized HD protocols, and timely surgical intervention for SDH in CKD patients. Conclusion: This case emphasizes the critical risk of SDH in HD patients, advocating for preventive strategies, including modified dialysis protocols and multidisciplinary care, to mitigate complications and improve patient outcomes.
A Chronic Hemophilia Patient With Manifestations of Spontaneous Penile Bleeding and Multiarthropathy Eka Dharma Putra, I Putu
International Journal of Psychology and Health Science Vol. 3 No. 1 (2025): International Journal of Psychology and Health Science (January - March 2025)
Publisher : Greenation Publisher & Yayasan Global Research National

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijphs.v3i1.755

Abstract

Hemophilia A is a hereditary bleeding disorder characterized by Factor VIII deficiency, with varying severity levels. This report presents a 27-year-old male patient with moderate Hemophilia A who experienced spontaneous penile bleeding and a history of multiarthropathy. The patient reported recurrent bleeding episodes since childhood and received Factor VIII therapy, resulting in significant symptom relief. This case highlights the importance of individualized management in chronic hemophilia, focusing on preventive measures to mitigate future bleeding episodes and comorbidities, thereby improving quality of life and life expectancy. Case report : A 27-year-old male patient presented with spontaneous penile bleeding triggered by minor trauma and associated with moderate Factor VIII deficiency (1%). Past medical history included recurrent joint and gastrointestinal bleeding episodes. The patient responded positively to Factor VIII therapy and packed red cell transfusions, with symptom resolution after 10 days of hospitalization. Family pedigree analysis and coagulation studies confirmed the diagnosis of moderate Hemophilia A. Discussion : Hemophilia A patients face lifelong bleeding risks, with multiarthropathy as a common complication. Factor VIII levels closely correlate with disease severity and bleeding manifestations. Preventive therapy, including Factor VIII administration, is crucial for minimizing complications. Additionally, managing viral infection risks is essential due to associated sexual behavior in certain demographics. Regular screening and patient education play pivotal roles in comprehensive care. Conclusion : This case underscores the significance of proactive management in moderate Hemophilia A, emphasizing tailored therapy and preventive strategies. Ensuring adequate access to clotting factor concentrates and addressing comorbidities can significantly enhance the quality of life and prognosis for chronic hemophilia patients.
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