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All Journal Siber Journal of Advanced Multidisciplinary International Journal of Psychology and Health Science
Putra, I Putu Eka Dharma
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Severe AV Shunt-Related Sepsis in a Chronic Dialysis Patient With Immobility and Protein Energy Wasting: A Case Report and Literature Review Putra, I Putu Eka Dharma
Siber Journal of Advanced Multidisciplinary Vol. 3 No. 1 (2025): (SJAM) Siber Journal of Advanced Multidisciplinary (April - June 2025)
Publisher : Siber Nusantara Research & Yayasan Sinergi Inovasi Bersama (SIBER)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/sjam.v3i1.419

Abstract

Vascular access infections, particularly those involving arteriovenous (AV) shunts, are a major cause of morbidity and mortality in chronic hemodialysis patients, especially among those with prolonged access use, immunocompromise, and comorbidities such as malnutrition or immobility. Case Report: We describe a 62-year-old female with end-stage renal disease (ESRD) undergoing dual dialysis modalities (hemodialysis and CAPD), who developed sepsis secondary to an infected left brachial AV shunt. Her condition was further complicated by three years of immobilization due to untreated bilateral femoral fractures and severe protein-energy wasting (PEW). Discussion: This case illustrates the diagnostic and therapeutic challenges of sepsis in dialysis patients, including atypical clinical presentation, altered inflammatory markers, and the complexity of antibiotic management in the setting of renal failure. Furthermore, it underscores how overlapping clinical issues such as infection risk, poor nutritional status, and physical dependency necessitate an integrated approach to care. Conclusion: Early recognition of AV shunt infections and prompt intervention are critical to preventing systemic complications. Comprehensive multidisciplinary collaboration is essential for improving outcomes in ESRD patients with complex comorbidities, emphasizing infection control, nutritional rehabilitation, mobility support, and individualized dialysis planning.
Multisystemic Complications in a Patient with Diabetes Mellitus: A Case of Spinal Cord Compression with Chronic Kidney Disease and Diabetic Neuropathy Putra, I Putu Eka Dharma
International Journal of Psychology and Health Science Vol. 3 No. 2 (2025): International Journal of Psychology and Health Science (April - June 2025)
Publisher : Greenation Publisher & Yayasan Global Research National

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.38035/ijphs.v3i2.873

Abstract

Diabetes mellitus is a major cause of multisystemic complications, particularly in patients with poor glycemic control since a young age. Chronic hyperglycemia induces vascular, neurological, and renal damage, predisposing patients to severe functional impairments and infections. Case Report: We present a 21-year-old male with long-standing uncontrolled diabetes mellitus who developed compressive myelopathy, diabetic kidney disease (DKD), diabetic neuropathy, and neurogenic bladder. The patient exhibited progressive lower limb weakness, urinary and fecal incontinence, chronic back pain, severe hyperglycemia, electrolyte imbalances, and a significant decline in renal function. Discussion: This case illustrates the complex interplay between diabetic microvascular and neurological complications. Chronic hyperglycemia led to glomerular hyperfiltration and progressive renal injury, while peripheral and autonomic neuropathy resulted in debilitating sensory-motor symptoms and recurrent urinary tract infections. The overlapping pathologies highlight the necessity for early screening, aggressive metabolic control, and a multidisciplinary approach to management. Conclusion: Early diagnosis and prompt multidisciplinary intervention are critical to prevent irreversible multisystem damage in patients with longstanding diabetes. Comprehensive management strategies focusing on infection control, renal protection, neuropathic pain relief, and glycemic stabilization are essential to optimize patient outcomes.
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