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INDONESIA
Indonesian Journal of Kidney and Hypertension
Published by Indonesian Society of Nephrology (InaSN)
ISSN : 30470765     EISSN : 26544253     DOI : https://doi.org/10.32867/inakidney
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
The primary mission of this journal is to serve as a conduit for the dissemination of both clinical and foundational research pertinent to the expansive domains of nephrology and hypertension. Spanning a diverse array of topics, the journal delves into multifaceted areas including but not limited to chronic kidney disease, electrolyte and pH imbalances, hyperparathyroidism, CKD-MBD (chronic kidney disease-mineral and bone disorder), anemia, acute kidney injury, renal replacement therapy encompassing both dialysis and transplantation modalities, hypertension, onconephrology, nephrotic and nephritic syndromes, as well as glomerulonephritis and various other glomerulopathies. Through comprehensive coverage of these multifaceted subjects, the journal aims to offer a holistic understanding of the intricate dynamics within the realms of nephrology and hypertension, thereby fostering advancements in clinical practice, research methodologies, and therapeutic interventions.
Arjuna Subject : Kedokteran - Nephrology
Articles 42 Documents
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Profile of Catheter-Related Infections in Hemodialysis Patients with Double Lumen Catheters at Dr. Reksodiwiryo Hospital, Padang Mindy Pasuma Putra; Achmad Vidiansyah; Evelin Veronike; Harnavi Harun
Indonesian Journal of Kidney and Hypertension Vol 2 No 2 (2025): Volume 2 No. 2, August 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i2.189

Abstract

Background: Hemodialysis (HD) is the primary therapy for patients with advanced-stage chronic kidney disease (CKD). Although effective, the use of double lumen catheters (CDL) as vascular access in HD carries a high risk of infection. Objective: This study aims to identify the infection profile in CKD patients using CDL during hemodialysis at Dr. Reksodiwiryo Hospital in Padang. Methods: This study employs a retrospective descriptive design involving 60 hemodialysis patients from May to July 2024. The variables analyzed include age, gender, etiology, clinical manifestations, catheter location, catheter duration, and hematological parameters (leukocytes), with catheter-related infections (CRI) as the main dependent variable. Results: The results show that the majority of patients were under 60 years old (51.7%), and more than half (56.7%) used CDL for less than 8 weeks. CDL infections most frequently occurred in the right jugular vein access (90.0%) with fever and chills as the primary symptoms (53.3%). Conclusion: Using CDL for less than 8 weeks is linked to a high infection rate, with fever and chills as common symptoms. Recommendations include strict aseptic techniques during catheter insertion, prophylactic antibiotics for high leukocyte levels, and early planning for arteriovenous fistula (AVF) to minimize complications from long-term catheter use.
Effect of Tacrolimus Once Daily XR on Variance of Blood Tacrolimus Concentrations in Comparison with Twice Daily Tacrolimus in Kidney Transplant Recipients I Gde Raka Widiana; I Made Rama Putra; Stefany Adi Wahyuningrum
Indonesian Journal of Kidney and Hypertension Vol 2 No 2 (2025): Volume 2 No. 2, August 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i2.190

Abstract

Background: Variability of tacrolimus concentration in the plasma of recipients is associated with nephrotoxicity, acute rejection, and affects graft survival. Objective: To test the hypothesis that the coefficient variation of plasma tacrolimus in new tacrolimus XR (extended-release) once daily is lower than conventional twice daily. Methods: The study was conducted in two phases. Phase 1, a comparative observational analysis with a single-group crossover, comparing periods of divided-dose treatment with crossover to prolonged-dose treatment. Phase 2, a cross-sectional design, is used to correlate IVP and serum creatinine variation. Results: A total of 19 kidney post-transplant recipients were included. There was a significant difference in blood tacrolimus CoV between XR tacrolimus and divided dose therapy (22.22±7.39% vs 44.32±15.54%, p<0.001). A significant linear correlation was observed between blood tacrolimus CoV and serum creatinine CoV in all patients (r=0.74; r2= 0.54; b=1.15; p<0.001). Subgroup analysis revealed a significant correlation between blood tacrolimus CoV in divided dose tacrolimus therapy subgroup (r=0.58; r2= 0.33; p=0.02) but not in the XR group (r=0.06; r2= 0.004; p=0.84). Multivariate ANCOVA showed serum CoV was associated with CoV of blood tacrolimus (B=0.72; r2= 0.255; p=0.01). Furthermore, XR tacrolimus was associated with lower serum creatinine CoV (B= -20.7; r2=0.20; p=0.02). Conclusion: XR tacrolimus therapy produces significantly lower variance of blood tacrolimus concentrations in kidney transplant recipients. This variance is associated with serum creatinine variance, especially in divided-dose tacrolimus therapy. Serum creatinine variance is linked to variances in blood tacrolimus levels, and XR tacrolimus therapy is associated with lower serum creatinine variance.
Microbiological Profile of Peritoneal Dialysis-Related Peritonitis at Dr. Hasan Sadikin Hospital, Bandung Dania Artriana; Llik Sukesi; Rizky Andhika
Indonesian Journal of Kidney and Hypertension Vol 2 No 2 (2025): Volume 2 No. 2, August 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i2.191

Abstract

Background: Peritonitis is a frequent complication in patients undergoing peritoneal dialysis. To provide appropriate therapy, identification of the pathogen that causes peritonitis is required. Objective: This study aims to understand the microbiological profile of CAPD peritonitis in hospitalized patients at Dr. Hasan Sadikin Hospital, Bandung. Methods: This was a descriptive retrospective study using secondary data of peritonitis patients undergoing CAPD in 2020-2023. A total sampling technique was used, where all cases that met the inclusion criteria were included. The criteria were patients aged ≥ 18 years with CAPD peritonitis, having complete medical record data, and CAPD fluid culture results. In addition, the data were analyzed using SPSS software. Results: A total of 67 peritonitis patients undergoing CAPD were included, with 36 (53.7%) having monomicrobial infections. In addition, 7.5% had polymicrobial infection and 38% had culture-negative. Gram-negative bacteria were the most common microbe found in 18 cases, and most patients recovered from peritonitis (86.6%), followed by catheter removal (9%), and death (4.5%). Gram-negative predominance contrasts with Ozdemir et al.’s findings, possibly due to regional antibiotic practices. Conclusion: Empirical antibiotic treatment and culture results helped in providing effective management. Adhering to ISPD guidelines and improving sampling techniques could improve microbiological diagnosis and patient outcomes.
Successful Management of Thyroid Storm with Continuous Renal Replacement Therapy without Plasma Exchange Calvin Kurnia Mulyadi; Elizabeth Yasmine Wardoyo; Anggraini Permata Sari; Aryan Yohanes; Johanes Sarwono; Fidkya Allisha; Marina Epriliawati; Muhammad Ikhsan Mokoagow
Indonesian Journal of Kidney and Hypertension Vol 2 No 2 (2025): Volume 2 No. 2, August 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i2.195

Abstract

Background: Thyroid storm is a life-threatening endocrine emergency that needs urgent management. Conventional therapies, however, may not always yield satisfactory outcome. Hereby, we report a case of refractory thyroid storm with hemodynamic and cardiac instability that showed significant improvement following continuous renal replacement therapy (CRRT) instead of therapeutic apheresis. Case Illustration: A 46-year-old woman presented to the emergency department with severe thyrotoxicosis and pneumonia. On arrival, she was alert and hemodynamically stable. Physical examination revealed rapid irregular heart rate, fever, exophthalmos, diffuse goitre, and bilateral pulmonary rales. Laboratory findings indicated primary thyrotoxicosis, remarkable leukocytosis, and high procalcitonin that was consistent with sepsis. The Burch-Wartofsky score was 65, indicating thyroid storm. Clinical deterioration including loss of consciousness occurred on the next few days with electrocardiography changing into unstable supraventricular tachycardia despite optimal medical treatment administered to manage thyrotoxicosis and infection. Due to a suboptimal response, continuous veno-venous hemofiltration (CVVH) was initiated for 33 hours. This resulted in marked clinical improvement, including a reduction in free thyroxine (fT4), hemodynamic stabilization and recovery of consciousness. Discussion: While therapeutic plasma exchange (TPE) is the recommended adjunctive therapy for refractory thyroid storm according to the ASFA 2016 guidelines, it is often unavailable in many centers, particularly in low-resource settings. CRRT may serve as an alternative, offering hemodynamic stabilization through mechanisms not yet fully understood. Conclusion: CRRT may be considered a safe and effective alternative treatment for thyroid storm in patients who are refractory to standard medical therapy and particularly for those presenting with hemodynamic instability.
Cell Therapy in Chronic Kidney Disease: Between Hope and Challenges Jonny Jonny
Indonesian Journal of Kidney and Hypertension Vol 2 No 2 (2025): Volume 2 No. 2, August 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i2.203

Abstract

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Differences in Type Characteristics of Peritoneal Membrane Using Peritoneal Equilibrium Test in End Stage Renal Disease Patients Undergoing Peritoneal Dialysis at Hasan Sadikin Hospital, Bandung Muhammad Fitriandi Budiman; Afiatin Afiatin; Rizky Andhika
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.192

Abstract

Background: Peritoneal dialysis (PD) clears solutes and removes fluids from the patient's body. PD failure is primarily due to the clearing of solutes and the removal of fluids. Due to overhydration, the high peritoneal equilibrium test (PET) group is at greater risk of technical failure and death than other groups. Objective: This study aimed to to determine the characteristics of PET in patients with end-stage renal failure undergoing peritoneal dialysis (PD) at Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, descriptive, and cross-sectional investigation. Results: Of the 34 PD patients, the PET results were as follows: 47.1% for high average, 14.7% for high, 35.3% for low average, and 2.9% for low. There were no significant differences in most variables analyzed between the PET groups, including age, gender, etiology, comorbid diseases, history of hemodialysis (HD), residual renal function, and laboratory parameters such as hemoglobin, urea, creatinine, and albumin. The current blood glucose and body mass index (BMI) levels in the high PET group showed higher values and significant differences (p = 0.019 and p = 0.043, respectively). Conclusion: Blood glucose and BMI may be important factors that distinguish patients with high PET from other PET groups.
The Correlation of Volume Overload Measured by Bio Impedance Analysis and Intradialytic Hypertension in End Stage Kidney Disease Patients at Bandung Hasan Sadikin Hospital Muhammad Iqbal; Ria Bandiara; Rudi Supriyadi; Lazuardhi Dwipa
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.194

Abstract

Abstract Background: Assessing dry weight is essential for calculating the ultrafiltration volume during dialysis. Volume overload affects hemodynamic stability including intradialytic hypertension (IDH). Using Bio Impedance Analysis (BIA) to guide fluid assessment enhances the accuracy of fluid overload evaluation. Objective: Find the correlation between volume overload and IDH in patients undergoing chronic dialysis at Bandung Hasan Sadikin Hospital. Methods: This is a cross-sectional study to evaluate the correlation of volume overload and IDH in patients undergoing chronic dialysis at Bandung Hasan Sadikin Hospital. Exclusion criteria was patient below the age of 18 years old, unable to performed BIA measurement. Blood pressure before, during and after dialysis session was recorded to asses IDH. BIA was measured after dialysis session. Point biserial correlation used to analyze correlation between volume overload and intradialytic hypertension. The data were analysed with SPSS version 23.0. The statistical significance was set at P<0.05. Result: Ninety-seven patients enrolled, the average age was 49,9 ± 12.3 years old, 55,7% was male. There were 23,7% of patients with IDH with increasing systolic blood pressure of 19.21 mmHg (10-66). A significant correlation was observed between the incidence of IDH and the percentage of volume overload after dialysis with R coefficient 0,238 (p 0,014). Conclusion: The majority (59.87%) of patients undergoing chronic hemodialysis had a greater dry weight based on BIA examination, 23,7% had IDH and its occurrence has a significant correlation with the percentage of volume overload after dialysis. Keywords: volume overload, dry weight, BIA, IDH.
Mechanical and Technical Complication in Patient with Continous Ambulatory Peritoneal Dialysis (CAPD) with Encapsulated Peritoneal Sclerosis Theodore Dharma Tedjamartono
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.197

Abstract

Continuous Ambulatory Peritoneal Dialysis (CAPD) relies on an intraperitoneal catheter for the inflow and outflow of dialysate fluid; therefore, mechanical complications are often encountered. Encapsulated peritoneal sclerosis (EPS) is one of the rare complications in CAPD patients, but it has high mortality and morbidity rates. A case of a patient with EPS was reported in a 53-year-old man in the form of a problem with the dwelling of the CAPD. Patients complain of a longer duration of dwelling with a positive fluid balance. There are no complaints of fever or abdominal pain. Abdominal inspection shows symmetrical, no mass, no wound or pus from the CAPD tip. The patient had a history of recurrent peritonitis. CAPD Cuff was released due to laparoscopy findings with grade IV adhesions in the omentum and peritoneum; it also showed omental cakes and peritoneal fluid with debris. Diagnosis of EPS was established based on the presence of clinical symptoms due to intestinal obstruction and structural disorders due to peritoneal fibrosis, like thickening and adhesions of the intra-abdomen, accompanied by findings of fibrous cocoon or omental cakes in the intestine, with laparotomy and/or laparoscopy. CAPD is related to various complications of infections and non-infections. Although complications related to infections are more often found, non-infection complications such as EPS can also occur in CAPD Patients; therefore, clinicians need to be aware of this complication, especially in patients with a history of recurrent peritonitis.
Understanding Readmission Risks in End-Stage Kidney Disease: A Study from Wangaya Hospital Ni Nyoman Gita Kharisma Dewi; Made Sindy Astri Pratiwi; Made Priska Arya Agustini; Putu Itta Sandi Lesmana Dewi; Cindy Fahira; I Wayan Sunaka
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.206

Abstract

Background: End-stage kidney disease (ESKD) is a growing health burden. Poor patient knowledge and treatment adherence contribute to increased morbidity, as reflected in readmission rates. Objective: This study aimed to identify factors associated with readmission among ESKD patients in Bali. Methods: A retrospective cohort study was conducted at Wangaya Hospital. Adult patients (≥18 years) diagnosed with ESKD, with or without dialysis, between 2022 and 2024 were included. Patients with incomplete records or a solitary kidney were excluded. Bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression) were used to assess associations, with significance set at p <0.05. Results: A total of 199 patients met the inclusion criteria; 61.8% were male, with a median age of 57 years (range: 22–88 years). Readmission rates within and beyond one month were 18.6% and 15.1%, respectively. Reduced eGFR was significantly associated with 30-day readmission (p = 0.041). For readmission beyond 30 days, significant predictors included diabetes mellitus (p = 0.014), neurologic disorders (p < 0.001), and adherence (p = 0.019). Conclusion: eGFR predicts early readmission, while diabetes mellitus, neurological disorders, and treatment adherence influence later readmissions. Identifying these factors is vital for improving patient education and reducing healthcare burdens.
Associated Factors with Erectile Dysfunction in Hemodialysis Patients at Dr. Reksodiwiryo Hospital Padang Achmad Vidiansyah; Mindy Pasuma Putra; Evelin Veronike; Harnavi Harun
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.218

Abstract

Background: Erectile dysfunction (ED) is a common condition affecting a significant number of men worldwide, with its prevalence particularly high among patients with chronic kidney disease (CKD). Objective: This study aims to investigate the association between ED and CKD in patients undergoing hemodialysis. Methods: This study used a survey approach, designed with cross-sectional involving 24 male patients undergoing hemodialysis at the hospital from January to July 2024. Data were gathered using the IIEF-5 questionnaire as well as patient records. The severity of ED was classified based on IIEF-5 scores, and data analysis was conducted using SPSS. Results: Most respondents (58.3%) were under 60 years old, with 58.3% having hemoglobin levels below 10 g/dL and 79.2% with a KT/V ratio under 1.8. ED prevalence was high at 95.8%, with severe ED affecting 54.2%. A significant correlation existed between KT/V and ED severity p<0.05, while hemoglobin levels showed no significant association p>0.05. The high prevalence of ED in CKD patients undergoing hemodialysis highlights the importance of regular screening and early intervention. The study indicates that sufficient hemodialysis, as measured by the Kt/V ratio, could be essential in reducing the severity of ED in this group. However, hemoglobin levels did not show a significant connection to ED severity, which contrasts with certain earlier research findings. Conclusion: Erectile dysfunction is common among CKD patients undergoing hemodialysis, with insufficient dialysis being a key contributing factor. This highlights the need to maintain adequate dialysis to reduce the severity of ED in these individuals.

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