Causes and Profiles Pertaining to the Emergency Room Admission of Stage V Chronic Kidney Disease Patients Undergoing Regular Hemodialysis at a Tertiary Hospital in Surabaya, Indonesia
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Introduction: Chronic kidney disease (CKD) is characterized by decreased kidney function, with a glomerular filtration rate below 60 mL/min/1.73 m² persisting for at least three months. Hemodialysis is a common therapy for stage V CKD, yet complications may arise requiring emergency treatment. This study aimed to elucidate the causes and profiles of stage V CKD patients on regular hemodialysis who were admitted to the Emergency Department of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Methods: A retrospective cross-sectional design and purposive sampling were used in this descriptive observational study. A univariate analysis was conducted on data collected from 72 stage V CKD patients who underwent regular hemodialysis and were admitted to the emergency room between January and March 2023. The inclusion criteria comprised stage V CKD patients undergoing regular hemodialysis in the emergency room. Patients with incomplete medical records were excluded. The collected data encompassed patients' age, sex, hemodialysis duration, interdialytic weight gain (IDWG), comorbidities, and complications.
Results: Among the 72 patients, the predominant demographic was male (51.4%), primarily aged 56–65 years (30.6%), with a hemodialysis duration of ≤12 months (65.3%), an IDWG of 1–2 kg (16.7%), and hypertension (54.2%). The complications leading to patient admission in the emergency room mostly included anemia (77.8%), metabolic acidosis (54.2%), urinary tract infection (23.6%), hyperkalemia (19.4%), pulmonary edema (18.1%), and pneumonia (18.1%).
Conclusion: Stage V CKD patients on regular hemodialysis are primarily admitted to the emergency room due to complications, including anemia, metabolic acidosis, urinary tract infections, hyperkalemia, pulmonary edema, and pneumonia.
Highlights:
- Since almost all patients with stage V chronic kidney disease (CKD) undergo routine hemodialysis, it is important to assess its associated complications to help improve patient outcomes.
- This study reports the prevalence of comorbid diseases and the diagnostic outcomes of patients experiencing complications in the Emergency Department of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
- The findings of this study provide valuable insights to patients, researchers, and future medical personnel regarding the characteristics of stage V CKD patients who regularly undergo hemodialysis and present to the emergency room.
Al Kamaliah NI, Cahaya N, Rahmah S (2021). Gambaran karakteristik pasien gagal ginjal kronik yang menggunakan suplemen kalsium di Poliklinik Sub Spesialis Ginjal Hipertensi Rawat Jalan RSUD Ulin Banjarmasin. Jurnal Pharmascience 8(1): 113–126. doi: 10.20527/jps.v8i1.8599.
Arista M, Ismahmudi R (2015). Analisis praktik klinik keperawatan pemberian breathing exercise pada pasien dengan chronic kidney disease (CKD) yang mengalami keletihan di Ruang Instalasi Gawat Darurat RSUD Abdul Wahab Sjahranie Samarinda Tahun 2015. Sekolah Tinggi Ilmu Kesehatan Muhammadiyah Samarinda. Retrieved from https://dspace.umkt.ac.id/handle/463.2017/989?show=full.
Artiany S, Aji YGT (2021). Gambaran komorbid pada pasien hemodialisis di Rumah Sakit Angkatan Udara (RSAU) dr. Esnawan Antariksa. Jurnal Keperawatan Cikini 2(2): 1–6. doi: 10.55644/jkc.v2i2.57.
Deltourbe L, Mariano LL, Hreha TN, Hunstad DA, Ingersoll MA (2022). The impact of biological sex on diseases of the urinary tract. Mucosal Immunology 15(5): 857–866. doi: 10.1038/s41385-022-00549-0.
Febriana L (2015). Hubungan antara kondisi komorbid dan mortalitas pada pasien gagal ginjal kronik yang menjalani hemodialisis di RSU Dokter Soedarso Pontianak. Jurnal Mahasiswa PSPD FK Universitas Tanjungpura 3(1): 1–34. Retrieved from https://jurnal.untan.ac.id/index.php/jfk/article/view/10587.
Gultom ECV, Sopaba FY, Lumban Gaul KB, Trinanda PA, Harefa LA (2024). Faktor-faktor yang berhubungan dengan peningkatan interdialytic weight gain pasien hemodialisis. Jurnal Keperawatan Cikini 5(1): 46–57. Retrieved from https://jurnal.akperrscikini.ac.id/index.php/JKC/article/view/153.
Hasanah U, Livana PH (2021). Slow deep breathing berpengaruh terhadap fatigue pada pasien dengan gagal ginjal kronik yang menjalani hemodialisis. Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal 11(1): 143–148. Retrieved from https://www.journal.stikeskendal.ac.id/index.php/PSKM/article/view/1172/703.
Hashmi MF, Aeddula NR, Shaikh H, Rout P (2024). Anemia of chronic kidney disease. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK539871/.
Kesmodel US (2018). Cross‐sectional studies – What are they good for? Acta Obstetricia et Gynecologica Scandinavica 97(4): 388–393. doi: 10.1111/aogs.13331.
Kim HJ (2021). Metabolic acidosis in chronic kidney disease: Pathogenesis, clinical consequences, and treatment. Electrolytes & Blood Pressure 19(2): 29–37. doi: 10.5049/EBP.2021.19.2.29.
Kovesdy CP (2022). Epidemiology of chronic kidney disease: An update 2022. Kidney International Supplements 12(1): 7–11. doi: 10.1016/j.kisu.2021.11.003.
Kusniawati (2018). Hubungan kepatuhan menjalani hemodialisis dan dukungan keluarga dengan kualitas hidup pasien gagal ginjal kronik di Ruang Hemodialisa Rumah Sakit Umum Kabupaten Tangerang. Jurnal Medikes (Media Informasi Kesehatan) 5(2): 206–233. doi: 10.36743/medikes.v5i2.61.
Luo J, Brunelli SM, Jensen DE, Yang A (2016). Association between serum potassium and outcomes in patients with reduced kidney function. Clinical Journal of the American Society of Nephrology 11(1): 90–100. doi: 10.2215/CJN.01730215.
Lv JC, Zhang LX (2019). Prevalence and disease burden of chronic kidney disease. In: Advances in Experimental Medicine and Biology. Springer Nature Link. doi: 10.1007/978-981-13-8871-2_1.
Ministry of Health of the Republic of Indonesia (2017). Situasi penyakit ginjal kronis. Infodatin. Pusat Data dan Informasi Kementerian Kesehatan RI. Retrieved from https://adoc.pub/infodatin-situasi-penyakit-ginjal-kronis-9-maret-pusat-data-.html.
Ministry of Health of the Republic of Indonesia (2019). Laporan nasional Riskesdas 2018. Retrieved from https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf.
Napitupulu R, Paridah P, Tukan RA, Alfianur A, Wijayanti D, et al. (2024). Penyakit ginjal kronis pada masyarakat di wilayah pesisir. MAHESA: Malahayati Health Student Journal 4(7): 2872–2882. doi: 10.33024/mahesa.v4i7.14713.
Natalia D, Susilawati S, Safyudin (2019). Hubungan laju filtrasi glomerulus dengan derajat anemia pada penderita penyakit ginjal kronik. Sriwijaya Journal of Medicine 2(3): 168–177. doi: 10.32539/SJM.v2i3.78.
Nordheim E, Jenssen TG (2021). Chronic kidney disease in patients with diabetes mellitus. Endocrine Connections 10(5): R151–R159. doi: 10.1530/EC-21-0097.
Pranandari R, Supadmi W (2015). Faktor risiko gagal ginjal kronik di Unit Hemodialisis RSUD Wates Kulon Progo. Majalah Farmaseutik 11(2): 316–320. Retrieved from https://jurnal.ugm.ac.id/majalahfarmaseutik/article/view/24120.
Santoso D, Sawiji, Oktantri H, Septiwi C (2022). Faktor-faktor yang berhubungan dengan fatigue pada pasien gagal ginjal kronik yang menjalani hemodialisa di RSUD Dr. Soedirman Kebumen. Jurnal Ilmiah Kesehatan Keperawatan 18(1): 60–70. doi: 10.26753/jikk.v18i1.799.
Saputra A, Wiryansyah OA (2021). Hubungan lama masa hemodialisis dengan kualitas hidup pasien gagal ginjal kronik. Babul Ilmi: Jurnal Ilmiah Multi Science Kesehatan 14(2): 112–122. Retrieved from https://jurnal.stikes-aisyiyah-palembang.ac.id/index.php/Kep/article/view/1067.
Saragih AM, Wahyuni S, Yuniarti R, Indrayani G, Peri P (2024). Gambaran karakteristik pasien gagal ginjal kronis stadium V yang menjalani hemodialisis. Scientica: Jurnal Ilmiah Sains dan Teknologi 3(1): 431–440. Retrieved from https://jurnal.kolibi.org/index.php/scientica/article/view/3728.
Sari SP, Rasyidah A, Maulani (2022). Hubungan lama hemodialisis dengan kualitas hidup pasien penyakit ginjal kronik di Ruang Hemodialisa Rumah Sakit Bhayangkara Kota Jambi. Jurnal Ilmiah Ners Indonesia 3(2): 54–62. doi: 10.22437/jini.v3i2.20204.
Shaik L, Thotamgari SR, Kowtha P, Ranjha S, Shah RN, et al. (2021). A spectrum of pulmonary complications occurring in end-stage renal disease patients on maintenance hemodialysis. Cureus 13(6): 6–11. doi: 10.7759/cureus.15426.
Shibata S, Uchida S (2022). Hyperkalemia in patients undergoing hemodialysis: Its pathophysiology and management. Therapeutic Apheresis and Dialysis 26(1): 3–14. doi: 10.1111/1744-9987.13721.
Siagian Y, Alit DN, Suraidah (2021). Analisis faktor yang berhubungan dengan kepatuhan pembatasan asupan cairan pasien hemodialisa. Menara Medika 4(1): 71–80. Retrieved from https://jurnal.umsb.ac.id/index.php/menaramedika/article/view/2801.
Sinaga CR, Fatimawali F, Tjitrosantoso H (2017). Evaluasi kerasionalan penggunaan antibiotik pada pasien gagal ginjal di RSUP Prof. Dr. R. D. Kandou Manado. Pharmacon Jurnal Ilmiah Farmasi 6(3): 10–19. doi: 10.35799/pha.6.2017.16512.
Thapa TB, Pokhrel S, Lamichhane A, Singh VK, Shrestha O, et al. (2023). Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease. Open Medicine 18(1). doi: 10.1515/med-2023-0824.
Vaidya SR, Aeddula NR (2024). Chronic kidney disease. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK535404/.
Wong MMY, McCullough KP, Bieber BA, Bommer J, Hecking M, et al. (2017). Interdialytic weight gain: Trends, predictors, and associated outcomes in the International Dialysis Outcomes and Practice Patterns Study (DOPPS). American Journal of Kidney Diseases 69(3): 367–379. doi: 10.1053/j.ajkd.2016.08.030.
Yumassik AM, Widodo GP, Andayani TM (2022). Analisis biaya dan indeks utilitas yang diukur menggunakan SF-6D pada pasien gagal ginjal kronis dengan hemodialisis di RSUD Adji Batara Agung Dewa Sakti Kutai Kartanegara. Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan 7(2): 290–299. doi: 10.36387/jiis.v7i2.942.
Zoccali C, Mallamaci F, Picano E (2022). Detecting and treating lung congestion with kidney failure. Clinical Journal of the American Society of Nephrology 17(5): 757–765. doi: 10.2215/CJN.14591121.
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