Evaluasi Penggunaan Eritropoetin (EPO) yang dikaitkan dengan Clinical Outcome pada Pasien Hemodialisis di RSUP Prof. R. D . Kandou Manado.
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Latar Belakang: Penyakit ginjal kronis (PGK) adalah isu kesehatan yang terjadi di hampir semua belahan di dunia dan jumlah pasien terus meingkat. Pasien PGK yang menjalani hemodialisis sering mengalami anemia yang berpengaruh pada penurunan kualitas hidup serta meningkatkan risiko morbiditas dan mortalitas. Eritropoietin (EPO) digunakan untuk mengobati anemia, tetapi efektivitasnya bisa terpengaruh oleh kondisi gizi, kombinasi terapi, dan faktor lainnya yang dapat mempengaruhi respons hemoglobin. Tujuan: Mengetahui gambaran terhadap terapi Eritropoietin pada pasien PGK yang menjalani hemodialisis di Unit Hemodialisis Dahlia RSUP Prof. Dr. R.D. Kandou Manado.Metode: Penelitian observasional dengan desain kohort retrospektif (Januari–Desember 2020 dengan pemantauan hingga Desember 2024) dan prospektif (Oktober–Desember 2024). Data dari rekam medis pasien diolah, dianalisis secara deskriptif serta analitis menggunakan uji t-independen, ANOVA dan ANCOVA.Hasil: Dari 547 pasien hemodialisis yang mendapat terapi EPO, 209 pasien dirawat di Unit Hemodialisis Dahlia, terdiri dari 109 pasien dengan jenis kelamin laki-laki atau 52,15% dan 100 pasien perempuan atau 47,85%. Rata-rata peningkatan sebesar 16,28% pada nilai hemoglobin pasca (Hb Post) dibandingkan dengan nilai hemoglobin sebelum (Hb Pre). Uji t-independen menunjukkan tidak ada perbedaan signifikan kadar Hb antara jenis kelamin laki-laki dan perempuan (p>0,05). Uji ANOVA menunjukan adanya perbedaan signifikan kadar hemoglobin pasca (Hb Post) antar kelompok umur (F(7,201)=3,517; p=0,001). Hasil analisis ANCOVA menunjukan bahwa hemoglobin sebelum (Hb Pre) adalah prediktor utama terhadap hemoglobin pasca (Hb Post) (F=161,151; p<0,001). Kesimpulan: Terapi EPO menunjukan adanya peningkatkan kadar Hb pada pasien PGK yang menjalani hemodialisis dengan respons yang dipengaruhi oleh usia dan hemoglobin sebelum (Hb Pre), namun tidak oleh jenis kelamin. hemoglobin sebelum (Hb Pre) merupakan prediktor utama keberhasilan terapi.
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Referensi
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Beto J. , Bhatt N. , Gerbeling T. , Patel C. , & Drayer D.. Overview of the 2017 kdigo ckd-mbd update: practice implications for adult hemodialysis patients. Journal of Renal Nutrition 2019;29(1):2-15. https://doi.org/10.1053/j.jrn.2018.05.006 DOI: https://doi.org/10.1053/j.jrn.2018.05.006
Li H. , Lu W. , Wang A. , Jiang H. , & Lyu J.. Changing epidemiology of chronic kidney disease as a result of type 2 diabetes mellitus from 1990 to 2017: estimates from global burden of disease 2017. Journal of Diabetes Investigation 2020;12(3):346-356. https://doi.org/10.1111/jdi.13355 DOI: https://doi.org/10.1111/jdi.13355
Endrich O. , Nakas C. , Triep K. , Fiedler M. , Jaime J. , & McGuire A.. Impact of precision in staging acute kidney injury and chronic kidney disease on treatment outcomes: an observational study. Diagnostics 2024;14(22):2476. https://doi.org/10.3390/diagnostics14222476 DOI: https://doi.org/10.3390/diagnostics14222476
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