Validity and Reliability of the Indonesian Version of Kidney Disease Quality of Life (KDQOL-36) Questionnaire in Hemodialysis Patients at Hasan Sadikin Hospital, Bandung, Indonesia

Background: the prevalence of chronic kidney disease (CKD) and dialysis patients is increasing every year in Indonesia. The impact of CKD and dialysis on patient quality of life (QOL) has been recognized as an important outcome measure in the management of CKD. The Kidney Disease Quality of Life (KDQOL-36) has been validated and is widely used as a measure of QOL for CKD and dialysis patients in many countries, but not in Indonesia. The aim of this study is to determine the reliabity and validity of the Indonesian version of KDQOL-36 on hemodialysis patients in Indonesia. Methods: the KDQOL-36 was translated into Indonesian language by a certified translator and then it was back-translated into English. The translated questionnaire was further reviewed by an expert panel. The final questionnaire was administered to hemodialysis patients in Hemodialysis Unit at Hasan Sadikin General Hospital. Validity was measured using Pearson’s correlation between the kidney disease-targeted scores, generic dimensions (SF-12) scores and each scale score in KDQOL-36. The internal consistensy was assessed using Cronbach’s Alpha and reliability was examined using test-retest. Results: out of 103 patients, we found that most subjects were male (52.4%) with median age of 51 (22-75) years. The duration of hemodialysis was 3.4 (SD 2.1) years. The validity test showed a significant correlation (p0,7 for all scales. Conclusion: the Indonesian version of the KDQOL-36 questionnaire is valid and reliable for evaluating QOL in reguler hemodialysis patients

PENGARUH PEMBERIAN OBAT ANTIHIPERTENSI TERHADAP KUALITAS HIDUP PASIEN HIPERTENSI DENGAN GANGGUAN GINJAL KRONIK DI INSTALASI HEMODIALISA RSUP DR. HASAN SADIKIN BANDUNG

ABSTRAK Hipertensi merupakan penyebab gangguan ginjal kronik melalui suatu proses yang mengakibatkan hilangnya sejumlah besar nefron fungsional yang progresif dan irreversible. The Kidney Disease Outcome Quality Initiative (K/DOQI) of the national kidney foundation (NKF) merekomendasikan target tekanan darah pada pasien gangguan ginjal kronik < 140/90 mmHg sehingga dapat mengurangi risiko terjadinya penyakit kardiovaskular. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian obat antihipertensi terhadap kualitas hidup pasien GGK yang menjalani hemodialisis di RSUP DR.Hasan Sadikin Bandung. Penelitian menggunakan desain cross sectional observational konkuren dengan mengkaji data rekam medis dan status harian pasien selama periode Desember 2015-Febuari 2016 dan hasil pengisian kuisioner Kidney Disease and Quality of Life (KDQOLTM-36). Subyek penelitian merupakan pasien GGK yang menjalani hemodialisis dan mendapatkan terapi obat antihipertensi (OAH), laki-laki dan perempuan, usia lebih dari 18 tahun. Terdapat perbedaan bermakna penurunan tekanan darah sistolik(p=0,011) dan diastolik (p=0,023) untuk setiap terapi OAH, kombinasi 2 OAH memberikan efek penurunan tekanan darah sistolik dan diastolik yang paling baik dan berbeda bermakna (p=0,001). Pengobatan tunggal dan kombinasi dua obat antihipertensi memberikan efek penurunan tekanan darah yang paling baik.Setiap jenis terapi obat antihipertensi tidak memberikan perbedaan bermakna terhadap kualitas hidup kecuali domain aspek efek penyakit (p=0,041). Kata kunci : Hipertensi, gagal ginjal kronik, hemodialisis, antihipertensi, KDQOL, kualitas hidup. 40 ABSTRACT Background: Hypertension is the leading cause of chronic kidney disease (CKD) through a process that resulted in loss of a large number of functional nephron on progressive and irreversible. The Kidney Disease Outcome Quality Initiative (K/DOQI) of The National Kidney Foundation (NKF) recommends a target blood pressure values of < 130/80 mmHg in CKD patients, it can reduce the risk of cardiovascular disease. Objective : The purpose of this study is to understand the antihypertension medication effects to the quality of life of hemodialysis patients in RSUP DR.Hasan Sadikin Bandung. Methods : The design of study is cross sectional observational with concurrent medical record with patients daily status analyses during December 2015 - February 2016 with questionnaire by the Kidney Disease and Quality of Life (KDQOL-36. Results : The analysis result shows significant differences in the reduction of systolic (p=0, 011) and diastolic (p=0, 023) blood pressure in each group of antihypertension therapy. Furthermore, 2 combination of antihypertension therapy gives the most significant different in reduction of systolic and diastolic blood pressure (p=0, 001). Conclusions : Second combination of antihypertension therapy can be reduce of blood pressure better than other therapy. Second combinations of antihypertension therapy is best for decrease of blood pressure and creatinin serum. In all domain of quality of lifes, symptom/problems have a highest score, and burden of kidney disease have a lowest score of quality of life. Keywords : chronic kidney disease, hemodialysis, antihypertension, KDQOL, quality of life

Elevated Endothelin-1 in Intradialytic Hypertension

Objective: To determine the relative change in endothelin-1 (ET-1) during hemodialysis procedure in Stage Five Dialysis-Dependent Chronic Kidney Disease (CKD-5D)patients with and without intradialytic hypertension (IDH).Methods: This was a cross-sectional, observational study involving 40 CKD-5D patients who received two hemodialysis per week for at least three months at the dialysis unit of Dr. Hasan Sadikin Hospital General Bandung, Indonesia during September 2016. Subjects were divided two groups: with IDH (n=20) and without IDH (n=20). Plasma ET-1 level was examined before and after hemodialysis.Results: There was a significant elevation of ET-1 level (mean±SD pg/mL) between pre- and post-dialysis state in patients with IDH (3.33±1.28 vs. 3.84±1.75; relative changes: 15.32%, p=0.013). No change was observed in patients without IDH (3.99±2.30 vs. 4.38±1.81; relative changes: 9.77% p=0.083). The post-dialysis absolute ET-1 level was significantly lower in CKD-5D patients with IDH (3.84±1.75 vs. 4.38±1.81; p=0.024).Conclusion: There was a significant elevation of ET-1 level in CKD-5D patients with IDH during hemodialysis procedure at the dialysis unit of Dr. Hasan Sadikin General Hospital Bandung

Validitas Kidney Injury Molecule-1 Urin Metode Mikro Enzyme-Linked Immunosorbent Assay Sebagai Penanda Dini Gangguan Ginjal Akut pada Sepsis

AAcute kidney injury (AKI) is a rapid decline in renal function marked by increased serum creatinine of ≥0.3 mg/dL or >1.5 times higher than the previous levels or decreased urine output of 0.8 ng/mL presented 96% sensitivity, 60% specificity, 70.6% positive predictive value, 93.8% negative predictive value and 78% accuracy. In conclusion, the level of urinary KIM-1 has high sensitivity and moderate specificity thus can be used for AKI screening in sepsis patients