Hubungan Kadar Hemoglobin dan Albumin Dengan Hs-CRP Pada Pasien Hemodialisis
Article Sidebar
Main Article Content
Abstract
Pasien hemodialisis mengalami inflamasi kronik sejak sebelum menjalani hemodialisis yang dapat meningkatkan morbiditas dan mortalitas. Pasien penyakit ginjal stadium akhir mengalami penurunan produksi eritropoietin yang akan menyebabkan anemia. Penurunan produksi erithropoietin disebabkan karena terjadi peningkatan sitokin proinflamasi Peningkatan sitokin proinflamasi akan menurunkan nafsu makan dan meningkatkan katabolisme tubuh. Tujuan penelitian ini untuk mengetahui hubungan antara serum albumin dan hemoglobin dengan hs-CRP sebagai penanda inflamasi dari pasien hemodialisis. Penelitian ini merupakan penelitian cross-sectional yang dilakukan pada 54 subjek penelitian (27 perempuan dan 27 laki-laki) pada dua unit hemodialisis yang ada di Kendal, Indonesia. Serum albumin diperiksa menggunkana metode Brom Cresol Purple (BCP), serum hs-CRP diukur menggunakan metode Enzyme Linked Immunosorbent Assay (ELISA) dan serum hemoglobin menggunakan metode sianmethemoglobin. Data dianalisis menggunakan uji korelasi Pearson. Hasilnya menunjukkan 55,6 persen mempunyai serum hs-CRP > 3 mg/L yang menunjukkan risiko tinggi inflamasi. Rentang nilai serum hs-CRP 0,29-19,5 mg/L. Sebagian besar (90,7%), mengalami anemia. Rerata serum hemoglobin 9,107±1,7272 gr/dl. Anemia berat terjadi pada 5,6 persen subjek. Subjek penelitian yang mempunyai serum albumin rendah sebesar 66,7 persen. Rerata serum albumin 3,33±0,3276 mg/dl. Analisa bivariat menunjukkan hubungan negatif tidak bermakna antara serum albumin dengan hs-CRP (p= 0,528,r=-0,088). Serum hemoglobin menunjukkan hubungan negatif tidak bermakna dengan serum hs-CRP (p= 0,390, r=-0,119)
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Pusat Data dan Informasi Kesehatan Kementrian Kesehatan Republik Indonesia. Situasi Penyakit Ginjal Kronis. Jakarta Selatan; 2017.
Hill et al. Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis. PLoS One. 2016:1-18. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0158765&type=printable.
Kementrian Kesehatan Republik Indonesia. 9th Annual report of Indonesian Renal Registry. In: Jakarta; 2016:1-46.
Himmelfarb J, Sayegh MH. Chronic Kidney Disease : Definition, Epidemiology, Cost, and Outcomes. In :Chronic Kidney Disease, Dialysis and Transplantation. 3rd ed. America: Saunders elsevier; 2010.
KK Z, Gladys B, MM A, JD K. Malnutrition inflammation complex syndrome in dialysis patients: causes an consequency. Am J Kidney Dis. 2012;69(3):864-881. doi:10.1053/S0272-6386(03)01005-9.
Lu D, Edyta G, Bengt L, Stevinkel Peter. End stage renal disease, inflammation and cardiovascular outcomes. Contrib Nephrol. 2017;191:32-43.
Stevinkel P. Inflammation in end stage renal disease a fire that burns within. Contrib Nephrol. 2005;149:185-199.
Zoccali C, Mallamaci F, Tripepi G. Inflammation and atherosclerosis in end stage renal disease. Blood Purif. 2003;21(pp):29-36.
Zadeh K, Kopple J, Block G. A malnutrition-inflammation score correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis. 2001;38:1251-1263.
Veisa G, Donciu M, Segall L, et al. Albumin as a Prognostic Factor for Malnutrition and Inflammation in Chronic Kidney Disease. :103-105.
Garcez AM, Frederico J, Pacheco R, et al. Hypoalbuminemia and oxidative stress in patients on renal hemodialysis program. Nutr Hosp. 2014;30(4):952-959. doi:10.3305/nh.2014.30.4.7667.
Honda H, Qureshi A, Heimburger O. Serum albumin, C-reaktive protein, Interleukin 6 and fetuin a as predictors of malnutrition, cardiovasculer disease, and mortality in patient with ESRD. Am J Kidney Dis. 47AD;2006:139-148.
Chonchol M, Lippi G, Montagnana M, Muggeo M, Targher G. Association of inflammation with anaemia in patients with chronic kidney disease not requiring chronic dialysis. Nephrol Dial Transplant. 2008;23(9):2879-2883. doi:10.1093/ndt/gfn109.
Stevinkel P. The role of inflammation in the anemia of end stage renal disease. Nephrol Dial Transpl. 2001;16:36-40.
James N, Parker M, Philip M. Albumin. Vol 10. 10th ed. (Philip MP, ed.). United States of America: Philip Parker; 2004.
National Kidney Foundation. KDOQI Clinical practice guidlines and clinical practice recommendation for anemia in chronic kidney disease: 2007. Updatr of hemoglobin. Am J Kidney Dis. 2007;50(3):471-530.
Wamer C, Zimmermann J, Schwedler S, Metzger T. Inflammation and Cardiovascular risk in dialysis patients. Kidney Int. 2002;61:99-102.
Hecking M, Biebers BA, Ethier J, Willer AK, Sunder G, D PM. Sex-specific differences in hemodialysis prevalence and practices and the male to female mortality rate : The dialysis outcomes and practice patterns study ( DOPPS). PLOS Med. 2014;11(10). doi:10.1371/journal.pmed.1001750.
Goldberg I, Krause I. the Role of Gender in Chronic Kidney Disease. Cit EMJ. 2016;1(2):58-64.
Kopple J., Shaul MG, Zadeh K. Nutritional Mangement of Renal Disease. 3rd ed. United State of America: Elsevier; 2013.
Kopple JD, Massry SG, Zadeh KK-. Nutritional Management of Renal Disease. USA: Elsevier; 2013. http://booksite.elsevier.com/9780123919342.
Jonathan H, Mohamed S. Chronic Kidney Disease, Dialysis, and Transplantation. America; 2009.
Steven L. Prevalence of Chronic Kidney Disease and Comorbid Illness in Elderly Patients in United States: Result From the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2010;55(3):S23-S33.
Mcquillan R, Lilyanna T, Fenton S, Charmaine E. Modifiable risk factor for early mortality on hemodialisis. Int J Nephrol. 2012.
Farida LS, Thaha M, Susanti D. Characteristics of Patients with End-Stage Renal Disease at Dialysis Unit Dr. Soetomo General Hospital Surabaya. Biomol Heal Sci. 2018;01(02):97-100.
Pernefri. 8 Th Report Of Indonesian Renal Registry 2015. Jakarta; 2016.
Sarnak M, Levely A, Schoolwerth A, Coresh J, Culleton B, Hamm L. Kidney disease as a risk factor for development of cardiovascular disease. Circulation. 2003;108(pp):2154-2169.
Beddhu S, Brun F, Saul M, Seddon P, Zeidei M. A Simple comorbidity sale predicts clinincal outcome and cost in dialysis patient. Am J Med. 2000;1088:609-613.
Braga S, Peixoto S, Gomes I, Acurcio F, Andrade E, Cherchiglia. Factors associated with healthrelated quality of life in elderly patients on hemodialysis. Rev Saude Publica. 2011;45(6).
BS S, G P, MG N, KC G. An assessment of the quality of life in hemodialysis patients using the WHOQOLBRF questionnaire. Indian J Nephrol. 2010.
Rocco M. KDOQI clinical practice quidline for hemodialysis adquacy: 2015 update abstract university of minnesota department of medicine. AJKD. 2015;66(5):884-930.
Saeed A, Bjorkander E, Carlstrom J, et al. Hemodialysisi twice versus three times a week in patients with residual kidney function : quality of life, cardiovascular outcomes and mortality. HTA -report. 2014:12-22.
Sanjay R, Kumar Y, Babu K, Hedge S, Ballal S, Tatu U. Evaluation of the role of serum leptin in hemodyalisis patients. Indian J Nephrol. 2002;12:69-72
Libetta C, Sepe V, Esposito P, Galli F. Oxidative stress and inflamamation: implication in uremia and hemodialysis. Clin Biochem. 2011;44:1189-1198.
Montazerifar F, Karajibani M, Hassanpour Z, Pourmofatteh M. Study of Serum Levels of Leptin , C-Reactive Protein and Nutritional Status in Hemodialysis Patients. Iran Red Crescent Med. 2015;17(8). doi:10.5812/ircmj.26880.
Bamgbola F, Kaskel F. Uremic malnutrition inflammation syndrome in chronic renal disease : a pathobiologic entity. J Ren Nutr. 2003;13:250-258.
Kalantar-zadeh K, Stenvinkel P, Pillon L, Kopple JD. Inflammation and Nutrition in Renal Insufficiency. Adv Ren Replace Ther. 2003;10(3):155-169. doi:10.1053/j.arrt.2003.08.008.
Bakris G. Prevalence and associations of anemia of CKD: Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES). Am J Kidney Dis. 2008;5:s46-s55.
Gahong W, McPhee S. Appetide and inflammation, nutrition, anemia and clinical outcome in haemodialysis patients. Am J Clin Nutr. 2010;80(1):299-307.
KDIGO. Red cell transfusion to treat anemia in CKD. Kidney Int Suppl. 2012;311-6.
National Kidney Foundation (NKF) Kidney Disease Outcome Quality Initiative. Advisory Board: K/DOQI clinical practice guideline for chronic kidney disease: evaluation, classification, and stratification. Kidney Disease Outcome Quality Initiative. Am J Kidney Dis. 2002;17:s19-s28.
E S. Nefrologi Klinik. Bandung: Fakultas Kedokteran Universitas Padjadjaran; 2006.
Kaysen G, Dubin J, Muller H. Relationships among inflammation nutrition and physiologic mechanisms establishing albumin levels in hemodyalisis patient. Kidney Int. 2002;61:2240-2249.
Vandana M, Tom G, Xuelei W, Arema A. C-reactive protein and albumin as predictors of all-cause and cardiovascular mortality in chronic kidney disease. Kidney Int. 2005;68:766-772. doi:10.1111/j.1523-1755.2005.00455.x