scholarly journals Karakteristik Pasien Anemia pada End Stage Renal Disease (ESRD) dengan Hemodialisis di Instalasi Hemodialisis RSUD Dr. Soetomo

2022 ◽  
Vol 7 (1) ◽  
pp. 573
Author(s):  
Shella Violita Sambodo ◽  
Nunuk Mardiana

Abstrak Latar belakang: Anemia merupakan salah satu komplikasi yang sering terjadi pada pasien dengan penyakit ginjal kronis dan sering mengakibatkan terjadinya penurunan kualitas hidup pasien, peningkatan morbiditas dan mortalitas pasien, serta meningkatkan laju progresivitas pada PGK. Pada pasien PGK stadium terminal, biasa disebut ESRD. Terapi pengganti ginjal untuk pasien ESRD salah satunya adalah hemodialisis. Tujuan: Untuk mendeskripsikan karakteristik pasien anemia pada ESRD dengan hemodialiasis di Instalasi Hemodialisis RSUD Soetomo Surabaya. Metode: Penelitian ini merupakan penelitian deskriptif observasional dengan metode cross sectional menggunakan data sekunder dari rekam medis pasien di Instalasi Hemodialisis RSUD Dr. Soetomo Surabaya. Hasil: Data dari 80 subjek penelitian, terdapat 17 orang (21,3%) berusia 18-40 tahun, berusia 41-60 dengan jumlah 53 orang (66,3%), dan usia > 60 tahun sebanyak 10 orang (12,5%) dengan hasil rerata usia 48,08 ± 10,598. Berdasarkan jenis kelamin pada pria ada 39 orang (48,8%), dan pada wanita 41 orang (51,2%), rerata jenis kelamin pria 9,46 ± 1,592 dan wanita 9,04 ± 1,329. Jenis penyakit komorbid yang paling banyak adalah hipertensi sebesar 49 orang (61,3%) dan yang paling sedikit adalah penyakit autoimun (lupus) dan glomerulonefritis serta urolithiasis yaitu 2 orang (2,5%).Total Saturasi Transferin (ST) terbanyak dengan kadar ST > 20% sejumlah 52 orang (65%) dan pada ST < 20% sebanyak 28 orang (35%). Subjek penelitian yang mendapatkan terapi eritropoietin (EPO) yaitu terdapat 55 orang (68,75%). Subjek penelitian yang mendapatkan terapi zat besi intravena (IV) sebesar 25 orang (31,25%).                                                                                                                                                                                                  Kesimpulan: Pasien anemia pada ESRD terbanyak pada interval usia 41-60 tahun, dengan jenis kelamin dominan pada wanita, dengan penyakit komorbid terbesar adalah hipertensi, dengan hasil ST dominan yaitu ST > 20, dan terdapat lebih banyak pasien yang menerima terapi EPO dibandingkan dengan menerima terapi zat besi intravena (dialifer). ---- Abstract Background: Anemia is a one of complication that often occurs in patients with chronic kidney disease and often results in a decrease in the patient's quality of life, an increase in patient morbidity and mortality, and an increase in the rate of progression of CKD. In patients with terminal stage CKD, it is known as ESRD. One of the renal replacement therapies for ESRD patients is hemodialysis. Objective: To describe the characteristics of anemia patients in ESRD with hemodialiasis at the Hemodialysis Installation of Dr. Soetomo General Hospital Surabaya. Methods: This research is a descriptive observational study with a cross sectional method using secondary data from the medical records of patients at the Hemodialysis Installation in Dr. Soetomo General Hospital Surabaya. Results: Data from 80 research subjects, there are 17 people (21.3%) aged 18-40 years, aged 41-60 with a total of 53 people (66.3%), and age > 60 years as many as 10 people (12.5 %) with a average age of 48.08 ± 10.598. Based on gender, there were 39 men (48.8%), and 41 women (51.2%), the average gender was 9.46 ± 1.592 for men and 9.04 ± 1.329 for women. The most common type of comorbid disease was hypertension by 49 people (61.3%) and the least was autoimmune disease (lupus) and glomerulonephritis and urolithiasis, namely 2 people (2.5%). ST > 20% a total of 52 people (65%) and on ST <20% as many as 28 people (35%). The research subjects who received erythropoietin (EPO) therapy were 55 people (68.75%). The research subjects who received intravenous (IV) iron therapy were 25 people (31.25%). Conclusion: The most anemia patients in ESRD were at the age interval of 41-60 years, with the dominant gender in women, with the largest comorbid disease being hypertension, with a dominant ST result of ST > 20, and there were more patients receiving EPO therapy compared to receiving intravenous iron therapy (dialifer).        

2005 ◽  
Vol 46 (2) ◽  
pp. 255-264 ◽  
Author(s):  
Kadriye Altok Reis ◽  
Galip Guz ◽  
Hakan Ozdemir ◽  
Yasemin Erten ◽  
Veli Atalay ◽  
...  

RSC Advances ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 1915-1922 ◽  
Author(s):  
Qiong Wu ◽  
Xue-li Lai ◽  
Hong-xia Zhao ◽  
Zhen-yu Zhu ◽  
Zhan-ying Hong ◽  
...  

Anemia is an almost universal complication of chronic kidney disease (CKD), and nearly all patients with end-stage renal disease (ESRD) and approximately 70% of those with earlier stages of CKD receive treatment for anemia.


2017 ◽  
Vol 6 (2) ◽  
pp. 67-73
Author(s):  
Tabassum Samad ◽  
Sarwar Iqbal ◽  
Wasim Md Mohosinul Haque ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
...  

Background: Glomerulonephritis (GN) remains the most probable underlying cause of end stage renal disease of uncertain aetiology in many developing countries including Bangladesh. The pattern of glomerular disease varies widely from country to country. In Bangladesh, the incidence and histological pattern of GN is inadequately described. We performed a study, aiming to determine the pattern of GN in a diabetic hospital of our country.Methods: It was a cross-sectional hospital based prospective study conducted at BIRDEM General Hospital starting from July 2013 to December 2014. It included all patients with suspected GN who underwent native kidney biopsy.Results: Total 57 biopsies were performed and four cases other than primary or secondary GN (renal cortical necrosis 1, tubulointertsitial nephritis 2,chronic GN 1) were excluded i.e total number of PGN was 37 and secondary GN was 16. number of patients with were 53. M:F was 1.2:1.Mean age was 42.35±15(14-72) years. Thirty one (58.49%) of the study subjects had diabetes mellitus (DM). Mesangialproliferative GN (15/37,40.5%) and diabetic nephropathy (9/16,56%) were the commonest histopathological pattern found among primary and secondary GN respectively. Membranoproliferative GN (10/37,27%),was the second commonly observed pattern followed by focal segmental proliferative GN (8%), membranous nephropathy (8%), focal segmental glomerulosclerosis (5.4%) in primary GN and lupus nephritis (6/16,38%) and Wegeners granulomatosis (1/16) were other varieties in secondary group. Among 53 cases, 37 had proliferative variety. Nephrotic range proteinuria (41.5%) was the commonest indication of biopsy and 22% had post biopsy bleeding and 3.7% required blood transfusion.Conclusion: In conclusion, mesangial proliferative and membranoproliferative GN are the two common causes of primary GN. Diabetic nephropathy is the commonest cause of secondary GN. Nephrotic range proteinuria was the main indication of biopsy. Post biopsy complication was negligible. Creation of a national renal registry is essential for obtaining more specific epidemiological data.Birdem Med J 2016; 6(2): 67-73


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Drozd ◽  
M Tkaczyszyn ◽  
K Wegrzynowska-Teodorczyk ◽  
M Kasztura ◽  
M Dziegala ◽  
...  

Abstract Background Large randomized clinical trials have demonstrated that intravenous (IV) iron therapy in iron-deficient patients with heart failure with reduced ejection fraction (HFrEF) brings clinical benefits related to symptoms of the disease and exercise capacity. Mechanisms underlying beneficial effects of such repletion are still the subject of interest as this is not solely related to improved haematopoiesis (IV iron works also in non-anaemic subjects). In patients with chronic heart failure iron deficiency (ID) is linked with inflammatory processess but data regarding the impact of IV iron on inflammation is scarce. Purposes We evaluated whether IV iron therapy affects circulating biomarkers of pro-inflammatory state in men with HFrEF and concomitant ID. Methods This is the sub-analysis of the study to investigate the effects of IV ferric carboxymaltose (FCM) on the functioning of skeletal muscles in men with HFrEF. For the purposes of current research we analyzed data of 20 men with HFrEF (median age 68 (62, 75 – in brackets interquartile ranges, respectively) years, LVEF: 30 (25, 35) %, ischaemic HF aetiology: 85%, NYHA class I/II/III: 30%/50%/20%) and ID (definition according to ESC guidelines - ferritin &lt;100 ng/mL, or ferritin 100–299 ng/mL with transferrin saturation [TSAT] &lt;20%) who were randomized in a 1:1 ratio to receive either the 24-week therapy with IV FCM (dosing scheme as in the CONFIRM-HF trial) or saline (controls). The study was double-blinded. We used ELISA to evaluate different circulating pro-inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], tumor necrosis factor alpha [TNF-α], interleukin 6 [IL-6], interleukin 1 beta [IL-1β], interleukin 22 [IL-22]) at baseline and week 24. Results IV FCM therapy repleted iron stores in men with HFrEF as reflected by an increase in serum ferritin and TSAT, which was not seen in a control group. IV FCM therapy (as well as the saline administration) affected neither haemoglobin concentration nor parameters reflecting iron stores in red cells. Baseline serum ferritin was not related to hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 (all p&gt;0.23). Baseline TSAT was related to hs-CRP (r=−0.47, p=0.02) but not other inflammatory biomarkers. Levels of hs-CRP, TNF-α, IL-6, IL-1β, and IL-22 at week 0 were similar in subjects who received IV iron and controls (all p&gt;0.22). Change from week 0 to week 24 adjusted for baseline value (delta W24-W0 as the percentage of W0) regarding IL-22 was lower in an active treatment arm as compared with saline (p=0.049) and there was a trend towards lower delta TNF-α in FCM group compared to saline (p=0.067). These findings were not valid for other measured pro-inflammatory biomarkers. Conclusions In men with HFrEF and concomitant ID intravenous iron therapy with FCM affects biomarkers of pro-inflammatory state. Clinical relevance of this finding requires further translational research. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): This research was funded by the National Science Centre (Poland) grant allocated on the basis of the decision number DEC-2012/05/E/NZ5/00590


Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1341
Author(s):  
Oliver Phipps ◽  
Hafid O. Al-Hassi ◽  
Mohammed N. Quraishi ◽  
Edward A. Dickson ◽  
Jonathan Segal ◽  
...  

Iron deficiency anemia is a common complication of colorectal cancer and may require iron therapy. Oral iron can increase the iron available to gut bacteria and may alter the colonic microbiota. We performed an intervention study to compare oral and intravenous iron therapy on the colonic tumor-associated (on-tumor) and paired non-tumor-associated adjacent (off-tumor) microbiota. Anemic patients with colorectal adenocarcinoma received either oral ferrous sulphate (n = 16) or intravenous ferric carboxymaltose (n = 24). On- and off-tumor biopsies were obtained post-surgery and microbial profiling was performed using 16S ribosomal RNA analysis. Off-tumor α- and β-diversity were significantly different between iron treatment groups. No differences in on-tumor diversity were observed. Off-tumor microbiota of oral iron-treated patients showed higher abundances of the orders Clostridiales, Cytophagales, and Anaeroplasmatales compared to intravenous iron-treated patients. The on-tumor microbiota was enriched with the orders Lactobacillales and Alteromonadales in the oral and intravenous iron groups, respectively. The on- and off-tumor microbiota associated with intravenous iron-treated patients infers increased abundances of enzymes involved in iron sequestration and anti-inflammatory/oncogenic metabolite production, compared to oral iron-treated patients. Collectively, this suggests that intravenous iron may be a more appropriate therapy to limit adverse microbial outcomes compared to oral iron.


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