Profil Tekanan Darah dan Pola Pemberian Terapi Antihipertensi pada Pasien Gagal Ginjal kronik yang Menjalankan Hemodialisis di Klinik PMI Gamping Yogyakarta Blood Pressure Profile and Pattern of Antihypertension Therapy in Chronic Kidney Failure Patients Undergoing Hemodialysis Clinic PMI Gamping Yogyakarta
Main Article Content
Abstract
Gagal ginjal kronik merupakan penyakit fungsi organ ginjal mengalami penurunan hingga akhirnya tidak lagi mampu bekerja sama sekali dalam hal penyaringan pembuangan elektrolit, menjaga keseimbangan cairan dan zat kimia tubuh (sodium dan kalium). Penelitian ini bertujuan untuk mengetahui profil tekanan darah dan pola pemberian terapi antihipertensi pada pasien gagal ginjal kronik yang menjalankan hemodialisis di Klinik PMI Gamping Yogyakarta periode Oktober sampai Desember 2023. Metode pada penelitian ini bersifat deskriptif kuantitatif mengunakan data retrospektif berupa data rekam medis pasien di Klinik PMI Gamping Yogyakarta periode Oktober-Desember 2023. Teknik sempling yang digunakan adalah total sampling, dengan jumlah sampel 100. Hasil penelitian menunjukan bahwa karakteristik pasien berdasarkan jenis kelamin yang paling banyak laki-laki sebanyak 72 pasien (72%), usia 18-59 tahun sebanyak 63 pasien (63%). Tekanan darah pasien yang memiliki persentase tebanyak adalah pada pre hipertensi dengan rentang angka 120-138/80 mmHg sebanyak 47 pasien (47%). Kesimpulan : Golongan obat yang sering digunakan adalah 2 golongan yaitu ARB + CCB (67,19%).
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
All rights reserved. This publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording.
References
Agarwal, R. (2021). Blood Pressure Management in Hemodialysis Patients: What's the Target? American Journal of Kidney Diseases, 77(2), 167–169. https://doi.org/10.1053/j.ajkd.2020.10.007
Böhm, M., Kober, L., Wachtell, C., Nilsson, P. M., Anker, S., McMurray, J. J. V., Zannad, F., Aronow, W. S., Mahaffey, K. W., Last, C. M., & others. (2021). Blood pressure targets in CKD: A review. Journal of the American College of Cardiology, 77(24), 2931–2945. https://doi.org/10.1016/j.jacc.2021.04.036
Carrero, J. J., Hecking, M., Chesnaye, N. C., & Jager, K. J. (2018). Sex and gender disparities in the epidemiology and outcomes of chronic kidney disease. Nature Reviews Nephrology, 14(3), 151–164. https://doi.org/10.1038/nrneph.2017.181
Cheung, A. K., Rahman, M., Reboussin, D. M., Craven, T. E., Greene, T., et al. (2021). Effects of intensive BP control in CKD. New England Journal of Medicine, 384(7), 610–619. https://doi.org/10.1056/NEJMoa2020443 Ku, E., Lee, B. J., Wei, J., & Weir, M. R. (2019). Hypertension in CKD: Core curriculum 2019. American Journal of Kidney Diseases, 74(1), 120–131. https://doi.org/10.1053/j.ajkd.2018.12.034
Cheung, A. K., Greene, T., & Beddhu, S. (2021). Effects of intensive BP control in CKD. New England Journal of Medicine, 384(7), 610–619. https://doi.org/10.1056/NEJMoa2020443
Flythe, J. E., Xue, H., Lynch, K. E., Curhan, G. C., & Brunelli, S. M. (2014). Association of mortality risk with various definitions of intradialytic hypotension. Journal of the American Society of Nephrology, 26(3), 724–734. https://doi.org/10.1681/ASN.2014020222
Flythe, J. E., Chang, T. I., Gallagher, M. P., et al. (2020). Blood pressure management in patients on dialysis: a review of recent literature. Current Opinion in Nephrology and Hypertension, 29(6), 547–553. https://doi.org/10.1097/MNH.0000000000000631
GBD 2015 Risk Factors Collaborators. (2016). Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks. The Lancet, 388(10053), 1659–1724. https://doi.org/10.1016/S0140-6736(16)31679-8
Harambat, J., van Stralen, K. J., Kim, J. J., & Tizard, E. J. (2012). Epidemiology of chronic kidney disease in children. Pediatric Nephrology, 27, 363–373. https://doi.org/10.1007/s00467-011-1939-1
Hidayati, Nugroho, A. E., & Inayati. (2011). Evaluasi penggunaan terapi anemia pada pasien askes dengan gagal ginjal kronik yang menjalani hemodialisis rutin di RS PKU Muhammadiyah Yogyakarta. Jurnal Manajemen Dan Pelayanan
Iseki, K., Ikemiya, Y., & Fukiyama, K. (2003). Gender differences in the association between hypertension and chronic kidney disease. Hypertension Research, 26(7), 515–519. https://doi.org/10.1291/hypres.26.515
Jha, V., Garcia-Garcia, G., Iseki, K., Li, Z., Naicker, S., Plattner, B., Saran, R., Wang, A. Y. M., & Yang, C. W. (2013). Chronic kidney disease: Global dimension and perspectives. The Lancet, 382(9888), 260–272. https://doi.org/10.1016/S0140-6736(13)60687-X
Kawada, N., Nakamura, M., & Niwa, T. (2020). Protective effect of ARB on renal function in dialysis patients. Hypertension Research, 43(7), 643–650. https://doi.org/10.1038/s41440-020-0403-0
Ku, E., Lee, B. J., Wei, J., & Weir, M. R. (2019). Hypertension in CKD: Core Curriculum 2019. American Journal of Kidney Diseases, 74(1), 120–131. https://doi.org/10.1053/j.ajkd.2018.11.021
Liyanage, T., Ninomiya, T., Jha, V., Neal, B., Patrice, H. M., et al. (2021). Worldwide access to treatment for end-stage kidney disease: A systematic review. The Lancet, 395(10238), 1975–1982. https://doi.org/10.1016/S0140-6736(20)30744-1
Liu, W., Zhang, X., Yuan, Y., Wang, C., & Li, X. (2021). Chronic inflammation and vascular dysfunction in CKD. Kidney International Reports, 6(8), 2022–2031. https://doi.org/10.1016/j.ekir.2021.05.014
Liu, Z., Li, S., & Yang, S. (2019). Comparative safety of antihypertensive drug classes in hemodialysis. Hypertension, 73(6), 1235–1243. https://doi.org/10.1161/HYPERTENSIONAHA.118.12396
Muntner, P., Shimbo, D., Carey, R. M., et al. (2022). Measurement of Blood Pressure in Humans: A Scientific Statement From the American Heart Association. Hypertension, 79(3), e154–e172. https://doi.org/10.1161/HYP.0000000000000203
Mills, K. T., Bundy, J. D., Kelly, T. N., Reed, J. E., Kearney, P. M., Reynolds, K., Chen, J., & He, J. (2016). Global disparities of hypertension prevalence and control: A systematic analysis of population-based studies from 90 countries. Circulation, 134(6), 441–450. https://doi.org/10.1161/CIRCULATIONAHA.115.018912
Nicholas, S. B., Kalantar-Zadeh, K., & Norris, K. C. (2014). Socioeconomic disparities in chronic kidney disease. Advances in Chronic Kidney Disease, 22(1), 6–15. https://doi.org/10.1053/j.ackd.2014.07.002
Ricardo, A. C., Yang, W., Sha, D., Appel, L. J., Chen, J., et al. (2015). Sex-related disparities in CKD progression. Journal of the American Society of Nephrology, 26(7), 1900–1909. https://doi.org/10.1681/ASN.2014070709
Sarafidis, P. A., Persu, A., Agarwal, R., Burnier, M., De Leeuw, P., Ferro, C. J., Jacobs, L., Kanbay, M., Mallamaci, F., Ortiz, A., Rossignol, P., Solerte, S. B., Vanholder, R., Wiecek, A., & London, G. M. (2019). Hypertension in dialysis patients: a consensus document by the European Renal and Cardiovascular Medicine (EURECA-m) working group. Nephrology Dialysis Transplantation, 34(4), 590–602. https://doi.org/10.1093/ndt/gfy382
Shafi, T., Waikar, S. S., & Inker, L. A. (2020). Risks of hyperkalemia with RAAS blockade in HD. American Journal of Kidney Diseases, 76(5), 630–638. https://doi.org/10.1053/j.ajkd.2020.04.023
Sinha, A. D., & Agarwal, R. (2021). Blood Pressure in Dialysis Patients: Recent Trends and Future Directions. Current Hypertension Reports, 23(1), 3. https://doi.org/10.1007/s11906-021-01118-4
Silbiger, S. R., & Neugarten, J. (2008). The impact of gender on the progression of chronic renal disease. American Journal of Kidney Diseases, 25(4), 515–533. https://doi.org/10.1053/ajkd.2008.01.010
Suh, S. H., Lee, J. P., & Joo, K. W. (2023). Management of blood pressure in dialysis patients: A clinical update. Kidney Research and Clinical Practice, 42(1), 1–10. https://doi.org/10.23876/j.krcp.22.123
Supadmi W., (2011). Evaluasi Penggunaan Obat Anti Hipertensi Pada Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisis. Jurnal Ilmiah Kefarmasian;1(1).
Tamura, M. K., Covinsky, K. E., Chertow, G. M., Yaffe, K., Landefeld, C. S., & McCulloch, C. E. (2009). Functional status of elderly adults before and after initiation of dialysis. New England Journal of Medicine, 361(16), 1539–1547. https://doi.org/10.1056/NEJMoa0904655
Yin, Y., He, Q., Chen, C., Zhang, J., & Lin, L. (2020). Dietary sodium intake and blood pressure in dialysis patients. Journal of Renal Nutrition, 30(5), 429–436. https://doi.org/10.1053/j.jrn.2020.01.003
Wadhwa, A., Srinivas, T., & Goggins, W. B. (2021). The role of diuretics in dialysis patients: Still relevant? Clinical Kidney Journal, 14(5), 1200–1208. https://doi.org/10.1093/ckj/sfab050
Wang, Jun; Li, Xian; Zhang, Mei; Chen, Wei; Liu, Hao; and Zhao, Ting. (2022). Combination therapy of CCB and ARB in hemodialysis. Therapeutic Advances in Cardiovascular Disease, 16, 17539447221122462. https://doi.org/10.1177/17539447221122462
Wu, H., Lin, Y., & Chen, X. (2021). Efficacy and safety of amlodipine in hemodialysis patients. Renal Failure, 43(1), 453–460. https://doi.org/10.1080/0886022X.2021.1898860
Zaenurrohmah, H.D., Rachmayanti, D. R. (2017). Hubungan Pengetahuan dan Riwayat Hipertensi Dengan Tindakan Pengendalian Tekanan Darah Pada Lansia. Jurnal Berkala Epidemiologi, 5. (2): 176.
Zhang, L., Wang, F., Wang, L., Wang, W., Liu, B., et al. (2008). Prevalence of chronic kidney disease in China: a cross-sectional survey. The Lancet, 379(9818), 815–822. https://doi.org/10.1016/S0140-6736(12)60033-6
Zhou, Y., Yang, Q., & Zhao, Y. (2020). Effects of calcium channel blockers in hypertensive patients with ESRD: A meta-analysis. BMC Nephrology, 21(1), 109. https://doi.org/10.1186/s12882-020-01756-5