HITHUNGAN STA.TUS VOLUME DAIN TEKANAN DARAH PENDERITA HEMODIALISIS KRONIK RS. DR KARIADI SEMARANG

Abstract

BACKGROUND: Cardiovascular disease is still the major cause of mortality to chronic hemodialySispatients. Hypertension is considered to play an important role in the mortality of cadiovaseular disease. Some effort arc carried out to decrease blood pressure , and one of them is volume status ( intradilytic plasma volume decrease) concept. For the time being the relationship between volume status and blood pressure in chronic hemodialysis patients remains incompletely understood. OB.TE'CTIVE : This research is done to asses the relation between volume status and blood pressure before, during and after hcmodialysis in chronic hcmodialysis patients. METHODS : Cohort method is used in this research. Samples were taken from 34 subjects, 61,89 % were man, 38,2 % were women, with average age of 48,18 ± 10,51 (mean ± SD), all of them are Javanese. Next vital sign , body weight, ECG , physical examination , blood samples were taken to measure from predialytic to postdialytic. RESULTS: Research " Relation volume status and blood pressure hemodialysis chronic patients" was included 34 subjects, 61,8% male, 38,2% female, and average age 48,2 ± 10,5 years, all of them are Javanese. Length of hcmodialysis average taken by patients was 11,8 ± 13,1 months, frequency of hemodialysis twice a week except one patient one a week only, duration average 4,2 ± 0,3 hours , and 58% patients have taken hypertension drugs before hemodialysis. Systolic blood pressure average was 161,8 ± 22,4 mmHg, postdialytic blood pressure was 159,1 ± 27,0 mmHg, predialytic diastolic blood pressure average was 100,4 ± 14,7 mmHg, postdialytic diastolic blood pressure was 92,9 ± 12,1 mmHg. Predialytic body weight average was 55,9 ± 13,0 kilogram, postdialytic body weight was 53,9 ± 12,6 kilogram. Relationship between volume status at fifth and diastolic blood pressure at fifth too (p < 0,05). Relationship between volume status and difference of body weight (p < 0,001). Relationship between volume status and difference of systolic blood pressure at 0-4 and 0-5 hour. CONCLUSION: In this research postdialytic volume status was correlation with _postdialytic diastolic_bood_pressurein_chronic_hemodialysis_patients. Latar Belakang Penyakit kardiovaskular merupakan penyebab utama kematian penderita hemodialis kronik Hipertensi berperan besar terhadap kematian akibat penyakit kardiovaskular. Upaya menurunkan tekanan darah dicapai melalui pengetahuan konsep status volume (penurunan volume plasma intradialitik), sementara hubungan status volume dan tekanan dara:i penderita hemodialisis kronik belum sepenuhnya dipahami. Tujuan Penelitian ini bertujuan menilai hubungan status volume dan tekanan darah sebelum, selama dan sesudah hemodialisis pada pasien hemodialisis kronik. Metodologi Penelitian ini dilakukan dengan metode kohort. Jumlah sample terpilih 34 orang kemudian dilakukan pemeriksaan tanda vital, berat badan, EKG, keadaan umum, anamncsis pengisian kucsioncr scrta sampc1 darah dari predialitik sampai postdiai itik, Flash : Pada penelitian Hubungan status volume dan tekanan darah penderita hemodialisis kronik " meliputi 34 responden 61,8% laki-laki, 38,2% wanita, rerata umur 48,2 ± 10,5 th, semua sub Jawa. Rerata lama hemodialis responden 11,8 ± 13,1 bulan, rerata frekwensi hemodialisis 2x /mg kccuali satu orang respond= lx/mg, rerata durasi hemodialisis 4,2 ± 0,3 jam dan responden yang minum obat anti hipertensi sebelum hemodialisis 58%. Rerata tekanan sistolik predialitik 161,8 ± 22,4 mmHg, postdialitik jam ke 5 : 159,1 ± 27,0 mmHg , diastolik predialitik 100,4 ± 14,7 mmHg, postdialitik jam ke 5 : 92.9 ± 12,1 mmHg . Rerata berat badan predialitik 55,9 ±13,0 kg, postdialitik 53,9 ± 12,6 kg, sedangkan rerata dosis dialisis/ UFG 2,1± 1,2 cc, rcrata kccepatan ultratilfrasi/ UFR 0,4 ± 0,3 ml/ jam. Hubungan status volume jam ke 5 dan tekanan darah diastolik jam ke 5 (p <0,05). Hubungan status volume jam ke 5 dan delta berat badan (p < 0,001) Hubungan status volume dan delta sistolik jam 0 — 4 dan jam 0 — 5 (p < 0,05). Kesimpulan : Pada penelitian ini status volume jam ke 5 akhir hemodialisis berhubungan dengan tekanan diastolik pada akhir hemodialisis.