Gambaran Kejadian Perdarahan Saluran Cerna pada Pasien Penyakit Ginjal Kronik di RSUP Dr. M. Djamil Padang

Asrining, Tyas (2019) Gambaran Kejadian Perdarahan Saluran Cerna pada Pasien Penyakit Ginjal Kronik di RSUP Dr. M. Djamil Padang. Diploma thesis, Universitas Andalas.

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Abstract

ABSTRACT DESCRIPTION OF GASTROINTESTINAL BLEEDING IN CHRONIC KIDNEY DISEASE PATIENT AT RSUP Dr. M. DJAMIL PADANG By Asrining Tyas Chronic kidney disease (CKD) can cause gastrointestinal bleeding (GI bleeding). The incidence and mortality of GI bleeding in CKD patients is higher than in general population. The effect of GI bleeding is very serious because decrease in blood pressure due to bleeding will decrease the glomerulus filtration rate, which means it worsens CKD. The purpose of this study is to describe the incidence of GI bleeding in CKD patients. This research was a cross-sectional descriptive study by collecting medical record data of patients with CKD stage 4 and 5 who were hospitalized at RSUP Dr. M. Djamil Padang during the period January–December 2018. Sampling technique using simple random sampling. Sample consisted of 207 patients that included in inclusion and exclusion criterias taken from 395 patients with CKD stage 4 and 5. Data analysis used univariate analysis and presented by distribution tables. This study showed that most CKD patients were stage 5 (94.2%), male sex (59.9%), age group 50–59 years (31.4%), serum urea levels 101–200 mg/dL (44.9%), anemia (96.6%), and routine hemodialysis (56.0%). The serum urea level of stage 4 CKD patients was 124.5 + 93.7 mg/dL, while stage 5 was 191.0 + 103.2 mg/dL. This study showed 11.6% (24/207) of CKD patients experienced a GI bleeding. The percentage of GI bleeding is higher in stadium 5 than stadium 4 (11.8% : 8.3%), male than female (12.1% : 10.8%), serum urea level >400 mg/dL (38.5%), anemia than non-anemia (12.0% : 0.0%), routine hemodialysis than non-routine hemodialysis (12.7% : 11.0%), and 100% consist of upper GI bleeding with the most manifestations depending on melena (41.7%). The serum urea level of CKD patients who experienced a GI bleeding was 277.8 + 134.9 mg/dL, while patients who did not experience GI bleeding were 176.3 + 103.2 mg/dL. Keywords: CKD, stadium, sex, age, serum urea level, anemia, hemodialysis, gastrointestinal bleeding   ABSTRAK GAMBARAN KEJADIAN PERDARAHAN SALURAN CERNA PADA PASIEN PENYAKIT GINJAL KRONIK DI RSUP Dr. M. DJAMIL PADANG Oleh Asrining Tyas Penyakit ginjal kronik (PGK) dapat menyebabkan perdarahan saluran cerna (PSC). Insidens dan mortalitas PSC pada pasien PGK lebih tinggi dibanding populasi umum. Efek PSC sangat serius karena penurunan tekanan darah akibat perdarahan akan semakin menurunkan laju filtrasi glomerulus yang berarti semakin memperburuk PGK. Penelitian ini bertujuan mendeskripsikan kejadian PSC pada pasien PGK. Jenis penelitian ini adalah deskriptif cross sectional menggunakan data rekam medis pasien PGK stadium 4 dan 5 rawat inap RSUP Dr. M. Djamil Padang periode Januari–Desember 2018. Teknik pengambilan sampel menggunakan simple random sampling. Sampel berjumlah 207 orang yang memenuhi kriteria inklusi dan eksklusi dari 395 orang pasien PGK stadium 4 dan 5. Analisis data berupa analisis univariat dan disajikan dalam bentuk tabel distribusi. Penelitian ini menunjukkan pasien PGK terbanyak adalah stadium 5 (94,2%), jenis kelamin laki-laki (59,9%), kelompok usia 50–59 tahun (31,4%), kadar ureum serum 101–200 mg/dL (44,9%), anemia (96,6%), dan hemodialisis rutin (56,0%). Kadar rerata ureum serum pasien PGK stadium 4 adalah 124,5 + 93,7 mg/dL, sedangkan stadium 5 adalah 191,0 + 103,2 mg/dL. Penelitian menunjukkan 11,6% (24/207) pasien PGK mengalami PSC. Persentase PSC lebih tinggi pada stadium 5 dibanding stadium 4 (11,8% : 8,3%), laki-laki dibanding perempuan (12,1% : 10,8%), kadar ureum serum >400 mg/dL (38,5%), anemia dibanding non-anemia (12,0% : 0,0%), hemodialisis rutin dibanding non-hemodialisis rutin (12,7% : 11,0%), dan 100% mengalami PSC bagian atas dengan manifestasi terbanyak berupa melena (41,7%). Kadar rerata ureum serum pasien PGK yang mengalami PSC adalah 277,79 + 134,92 mg/dL, sedangkan pada pasien yang tidak mengalami PSC adalah 176,27 + 103,17 mg/dL. Kata kunci: PGK, stadium, jenis kelamin, usia, kadar ureum serum, anemia, hemodialisis, perdarahan saluran cerna

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