Gambaran dan Luaran Klinik Terapi Anemia Pada Pasien Chronic Kidney Disease Dengan Hemodialisis Di RS PKU Muhammadiyah Yogyakarta
Nurfina Dian Kartikawati(1*), Tri Murti Andayani(2), Dwi Endarti(3)
(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(3) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(*) Corresponding Author
Abstract
Adanya penurunan fungsi pada ginjal dapat mempengaruhi proses eritropoiesis yang beresiko terjadinya anemia. Prevalensi anemia meningkat seiring meningkatnya stage penyakit ginjal kronik. Penelitian ini untuk melihat gambaran terapi anemia dan luaran klinis terapi eritropoetin pada pasien CKD dengan hemodialisis di RS PKU Muhammadiyah Yogyakarta. Penelitian dilakukan dengan design cohort retrospektif secara observasional-analitik. Kriteria inklusi berupa pasien dengan usia >18 tahun, pasien penyakit ginjal kronik stage 4 dan 5 yang menjalani rawat jalan dan hemodialisis rutin minimal selama 3 bulan dengan kondisi yang stabil, pasien dengan diagnosis anemia normositik normokromik dan mendapatkan terapi anemia berupa eritropoetin, tersedia data rekam medis. Pengumpulan data dilakukan dilakukan selama 3 bulan berdasarkan rekam medis periode Januari – Desember 2020. Analisis statistik independent t-test dilakukan untuk membandingkan perbedaan peningkatan kadar Hb antara eritropoetin alfa dan beta dalam 3 bulan. Terdapat 113 pasien memenuhi kriteria inklusi. Karakteristik pasien didominasi pasien laki-laki (58%); rentang usia 41-60 tahun (44%); CKD stage V (98%); frekuensi hemodialisis 2x setiap minggu (92%); dan terapi menggunakan epoetin alfa (85%). Rata-rata nilai Hb selama 3 bulan pada kelompok epoetin beta (9,51 mg/dl) lebih tinggi dibandingkan pada kelompok epoetin alfa (8,73 mg/dl) dan berbeda signifikan secara statistik (p<0,005).
Keywords
Full Text:
PDFReferences
Fishbane S, Spinowitz B. Update on Anemia in ESRD and Earlier Stages of CKD: Core Curriculum 2018. American Journal of Kidney Diseases. 2018;71(3):423-435. doi:10.1053/j.ajkd.2017.09.026 2. Jing Z, Wei-jie Y, Nan Z, Yi Z, Ling W. Hemoglobin Targets for Chronic Kidney Disease Patients with Anemia: A Systematic Review and Meta-analysis. James LR, ed. PLoS ONE. 2012;7(8):e43655. doi:10.1371/journal.pone.0043655 3. WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization. Published online 2015. Accessed June 5, 2021. http://apps.who.int/iris/bitstream/handle/10665/177094/9789241564960_eng.pdf;jsessionid=AD3FE29D9F969720229498470F335E52?sequence=1 4. KDIGO. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Published online 2012. 5. Cases A, Egocheaga MI, Tranche S, et al. Anemia of chronic kidney disease: Protocol of study, management and referral to Nephrology. Nefrología (English Edition). 2018;38(1):8-12. doi:10.1016/j.nefroe.2018.01.007 6. Zadrazil J, Horak P. Pathophysiology of anemia in chronic kidney diseases: A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(2):197-202. doi:10.5507/bp.2013.093 7. Fassett RG, Venuthurupalli SK, Gobe GC, Coombes JS, Cooper MA, Hoy WE. Biomarkers in chronic kidney disease: a review. Kidney International. 2011;80(8):806-821. doi:10.1038/ki.2011.198 8. PERNEFRI. Konsensus Manajemen Anemia Pada Penyakit Ginjal Kronik. Published online 2011. 9. Kandarini Y. Penatalaksanaan Anemia Pada Penyakit Ginjal Kronik. In: ; 2017. 10. Del Vecchio L, Locatelli F. An overview on safety issues related to erythropoiesis-stimulating agents for the treatment of anaemia in patients with chronic kidney disease. Expert Opinion on Drug Safety. 2016;15(8):1021-1030. doi:10.1080/14740338.2016.1182494 11. Dowling TC. Prevalence, etiology, and consequences of anemia and clinical and economic benefits of anemia correction in patients with chronic kidney disease: An overview. American Journal of Health-System Pharmacy. 2007;64(13_Supplement_8):S3-S7. doi:10.2146/ajhp070181 12. O’Mara NB. Anemia in Patients With Chronic Kidney Disease. Diabetes Spectrum. 2008;21(1):8. 13. Collister D, Komenda P, Hiebert B, et al. The Effect of Erythropoietin-Stimulating Agents on Health-Related Quality of Life in Anemia of Chronic Kidney Disease: A Systematic Review and Meta-analysis. Ann Intern Med. 2016;164(7):472. doi:10.7326/M15-1839 14. Escudero-Vilaplana V, Martínez-Nieto C, López-Gómez JM, Vega-Martínez A, Bellón-Cano JM, Sanjurjo-Sáez M. Erythropoiesis-stimulating agents in anaemia due to chronic kidney disease: a cost-minimization analysis. Int J Clin Pharm. 2013;35(3):463-468. doi:10.1007/s11096-013-9774-z 15. Prasetya AANPR, Suprapti B, Shanti BD. Effectivity of Erythropoietin Alpha Compared to Erythropoietin Beta in Patients with Chronic Kidney Disease-Anemia on Hemodialysis. FMI. 2019;55(2):82. doi:10.20473/fmi.v55i2.14330 16. Okada K, Yanai M, Takeuchi K, et al. Sex Differences in the Prevalence, Progression, and Improvement of Chronic Kidney Disease. Kidney Blood Press Res. 2014;39(4):279-288. doi:10.1159/000355805 17. Jafar TH. The rate of progression of renal disease may not be slower in women compared with men: a patient-level meta-analysis. Nephrology Dialysis Transplantation. 2003;18(10):2047-2053. doi:10.1093/ndt/gfg317 18. International Society of Nephrology. Definition and classification of CKD. Kidney Int Suppl (2011). 2013;3(1):19-62. doi:10.1038/kisup.2012.64 19. Mallappallil M, Friedman EA, Delano BG, McFarlane SI, Salifu MO. Chronic kidney disease in the elderly: evaluation and management. Clin Pract (Lond). 2014;11(5):525-535. doi:10.2217/cpr.14.46 20. CDC. Chronic Kidney Disease in the United States 2021. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention. Published online 2021:4. 21. USRDS. Unites States Renal Data System Annual Data Report 2020. USRDS. Published 2020. Accessed December 6, 2021. https://adr.usrds.org/ 22. Adiatma DC. Prevalensi dan Jenis Anemia Pada Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis Reguler (Studi Di RSUP Kariadi Semarang). Jurnal Media Medika Muda. Published online 2014:16. 23. Gunaseelan R, Surudarma IW, Wihandani DM, Sutadarma IWG. Prevalence of anemia on chronic kidney disease and its influenced factors in Sanglah General Hospital 2015-2017, Bali. Intisari Sains Medis. 2020;11(1):248. doi:10.15562/ism.v11i1.247 24. Tania F, Thabrany H. Biaya dan Outcome Hemodialisis di Rumah Sakit Kelas B dan C. jurnaleki. 2017;1(1). doi:10.7454/eki.v1i1.1763 25. BPJS. BPJS Kesehatan Kembangkan Sistem Penyederhanaan Prosedur Hemodialisa. Published January 25, 2020. Accessed May 24, 2022. https://www.bpjs-kesehatan.go.id/bpjs/post/read/2020/1420/BPJS-Kesehatan-Kembangkan-Sistem-Penyederhanaan-Prosedur-Hemodialisa 26. Hidayati, Nugroho AE, Inayati. Evaluasi Penggunaan Terapi Anemia Pada Pasien ASKES Dengan Gagal Ginjal Kronik Yang Menjalani Hemodialisi Rutin Di RS PKU Muhammadiyah Yogyakarta. Jurnal Manajemen dan Pelayanan Farmasi. 2011;Vol. 1 No. 3:147-152. 27. Mafazadara D. Studi Penggunan Epoetin Alfa Dan Epoetin Beta Pada Pasien Penyakit Ginjal Kronik Yang Menjalani Hemodialisis. Universitas Brawijaya; 2015. Accessed May 17, 2022. https://repository.unair.ac.id/19949/2/2.%20ABSTRAK%20.pdf 28. Widianti C, Anggriani Y, Kusumaeni T, Meila O. Analisis Efektivitas Biaya Penggunaan Eritropoetin (HEMAPO® , EPOTREX®, NEORECORMON®) Pada Pasien Hemodialisis Di RSUP Persahabatan. Published online 2018:5. 29. Sihombing JP. Cost Effectiveness Analysis Eritropoetin α Ddibandingkan dengan Eritropoetin β Pada Pengobatan Anemia Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisa Rutin. Universitas Gadjah Mada. Published online 2019:202. 30. Alvionita A, Ayu WD, ... Pengaruh Penggunaan Asam Folat terhadap Kadar Hemoglobin Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis Di RSUD Abdul Wahab Sjahranie. Journal of Tropical …. Published online 2016. http://jtpc.farmasi.unmul.ac.id/index.php/jtpc/article/view/104 31. Capelli I, Cianciolo G, Gasperoni L, et al. Folic Acid and Vitamin B12 Administration in CKD, Why Not? Nutrients. 2019;11(2):383. doi:10.3390/nu11020383 32. de Boer IH, Caramori ML, Chan JCN, et al. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International. 2020;98(4):S1-S115. doi:10.1016/j.kint.2020.06.019 33. Carson JL, Guyatt G, Heddle NM, et al. Clinical Practice Guidelines From the AABB: Red Blood Cell Transfusion Thresholds and Storage. JAMA. 2016;316(19):2025. doi:10.1001/jama.2016.9185 34. Banzi R, Gerardi C. Application for Erythropoietin-Stimulating Agents (Erythropoietin Type Blood Factors) Version 3. Vol Version 3. (Bertele V, Garattini S, Schieppati 2 Arrigo, eds.). WHO EML 2016-2017; 2016. Accessed July 13, 2021. https://www.who.int/selection_medicines/committees/expert/21/applications/s10_erythropoietins_add.pdf?ua=1
DOI: https://doi.org/10.22146/farmaseutik.v19i1.74877
Article Metrics
Abstract views : 2364 | views : 4192Refbacks
- There are currently no refbacks.