Hubungan Kadar Indoksil Sulfat terhadap Kejadian Kardiovaskular Mayor pada Pasien Penyakit Ginjal Kronis yang Menjalani Hemodialisa di RSUP H. Adam Malik

Abstract

Background. Chronic kidney disease (CKD) affects quality of life and increases mortality risk. Prevalence in Indonesia rose from 0. 2% in 2013 to 0. 3% in 2018. Hemodialysis costs are high. CKD links to immune issues and cardiovascular disease. Uremia changes immune responses, raising infection risks. HDL cholesterol levels impact CKD. Understanding cardiovascular risks in CKD patients is crucial for better outcomes. Thus, this study aim is to assess the association between indoxyl sulfate and major cardiovascular events in chronic kidney disease undergoing hemodyalisis in RSUP H. Adam Malik. Methods. This study is an observational analytic study using a case control approach at H. Adam Malik Hospital. Consecutive sampling was used as the sampling technique in this study. The inclusion criteria of this study were: patients who are willing to become a research sample by signing the research informed consent, patients who are willing to undergo laboratory examination procedures, and patients diagnosed with chronic kidney disease and undergoing hemodialysis. Exclusion criteria for this study were patients with previous history of acute myocardial infarction undergoing PCI or CABG, patients with previous history of cardiac arrest or arrhythmia, and patients with incomplete laboratory test results. The collected data were analyzed using SPSS. Results. The study found 15 females with KKVM and 14 males without it, with no significant statistical difference (p=0. 158). The average age was 55. 4 for KKVM and 47. 8 for non-KKVM, showing a significant difference (p=0. 015). Among 50 patients with CKD stage 5, 29 had KKVM and 21 did not. The average HD duration was 15. 9 years for KKVM and 25. 86 years for non-KKVM, indicating a significant difference (p=0. 005). No significant differences were found in Hb and urea levels (p=0. 914 and p=0. 958), but significant differences in creatinine, urea creatinine ratio, and eGFR were noted (p=0. 014, p=0. 007, p<0. 001). The average Indoxyl Sulfate level was 2. 0±0. 5x103 for KKVM and 1. 6±0. 2x103 for non- KKVM, with a significant difference (p<0. 001). A significant statistical relationship between indoxyl sulfate levels and major cardiovascular events was found (p=0. 001). Conclusion. we found a significant relationship between indoxyl sulfate and major cardiovascular events.