Hubungan Kadar Produk Kalsium Fosfas terhadap Variabilitas Pulse Pressure pada Pasien Hemodialisis Rutin di RS Haji Adam Malik

Abstract

Background: Patients with chronic kidney disease undergoing maintenance hemodialysis are at high risk for cardiovascular complications, which remain the leading cause of mortality in this population. Disturbances in mineral metabolism, particularly elevated calcium–phosphate product (Ca×P), play a critical role in vascular calcification, leading to increased arterial stiffness. This condition contributes to elevated pulse pressure (PP), a well-established marker of vascular dysfunction and a strong predictor of cardiovascular events in hemodialysis patients. Objective: This study aimed to evaluate the association between serum calcium–phosphate product and pulse pressure in patients undergoing routine hemodialysis at Haji Adam Malik General Hospital, Medan. Methods: This study employed an observational analytic cross-sectional design. Participants were chronic kidney disease patients receiving routine hemodialysis who met the inclusion criteria. Data collected included demographic characteristics, serum calcium levels, serum phosphate levels, calcium–phosphate product values, and pulse pressure measurements. Statistical analyses were performed to assess the relationship between calcium–phosphate product and pulse pressure. Results: The findings demonstrated a significant association between serum calcium–phosphate product and pulse pressure in patients undergoing routine hemodialysis. Higher calcium–phosphate product levels were associated with increased pulse pressure, reflecting greater vascular stiffness. Conclusion: There is a significant relationship between calcium–phosphate product and pulse pressure in routine hemodialysis patients at Haji Adam Malik General Hospital. Optimal control of calcium and phosphate levels may play an important role in reducing cardiovascular risk in this high-risk population. Keywords: chronic kidney disease, hemodialysis, calcium–phosphate product, pulse pressure, cardiovascular disease