Hubungan Kadar Fibroblast Growth Factor-23 (FGF-23) dengan Restless Leg Syndrome pada Pasien Hemodialisis Reguler

Abstract

Introduction : Restless Legs Syndrome (RLS) is one of the most common sleep disturbance problems in dialysis patients. In this study, we would like to explore some of bone and mineral marker disorder especially fibroblast growth factor-23 (FGF-23)and its correlation with RLS in regular hemodialysis patients. Methods : This is a cross sectional study design involving 71 respondents with chronic kidney disease that already had regular hemodialysis at Haji Adam Malik Hospital Medan. Status of RLS in this patients were being evaluated according to the International Restless Leg Syndrome Study Group (IRLSG) by interviewing and laboratory examination of FGF-23, hemoglobin (Hb), serum iron (SI), total iron binding capacity (TIBC), transferrin saturation (TSAT), serum ferritin, calcium (Ca) and phosphate (P) level.. Results : Of all study subjects, 26 respondents (34.6%) diagnosed with RLS. Bivariate analysis result showed that there is a relationship between FGF-23, hemoglobin, phosphate, and transferrin saturation level with RLS. Logistic regression analysis used to see the most dominant factor of all. Conclusion : This study conclude that increase in FGF-23 levels can increase the risk of RLS. However, FGF-23 is not the most dominant risk factor for RLS in regular hemodialysis patients.

Latar Belakang : Restless Legs Syndrome (RLS) merupakan salah satu gangguan tidur yang pali ng sering dijumpai pada pasien dialysis. Pada penelitian ini, kami ingin mengesksplorasi beberapa penanda gangguan tulang dan mineral terutama fibroblast growth factor-23 (FGF-23) dan hubungannya dengan RLS pada pasien hemodialisis reguler. Metode : Penelitian cross sectional ini melibatkan 71 responden dengan penyakit ginjal kronis yang sudah menjalani hemodialisis rutin di Rumah Sakit Haji Adam Malik Medan. Status RLS pada pasien ini dievaluasi sesuai dengan International Restless Leg Syndrome Study Group (IRLSG) melalui wawancara dan pemeriksaan laboratorium FGF-23, hemoglobin (Hb), besi serum (SI), total iron binding capacity (TIBC), saturasi transferrin (TSAT), serum ferritin, kalsium (Ca) dan tingkat fosfat (P). Hasil : : Dari semua subjek penelitian, 26 responden (34,6%) didiagnosis dengan RLS. Hasil analisis bivariat menunjukkan bahwa ada hubungan antara FGF-23, hemoglobin, fosfat, dan tingkat saturasi transferrin dengan RLS. Analisis regresi logistik digunakan untuk melihat faktor yang paling dominan dari semuanya. Kesimpulan : Peningkatan kadar FGF-23 dapat meningkatkan risiko RLS. Namun, FGF-23 bukan faktor risiko paling dominan untuk RLS pada pasien hemodialisis reguler.