Korelasi antara Interleukin-6 dengan Respon Awal Terapi Eritropoietin pada Pasien Hemodialisis Reguler

Abstract

Background: In hemodialysis patients conditions inflammation can play a main role in causing hiporesponsif erythropoietin therapy. Interleukin - 6 (IL-6) was a predictor of mortality that is more powerful than other inflammatory markers. Objective: To determine correlation between Interleukin-6 with respon ESA which assessed based on changes of hemoglobin level before and after ESA treatment to regular hemodialysis patients. Methods: The cohort study of experimental methods of measurement data pre and post test from December 2014 to Mei 2016 with 50 hemodialysis patients do a complete blood count, interleukin - 6 and iron profiles before and 1 month after the intervention. Patients were given injections of erythropoietin (rHuEPO) for I month subcutaneously at a dose of 2.000-4.000 each time the hemodialysis procedure. Kolmogorov-Smimov test was used to detennine the distribution of the data. Spearman assess the association between interleukin - 6 with an increase hemoglobin before and after be given erythropoietin therapy. Results: The mean levels of IL - 6 was 20 .24 pg / mL and the mean increase in hemoglobin after erythropoietin administration of 0.56 mg / dL. Found a significant negative correlation ( r = -0.287 ; p = 0.043 ) between IL - 6 and increased hemoglobin level, the higher the levels of IL-6, then the increase of hemoglobin level after erythropoietin administration will be lower than expected. Conclusion: Found a negative correlation between Interleukin-6 with hiporesponsifity erythropoietin in reguler hemodialysis patients

Latar Belakang: Pada pasien hemodialisis, kondisi inflamasi dapat memegang

peranan utama dalam menyebabkan hiporesponsifterapi eritropoietin. Interleukin- 6 (IL-6) merupakan prediktor mortalitas yang lebih kuat daripada penanda

inflamasi lainnya. Tujuan: Untuk mengetahui korelasi antara interleukin-6 dengan respon ESA yang dinilai berdasarkan kadar hemoglobin sebelum dan sesudah terapi eritropoietin pada pasien hemodialysis reguler. Metode: Penelitian kohort eksperimental dengan metode pengukuran data secara pre & post test dari bulan Desember 2014 hingga Mei 2016 terhadap 50 pasien hemodialisis dilakukan pemeriksaan darah lengkap, interleukin-6 dan profil besi sebelum dan I bulan setelah intervensi. Pasien diberikan suntikan eritropoietin (rHuEPO) selama I bulan secara subkutan dengan dosis 2.000-4.000 setiap kali prosedur hemodialisis. Uji Kolmogorov Smirnov digunakan untuk mengetahui distribusi data. Uji korelasi Spearman menilai hubungan antara interleukin-6 dengan peningkatan hemoglobin sebelum dan sesudah pemberian terapi eritropoietin. Hasil: Rerata kadar IL-6 adalah 20,24 pg/mL dan rerata peningkatan Hb setelah pemberian eritropoietin sebesar 0.56 mg/dL. Dijumpai korelasi negatif yang signifikan (r= -0.287; p=0.043) antara IL-6 dan peningkatan Hb, semakin tinggi kadar IL-6 maka peningkatan Hb setelah pemberian eritropoietin akan semakin kecil. Kesimpulan: Dijumpai korelasi negatif yang signifikan antara interleukin-6 dengan hiporesponsifitas eritropoietin pada pasien hemodialisis reguler