Perbandingan Tekanan Arteri Pulmonalis Pasien Penyakit Ginjal Kronis Stadium 5-D yang Menjalani Hemodialisis Reguler dengan dan tanpa Fistula AV Permanen

Abstract

Background - End-stage renal disease (ESRD) and its complications re,main a major hsalth problern in lndonesia One of thenn is PuLmonary Hypertonsion (PI,{D. Permanent arteriovenous (Ay) fistulae for vascular acoess has been considsed to play a mqior role in pathogenesis of PHT inESRD patients. Aim - To deterrrine the difference of Pulmonary Arterial Pressure (PAP) among ESRD patients undergoing regular hemodialysis (HD) with or without permanent AV fistulae, and other factors that mightbe influenced. Methods - This was a quasi-experimental study, conducted to ESRD patients who had undergo HD for at least 3 months. Samples divided into group I (with p€rmarent AV fistulae) and Soup II (without permanent AV fistulae). Ttre ls group'then divided into subgroup based on HD durcion; subgruop I-A (<12 months), l-B(12-24 months) and I{,(J+ r-rcftnJ. Echmardiography immedidely perfonned after HD sessior, using a single device by an independent cnrdiologist. Results - From 64 sarnples in early screening, 60 sarnples (30 in group I; 30 in gtroup II) is selectd for the study. There are no differences for mean age, sex, ESRD etiology, smoking habit, interdialytic weight gain (IDWG), hemoglobin (Hb) and Echocardiography-HD time between two groups. HD duration is longer in group I ttran in goup ll Q6.53 + 17.55 vs I1.50 + 10.87 months, p<0.05). PAP is higher in group I than in group lI(46.U + 13.83 vs 25.00 + 0.00 mmHg, p<0.05). PHT occurs more often in group I (86.67% vs V/o, p<005). There are no correlatiolr for HD duration in all of subgroup fi,om goup I with PAP (IF0.28). There are also no correlation between HD duration, Echocardiography-HD time, IDWG, Hb and ejection fraction with PAP. Conclirsion - PAP furcrease and PHT is significantly higher in ESRD patients undergoing regular I{D with permanent AV fistulae. Therefor, permanent AV fistulae is a predisposing factor for PAP increase and higher PHT prevalence in ESRD patients