Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 167890 dokumen yang sesuai dengan query
cover
Maretha Primariayu
Terapi medik gizi terhadap kekuatan genggam tangan dan kadar albumin pasien penyakit ginjal kronis dengan hemodialisis rutin = Medical nutrition therapy on handgrip strength and albumin in chronic kidney disease with routine hemodialysis
"Latar belakang: Penyakit ginjal kronis (PGK) merupakan penyakit kronis yang menjadi masalah kesehatan global. Hemodialisis (HD) adalah salah satu terapi pengganti ginjal pada PGK stadium akhir yang bersifat katabolik. Pasien PGK dengan HD rutin rentan mengalami protein energy wasting (PEW) apabila tidak mendapatkan asupan energi dan protein yang adekuat. Terapi medik gizi yang komprehensif dan holistik diperlukan untuk mencegah terjadinya atau bertambahnya progresivitas PEW yang memengaruhi
kualitas hidup pasien.
Kasus: Empat orang perempuan berusia 24-52 tahun dengan diagnosis PGK stadium akhir yang rutin menjalani HD. Selama menjalani HD, seluruh pasien memiliki riwayat asupan energi total <25 kkal/kg BB dengan protein <1 g/kg BB. Kekuatan genggam tangan pada seluruh pasien <18 kg dan kadar albumin tiga pasien <3,8 g/dL. Tiga pasien telah mengalami PEW dan satu lainnya berisiko PEW. Terapi medik gizi diberikan sesuai kondisi klinis masing-masing pasien dengan target protein 1,2-1,4 g/kgBB/hari.
Hasil: Asupan energi dan protein pada seluruh pasien meningkat pada akhir pemantauan. Rerata pasien dapat mencapai 90% KET dengan protein mencapai 1,3 g/kg BB/hari selama pemantauan. Kekuatan genggam tangan, kadar albumin, hemoglobin, dan komposisi tubuh pasien PGK dengan HD rutin yang mendapatkan terapi medik gizi mengalami perbaikan.
Kesimpulan:
Terapi medik gizi yang adekuat mendukung perbaikan klinis serta parameter
laboratorium pada pasien PGK dengan HD rutin sehingga dapat mencegah terjadinya atau bertambahnya progesivitas PEW.
Background: Chronic kidney disease (CKD) is a chronic disease that has become global health problem. One of renal replacement therapy in end-stage CKD is hemodialysis (HD) which is a catabolic procedure. CKD patients on maintenance HD (MHD) is susceptible to develop protein energy wasting (PEW) if they get inadequate energy and protein intake. Comprehensive and holistic nutritional medical therapy is needed to prevent development or rapid progression of PEW which affects the quality of life of patients.
Case:
Four women aged 24-52 years with end-stage CKD on MHD. All patients had total energy intake <25 kcal / kg BW with protein intake <1 g / kg body weight. Handgrip strength in all patients were less than 18 kg and three of them have albumin levels less than 3.8 g/dL. Three patients experienced PEW and the other had risk of PEW. Nutritional medical therapy is given according to the clinical conditions of each patient with target of protein from 1.2-1.4 g / kg BW / day.
Results: All patient showed increment intake of energy and protein. The average of energy intake patient can reach 90% total energy requirement with protein intake reached 1.3 g / kg / day during monitoring. Handgrip strength, albumin, hemoglobin levels, and body composition in CKD patient on MHD who received nutritional medical therapy were improved.
Conclusion: Adequate nutritional medical therapy supports improvement of clinical condition and laboratory parameters in CKD patients on MHD with the purposes of preventing development or rapid progression of PEW."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Olivia Charissa
Terapi medik gizi pada penyakit ginjal kronik yang menjalani hemodialisis dengan anemia dan asupan rendah = Medical nutrition therapy in chronic kidney disease patients with anemia and low nutritional intake undergoing hemodialysis
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Kristina Joy Herlambang
Terapi medik gizi pada penyakit ginjal kronik dengan riwayat hipertensi dan hemodialisis = Nutrition management in chronic kidney disease patient with hypertension on hemodialysis
"ABSTRAK
Penyakit ginjal kronik PGK merupakan penyakit kronik progresif yang mengakibatkan penurunan fungsi ginjal dan bersifat irreversible. Pasien PGK stadium akhir membutuhkan terapi pengganti ginjal untuk memertahankan tubuh dari toksisitas uremia. Prosedur dialisis bersifat katabolik, sehingga pasien yang menjalani hemodialisis HD mengalami peningkatan kebutuhan energi dan protein yang penting untuk mencegah terjadinya protein-energy wasting PEW . Empat orang pasien dalam serial kasus ini mengalami PGK stadium akhir dan telah menjalani hemodialisis dengan rentang waktu yang berbeda, 2 orang dalam rawat inap dan dua orang lainnya rawat jalan. Pasien didiagnosis dengan PGK stadium 5 dengan HD, hipertensi, diabetes melitus, dan ensefalopati uremikum. Walaupun saat pemeriksaan status gizi pasien normoweight dan satu orang mengalami malnutrisi ringan, seluruh pasien memiliki riwayat asupan protein 10 dalam 6 bulan, sehingga dibutuhkan terapi medik gizi yang mencakup penentuan kebutuhan makro dan mikronutrien, nutrien spesifik, sesuai dengan toleransi dan kondisi klinis pasien. Hasil pemantauan menunjukkan pasien mengalami perbaikan klinis, toleransi asupan dan kapasitas fungsional serta kualitas hidup pasien dapat dipertahankan. Terapi medik gizi berperan penting pada semua pasien PGK yang menjalani HD dengan mencegah PEW, memperbaiki kondisi klinis, serta meningkatkan kapasitas fungsional pasien.Kata kunci: terapi medik gizi, penyakit ginjal kronik, hemodialisis, hipertensi.
ABSTRACT
Chronic kidney disease is a irreversible progressive chronic process that causes worsening renal function. Patients with end stage renal disease needs renal replacement therapy to protect themselves from uremia toxicity. Patients who have to undergo dialysis are in high catabolism state and has an increased energy and protein expenditure. Adequate energy and protein for these patients are needed to prevent protein energy wasting PEW . Four cases from this serial case has ESRD and has been on hemodialysis with different time frames. Two outpatient and two inward patients who have CKD stage V with hypertension, diabetes mellitus, and uremic encephalopathy. Although only one patient I categorized as mildly malnourished, 3 of four patients experienced weigth loss 10 in 6 months. Thus, medical nutritional therapy is needed to determine energy and protein requirements in these patients. Evaluation and monitoring form these cases shows that all patients have better clinical outcome, better nutrition intake, and functional capacity were preserved. Medical nutrition therapy has an important role in all CKD patients with dialysis to prevent PEW, to improve their clinical outcome and to increasetheir functional capacity. Key words medical nutrition therapy, chronic kidney disease, hemodialysis, hipertension."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Muningtya Philiyanisa Alam
Terapi medik gizi pada pasien penyakit ginjal kronik dengan malnutrisi yang menjalani hemodialisis (pendekatan terhadap lingkar otot lengan atas) = Medical nutrition therapy in chronic kidney patients with malnutrition undergoing hemodialysis (approach to the measurement of upper arm muscle circumference) / Muningtya Philiyanisa Alam
"ABSTRAK
Penyakit ginjal kronik (PGK) telah menjadi penyakit epidemik global dan prevalensinya di Indonesia terus meningkat. Hemodialisis (HD) merupakan terapi pengganti ginjal yang paling sering dilakukan pada pasien PGK stadium akhir. Pasien PGK yang menjalani HD rutin rentan mengalami protein energy wasting (PEW) sehingga memengaruhi status gizi. Lingkar otot lengan atas (LOLA) merupakan indeks yang dapat menggambarkan total protein tubuh dan massa otot. Terapi medik gizi komprehensif diperlukan untuk menghindarkan pasien dari PEW dan memperbaiki kualitas hidup pasien. Pemantauan terhadap empat pasien berusia 32-61 tahun dengan proporsi jenis kelamin sama, didiagnosis PGK stadium akhir dan menjalani HD rutin. Berdasarkan kriteria The American Society for Parenteral and Enteral Nutrition seluruh pasien mengalami malnutrisi. Dua pasien telah menderita PEW, dua lainnya berisiko PEW. Terapi medik gizi diberikan sesuai dengan keadaan klinis pasien dengan target protein yaitu 1,1-1,4 g/kgBB/hari. Asupan energi dan protein pada dua pasien telah lebih dari 35 kkal/kgBB/hari dan 1,2 kkal/kgBB/hari sejak awal, sedangkan dua pasien lainnya rendah pada awal pengkajian namun mengalami peningkatan di akhir pemantauan. Seluruh pasien memiliki nilai LOLA yang rendah dan diduga mengalami deplesi otot, namun dua pasien mengalami peningkatan LOLA di akhir pemantauan.
ABSTRACT
Chronic kidney disease has become a global epidemic disease and the prevalence is increasing in Indonesia. Hemodialysis (HD) is the most common treatment for end stage renal disease (ESRD) patients. Patients who undergoing HD routinely are vulnerable to increase protein energy wasting (PEW) so nutritional status must be monitored closely. Mid upper arm muscle circumference (MUAMC) can be use to show total body protein and muscle mass. Medical nutrition therapy is needed to prevent patients from PEW and improve the quality of life. Four patients age range 32-61 years and same sex ratio, diagnosed with ESRD undergoing HD. Based on The American Society for Parenteral and Enteral Nutrition s criteria all patients were malnutrition. Two patients experienced PEW and the other had risk of PEW. Medical nutritional therapy is given according to clinical condition of each patient with target protein from 1.1-1.4 g/kgBW/day. Energy and protein intake in two patients was more than 35 kcal/kgBW/day and 1.2 kcal/kgBW/day at first assessment. Unfortunately the others patient intake were low at the first assessment but incresed at the end of monitoring. All patients had low MUAMC scores which indicate muscle depletion. Two patients had increased MUAMC at the end of monitoring."
2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Dina Nurul Istiqomah
Profil Parameter Metabolisme Mineral dan Tulang pada Penyakit Ginjal Kronik: Kajian pada Pasien dengan Hemodialisis Rutin = Profile of Mineral and Bone Parameter in Chronic Kidney Disease: A Study in Patients on Routine Hemodialysis
"Gangguan metabolisme mineral dan tulang pada penyakit ginjal kronik (GMT-PGK) merupakan salah satu komplikasi yang ditemukan pada pasien PGK yang menjalani hemodialisis (PGK-HD). Manifestasi GMT-PGK dapat merupakan kelainan sistemik ataupun hanya ditemukan di tulang yang disebut sebagai renal osteodystrophy(ROD). Risiko kematian akibat GMT-PGK mencapai 17,5%. Di Indonesia, pemeriksaan penanda tulang terkait GMT-PGK belum secara rutin dikerjakan karena belum tercakup dalam pembiayaan Jaminan Kesehatan Nasional (JKN). Tujuan penelitian ini menganalisis profil kalsium, fosfat, PTH, dan vitamin D 25(OH) pada pasien PGK-HD. Penelitian ini merupakan studi potong lintang yang melibatkan 124 pasien hemodialisis rutin di Unit Hemodialisis RS Cipto Mangunkusumo (RSCM) yang berlangsung pada bulan Juni sampai Oktober 2022. Penelitian ini menggunakan data sekunder dari semua pasien hemodialisis yang memiliki data jenis kelamin, usia, durasi HD, fosfat, kalsium total, vitamin D 25(OH), dan PTH. Profil parameter tulang di dominasi turnover tinggi (75,8%), normokalsemia (78%), hiperfosfatemia (57,3%), dan status defisiensi vitamin D (82,3%). Pada penelitian ini didapatkan korelasi hanya pada parameter durasi HD dan PTH. Profil kelainan tulang berdasarkan penelitian ini lebih didominansi kelainan turnover tinggi sehingga dapat menjadi dasar untuk pemberian suplementasi analog vitamin D dan atau kalsimimetik dalam pengendalian peningkatan PTH pada pasien HD. Hiperfosfatemia masih mendominasi proporsi pasien HD sehingga tatalaksana terhadap hiperfosfatemia perlu lebih ditingkatkan dan disarankan untuk pemeriksaan berkala.
Chronic kidney disease–mineral and bone disorder (CKD-MBD) is one of the complications found in CKD patients undergoing hemodialysis (CKD-HD). Manifestations of CKD-MBD can be a systemic disorder or only found in the bone which is known as renal osteodystrophy (ROD). The risk of death from CKD-MBD reaches 17.5%. In Indonesia, examination of bone markers related to CKD-MBD has not been routinely carried out because it has not been covered by the National Health Insurance financing. The aim of this study was to analyze the profile of calcium, phosphate, PTH, and vitamin D 25(OH) in patients with chronic kidney disease undergoing routine hemodialysis. This research is a cross-sectional study involving 124 routine hemodialysis patients at the Hemodialysis Unit of Cipto Mangunkusumo Hospital (RSCM) which took place from June to October 2022. This study used secondary data from all hemodialysis patients who had data on gender, age, duration of HD, phosphate, total calcium, vitamin D 25(OH), and PTH. Bone parameter profile was dominated by high turnover (75.8%), normocalcemia (78%), hyperphosphatemia (57.3%), and vitamin D deficiency status (82.3%). In this study, correlation was found only on the HD and PTH duration parameters. The profile of bone abnormalities based on this study is more dominated by high turnover disorders so it can be a basis for administering supplementation of vitamin D analogues and or calcimimetics in controlling increased PTH in HD patients. Hyperphosphatemia still dominates the proportion of HD patients so that the management of hyperphosphatemia needs to be further improved and periodic checks are recommended."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Pinontoan, Rosnah
Terapi nutrisi pada pasien rawat jalan dengan penyakit ginjal kronis yang menjalani hemodialisis = Nutritional therapy in outpatients with chronic kidney disease undergoing hemodialysis
"ABSTRAK
Latar belakang: Penyakit ginjal kronis PGK merupakan penyakit yang perlu menjalani Hemodialisis HD . HD merupakan suatu prosedur yang bersifat katabolik, sehingga memerlukan asupan energi dan protein yang adekuat untuk menghindari risiko malnutrisi.Kasus: Total pasien PGK dalam serial kasus ini berjumlah empat orang, berusia 36 ndash;54 tahun, telah menjalani HD dalam rentang waktu yang berbeda. Seluruh pasien mempunyai riwayat asupan protein
ABSTRACT Introduction As one of primary treatment for end stage renal disease patients, hemodialysis HD is a catabolic procedure. Unless having adequate energy and protein intake, dialysis patients will be at risk for malnutrition. Cases Four dialysis patients in this case series, aged 36 54, have undergone HD at different timescales. All patients had high risk of malnutrition, due to protein intake "
2017
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Leovinna
Profil asam amino pada pasien penyakit ginjal kronik: Kajian pada pasien dengan hemodialisis rutin = Amino acid profile in chronic kidney disease patients: Study on patients with routine hemodialysis
"Protein energy wasting (PEW) merupakan sindrom gangguan nutrisi yang sering terjadi
pada pasien penyakit ginjal kronik (PGK) dengan hemodialisis rutin sekitar 28-80%.
Proses hemodialisis dapat meyebabkan hilangnya nutrien seperti asama amino,
meningkatkan proses inflamasi yang kemudian dapat meningkatkan katabolisme protein,
dan dapat menghambat utilisasi asam amino dalam sintesis protein. Jika tidak ditangani,
PEW dapat meningkatkan morbiditas dan mortalitas pasien PGK. Tujuan utama
penelitian adalah untuk mengetahui profil asam amino pasien PGK dengan hemodialisis
rutin. Desain penelitian adalah potong lintang dengan 60 subjek pasien PGK usia >18
tahun dengan hemodialisis rutin di RS. Umum Pusat Nasional Dr. Cipto Mangukusumo.
Sampel berupa dried blood spot (DBS) dan pemeriksaan asam amino menggunakan
metode Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). Asam amino
yang diperiksa adalah asam amino nonesensial (alanin, arginin, asam aspartat, asam
glutamat, asparagin, glisin, glutamin, prolin, serin, tirosin), esensial (histidin, fenilalanin,
isoleusin, leusin, lisin, metionin, treonin, triptofan, valin), dan khusus (ornitin, sitrulin).
Hasil penelitian didapatkan hampir semua kadar asam amino pada subjek lebih rendah
terutama alanin, tirosin, histidin, dan valin; sebaliknya asam aspartat dan serin ditemukan
lebih tinggi kadarnya dibandingkan nilai rujukan Mayo dan data internal dewasa sehat.
Didapatkan adanya hubungan bermakna antara jenis kelamin dengan fenilalanin,
isoleusin, leusin; hipoalbuminemia (albumin <4 g/dL) dengan glisin; hipoalbuminemia
(<3,5 g/dL) dengan arginin, asam aspartat, asparagin, histidin, lisin, metionin, dan
ornitin. Didapatkan korelasi yang bermakna antara usia dengan BCAA (isoleusin, leusin,
valin), dan metionin; dan hemoglobin dengan isoleusin. Penelitian ini merupakan
penilitian pertama tentang profil asam amino pada pasien PGK dengan hemodialisis di
Indonesia dan penelitian pertama kali yang menggunakan sampel DBS pada orang
dewasa. Dengan diketahuinya profil asam amino pada PGK dapat dimanfaatkan sebagai
dasar pemberian jenis suplementasi asam amino yang sesuai dengan populasi pasien PGK
dengan hemodialisis di Indonesia.
Protein energy wasting (PEW) is a nutritional disorder syndrome that often occurs in
patients with chronic kidney disease (CKD) on routine hemodialysis around 28-80%. The
process of hemodialysis can cause the loss of nutrients such as amino acids, increase the
inflammatory process which can increase protein catabolism, and be able to inhibit the
utilization of amino acids in protein synthesis. If untreated, PEW can increase the
morbidity and mortality of CKD patients. The main objective of the study was to
determine the amino acid profile of CKD patients on routine hemodialysis. The study
design was cross sectional with 60 subjects of CKD patients aged >18 years on routine
hemodialysis at Dr. Cipto Mangunkusumo National Public Hospital. Samples in the form
of dried blood spot (DBS) and amino acid examination using the Liquid Chromatography
Tandem Mass Spectrometry (LC-MS/MS) method. Amino acids examined were
nonessential amino acids (alanine, arginine, aspartic acid, glutamic acid, asparagine,
glycine, glutamine, proline, serine, tyrosine), essential (histidine, phenylalanine,
isoleucine, leucine, lysine, methionine, glycine, glutamine, proline, serine, tyrosine),
special (ornithine, citrulline). The results showed that almost all amino acid levels in the
subjects were lower especially alanine, tyrosine, histidine, and valine; in contrast, aspartic
acid and serine were found to be higher than Mayo reference value and internal data of
healthy adults. A significant relationship was found between gender and phenylalanine,
isoleucine, leucine; hypoalbuminemia (albumin <4g/dL) with glycine; hypoalbuminemia
(<3.5 g/dL) with arginine, aspartate acid, asparagine, histidine, lysine, methionine, and
ornithine. Significant correlation was obtained between age with BCAA (isoleucine,
leucine, valine), and methionine; and hemoglobin with isoleucine. This study is the first
study of the amino acid profile in CKD patients with hemodialysis in Indonesia and the
first study using DBS samples in adults. Knowing the amino acid profile in CKD can be
used as a basis for the of amino acid supplementation that is suitable for the population
of CKD patients with hemodialysis in Indonesia."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Sinaga, Wina
Tatalaksana nutrisi pasien penyakit ginjal kronik derajat 5 dengan hemodialisis = Nutrition therapy for stage 5 of chronic kidney disease with hemodialysis
"[ABSTRAK
Pasien penyakit ginjal kronik derajat 5 mengalami suatu keadaan di mana ginjal sama sekali tidak dapat mempertahankan homeostasis metabolisme tubuh sehingga membutuhkan terapi pengganti ginjal. Terapi pengganti ginjal yang paling sering dipilih oleh pasien PGK derajat 5 adalah hemodialisis. Perubahan metabolik pada PGK derajat 5 dengan hemodialisis dapat disebabkan oleh gangguan fungsi ginjal dan proses hemodialisis. Perubahan metabolik tersebut antara lain gangguan keseimbangan cairan, dan asam basa serta gangguan
metabolisme protein, karbohidrat, dan lemak. Dibutuhkan terapi terintegrasi pada pasien PGK yang terdiri atas terapi farmakologi, terapi pengganti ginjal, terapi nutrisi dan dukungan psikologis. Peran nutrisi dalam menurunkan komplikasi dan meningkatkan kualitas hidup sangat penting dalam tatalaksana pasien PGK. Pemberian nutrisi pada pasien PGK dengan hemodialisis bertujuan untuk mengatasi gejala akibat gangguan ginjal dan mencegah komplikasi akibat progresivitas kerusakan ginjal. Pemberian nutrisi yang tepat dapat dilakukan dengan memahami patofisiologi yang terjadi pada pasien PGK dan proses
hemodialisis yang dipilih sebagai terapi pengganti ginjal. Berdasarkan hal tersebut, dilaporkan empat serial kasus pada pasien PGK derajat 5 dengan hemodialisis rutin. Diberikan terapi nutrisi sesuai panduan yaitu energi 30-35 kkal per kg berat badan, protein 1,2 g per kg berat badan, lemak 25-30% energi total, dan karbohidrat 60-65% energi total. Diketahui bahwa penyebab asupan tidak terpenuhi adalah keadaan klinis yaitu sesak, penurunan kesadaran, dan gangguan saluran cerna yaitu mual dan muntah.
ABSTRACT
Stage 5 of chronic kidney disease represents total inability of kidneys to maintain body homeostasis normally. At this stage, it is necessary to use methods that substitute kidney function such as hemodialysis, peritoneal dialysis, or kidney transplantation. The most used method is hemodialysis. Metabolic changes in stage 5 of chronic kidney disease can be caused by kidney disease itself and also hemodialysis treatment. Metabolic complications of chronic kidney disease and hemodialysis include changes in acid-base balance and metabolism of proteins,
carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complication and to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are to overcome the symtoms and to prevent the complication that caused by kidney disease. Nutrition therapy can be done properly by understand the pathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney disease with hemodialysis are reported here. The nutrition which is given consist of energy 30-35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid 25-30 % total energy, and carbohydrate 60-65 % total energy. There is inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit. Stage 5 of chronic kidney disease represents total inability of kidneys to maintain body homeostasis normally. At this stage, it is necessary to use methods that
substitute kidney function such as hemodialysis, peritoneal dialysis, or kidney transplantation. The most used method is hemodialysis. Metabolic changes in stage 5 of chronic kidney disease can be caused by kidney disease itself and also hemodialysis treatment. Metabolic complications of chronic kidney disease and hemodialysis include changes in acid-base balance and metabolism of proteins, carbohydrates and lipids. Patients need integrated therapy that consist of medicine, kidney function substitution, nutrition, and psychological support. Nutrition therapy is important in chronic kidney disease therapy because it can help to decrease complication and to increase quality of life. The purpose of nutrition therapy in chronic kidney disease are to overcome the symtoms and to prevent the complication that caused by kidney disease. Nutrition therapy can be done properly by understand the pathophysiologycal mechanism and the process of hemodialysis. Based on the description, four cases of stage 5 of chronic kidney disease with hemodialysis are reported here. The nutrition which is given consist of energy 30-35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid 25-30 % total energy, and carbohydrate 60-65 % total energy. There is inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit., Stage 5 of chronic kidney disease represents total inability of kidneys to maintain
body homeostasis normally. At this stage, it is necessary to use methods that
substitute kidney function such as hemodialysis, peritoneal dialysis, or kidney
transplantation. The most used method is hemodialysis. Metabolic changes in
stage 5 of chronic kidney disease can be caused by kidney disease itself and also
hemodialysis treatment. Metabolic complications of chronic kidney disease and
hemodialysis include changes in acid-base balance and metabolism of proteins,
carbohydrates and lipids.
Patients need integrated therapy that consist of medicine, kidney function
substitution, nutrition, and psychological support. Nutrition therapy is important
in chronic kidney disease therapy because it can help to decrease complication
and to increase quality of life.
The purpose of nutrition therapy in chronic kidney disease are to
overcome the symtoms and to prevent the complication that caused by kidney
disease. Nutrition therapy can be done properly by understand the
pathophysiologycal mechanism and the process of hemodialysis.
Based on the description, four cases of stage 5 of chronic kidney disease
with hemodialysis are reported here. The nutrition which is given consist of
energy 30–35 kkal per kg body weight, protein 1,2 g per kg body weight, lipid
25–30 % total energy, and carbohydrate 60–65 % total energy. There is
inadequacy of intake due to clinical conditions such as dispnoe, the decreased of consciousness, and intestinal disturbance like nausea and vomit.]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Vikie Nouvrisia Anandaputri
Peran terapi medik gizi pada perubahan indeks massa bebas lemak dan kadar albumin serum pasien Kanker Laring dengan Radioterapi = The Role of medical nutrition therapy on changes of fat free mass index and serum albumin level in Laryngeal Cancer Patients with Radiotherapy
"Latar Belakang. Pasien kanker laring dapat mengalami malnutrisi sebelum
menjalani radioterapi yang ditandai dengan penurunan berat badan yang tidak
disengaja akibat penurunan massa bebas lemak. Kasus serial ini bertujuan untuk
mengamati kaitan asupan protein dengan perbaikan fat free mass index (FFMI).
Metode. Empat pasien pada serial kasus ini didiagnosis karsinoma sel skuamosa
laring pascalaringektomi total dan diseksi leher stadium III dan IV dengan status
gizi malnutrisi berat dan sedang, berat badan normal, dan obes I, berusia 51-62
tahun yang dikonsulkan ke dokter Gizi Klinik pada bulan Agustus sampai
November 2019 sejak awal radioterapi. Terapi medik gizi diberikan sesuai dengan
kondisi klinis melalui jalur oral. Pemantauan dilakukan pada minggu pertama
radiasi, selama radiasi, minggu terakhir radiasi, dan pascaradiasi.
Hasil. Kadar albumin serum keempat pasien dalam batas normal dan meningkat
saat akhir radiasi pada tiga orang pasien. Pasien malnutrisi sedang mengalami
penurunan FFMI dengan asupan protein <2 g/kg BB, pasien malnutrisi berat
mengalami peningkatan FFMI dengan asupan protein 1,1-1,4 g/kg BB. FFMI
pasien obes meningkat lalu menurun dengan asupan protein 0,8-1,7 g/kg BB.
FFMI pasien BB normal meningkat dengan asupan protein 2 g/kg BB. Rentang
asupan protein adalah 0,7-1,5 g/kg BB saat awal radiasi, selama radiasi 0,8-2 g/kg
BB, akhir radiasi 1,1-2 g/kg BB.
Kesimpulan. FFMI cenderung mengalami peningkatan sampai akhir radiasi pada
asupan protein yang mencapai 2 g/kg BB pada pasien BB normal. Perlu penelitian
lebih lanjut mengenai hubungan asupan protein dan FFMI pada pasien KSS laring
yang menjalani radioterapi.
Bacground. Laryngeal cancer patients can experience malnutrition before
undergoing radiotherapy characterized by unintentional weight loss due to a
reduction in fat free mass. Aim of the case series to observe protein intake with fat
free mass index (FFMI) improvement.
Method. Four patients were diagnosed with laryngeal squamous cell carcinoma
post total laryngectomy and neck dissection with nutritional status of severe and
moderate malnutrition, normal weight, and obese grade I, aged 51-62 years who
were consulted to Clinical Nutrition physician in August to November 2019 which
underwent radiotherapy. Medical nutrition therapy is given according to the
clinical condition of each patient through oral. Monitoring was carried out in the
first week, during, the end, and after radiation.
Results. Serum albumin were within normal level and increased at the end of
radiation in 3 patients. FFMI of malnourished patients was decreased with
protein intake <2 g/kg BW. FFMI of severely malnourished patients increases
with protein intake from 1.1 to 1.4 g/kg body weight. FFMI of obese patients
increases then decreases with protein intake from 0.8 to 1.7 g/kg body weight.
FFMI of normoweight patients increases with a protein intake of 2 g/kg BW. The
range of protein intake is 0.7-1.5 g/kg BW at first week, 0.8-2 g/kg BW during,
and 1.1-2 g/kg BW at the end of radiation.
Conclusion. FFMI tends to increase on protein intake 2 g/kg BW in normoweight
patients. Further research is needed regarding the relationship of protein intake
and FFMI in laryngeal patients undergoing radiotherapy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Cut Mela Yunita Sari
Korelasi Kekakuan Arteri Sentral dengan Kekuatan Genggam Tangan pada Pasien yang Menjalani Hemodialisis Kronik = Correlation between Central Arterial Stiffness and Handgrip Strength in Chronic Hemodialysis Patient
"Latar Belakang: Penurunan kapasitas latihan dan kekuatan otot merupakan gambaran yang umum dijumpai pada pasien hemodialisis (HD) kronik. Perbaikan kadar hemoglobin (Hb) tidak memperbaiki secara optimal kapasitas latihan. Prevalensi kalsifikasi arteri tinggi pada pasien HD. Hal ini menyebabkan berkurangnya elastisitas pembuluh darah sehingga meningkatkan kekakuan arteri. Terdapat bukti klinis bahwa kekakuan arteri sentral memengaruhi kapasitas latihan pada pasien penyakit ginjal kronik (PGK). Kapasitas latihan dapat diprediksi dengan menilai kekuatan otot perifer.
Tujuan: Mengetahui korelasi kekakuan arteri sentral dengan kekuatan genggam tangan pada pasien yang menjalani HD kronik.
Metode: Penelitian ini merupakan penelitian potong lintang dengan subyek pasien HD kronik yang diambil dengan teknik consecutive sampling dengan rentang usia 18 – 59 tahun.  Analisis bivariat dilakukan untuk menilai korelasi kekakuan arteri sentral (dengan menilai central pulse wave velocity/cPWV) dengan kekuatan genggam tangan (KGT), kemudian dilakukan korelasi parsial terhadap variabel perancu (usia, dialysis vintage, Hb, dan aktivitas fisik).
Hasil: Terdapat 45 pria dan 40 wanita dengan median usia masing-masing 47 (19-59) dan 47 (18-59) tahun. Kedua kelompok mempunyai tingkat aktivitas fisik sedang. Tidak terdapat korelasi antara cPWV dengan KGT baik pada  pria (r = -0,046, p = 0,763) maupun wanita (r = -0,285, p = 0,113). Analisis stratifikasi pada wanita yang memiliki tinggi badan (TB) >150 cm menunjukkan korelasi negatif derajat sedang antara cPWV dengan KGT (r = -0,466; r2 = 0,217; p = 0,016). Nilai cPWV berperan sebesar 21,7% terhadap KGT, dan 78,3% diduga dipengaruhi oleh faktor perancu. Kelompok KGT rendah memiliki nilai cPWV yang meningkat pada semua kategori usia.
Simpulan: Kekakuan arteri sentral tidak berhubungan dengan kekuatan genggam tangan pada pasien yang menjalani HD kronik. Terdapat kecenderungan peningkatan nilai cPWV pada subjek yang memiliki KGT rendah.
Background: Exercise intolerance and muscle weakness are the common features in hemodialysis patients. However, correction of renal anemia by eritropoetin does not optimize the exercise capacity. The prevalence of arterial calcification among the hemodialysis patient is high. It thereby decreased the elasticity of the vessels and increased the arterial stiffness. Clinical evidence showed that central arterial stiffness affects the exercise capacity in chronic kidney disease (CKD). Exercise capacity can be predicted by assessing peripheral muscle strength.
Objective: To investigate the correlation between central arterial stiffness and handgrip strength in chronic hemodialysis patients.
Methods: This study use cross-sectional design which perform in chronic HD patients aged between 18 and 59 years old by consecutive sampling. Bivariate analysis was done to determine the correlation between central arterial stiffness (assessed using central pulse wave velocity /cPWV) and handgrip strength (HGS). Afterwards, partial correlation of confounding variables (age, dialysis vintage, Hb and physical activity) were also be analyzed.
Results: There were 45 men and 40 women with the median age of 47 (19-59) and 47 (18-59) years old, respectively. Both groups have moderate level of physical activity. There was no correlation between cPWV and HGS in men (r = -0.046, p = 0.763) and women (r = -0.285, p = 0.113). Stratified analysis in women with height over 150 cm showed a moderate negative correlation between cPWV and HGS (r = -0,466; r2 = 0,217; p = 0,016). cPWV accounted for 21.7% of HGS, while 78.3% were suggested to be influenced by the confounding factors. The group with low HGS had an increased cPWV in all age categories.
Conclusion: Central artery stiffness was not associated with HGS in chronic HD patient. There was a tendency of increased central arterial stiffness in the group of subjects who had low HGS."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T58576
UI - Tesis Membership  Universitas Indonesia Library
<<   1 2 3 4 5 6 7 8 9 10   >>