定期血液透析患者胃肠道疾病的影响因素

rosarina pasaribu, R. Muzasti
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摘要

背景:慢性肾脏疾病(CKD)是一个巨大的健康问题。包括印度尼西亚在内的世界范围内,流行率每年都在上升。与这一趋势一致,血液透析(HD)作为一种治疗方法的患病率也在增加。CKD和HD经常导致一些并发症,其中之一是胃肠道疾病。许多因素与CKD合并HD患者胃肠道疾病的发生率相关。目的:观察普通HD患者胃肠道疾病的影响因素。方法:采用横断面研究的方法,对棉兰胡胡斯银杏树进行观察分析。本研究使用的数据主要来自胃肠道症状评定量表(GSRS)问卷,用于评估HD患者胃肠道疾病的严重程度;次要数据来自年龄、吸烟史、阿司匹林使用情况、HD持续时间、BUN和Kt/V(作为HD充分性的参数)等医疗记录。然后利用线性回归模型对数据进行单变量、双变量和多变量分析。如果得到的p值< 0.05 (p< 0.05),则认为具有显著性。结果:所有患者(100%)均出现胃肠功能紊乱,以轻度为主(67.1%)。最终的多因素分析显示,HD持续时间、BUN水平和Kt/V与胃肠道疾病恶化显著相关(OR:14,157,95%CI 2,851±71,183,p=0,001;OR: 8,352, 95%CI: 0,914±76,344,p= 0,060;OR:8,219,95%CI = 0,893±75,674,p= 0,063)。结论:HD病程、BUN水平、Kt/V与HD患者胃肠道疾病恶化相关。
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Factors Affecting Gastrointestinal Disorders in Patients Undergoing Regular Hemodialysis
Background: Chronic Kidney Disease (CKD) is an immense health issue. The prevalence is increasing each year worldwide, including Indonesia. Consistent with this trend, the prevalence of hemodialysis (HD) as a therapy is also increasing. CKD as well as HD often result in some complications, one being gastrointestinal disorders. Many factors are  correlated  with the incidence of gastrointestinal disorders in CKD patients undergoing HD. Objective: This research is held to observe the factors affecting gastrointestinal disorders in regular HD patients. Method: This is an observational analytical research with cross-sectional study at RS Khusus Ginjal Rasyida Medan. The datas used in the research are primary datas, obtained from Gastrointestinal Symptoms Rating Scale (GSRS) questionnaire to assess severity of gastrointestnal disorders in HD patients, and secondary datas, obtained from medical records of age, smoking history, use of aspirin, HD duration, BUN, and Kt/V (as a parameter of HD adequacy). Then the datas are analyzed univariately, bivariately, and mutivariately using biner logistic regression model. It is considered significant if the obtained p value is <0,05 (p<0,05). Result: All patients (100%) suffer from gastrointestinal disorders, with the most common being mild ones (67,1%). Final multivariate analysis shows that the duration of HD, BUN level, and Kt/V are significantly  correlated  with worsening gastrointestinal disorders (OR:14,157 ,95%CI 2,851 ± 71,183, p=0,001; OR: 8,352, 95%CI 0,914 ± 76,344, p= 0,060; OR:8,219 ,95%CI 0,893 ± 75,674, p= 0,063). Conclusion: The duration of HD, BUN level, and Kt/V are  correlated  with worsening gastrointestinal disorders in HD patients.
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