Fina Meilyana
Faculty of Medicine Padjadjaran University/ Hasan Sadikin General Hospital Bandung

Published : 2 Documents
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Hemodialysis in Children with Chronic Kidney Disease Rachmadi, Dedi; Meilyana, Fina
Journal of the Indonesian Medical Association Vol. 59 No. 11 November 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

Patient with Chronic Kidney Disease (CKD) may have acute exacerbation symptoms, which can be seen as acute worsening of renal function. This condition is an emergency case and need prompt acute dialytic treatment. Acute peritoneal dialysis remains a viable option for the dialytic treatment in children, particularly those who are hemodynamically compromised. Hemodialysis is use when contra indications of peritoneal dialysis are found or when peritoneum membran is less efective like in peritonitis. This case report a hemodialisis treatment in children with acute exacerbation of CKD. A boy, 13 years old came to Hasan Sadikin general hospital with the chief complaint was difficulty of breathing, which was accompanied by pale, head aches, vomiting, and blurred vision. There was history of edema anasarca, hypertension, and colacolored urine in 3 years ago. Physical examination revealed established hypertension, kussmaul breathing, anemia, hypervolemia sign (cardiomegaly, pulmonary edema). From, the laboratory examination, anemia, thrombocytopenia, hyperkalemia, hyponatremia, metabolic acidosis, increased ureum 383 mg/dL, creatinin 21.44 mg/dL, and proteinuria, leucocyturia, microscopic hematuria in urinalysis were found. Chest x ray showed cardiomegaly, and pulmonary edema. USG of kidney found chronic process of both kidney. We performed an acute peritoneal dialisys to overcome the acute exacerbation. Since the patient had peritonitis, the treatment was changed to hemodialysis. Further assessment revealed CKD grade 5 (end stge renal disease) and the management followed by chronic hemodialysis before kidney transplantation performed.Keywords: chronic kidney disease, hemodialysis in children
Status Gizi Berdasarkan Subjective Global Assessment Sebagai Faktor yang Mempengaruhi Lama Perawatan Pasien Rawat Inap Anak Meilyana, Fina; Djais, Julistio; Garna, Herry
Sari Pediatri Vol 12, No 3 (2010)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (75.952 KB) | DOI: 10.14238/sp12.3.2010.162-7

Abstract

Latar belakang. Length of stay (LOS) adalah masa rawat seorang pasien di rumah sakit dihitung sejakpasien masuk rumah sakit dan keluar rumah sakit, yang dipengaruhi oleh faktor usia, komorbiditas, hipermetabolisme,dan kegagalan organ serta defisiensi nutrisi. Status gizi merupakan salah satu komponenyang mempengaruhi biaya perawatan, lama hari perawatan, dan kualitas hidup. Salah satu cara penilaianstatus gizi adalah subjective global assessment (SGA) yang terdiri dari anamnesis dan pemeriksaan fisis yangmencerminkan perubahan metabolik dan fungsional.Tujuan. Penelitian ini bertujuan untuk menilai pengaruh status gizi berdasarkan SGA terhadap lama perawatanpasien rawat inap anak.Metode. Penelitian analitik observasional dengan rancangan kohort prospektif dilakukan selama periodeFebruari - Juni 2010 terhadap 311 pasien yang menderita infeksi akut usia 1 bulan 14 tahun yang dirawatdi ruang perawatan anak kelas III RSUP dr. Hasan Sadikin. Penilaian status gizi berdasarkan SGA dikelompokanmenjadi SGA A (gizi baik), SGA B (malnutrisi ringan + sedang, dan SGA C (malnutrisi berat).Hasil. Berdasarkan penilaian status gizi dengan SGA berturut-turut didapatkan SGA A, SGA B, dan SGAC sebesar 114 (36,7%), 98 (31,5%), dan 99 (31,8%). Dengan menggunakan uji chi square, didapatkanperbedaan lama perawatan yang bermakna (p<0,001) pada kelompok subjek SGA C dibandingkan kelompokSGA B dan SGA A. Berdasarkan analisis multivariat regresi logistik, kelompok SGA C berisiko 2,205 kalilebih tinggi untuk menjalani perawatan lebih lama (RR: 2,205; 95% CI: 1,151-4,227).Kesimpulan. Penelitian ini menunjukkan bahwa status gizi yang dinilai dengan SGA terbukti berpengaruhterhadap lama hari perawatan dan dapat dianjurkan untuk digunakan dalam penilaian status gizi.