Ankle Pump Exercise as Evidence-Based Nursing for Managing Hypervolemia in Chronic Kidney Disease Patients

Authors

  • Zulfiana Nurlaili Universitas Muhammadiyah Surakarta
  • Nur Asa Rhahmadani Susanti Universitas Muhammadiyah Surakarta
  • Beti Kristinawati Universitas Muhammadiyah Surakarta
  • Afif Riada Pratama Universitas Muhammadiyah Surakarta

DOI:

https://doi.org/10.37287/ijghr.v8i4.1605

Keywords:

ankle pump exercise, chronic kidney disease, evidence-based nursing, hipervolemia

Abstract

Hypervolemia in patients with Chronic Kidney Disease (CKD) can cause lower extremity oedema. Non-pharmacological methods like ankle pump exercises and 30° leg elevation effectively reduce oedema and improve circulation by utilising muscle pump action and gravity to enhance venous return to the heart. The purpose of this case report evaluates the patient's response to the therapy provided. The method used is a descriptive design informed by evidence-based nursing (EBN). Data collection was conducted through interviews, observations, and the review of secondary data from medical records. The degree of oedema was measured using the Brodovicz pitting oedema scale. The study subject was Mrs S, a 60-year-old woman with stage V chronic kidney disease (CKD). She experienced fluid overload, shown by swelling, high neck vein pressure, weight gain, and low urine output. The intervention was carried out during four sessions, each lasting 40 minutes. The evaluation included the degree of oedema (Brodovicz pitting oedema), weight change, and foot circumference measurement. The results showed a decrease in the degree of oedema from 3 to 2, a decrease in weight from 48 kg to 46 kg, and an increase in urine output. Patients reported a reduction in heaviness and swelling in the lower extremities after the Ankle Pump Exercise and 30° leg elevation interventions, and no side effects were found during the implementation of these two interventions. Ankle pump exercise and 30° leg elevation proved to be effective, safe, and easy to apply as part of self-care. The results indicate that ankle pump exercise and 30° leg elevation can be used as non-pharmacological nursing interventions in the management of oedema in CKD patients with hypervolemia. Nurses play a crucial role in educating and guiding patients and their families to help them perform self-care interventions independently and continuously.

References

Damayanti, A., Sutrisno, R. Y., & Widiyanto, P. (2024). Pengaruh Penerapan Terapi Ankle Pump Exercise Dengan Elevasi Kaki 30° Terhadap Edema Kaki Pada Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisa. 2(2).

Evirgen, S., & Yildiz, A. (2021). The Relationship Between Pulse Pressure and Hypervolemia in Hemodialysis Patients. 5(3), 380–385. https://doi.org/10.29058/mjwbs.951357

Fatchur, M. F., & Palupi, L. M. (2020). Kombinasi Ankle Pumping Exercise dan Contrast Bath Terhadap Penurunan Edema Kaki Pada Pasien Gagal Ginjal Kronik. 5(1), 1–10.

Gusty, R. P., Rivaldi, F., & Harni, S. Y. (2025). Studi Kasus : Kombinasi Latihan Ankle Pump dan Elevasi 30° pada Edema Kaki Pasien Gagal Ginjal Kronis Pendahuluan Penyakit Gagal Ginjal Kronik ( GGK (GGK) merupakan masalah kesehatan global yang ditandai oleh ginjal kronik sebagai bentuk implementasi interve. 8(2), 269–278.

Jufan, A. Y., Adiyanto, B., & Arifin, A. R. (2020). Manajemen Dan Stabilisasi Pasien Dengan Edema Paru Akut. 7, 61–73.

Riskesdas. (2020). Riskesdas. https://layanandata.kemkes.go.id/katalog-data/profil-kesehatan/ketersediaan-data/profil-kesehatan-2020

Kristinawati, B., Runtuwene, L., Rahmawati, S., & Iriani, A. D. (2021). Retrograde Massage, Exercises, Kompresi Perban Elastis, Dan Elevasi Tangan Sebagai Evidence-Based Nursing Untuk Mengurangi Edema Tangan. The 13th University Research Colloqium, 887–894.

Lestari, L., Azhar, B., Yanti, S., & Hasanah, U. (2025). Penerapan Ankle Pump Exercise Dengan Elevasi 300 Untuk Mengatasi Edema Pasien CKD Di Ruangan Kenanga RSUD Arifin Achmad Provinsi Riau. 15(4). https://doi.org/10.5455/mnj.v1i2.644

Li, H., Zhang, W., Lu, Q., Wang, J., Zhi, Y., Zhang, L., & Zhou, L. (2022). Which Frequency of Ankle Pump Exercise Should Be Chosen for the Prophylaxis of Deep Vein Thrombosis? Inquiry (United States), 59(168), 1–8. https://doi.org/10.1177/00469580221105989

Manawan, S., & Rosa, M. . (2021). Efektivitas latihan kaki terhadap diameter edema. 3, 771–776.

Maro, S. O., & Pitang, Y. (2024). Pemberian Terapi Ankle Pump Exercise Dan Elevasi 300 Untuk Mengurangi Edema Pada Pasien CKD. 2(1).

Nursanti, A., Rosyida, W. R., & Setyorin, Y. (2024). The Combination of Ankle Pumping Exercise and 30˚ Leg Elevation on Foot Edema in Chronic Kidney Disease. 18(August), 61–68.

Putri, Y., Suryarinilsih, Y., Anggreni, S., Efitra, Bahar, I., Delima, & Renidayati. (2025). Gambaran faktor risiko kejadian gagal ginjal kronik. 20(1), 175–185.

Rahmah, A. N., Sari, E. A., & Fitria, N. F. (2023). Management of Hypervolemia In Chronic Kidney Disease Stage 5 At Sumedang Hospital: A Case Study Annisa. 3(2).

Rahmani, S. A., & Mardalena, I. (2025). Penerapan Ankle Pump Exercise dan Elevasi Kaki 30° untuk Menurunkan Derajat Edema Ekstremitas Bawah pada Pasien Chronic Kidney Disease (CKD): Studi Kasus. I(3), 38–43.

Rahmasari, I., Kartiko, E., Irawan, A., Dyan, D., & Sulistyaningsih, S. (2025). Ankle Pump Exercise Dengan Elevasi Kaki 30 Derajat Mampu Menurunkan Derajat Edema Pada Pasien Gagal. 83–90.

Rajendran, K., Mukundan, P. P. V, John, H. T., & Chakravarthy, S. M. (2025). Interdialytic Weight Gain and Cardiovascular Risk in Haemodialysis Patients With Chronic Kidney Disease : Findings From a Prospective Cohort Study. 17(Dm). https://doi.org/10.7759/cureus.97495

Riska, W., Noor, M., Suyanto, & Wahyuningsih, I. (2023a). Effect Of The Combination Of Ankle Pump Exercise And 30°. 8(1).

Riska, W. M., Noor, M. A., Suyanto, & Wahyuningsih, I. S. (2023b). Effect Of The Combination Of Ankle Pump Exercise And 30° Foot Elevation On Foot Edema In CKD Patients. 8(1).

Sangadah, D. K., Septiana, N. T., Ashar, N., & Nurhayati. (2025). Implementation of Ankle Pump Exercise for Edema Reduction in Chronic Kidney Disease Patients. 4(1), 24–35.

Sari, K. I. P., & Setiyowati, Y. D. (2024). Studi Kasus : Intervensi Ankle Pump dan Elevasi 30° Dalam Menurunkan Derajat Edema Tungkai Pada Pasien Chronic Kidney Disease. Jurnal Riset Kesehatan Modern, 6(3), 70–75.

Sari, Y. K., Sari, E. A., & Pratiwi, S. H. (2023). Hipervolemia Dan Keletihan Pada Pasien Chronic Kidney Disease Stage 5: Sebuah Studi Kasus. 3, 2605–2618.

Wisnu, A., Adi, N., Krisnamurti, M. H., Brikana, J., Nugroho, A., Putra, E. P., Maria, A., Narmada, V., & Kustanti, C. Y. (n.d.). Efektivitas elevasi kaki 30° untuk menurunkan edema pada pasien congestive heart failure di ruang intensive cardiology care unit: case report. 2023, 304–310.

World Health Organisation. (2020). Chronic kidney disease. https://www.paho.org/en/topics/chronic-kidney-disease

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Published

2026-08-02

How to Cite

Nurlaili, Z., Susanti , N. A. R., Kristinawati , B., & Pratama , A. R. (2026). Ankle Pump Exercise as Evidence-Based Nursing for Managing Hypervolemia in Chronic Kidney Disease Patients. Indonesian Journal of Global Health Research, 8(4), 509–516. https://doi.org/10.37287/ijghr.v8i4.1605

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