Hemodialisis Inkremental sebagai Upaya Mempertahankan Fungsi Ginjal Residual: Laporan Kasus Seri
DOI:
https://doi.org/10.37287/jppp.v8i3.2423Keywords:
fungsi ginjal residual, hemodialisis inkremental, kecukupan hemodialisis, kualitas hidup, penyakit ginjal kronikAbstract
Fungsi ginjal residual (FGR) pada pasien yang memulai hemodialisis (HD) berkontribusi signifikan terhadap kecukupan dialisis, kualitas hidup, dan mortalitas. Hemodialisis inkremental merupakan strategi pemberian HD dengan frekuensi dan dosis rendah di awal terapi, yang disesuaikan secara bertahap berdasarkan penurunan FGR. Melaporkan profil klinis dan perjalanan penyakit lima pasien penyakit ginjal kronik (PGK) stadium 5 yang menjalani hemodialisis inkremental berbasis FGR. Laporan kasus seri retrospektif pada lima pasien yang memulai HD inkremental (sekali seminggu) pada periode 2020–2023. Evaluasi klinis dan laboratorium dilakukan setiap enam bulan hingga 30 bulan, meliputi diuresis, Kt/V, URR, tekanan darah, hemoglobin, dan keluhan klinis. Dari lima pasien, satu pasien (Pasien 5) berhasil menghentikan HD setelah 12 bulan (kemungkinan renal recovery), satu pasien (Pasien 1) tetap menjalani HD sekali seminggu selama 30 bulan dengan FGR yang terjaga, dan tiga pasien (Pasien 2, 3, dan 4) mengalami penurunan FGR sehingga HD ditingkatkan menjadi dua kali seminggu pada bulan ke-18. Hemodialisis inkremental berbasis FGR merupakan pendekatan yang aman dan layak diterapkan di Indonesia.
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