SKRIPSI

FAKULTAS KEDOKTERAN
UNIVERSITAS HASANUDDIN
November 2016

Ahmad Yani Sukarso/C11111152

Dr. dr. Andi Alfian Zainuddin, M.KM

FAKTOR-FAKTOR RISIKO KEJADIAN GAGAL GINJAL

KRONIK/END-STAGE RENAL DISEASE (ESRD) PADA PASIEN RAWAT
JALAN DI UNIT HEMODIALISA RSUD UNDATA KOTA PALU,
SULAWESI TENGAH TAHUN 2016 (xiv + 77 halaman + 9 gambar + 22
tabel + 3 grafik + lampiran)

ABSTRAK

Latar Belakang: Gagal ginjal kronik atau ESRD (End-Stage Renal Disease)
merupakan suatu kondisi klinis yang ditandai dengan penurunan fungsi ginjal
yang irreversible, yang membutuhkan terapi pengganti ginjal yang tetap untuk
mempertahankan kehidupan, berupa dialisis atau transplantasi ginjal. Berdasarkan
data epidemiologi dari National Kidney Foundation memaparkan bahwa terdapat
sekitar 10% dari populasi dunia terkena gagal ginjal kronik, yang menyebabkan
kematian pada 409.000 jiwa pada tahun 1990 menjadi 956.000 jiwa pada tahun
2013. Data epidemiologi di Indonesia berdasarkan Riskesdas 2013 memaparkan
prevalensi penyakit ginjal kronik di Indonesia adalah 0,2% dari total populasi.
Berdasarkan pemaparan di atas, penting untuk mengetahui faktor-faktor
determinan kejadian penyakit ginjal kronik (PGK) menjadi ESRD (End-Stage
Renal Disease), agar faktor-faktor ini dapat dimodifikasi untuk mencegah
kejadian penyakit. Sehingga upaya-upaya pencegahan, kontrol, edukasi, dan
intervensi medis bisa lebih maksimal, dan menghasilkan penurunan angka
kejadian ESRD.
Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang
berpengaruh terhadap kejadian gagal ginjal kronik di RSUD Undata Kota Palu
tahun 2016
Metode Penelitian: Penelitian ini merupakan jenis penelitian observasional
analitik dengan menggunakan desain case-control study. Penelitian ini melibatkan
96 responden yang terbagi dalam 32 orang kelompok kasus dan 64 orang
kelompok kontrol. Kasus adalah pasien yang terdiagnosis gagal ginjal kronik
sedangkan kontrol adalah pasien tanpa penyakit gagal ginjal kronik. Sampel
dikumpulkan menggunakan teknik consecutive sampling. Instrumen penelitian
menggunakan kuisioner dan analisis data dilakukan dengan program SPSS
(Statistical Product and Service Solution).
Hasil: Berdasarkan penelitian yang dilakukan, hasil analisis bivariat
menunjukkan bahwa adanya riwayat hipertensi merupakan faktor risiko yang
berpengaruh terhadap kejadian gagal ginjal kronik (p<0,05; OR 2,480 95% CI
1,060-5,803), dan tekanan darah 160/100 mmHg memiliki hubungan bermakna
terhadap kecenderungan kejadian gagal ginjal kronik dibanding tekanan darah

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normal (<120/<80 mmHg) serta tidak terdapat hubungan bermakna antara pola
minum obat antihipertensi terhadap kejadian gagal ginjal (p>0,05 OR 2,677 95%
CI 0,738-9,629). Selain hipertensi, faktor lain yang diteliti yaitu diabetes mellitus,
hiperkolesterolemia, obesitas, dan riwayat merokok. Hasil analisis bivariat untuk
diabetes adalah tidak ada hubungan antara riwayat diabetes dengan kejadian gagal
ginjal kronik (p>0,05 OR 0,688 95% CI 0,257-1,841), selain itu tidak ada
hubungan antara kadar gula darah (p>0,05 OR 0,673 95% CI 0,194-2,333) dan
pola keteraturan berobat diabetes (p>0,05 OR 8,800 95% CI 0,722-100,255)
terhadap kejadian gagal ginjal. Analisis bivariat hiperkolesterolemia menunjukkan
tidak ada hubungan bermakna riwayat hiperkolesterolemia terhadap kejadian
gagal ginjal (p>0,05 OR 1,357 95% CI 0,457-4,028) dan tidak ada pula hubungan
bermakna antara pola pengobatan antihiperkolesterolemia yang dilakukan
terhadap kejadian gagal ginjal (p>0,05 OR 12,00 95% CI 0,956-150,688). Hasil
analisis bivariat riwayat obesitas menunjukkan tidak ada hubungan bermakna
riwayat IMT 25 kg/m2 (obesitas) dengan IMT <25 kg/m 2 (non-obes) terhadap
kejadian gagal ginjal kronik (p>0,05 OR 1,545 95% CI 0,616-3,878). Dari segi
perilaku merokok responden juga didapatkan hasil bahwa tidak ada hubungan
bermakna antara riwayat merokok terhadap kejadian gagal ginjal kronik (p>0,05
OR 1,396 95% CI 0,552-3,530), selain itu juga tidak terdapat hubungan antara
jumlah konsumsi rokok perhari (p>0,05 OR 7,500 95% CI 0,743-75,721) dan
durasi merokok (p>0,05 OR 2,444 95% CI 0,405-14,748) terhadap kejadian gagal
ginjal kronik.
Kesimpulan dan saran: Kesimpulan penelitian ini adalah faktor risiko yang
terbukti berpengaruh terhadap kejadian gagal ginjal kronik riwayat hipertensi dan
terbukti bahwa tekanan darah 160/100 mmHg berisiko mengalami gagal ginjal
kronik dibanding tekanan darah normal. Adapun faktor risiko lainnya seperti
riwayat diabetes mellitus, kadar gula darah, riwayat hiperkolesterolemia, pola
pengobatan hipertensi, diabetes, dan antihiperkolesterolemia, riwayat obesitas,
riwayat merokok, jumlah konsumsi rokok perhari, dan durasi merokok tidak
terbukti berpengaruh terhadap kejadian gagal ginjal kronik pada penelitian ini.
Saran agar dilakukan penelitian lebih lanjut dengan skala lebih besar tentang
faktor risiko gagal ginjal kronik ini, serta perlunya meneliti etiologi yang berperan
langsung terhadap kejadian penyakit. Selain itu perlunya memaksimalkan
penyuluhan tentang kesehatan ginjal sejak usia dini, serta edukasi kepada pasien
yang memiliki risiko agar mengontrol kesehatannya secara rutin.

Kata Kunci: Gagal Ginjal Kronik, End-stage Renal Disease (ESRD), Faktor
Risiko, Hipertensi, Diabetes Melitus, Hiperkolesterolemia, Indeks Massa Tubuh
(IMT), Perilaku Merokok

Daftar Pustaka: 26 (2001-2015)

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 ESSAY
FACULTY OF MEDICINE
HASANUDDIN UNIVERSITY
November 2016

Ahmad Yani Sukarso/C11111152

Dr. dr. Andi Alfian Zainuddin, M.KM

RISK FACTORS FOR INCIDENCE OF CHRONIC RENAL

FAILURE/END-STAGE RENAL DISEASE (ESRD) IN OUTPATIENTS ON
HEMODIALYSIS UNIT RSUD UNDATA PALU, SULAWESI TENGAH IN
2016
(xiv + 77 pages + 9 figures + 22 tables + 3 graphics + appendix)

ABSTRACT

Background: Chronic renal failure or ESRD (End-Stage Renal Disease) is a

clinical condition characterized by the irreversible decline in kidney function,
requiring renal replacement therapy that remains to sustain life, in the form of
dialysis or a kidney transplant. Based on epidemiological data from the National
Kidney Foundation explained that approximately 10% of the world population
affected by chronic kidney failure, which causes death in 409,000 inhabitants in
1990 to 956 000 inhabitants in 2013. Epidemiological data in Indonesia by
Riskesdas 2013 describes the prevalence of chronic kidney disease in Indonesia is
0.2% of the total population. Based on the explanation above, it is important to
know the factors determinant incidence of chronic kidney disease (CKD) to
ESRD (End-Stage Renal Disease), so that these factors can be modified to prevent
the incidence of the disease. So that the efforts of prevention, control, education,
and medical interventions can be more leverage, and result in decreased incidence
of ESRD.
Research Purposes: This study aims to determine the factors that influence the
incidence of chronic renal failure in the Hospital of Undata Palu in 2016.
Research Methods: This study is observational analytic study using a case-
control study design. The study involved 96 respondents were divided into 32
cases and 64 controls. Cases were patients diagnosed with chronic renal failure,
while controls were patients without chronic kidney disease. Samples were
collected using consecutive sampling technique. The research instrument used
questionnaires and data analysis was performed with SPSS (Statistical Product
and Service Solution).
Results: Based on research that has been conducted, the results of bivariate
analysis showed that a history of hypertension is a risk factor that influenced the
incidence of chronic renal failure (p <0.05; OR 2.480 95% CI 1.060 to 5.803), and
blood pressure 160 / 100 mmHg have a significant relationship to the trend of

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the incidence of chronic renal failure compared to normal blood pressure (<120 /
<80 mmHg) and there is no significant relationship between drinking patterns of
antihypertensive drugs on the incidence of renal failure (p> 2.677 OR 0.05 95%
CI 0.738 to 9.629) , In addition to hypertension, other factors studied were
diabetes mellitus, hypercholesterolemia, obesity, and smoking history. The results
of the bivariate analysis for diabetes is no relationship between a history of
diabetes in the incidence of chronic renal failure (p> 0.688 OR 0.05 95% CI 0.257
to 1.841), other than that there is no relationship between blood sugar levels (p>
0.05 OR 0.673 95% CI 0.194 to 2.333) and patterns of regularity of treatment of
diabetes (p> 8.800 OR 0.05 95% CI 0.722 to 100.255) on the incidence of renal
failure. Hypercholesterolaemia bivariate analysis showed no significant
relationship history of hypercholesterolemia on the incidence of renal failure (p>
1.357 OR 0.05 95% CI 0.457 to 4.028) and there is also a significant relationship
between treatment patterns antihiperkolesterolemia conducted on the incidence of
renal failure (p> 0, 12.00 05 OR 95% CI 0.956 to 150.688). The results of the
bivariate analysis of a history of obesity showed no significant relationship
history BMI 25 kg / m2 (obese) with BMI <25 kg / m2 (non-obese) on the
incidence of chronic renal failure (p> 0.05 1.545 95% CI OR 0,616- 3.878). In
terms of smoking behavior of respondents also showed that there was no
significant relationship between history of smoking on the incidence of chronic
renal failure (p> 1.396 OR 0.05 95% CI 0.552 to 3.530), but it is also no
correlation between the amount of cigarette consumption per day (p > 7,500 OR
0.05 95% CI 0.743 to 75.721) and the duration of smoking (p> 2.444 OR 0.05
95% CI 0.405 to 14.748) on the incidence of chronic renal failure
Conclusions and Recommendations: The conclusion of this study is a proven
risk factor influenced the incidence of chronic renal failure is a history of
hypertension and proved that blood pressure 160 / 100 mmHg is at risk of
chronic renal failure compared to normal blood pressure. As for other risk factors
such as history of diabetes mellitus, blood sugar levels, a history of
hypercholesterolemia, patterns of treatment of hypertension, diabetes, and
antihiperkolesterolemia, history of obesity, history of smoking, the number of
cigarette consumption per day, and the duration of smoking is not proven effect on
the incidence of chronic renal failure in this study , suggestions for further
research is doing research with a larger scale of the risk factors of chronic renal
failure, as well as the need to investigate the etiology of which play a direct role
on the incidence of the disease. Besides that, we need to maximize education
about kidney health from an early age, and education to patients who have a risk
in order to control their health routine.

Key Words: Chronic Renal Failure, End-stage Renal Disease (ESRD), Risk
Factors, Hypertension, Diabetes Mellitus, Hypercholesterolaemia, Body Mass
Indeks (BMI), Smoking behavior

Bibliography: 26 (2001-2015)

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