Anemia

pada Penyakit
Ginjal Kronis
Pembimbing :
dr. Doddy Widjanarko Sp.PD

Jhouharotul Faradisah 2019.04.2.0106

Kinanti Hapsari 2019.04.2.0112
 FUNGSI GINJAL

sebagai alat untuk membersihkan tubuh dari

bahan sisa metabolisme

Pengaturan Produksi Eritrosit atau

eritropoietin

Pengaturan Keseimbangan air dan elektrolit

PENYAKIT
GINJAL
KRONIK

FUNGSI ERITROPOI
GINJAL ETIN

ANEMIA
 prevalensi
- Pasien dengan nilai LFG < 60
mL/min/1,73m2. Akan tetapi anemia juga
bisa terdapat pada pasien dengan LFG yang
lebih
- Laki-laki > penderita perempuan
- Pada hasil penelitian menunjukkan bahwa
anemia pada penderita PGK sebagian besar
adalah anemia sedang dan berat (Natalia,
2019).
Derajat Penjelasan LFG (ml/mnt) Komplikasi

1 Kerusakan ginjal dengan LGF ≥90 -

normal

2 Kerusakan ginjal dengan 60-89 Tekanan darah mulai naik

penurunan LGF ringan

3 Penurunan LGF sedang 30-59 Hiperfosfatemia

Hipokalsemia
Anemia
Hiperparatiroid
Hipertensi
Hiperhomosistinemia

4 Penurunan LGF berat 15-29 Malnutrisi

Asidosis metabolik
Cenderung hiperkalemia
Dislipidemia
 Etiologi Penjabaran etiologi

Penyebab utama Defisiensi relatif dari eritropoietin

Penyebab tambahan Kekurangan zat besi

Inflamasi akut dan kronik
Pendeknya masa hidup eritrosit
Bleeding diathesis
Hiperparatiroidisme/ fibrosis sumsum
tulang

Hemoglobinopati, hipotiroid, hipertiroid,

Kondisi komorbiditas kehamilan,
penyakit HIV, penyakit autoimun, obat
imunosupresif
Manifestasi klinis yang biasa ditemukan: Temuan
 Kelemahan umum/malaise, mudah pemeriksaan
lelah
fisik:
 Nyeri seluruh tubuh/mialgia
 Neurovaskular (penurunan kemampuan
 Gejala ortostatik ( misalnya pusing, kognitif)
dll )
 Kulit (pucat)
 Sinkop atau hampir sincope
 Mata (konjungtiva pucat)
 Penurunan toleransi latihan
 Kardiovaskular (hipotensi ortostatik,
 Dada terasa tidak nyaman takiaritmia)
 Palpitasi  Pulmonary (takipnea)
 Intoleransi dingin  Abdomen (asites, hepatosplenomegali)
 Gangguan tidur
 Ketidakmampuan untuk
berkonsentrasi
 Kehilangan
nafsu
makan
 Diagnosa
• Beberapa poin harus diperiksa dahulu sebelum
dilakukan pemberian terapi penambah eritrosit, yaitu :
• Darah lengkap
• Pemeriksaan darah tepi
• Hitung retikulosit
• Pemeriksaan besi (serum iron, total iron binding
capacity, saturasi transferin, serum feritin)
• Pemeriksaan darah tersamar pada tinja
• Kadar vitamin B12
• Hormon paratiroid
penatalaksanaan
 PENDAHULUAN

Kidneys
remove waste products
from your body
 Kidneys
Maintain the right remove
amount of water in the body
excess fluid
from your
body
 Early kidney disease
has no signs or symptoms
 Kidneys
help the body produce
red blood cells

ERYTHROPOIETIN
 Maintain
a healthy
fluid intake
 Do NOT take
over-the-counter
pills on
a regular basis
Kidney transplantation
150-170
5.2 – 5.9
Make

Purify
THE KIDNEY
The urinary tract or system

Tissue part
Kidney

Drainage part
Link to the bladder
 Thousands
of filters

Two
blood
vessels
The urinary tract or system

Ureters

Urethra
KIDNEYS
FOOD
=
• Proteins
• Fats
• Starches
• ...
 Kidneys
balance the minerals and
chemicals in your body
 Kidneys
control your
blood pressure

RENIN
Kidneys help maintain
healthy bones

VITAMIN
D
Ca++
KIDNEYS
Kidney shape
Kidney size
Every minute In one day

1200 1700
ml of blood enters liters of blood
both kidneys is purified

20% 3592.7
of the total blood pumped by the heart pints
Adults have Filtered

7- 8 400
liters of blood times per day!

14 - 16
pints
Nephrons
from both
kidneys placed
horizontally
end to end
 16
kilometers

9.95
miles
Your body can work normally
with a single kidney
KIDNEYS
 Blood and urine tests
are the only way to know
Kidneys function Kidneys
less than 10% no longer function
of normal at all

End stage Dialysis

kidney
Trans-
disease
plantation
 Dialysis removes
waste products and
unwanted water
Hemodialysis
Peritoneal dialysis
 The old
damaged
kidneys
are not usually
removed
KIDNEYS
8 Golden Rules
 Keep
fit and active
 Eat healthy food
to ensure good nutrition and good
control of your blood sugar level
Monitor your
blood pressure
 Eat healthy and
keep your weight in check
Do NOT
smoke
KIDNEYS
You have You have
diabetes hypertension You are
overweight
One of
your parents or
other family
You come
members
from an ethnic
suffer from
group
kidney disease
with high risk
Move
your feet
for