Pemberian diet ekstra formula komersial dan diet ekstra filtrat ikan gabus intradialisis serta pengaruhnya terhadap kadar serum albumin dan kreatinin pasien dengan hemodialisis di RSU Dr. Saiful Anwar Malang

https://doi.org/10.22146/ijcn.17550

Etik Sulistyowati(1*), Hamam Hadi(2), Susetyowati Susetyowati(3), Atma Gunawan(4)

(1) Politeknik Kesehatan Departemen Kesehatan RI Malang
(2) Magister Gizi Kesehatan Universitas Gadjah Mada
(3) Instalasi Gizi RSUP Dr. Sardjito Yogyakarta
(4) RSU Dr. Saiful Anwar, Malang
(*) Corresponding Author

Abstract


Background: Nowadays chronic kidney disease (CKD) is a serious health problem because of its increasing incidence. In Indonesia, approximately there are 100 CKD patients per 1 million people per year. Hemodialysis is one of ways to prolong CKD patient’s life that should be done recurrently and for a long time. However, hemodialysis causes loss of nutrients leading to high prevalence of malnutrition among CKD patients. Until today intradialysis diet therapy which can replace loss of nutrients particularly protein has not been initiated as part of diet therapy in Indonesian hospitals. To improve nutritional status and minimize mortality rate, oral intradialysis diet therapy with proper formula is needed.

Objective: To study the effect of the supply of commercial formula and local catfish filtrate extra diet to albumin and creatinine serum level among hemodialysis patients.

Method: The study was experimental with randomized control trial design carried out at Dialysis Installation of Dr. Saiful Anwar Hospital, Malang. There were as many as 36 hemodialysis patients divided into 3 groups; 1 group with standard diet, 1 group with commercial formula and standard diet, and 1 group with local catfish filtrate and standard diet. Data were obtained through interview, note taking, and laboratory tests which consisted of subject characteristics in weight, height, albumin and creatinin serum level as well as food intake one day before, during and one day after hemodialysis. Data analysis was done descriptively and inferentially using chi square, anova, and paired t-test. The conclusion was based on significance level (α ) 0.05 or p < 0.05.

Results: There was no significant difference in the characteristics of the subject at the beginning of the study with average albumin serum level 3.61 ± 0.48 g/dL and creatinine serum level 9.04 ± 2.73 mg/dL. There was no difference in average energy and protein intake of the subject. At the end of the study average albumin serum level was 3.38 ± 0.42 g/dL, creatinine serum level 8.34 ± 3.6 mg/dL, and there was significant difference in albumin serum level (p = 0.000) of the subject. Although there was an increase of creatinine serum level in the group with local catfish filtrate extra diet, it was statistically insignificant.

Conclusion: There was significant effect of the supply of commercial formula and local catfish filtrate extra diet to increase of albumin serum level of the subject and there was no significant effect of the supply of extra diet to creatinine serum level; however, the supply of local catfish filtrate extra diet could maintain creatinine serum level.

Keywords


hemodialysis; intradialysis diet theray; commercial formula; local catfish filtrate; albumin serum; creatinine serum

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References

Perhimpunan Nefrologi Indonesia Pernefri. Konsensus Dialisis. Jakarta: Pernefri; 2003.

Hung YM, Lee SJ. Analysis of Early and Late Mortality of Chronic Hemodialysis Patients in A Hemodialysis Center of Southern Taiwan. Dial Transplant 2003;32(4):198-203.

Bakri S. 22 Tahun Menggeluti Penyakit Ginjal. Kompas 3 September 2005; Sect. A:1 (col.1-3).

Kopple J, Massry SG. Nutritional Management of Renal Disease. Philadelphia: Lippincott Williams & Wilkins; 2003.

Pollock CA, Ibels LS, Allen BJ. Nutritional Markers and Survival in Maintenance Dialysis Patients. Nephron 1996;74;625-41.

Protica. Protein Requirements During Treatment of Renal Failure. Protica Publications; 6 Mei 2005.

Foulks CJ. The Effect of Intradialytic Parenteral Nutrition on Hospitalization Rate and Mortality in Malnourished Hemodialysis Patiens. J Ren Nutr 1996;4:5–10. 8.

Ruggian JC, Fishbane S, Frei GL. Effect of Intradialytic Parenteral Nutrition (IDPN) on Hypoalbunemic Hemodialysis (HD) Patients. J Am Soc Nephrol 1994;5:502.

FitzGerald RJ, Murray BA, Walsh DJ. Hypotensive Pep- tides from Milk Proteins. J Nutr 2004;134:980S-8S.

Soemarko. Pengaruh Diet Ikan Kutuk dan Putih Telor terhadap Peningkatan Albumin dan Penutupan Luka Operasi. Malang: RSSA; 1998.

Santosa A. Profil Zat Gizi Filtrat Ikan Gabus. Laporan Penelitian. Malang: Poltekkes Depkes Malang; 2005.

Suprayitno E, Moedjiharto TJ, Madkhoiri. Penggunaan Albumin Ikan Gabus (Ophiochephalus striatus) pada Penutupan Luka Tikus Putih Wistar. Malang: Universi- tas Brawijaya; 2003.

Lemeshow S, Hosmer D, Klar J. 1990. Adequacy of Sample Size in Health Studies. (Terjemahan) Pramono D. Yogyakarta: UGM Press; 1997. h. 49-52.

Sastroasmoro S, Ismael S. Dasar-Dasar Metodologi Penelitian Klinis. Jakarta: Binarupa Aksara; 1995.

Heacock P, Nabel J, Norton P, Heile S, Royse D. An Exploration of The Relationship Between Nutritional Status and Quality of Live in Chronic Hemodialysis Patients. J Ren Nutr 1996;6(3):152-7.

Lindsay R, Spanner E, Heidenheim P, Le Febure JM. (1992) Wich Comes First. Kt/V or PCR Chicken or Egg? Kidney Int;42:S32-7.

Susetyowati. Peranan Konsultasi Gizi Berkelanjutan terhadap Kadar Albumin Serum Penderita Penyakit Ginjal Kronik dengan Hemodialisis di RS Dr Sardjito Yogyakarta. Berkala Kesehatan Klinik 2005;XI(1):22-5.

Veeneman JM, Kingma HA, Boer TS. Protein Intake During Hemodialysis Maintains A Positive Whole Body Protein Balance in Chronic Hemodialysis Patients. Am J Physiol 2003;284:E954-65.

Ray C. Protein Supplementations in Patients Using Peritoneal Dyalisis. J Ren Nutr 2005;15(2):260-4.

Dwyer JT, Larive B, Leung J. Nutritional Status Affects Quality of Life in Hemodialysis (HEMO) Study Patients at Baseline. J Ren Nutr 2002;22:213-33.

Kalantar ZK, Kopple DJ, Deepak S. Food Intake Characteristics of Hemodialysis Patients As Obtained by Food Frequency Questionnaire. J Ren Nutr 2002;12:17- 21.

Akner G, Cederholm. Treatment of Protein Energy Malnutrition in Chronic Nonmalignant Disorder. Am J Clin Nutr 2001;74(1):6-7.

Cano N. Hemodialysis, Inflammation and Malnutrition. Nefrol 2001;XXI:1-9.

Sharma M, Rao M, Jacob S, Jacob CK. A Controlled Trial of Intermittent Enteral Nutrition Supplementation in Maintenance Hemodialysis Patients. J Ren Nutr 2002;12:29-37.

Sidabutar RP, Suhardjono, Kapojos EJ. Gagal Ginjal Kronik. Dalam: Soeparman, Waspadji S, editors. Ilmu Penyakit Dalam. Jakarta: Balai Penerbit FKUI; 1991.

Mendez CM, McClain CJ, Marsono LS. Albumin Therapy in Clinical Practise. Nutr Clin Pract 2005;20(3):314-20.

Wilkens KG. Medical Nutrition Therapy for Renal Disorders. In: Mahan LK, Stump SE, editors. Krause’s: Food Nutrition and Diet Therapy.11th edition. Philadelphia: WB Saunders; 2004.pp. 970-85.

De Arau’jo IC, Kamimura MA, Draibe SA, Canziani M, Manfredi SR, Avesani, et al. Nutritional Parameters and Mortality in Incident Hemodialysis Patients. J Ren Nutr 2006;16(1):27-35.

National Kidney Foundation/Kidney Disease Outcome Quality Initiative (NKF/KDOQI). Clinical Practical Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. Am J Kidney Dis 2002;39(2):S1-S246.

Bellizzi V, Iorio BR, Terracciano V, Minutolo R, Iodice C, Nicola LD, et al. Daily Nutrition Intake Represents A Modifiable Determinant of Nutritional Status in Chronic Hemodialysis Patients. Nephrol Dial Transplant 2003;18:1874-81.

Cano N. Malnutrition and Hemodialysis. Paper Presented at The Meeting of ESPEN Congress Canes. 2003.

Jones CH. Serum Albumin in Peritoneal Dialysis Patients. Paper Presentet at The Meeting of 3th Congress of Nephrology in Internet: 2003; New York, USA.

Rigby JA. Growing Numbers of People with Chronic Kidney Disease Require that Dietitians Get Up to Speed on Prevention and Treatment. Kidney Dis 2004;6(11):44.

DeMan JM. Kimia Makanan. (Terjemahan) Ismadi M. Edisi Kedua. Jakarta: EGC;.1997.

Lim VS, Ikizler TA. Does Hemodialysis Increase Protein Breakdown? Dissociation Between Whole Body Amino Acid Turnover and Regional Muscle Kinetics. J Am Soc Nephrol 2005;16:862-8.

Pupim LB, Flakoll PJ, Ikizler TA. Nutritional Supplementation Acutely Increases Albumin Fractional Synthetic Rate in Chronic Hemodialysis Patients . J Am Soc Nephrol 2004;15:1920-6.

Tietze IN, Pedersen EB. Effect of Fish Protein Supplementation on Amino Acid Profile and Nutritional Status in Hemodialysis Patients. Nephrol Dial Transplant 1991;6:948-54.

Mitch WE, Goldberg AL. Mechanisms of Muscle Wasting. N Engl J Med 2004;25(335):1897-905.

Iseki K, Kawazoe N, Fukiyama K. Serum Albumin is A Strong Predictor of Death in Chronic Dialysis Patients. Kidney Int 1999;44:115-9.

Williams. Early Clinical, Quality of Life and Biochemical Changes of Daily Hemodialysis. Am J Kidney Dis 2004;43(1):169-70.



DOI: https://doi.org/10.22146/ijcn.17550

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