Association between Frailty and Dialysis Symptom Index among Chronic Hemodialysis Patients in Indonesia

Jeremia Immanuel Siregar; Hosea Glory

doi:10.56951/06rnm232

Association between Frailty and Dialysis Symptom Index among Chronic Hemodialysis Patients in Indonesia

Penulis

Jeremia Immanuel Siregar Department of Internal Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
Hosea Glory Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia

DOI:

https://doi.org/10.56951/06rnm232

Kata Kunci:

frailty, dialysis symptom index, hemodialisis kronis

Abstrak

Latar belakang: Penyakit ginjal kronis (PGK) merupakan salah satu penyebab kematian global dengan 79% di antaranya tergolong stadium G3-G5, yang berkorelasi dengan tingginya kebutuhan hemodialisis. Pasien hemodialisis memiliki
risiko tinggi untuk mengalami efek samping, khususnya frailty. Sebaliknya, frailty juga dapat memperburuk efek samping hemodialisis, bahkan meningkatkan risiko mortalitas. Penelitian ini bertujuan untuk melihat hubungan antara frailty terhadap Dialysis Symptom Index (DSI) pada pasien yang menjalani hemodialisis kronis. Metode: Penelitian ini menggunakan metode cross-sectional dengan desain studi analitik komparatif numerik tidak berpasangan. Data diperoleh dengan menggunakan kuesioner DSI dan kuesioner RAPUH. Populasi pada penelitian adalah pasien berusia 18 tahun ke atas yang menjalani hemodialisis kronis. Analisis statistik dilakukan menggunakan uji t atau uji Mann-Whitney. Hasil: Terdapat 35 (24,8%) pasien hemodialisis yang mengalami frailty dan 106 (75,2%) pasien hemodialisis yang tidak mengalami frailty. Kelompok pasien yang mengalami frailty menunjukkan frekuensi gejala yang signifikan dibandingkan kelompok yang tidak mengalami frailty, di antaranya kurang nafsu makan (p<0,001), sesak napas (p=0,039), pusing (p=0,022), merasa lelah atau kurang berenergi (p<0,001), mulut kering (p=0,004), nyeri tulang atau sendi (p=0,001), sulit tidur (p=0,014), mudah terbangun (p=0,007), hasrat seks menurun (p<0,001), dan sulit terangsang secara seksual (p<0,001). Kesimpulan: Penelitian ini menunjukkan adanya hubungan yang signifikan antara frailty dengan efek samping hemodialisis. Gejala yang paling sering muncul adalah merasa lelah atau kurang berenergi, hasrat seks menurun, sulit terangsang secara seksual, mudah terbangun, kram otot, dan kesulitan tidur.

Unduhan

Baca Selengkapnya

Referensi

1. Vaidya SR, Aeddula NR. Chronic renal failure. The scientific basis of urology, 2nd edition [Internet]. 2022;257–64. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535404/

2. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022;12(1):7–11. doi:10.1016/j.kisu.2021.11.003.

3. Luyckx VA, Tonelli M, Stanifer JW. The global burden of kidney disease and the sustainable development goals. Bull World Health Organ. 2018;96(6):414–22D. doi:10.2471/BLT.17.206441.

4. Kementerian Kesehatan RI. Laporan Nasional RISKESDAS 2018. Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan. Jakarta:2019.

5. Ye H, et al. Hemodialysis. In: Yang J, He W, editors. Chronic Kidney Disease. Singapore: Springer; 2020. p. 209–31. doi:10.1007/978-981-32-9131-7_17.

6. You AS, Kalantar SS, Norris KC, Peralta RA, Narasaki Y, Fischman R, et al. Dialysis symptom index burden and symptom clusters in a prospective cohort of dialysis patients. J Nephrol. 2022;35(5):1427–36. doi:10.1007/s40620-022-01313-0.

7. Chaiviboontham S, Phinitkhajorndech N, Tiansaard J. Symptom clusters in patients with end-stage renal disease undergoing hemodialysis. Int J Nephrol Renovasc Dis. 2020;13:297–305. doi:10.2147/IJNRD. S271619.

8. Guo Y, Tian R, Ye P, Luo Y. Frailty in older patients undergoing hemodialysis and its association with allcause mortality: a prospective cohort study. Clin Interv Aging. 2022;17:265–75. doi:10.2147/CIA.S357582.

9. Li Y, Zhang D, Ma Q, Diao Z, Liu S, Shi X. The impact of frailty on prognosis in elderly hemodialysis patients: a prospective cohort study. Clin Interv Aging. 2021;16:1659–67. doi:10.2147/CIA.S329665.

10. Johansen KL, Chertow GM, Jin C, Kutner NG. Significance of frailty among dialysis patients. J Am Soc Nephrol. 2007;18(11):2960–7. doi:10.1681/ASN.2007020221.

11. Garcia-Canton C, Rodenas A, Lopez-Aperador C, Rivero Y, Anton G, Monzon T, et al. Frailty in hemodialysis and prediction of poor short-term outcome: mortality, hospitalization and visits to hospital emergency services. Ren Fail. 2019;41(1):567–75. doi:10.1080/0886022X.2019.1628061.

12. Yoshikoshi S, Yamamoto S, Suzuki Y, Imamura K, Harada M, Yamabe S, et al. Association between physical frailty and sleep disturbances among patients on hemodialysis: a cross-sectional study. Nephron. 2024;148(3):152–9. doi:10.1159/000533418.

13. Pereira M, Tocino MLS, Mas-Fontao S, Manso P, Burgos M, Carneiro D, et al. Dependency and frailty in the older haemodialysis patient. BMC Geriatr. 2024;24(1):416. doi:10.1186/s12877-024-04973-8.

14. Fleishman TT, Dreiher J, Shvartzman P. Patient-reported outcomes in maintenance hemodialysis: a crosssectional, multicenter study. Qual Life Res. 2020;29(9):2345–54. doi:10.1007/s11136-020-02508-3.

15. Zhou M, Gu X, Cheng K, Wang Y, Zhang N. Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study. BMC Nephrol. 2023;24(1):115. doi:10.1186/s12882-023-03176-4.

16. Szepietowski JC, Reich A, Schwartz RA. Uraemic xerosis. Nephrol Dial Transplant. 2004;19(11):2709–12. doi:10.1093/ndt/gfh480.

17. Agarwal P, Garg V, Karagaiah P, Szepietowski JC, Grabbe S, Goldust M. Chronic kidney disease-associated pruritus. Toxins (Basel). 2021;13(8):527. doi:10.3390/toxins13080527.

18. Rezaiee O, Shahgholian N, Shahidi S. Assessment of hemodialysis adequacy and its relationship with individual and personal factors. Iran J Nurs Midwifery Res. 2016;21(6):577–82. doi:10.4103/1735-9066.197673.

19. Mourad B, Hegab D, Okasha K, Rizk S. Prospective study on prevalence of dermatological changes in patients under hemodialysis in hemodialysis units in Tanta University hospitals, Egypt. Clin Cosmet Investig Dermatol. 2014;7:313–9. doi:10.2147/CCID.S70842.

20. Pagels A, Heiwe S, Hylander B. Der Ernährungszustand von Prädialysepatienten [Nutritional status of predialysis patients]. J Ren Care. 2006;32(3):162–6. German. doi:10.1111/j.1755-6686.2006.tb00009.x.

21. Tsirigotis S, Polikandrioti M, Alikari V, Dousis E, Koutelekos I, Toulia G, et al. Factors associated with fatigue in patients undergoing hemodialysis. Cureus. 2022;14(3):e22994. doi:10.7759/cureus.22994.

22. Kodama H, Togari T, Konno Y, Tsuji A, Fujinoki A, Kuwabara S, et al. A new assessment scale for postdialysis fatigue in hemodialysis patients. Renal Replacement Therapy. 2020;6:1–8. doi:10.1186/S41100-019-0252-5.

23. Jhamb M, Weisbord SD, Steel JL, Unruh M. Fatigue in patients receiving maintenance dialysis: a review of definitions, measures, and contributing factors. Am J Kidney Dis. 2008;52(2):353–65. doi:10.1053/j. ajkd.2008.05.005.

24. Liu HE. Fatigue and associated factors in hemodialysis patients in Taiwan. Res Nurs Health. 2006;29(1):40–50. doi:10.1002/nur.20109.

25. Unruh M, Miskulin D, Yan G, Hays RD, Benz R, Kusek JW, et al. Racial differences in health-related quality of life among hemodialysis patients. Kidney Int. 2004;65(4):1482–91. doi:10.1111/j.1523-1755.2004.00529.x.26. Rimsevicius L, Gincaite A, Vicka V, Sukackiene D, Pavinic J, Miglinas M. Malnutrition assessment in hemodialysis patients: role of bioelectrical impedance analysis phase angle. J Ren Nutr. 2016;26(6):391–5. doi:10.1053/j.jrn.2016.05.004.

27. Zaki DSD, Mohamed RR, Mohammed NAG, Abdel-Zaher RB. Assessment of malnutrition status in hemodialysis patients. Clinical Medicine and Diagnostics. 2019;9(1):8–13. doi:10.5923/j.cmd.20190901.02.

28. Segall L, Mardare NG, Ungureanu S, Busuioc M, Nistor I, Enache R, et al. Nutritional status evaluation and survival in haemodialysis patients in one centre from Romania. Nephrol Dial Transplant. 2009;24(8):2536–40. doi:10.1093/ndt/gfp110.

29. Rodrigues J, Cuppari L, Campbell KL, Avesani CM. Nutritional assessment of elderly patients on dialysis: pitfalls and potentials for practice. Nephrol Dial Transplant. 2017;32(11):1780–9. doi:10.1093/ndt/gfw471.

30. Souza Júnior EV, Silva CDS, Pirôpo US, Santos BFMD, Guedes TP, Siqueira LR, et al. Effects of sexuality on frailty and quality of life in the elderly: a cross-sectional study. Rev Bras Enferm. 2021;75(1):e20210049. English, Portuguese. doi:10.1590/0034-7167-2021-0049.

31. Tsujimura A. The relationship between testosterone deficiency and men’s health. World J Mens Health. 2013;31(2):126–35. doi:10.5534/wjmh.2013.31.2.126.

32. Chiang JM, Kaysen GA, Segal M, Chertow GM, Delgado C, Johansen KL. Low testosterone is associated with frailty, muscle wasting and physical dysfunction among men receiving hemodialysis: a longitudinal analysis. Nephrol Dial Transplant. 2019;34(5):802–10. doi:10.1093/ndt/gfy252.

33. Barrera A, Rezende LFM, Sabag A, Keating CJ, Rey-Lopez JP. Understanding the causes of frailty using a life-course perspective: a systematic review. Healthcare (Basel). 2023;12(1):22. doi:10.3390/healthcare12010022.

34. Uslu A, Canbolat O. Relationship between frailty and fatigue in older cancer patients. Semin Oncol Nurs. 2021;37(4):151179. doi:10.1016/j.soncn.2021.151179.

35. Theou O, Jones GR, Overend TJ, Kloseck M, Vandervoort AA. An exploration of the association between frailty and muscle fatigue. Appl Physiol Nutr Metab. 2008;33(4):651–65. doi:10.1139/H08-058.