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"Nanoporous polyethersulfone (PES) membrane is widely used as a filtration membrane in hemodialysis systems. Unfortunately, it has low blood compatibility, and induces blood clots that adhere to the membrane’s surface during dialysis treatment. This paper reports on a review of surface modification that is used to improve the PES membrane’s blood compatibility. The method consists of applying two coating materials, in the form of parylene and fluorinated diamond-like carbon (F-DLC) films, onto the membrane’s surface. The parylene film is deposited on the diffusion layer of the membrane surface using glycerin liquid, while the F-DLC film is specially coated on the supporting layer of the membrane. The unique property of parylene, which has the characteristics of conformal coating, prevents the parylene from being coated on the supporting layer of the membrane. Conversely, F-DLC film, which is hard, fragile and has a less conformal coating than parylene, is only meant to be coated on the supporting layer. Finally, the coated membranes, along with the bare PES membrane, are compared and investigated under a long-term diffusion test to assess their permeability and blood compatibility. The experiment results show that both coating materials have the capacity to improve the membrane’s blood compatibility in different ways."

"Saat ini data peritonitis rate dan angka kematian pasien penyakit ginjal kronik (PGK) stadium akhir pengguna terapi Continuous Ambulatory Peritoneal Dialysis (CAPD) di Asian Tenggara masih terbatas. Angka peritonitis rate dan angka kematian pasien CAPD merupakan key performance indicator (KPI) yang diperlukan untuk melakukan evaluasi dan perbaikan mutu pelayanan secara berkelanjutan/continuous quality improvement (CQI) terhadap pelayanan terapi CAPD di rumah sakit. Peritonitis dapat menyebabkan kegagalan terapi CAPD sehingga pasien beralih ke metode hemodialisis atau berujung kematian. Metode CAPD memiliki keunggulan dibandingkan hemodialisis karena lebih hemat biaya, memberikan kualitas hidup lebih baik dan tidak memerlukan perawatan khusus di pusat hemodialisis. Metode ini cocok diterapkan di negara Asia Tenggara yang mengalami peningkatan jumlah penderita PGK tahap akhir yang membutuhkan biaya terapi sangat besar namun memiliki dana serta sumber daya terbatas. Tujuan utama systematic review ini untuk mengetahui peritonitis rate dan angka kematian pasien CAPD di Asia Tenggara. Systematic review menggunakan data renal registry serta basis data PubMed dan ProQuest khusus berbahasa Inggris dan Indonesia sejak tanggal 1 Januari 1992 sampai dengan 1 November 2022. Semua jenis studi yang memberikan informasi terkait peritonitis rate dan angka kematian pasien CAPD diambil dalam penelusuran systematic review. Penulis menyaring, memilih dan mengekstrak data sesuai skema systematic review PRISMA 2020. Artikel terpilih diberikan tinjauan kritis dan dilakukan sintesis data. Hasil sintesis data dilaporkan secara secara naratif serta diperjelas dengan tabel dan diagram. Dalam melakukan systematic review penulis menggunakan aplikasi Mendeley dan Microsoft Exel 2010 sebagai alat bantu. Hasil: Dari pencarian database Pubmed (1397) dan Proquest (422) serta laporan renal registry total terjaring 1819 artikel dan 5 laporan renal registry. Setelah proses penyaringan dan tinjauan kritis diperoleh 34 artikel dan 3 laporan renal registry. Hasil analisis menunjukkan telah terjadi penurunan tingkat peritonitis rate di Asia Tenggara dalam kurun waktu 1993-2022. Terdapat 4 negara yaitu Indonesia (0,25 episode per pasien-tahun),Vietnam (0,19 episode per pasien-tahun), Singapura (0,31-0,339 episode per pasien-tahun) dan Malaysia (0,13-0,33 episode per pasien-tahun) secara umum mencapai target International Society for Peritoneal Dialysis (ISPD)2022 yaitu tingkat peritonitis dibawah 0,4 episode episode per pasien-tahun. Adapun Thailand (0,39-0,864 episode per pasien-tahun) dan Brunei Darussalam (0,38-0,49 episode per pasien-tahun) belum mencapai target yang telah ditetapkan oleh International Society for Peritoneal Dialysis (ISPD) 2022. Sebagian besar angka kematian di bawah 20%. Angka kematian akibat peritonitis berkisar 3,2-5,5%. Mikroorganisme penyebab peritonitis yang paling sering ditemukan adalah Staphylococcus aureus dan Coagulase-negative Staphylococcus. Faktor risiko peritonitis yang ditemukan yaitu faktor usia tua (60 tahun keatas); diabetes milletus; sosial ekonomi rendah; tidak adanya sumber air bersih; hipoalbuminemia; kemampuan pasien CAPD dalam menerapkan tindakan aseptik saat pertukaran cairan dialisat yang buruk; rasio pasien-perawat lebih dari (50:1); jarak rumah yang jauh dari pusat dialisis; letak geografis dan penggunaan mupirocin topikal pada exit-site CAPD. Penggunaan cairan dialisat Dextrosa 4,2% yang sering dan terus menerus meningkatkan risiko kematian pada pasien CAPD sebanyak 2 kali lipat. Kesimpulan: Sebagian besar Negara di Asia Tenggara memiliki kualitas pelayanan yang baik terhadap pasien penyakit ginjal kronik stadium akhir pengguna terapi CAPD. Untuk mencapai kualitas pelayanan CAPD yang baik diperlukan bagi rumah sakit untuk memperhatikan faktor risiko peritonitis dan faktor risiko kematian dalam melakukan seleksi terhadap pasien CAPD serta melakukan pelatihan terhadap pasien CAPD sesuai rekomendasi International Society for Peritoneal Dialysis (ISPD).

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Currently data on the peritonitis rate and mortality rate of end-stage chronic kidney disease (CKD) patients using Continuous Ambulatory Peritoneal Dialysis (CAPD) therapy in Southeast Asia are still limited. The peritonitis rate and mortality rate of CAPD patients are key performance indicators (KPI) needed to evaluate and improve continuous quality improvement (CQI) for CAPD therapy services in hospitals. Peritonitis can lead to failure of CAPD therapy so that patients switch to hemodialysis methods or lead to death. The CAPD method has advantages over hemodialysis because it is more cost-effective, provides a better quality of life and does not require special treatment at a hemodialysis center. This method is suitable for use in Southeast Asian countries where there is an increasing number of end-stage CKD patients who require very large therapeutic costs but have limited funds and resources. The main aim of this systematic review is to determine the peritonitis rate and mortality rate of CAPD patients in Southeast Asia. The systematic review used renal registry data and the English and Indonesian PubMed and ProQuest databases from January 1 1992 to November 1 2022. All types of studies that provided information regarding the peritonitis rate and mortality rate of CAPD patients were included in a systematic review search. The author filters, selects and extracts data according to the PRISMA 2020 systematic review scheme. Selected articles are given a critical review and data synthesis is carried out. The results of data synthesis are reported in a narrative manner and clarified by tables and diagrams. In carrying out a systematic review, the author uses the Mendeley application and Microsoft Exel 2010 as a tool. Results: From a search of the Pubmed (1397) and Proquest (422) databases and renal registry reports, a total of 1819 articles and 5 renal registry reports were captured. After screening and critical review, 34 articles and 3 renal registry reports were obtained. The results of the analysis show that there has been a decrease in the peritonitis rate in Southeast Asia in the period 1993-2022. There are 4 countries namely Indonesia (0.25 episodes per patient-year), Vietnam (0.19 episodes per patient-year), Singapore (0.31-0.339 episodes per patient-year) and Malaysia (0.13-0, 33 episodes per patient-year) generally achieves the International Society for Peritoneal Dialysis (ISPD) 2022 target of a peritonitis rate below 0.4 episodes per patient-year. Meanwhile, Thailand (0.39-0.864 episodes per patient-year) and Brunei Darussalam (0.38-0.49 episodes per patient-year) have not yet reached the target set by the International Society for Peritoneal Dialysis (ISPD) 2022. Most of them mortality rate below 20%. The mortality rate from peritonitis ranges from 3.2-5.5%. The most common microorganisms that cause peritonitis are Staphylococcus aureus and Coagulase-negative Staphylococcus. The risk factors for peritonitis found were old age (60 years and over); milletus diabetes; low socioeconomic; lack of clean water sources; hypoalbuminemia; poor ability of CAPD patients to apply aseptic measures during dialysate fluid exchange; patient-nurse ratio more than (50:1); the distance from the house to the dialysis center; geographic location and use of topical mupirocin in CAPD exit-sites. Frequent and continuous use of Dextrose 4.2% dialysate fluid increases the risk of death in CAPD patients by 2 times. Conclusion: Most countries in Southeast Asia have good quality of care for patients with end-stage chronic kidney disease using CAPD therapy. To achieve good quality CAPD services, it is necessary for hospitals to pay attention to risk factors for peritonitis and risk factors for death in selecting CAPD patients and conducting training for CAPD patients according to the recommendations of the International Society for Peritoneal Dialysis (ISPD)."

""Handbook of Dialysis is now completely revised in its Fifth Edition. It continues to provides practical, accessible information on all aspects of dialysis with emphasis on day-to-day patient management. Authored by international experts, chapters provide complete coverage of hemodialysis, peritoneal dialysis, special problems in dialysis patients, and problems pertaining to various organ systems"--Provided by publisher."

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Ketercapaian adekuasi hemodialisis merupakan salah satu indikator kualitas keperawatan hemodialisis. untuk menghasilkan hemodialisis yang adekuat diperlukan adanya perawat yang memiliki kompetensi yang baik dalam memberikan asuhan keperawatan pada pasien hemodialisis. penelitian ini bertujuan untuk mengetahui hubungan antara kompetensi perawat dengan ketercapaian adekuasi hemodialisis. penelitian ini menggunakan metode cross-sectional. Sampel terdiri dari 82 perawat yang bekerja di unit hemodialisis dan 82 pasien hemodialisis. Teknik pengumpulan sampel menggunakan purposive sampling. analisis data dengan Chi-Square dan regresi logistik berganda. Terdapat hubungan antara kompetensi perawat dengan ketercapaian adekuasi hemodialisisb(p=0,000). Faktor yang berpengaruh terhadap ketercapaian adekuasi hemodialisis yaitu kompetensi perawat, jenis kelamin, tingkat pendidikan, dan pengalaman bekerja di rumah sakit. Penelitian ini merekomendasikan agar kompetensi perawat terus ditingkatkan melalui pendidikan baik formal maupun informal agar menambah pengetahuan, sikap. dan keterampilan perawat dalam melaksanakan asuhan keperawatan. 

 

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Achievement of adequate hemodialysis is one indicator pf the quality of hemodialysis care. To produce adequate hemodialysis, it is necessary to have nurses who have good competence in providing nursing care to hemodialysis patients. this study aimed to determine the relationship between nurse competencies and the achievemnet of adequate hemodialysis. this research applied cross sectional method was included 82 nurses in hemodialysis unit and 82 hemodialysis patients with purposive sampling technique. Data analysis with chi-square and multiple logistic regression. It has been recognized that there was a relationship between nurse competence and achievement of adequate hemodialysis (p=0,000). furthermore, it is known that the factors that influence the achievement of adequate hemodialysis are nurses competencies, gender, level of education, and nurses working experience in the hospital. From the study, it can be concluded that nurses competencies be improved through formal and informal education in order to increase the knowledge, attitudes, and skills of nurses in implementing nursing care.

 

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"Manajemen terapi dialisis yang terdiri dari program hemodialisis, regimen pengobatan, pengontrolan cairan dan diet merupakan masalah yang masih terjadi pada pasien hemodialisis. Ketidakpatuhan pada manajemen tersebut dapat meningkatkan angka kejadian morbiditas dan mortalitas yang secara tidak langsung akan mempengaruhi kualitas hidup. Tujuan penelitian ini adalah mengidentifikasi hubungan antara kepatuhan manajemen terapi dialisis dengan kualitas hidup pasien hemodialisis. Metode yang digunakan dalam penelitian ini ialah desain penelitian cross sectional dengan sampel 57 pasien hemodialysis dengan teknik sampling purposive sampling. Hasil penelitian menggunakan uji chi square menunjukan bahwa terdapat hubungan antara kepatuhan manajemen terapi dialisis dengan kualitas hidup pasien hemodialisis dengan P value 0,047.

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Dialysis therapy management consists of hemodialysis attendance, prescribed medications, fluid restrictions, and dietary intake. Non adherence to these management can increase the morbidity and mortality rate that will indirectly affect quality of life. The purpose of this study was to identify the relation between adherence to dialysis therapy management and quality of life in patients on hemodialysis. This study used cross sectional study design, involved 57 hemodialysis patients by technique purposive sampling. The result showed that there is relationship between adherence to regiment treatment and quality of life in patiens on hemodialysis with P value 0,047."