Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar belakang dan objektif: Keberhasilan hemodialisis ditentukan oleh kesuksesan akses vaskular, baik dicapai melalui arteriovenous fistula AVF , arteriovenous graft AVG , atau central venous catether CVC . Dari berbagai pilihan akses vaskular lainnya, AVF adalah akses vaskular hemodialisis yang paling disarankan untuk jangka panjang karena memiliki patensi yang lebih panjang dan tingkat komplikasi yang rendah. Meskipun demikian, AVF memiliki tingkat kegagalan maturasi tinggi, dengan angka sekitar 43-63 . Rumah Sakit Umum Pusat Rujukan Nasional Cipto Mangunkusumo RSCM , rumah sakit tersier terbesar di Indonesia, tidak memiliki data mengenai tingkat patensi AVF. Penelitian ini bertujuan untuk mengetahui tingkat patensi primer AVF di RSCM. Metode: Penelitian kohort retrospektif dilakukan pada seluruh pasien yang menjalani pemasangan AVF di RSCM pada periode Januari 2011 sampai Desember 2013. Hasil: Dari 269 pasien rerata umur 53.1 13.9 , 190 70.6 pasien menjalani pemasangan fistula brakiosefalika, 71 26.4 pasien menjalani pemasangan fistula radiosefalika, dan 7 2.6 pasien menjalani pemasangan fistula jenis lainnya. Tingkat patensi tahun pertama adalah 71.4 . Kesimpulan: Tingkat patensi primer AVF pada pasien end-stage renal disease ESRD memenuhi standar target yang ditentukan oleh pedoman National Kidney Foundation Dialysis Outcomes Quality Initiative NKF/DOQI . Penelitian ini menunjukkan bahwa diameter vena memiliki korelasi yang signifikan dengan tingkat patensi primer AVF. Faktor-faktor lainnya tidak berkaitan dengan patensi primer. ......Background and objectives The success of haemodialysis relies on the success of the vascular access, whether achieved with an arteriovenous fistula AVF , an arteriovenous graft AVG , or a central venous catether CVC . Among other access options, arteriovenous fistula is the preferred long term haeemodialysis vascular access due to longer patency and low complication rate. However, AVF maturation failure rates are high, ranging from 43 to 63 . Cipto Mangunkusumo Hospital, the largest tertiary referral hospital in Indonesia, lacks data on AVF patency rates. This study is aimed to determine the primary patency rates of AVF in Cipto Mangunkusumo Hospital. Methods A single centre retrospective study was performed in all patients who had primary arteriovenous fistulas created at Cipto Mangunkusumo Hospital during the period between January 2011 and December 2013. Results Of 269 patients mean age 53.1 13.9 , 190 70.6 patients underwent brachiocephalic fistula creation, 71 26.4 patients underwent radiocephalic fistula creation, and 7 2.6 patients underwent other fistula types creation during the two year study period. The first year patency rate was 71.4 . Conclusions In this setting, the rate of AVF creation for end stage renal disease patients meets the standard of the target goals set forward by the National Kidney Foundation published updated Dialysis Outcomes Quality Initiative NKF DOQI Guidelines. Our study suggested that venous diameter was significantly correlated with primary patency rates of AVF. Other factors were not associated with primary patency.

Abstrak :
Latar belakang dan objektif: Keberhasilan hemodialisis ditentukan oleh kesuksesan akses vaskular, baik dicapai melalui arteriovenous fistula AVF , arteriovenous graft AVG , atau central venous catether CVC . Dari berbagai pilihan akses vaskular lainnya, AVF adalah akses vaskular hemodialisis yang paling disarankan untuk jangka panjang karena memiliki patensi yang lebih panjang dan tingkat komplikasi yang rendah. Meskipun demikian, AVF memiliki tingkat kegagalan maturasi tinggi, dengan angka sekitar 43-63 . Rumah Sakit Umum Pusat Rujukan Nasional Cipto Mangunkusumo RSCM , rumah sakit tersier terbesar di Indonesia, tidak memiliki data mengenai tingkat patensi AVF. Penelitian ini bertujuan untuk mengetahui tingkat patensi primer AVF di RSCM. Metode: Penelitian kohort retrospektif dilakukan pada seluruh pasien yang menjalani pemasangan AVF di RSCM pada periode Januari 2011 sampai Desember 2013. Hasil: Dari 269 pasien rerata umur 53.1 13.9 , 190 70.6 pasien menjalani pemasangan fistula brakiosefalika, 71 26.4 pasien menjalani pemasangan fistula radiosefalika, dan 7 2.6 pasien menjalani pemasangan fistula jenis lainnya. Tingkat patensi tahun pertama adalah 71.4 . Kesimpulan: Tingkat patensi primer AVF pada pasien end-stage renal disease ESRD memenuhi standar target yang ditentukan oleh pedoman National Kidney Foundation Dialysis Outcomes Quality Initiative NKF/DOQI . Penelitian ini menunjukkan bahwa diameter vena memiliki korelasi yang signifikan dengan tingkat patensi primer AVF. Faktor-faktor lainnya tidak berkaitan dengan patensi primer. ......Background and objectives The success of haemodialysis relies on the success of the vascular access, whether achieved with an arteriovenous fistula AVF , an arteriovenous graft AVG , or a central venous catether CVC . Among other access options, arteriovenous fistula is the preferred long term haeemodialysis vascular access due to longer patency and low complication rate. However, AVF maturation failure rates are high, ranging from 43 to 63 . Cipto Mangunkusumo Hospital, the largest tertiary referral hospital in Indonesia, lacks data on AVF patency rates. This study is aimed to determine the primary patency rates of AVF in Cipto Mangunkusumo Hospital. Methods A single centre retrospective study was performed in all patients who had primary arteriovenous fistulas created at Cipto Mangunkusumo Hospital during the period between January 2011 and December 2013. Results Of 269 patients mean age 53.1 13.9 , 190 70.6 patients underwent brachiocephalic fistula creation, 71 26.4 patients underwent radiocephalic fistula creation, and 7 2.6 patients underwent other fistula types creation during the two year study period. The first year patency rate was 71.4 . Conclusions In this setting, the rate of AVF creation for end stage renal disease patients meets the standard of the target goals set forward by the National Kidney Foundation published updated Dialysis Outcomes Quality Initiative NKF DOQI Guidelines. Our study suggested that venous diameter was significantly correlated with primary patency rates of AVF. Other factors were not associated with primary patency.

Abstrak :
Latar Belakang: Penyakit Ginjal Kronik (PGK) dan Penyakit Ginjal Tahap Akhir (PGTA) merupakan penyebab utama morbiditas dan mortalitas pada 10% populasi dunia penderita PGK. Terapi yang tersering dipilih adalah hemodialisis dengan pembuatan fistula arteriovenosa (FAV). Akan tetapi, angka kegagalan FAV relatif tinggi akibat feeding artery dan draining vein inadekuat. Teknik dilatasi angioplasty balon (PBA) merupakan salah satu cara mengatasi kegagalan FAV. Penelitian unutk mengetahui lama ketahanan / patency rate dengan dan tanpa PBA belum banyak dilakukan. Tujuan: Menganalisis perbandingan patency rate dan jumlah patency failure pada pasien FAV dengan dan tanpa PBA. Metode: Desain penelitian adalah survival analysis pada kohort prospektif, dilakukan di RSUPN Cipto Mangunkusumo, RSUPN Fatmawati, dan RSUD Kabupaten Tangerang. Penelitian dilaksanakan pada bulan Januari 2020 – Maret 2022. Hasil: Total subyek 60 orang, sebanyak 29 subyek dengan PBA, 31 tanpa PBA. Terdapat perbedaan signifikan antara kedua kelompok dari segi diameter vena dan volume flow vena pasca operasi (p<0,01). Uji log-rank menunjukkan ada beda signifikan patency failure dengan nilai p 0,028, pada kelompok tanpa PBA (35,5%; rerata patency rate 56,3 minggu) dibandingkan dengan kelompok dengan PBA (10,3%; rerata patency rate 104,4 minggu). Median durasi menunjukkan sebanyak 50% dari kelompok tanpa PBA mengalami patency failure pada minggu ke-59,3, sedangkan hingga akhir pengamatan pada kelompok dengan PBA yang mengalami patency failure tidak sampai 50%. Simpulan: Penggunaan teknik PBA dapat menurunkan kejadian patency failure dan mempertahankan patensi dalam jangka waktu lebih lama pada pasien dengan FAV. ......Background: Chronic kidney disease (CKD) and end stage renal disease (ESRD) are the main causes of morbidity and mortality in 10% of the world's population with CKD. The most commonly chosen therapy is hemodialysis with the creation of an arteriovenous fistula (AVF). However, the FAV failure rate is relatively high due to inadequate feeding artery and draining vein. Primary balloon angioplasty (PBA) dilatation technique is a way to mitigate FAV failure. There have not been many studies to determine the patency rate with and without PBA. Objective: To analyze the comparison of the patency rate and the number of patency failures in AVF patients with and without PBA. Methods: The study design was a survival analysis in a prospective cohort, conducted at Cipto Mangunkusumo General Hospital, Fatmawati Hospital, and Tangerang District Hospital. The research was conducted in January 2020 – March 2022. Results: There were 60 subject as a total, 29 subjects with, 31 without PBA. There were a significant difference between the two groups in terms of venous diameter and postoperative venous flow volume (p<0.01). The log-rank test showed a significant difference in patency failure in the group without PBA (35.5%; mean patency rate 56.3 weeks) compared to the group with PBA (10.3%; mean patency rate 104.4 week), p-value=0.028,. The median duration showed that 50% of the group without PBA experienced patency failure at week 59.3, while until the end of the observation, the group with PBA experienced patency failure of less than 50%. Conclusion: The use of PBA technique can reduce the incidence of patency failure and maintain patency in the longer term in patients with AVF.

Abstrak :
Introduction: Peripheral arterial disease (PAD) is the most common macroangiopathic complication in type II diabetes mellitus, arising from inadequate blood sugar control. In the presence of PAD, the risk of limb loss will also increase, and arterial bypass is one method to reduce the risk of amputation. In Indonesia, the level of patency for the arterial bypass has not yet been published. On bypass with venous grafts, the patency rates at the location of infrapopliteal reach at 70-80%, while the prosthetic graft is 30-50%. Method: From 2009 to 2012, patients with arterial bypasses were analyzed. The level of patency was described by ultrasound examination and pulsation on clinical examination in the distal anastomosis, reduced pain, and other examinations that support adequate revascularization. Identification of risk factors that affect patency, particularly protective risk factors, were also taken into account. Results: From 2009 to 2012, 29 patients with infra-inguinal arterial bypass were collected. The ratio of men to women was 5:1, with a one-year patency rate of 88% in men, and 75% in women, for an overall of 86.2%. The irreversible risk factor affecting patency was male (p = 0.117). Modifiable risk factors that decreasing patency level were smoking (p = 0.042) and more advanced stage of PAD (p = 0.067). Smoking cessation (p = 0.041) and the use of drugs after bypass procedure (p = 0.072) were known to increase the level of patency. Conclusion: The one-year patency rate for infra-inguinal artery bypass was 37-89%. Smoking cessation was known to increase the level of patency.