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[ABSTRAK
Latar belakang: Hipertensi dan aterosklerosis berkaitan dengan disfungsi endotel yang ditandai oleh pengurangan produksi nitric oxide (NO) dan penurunan NO bioavailability. Disfungsi endotel dapat terjadi sejak usia anak-anak dan inaktivitas fisik menjadi faktor risiko penyakit kardiovaskular. Namun belum banyak penelitian mengenai perbedaan pengaruh latihan fisik aerobik pada juvenil dibandingkan dengan dewasa terhadap fungsi vaskular. Penelitian ini bertujuan untuk mengetahui pengaruh usia latihan fisik terhadap kadar NO, MDA dan aktivitas spesifik enzim SOD pada aorta abdominal dengan lama latihan yang sama. Metode: Subjek penelitian adalah tikus usia juvenil dan dewasa muda yang dibagi dalam kelompok latihan dan kontrol. Latihan aerobik selama 8 minggu menggunakan treadmill dengan kecepatan disesuaikan dengan usia tikus selama 20 menit intermitten, 5x seminggu. Analisis kadar NO, MDA dan aktivitas SOD aorta abdominal menggunakan uji t-test independen (data berdistribusi normal dan homogen) atau uji U-Mann Whitney (data tidak normal). Hasil: Kadar NO dan aktivitas spesisfik SOD lebih tinggi pada kelompok latihan dibandingkan kontrol, baik pada kelompok juvenil maupun dewasa muda. Namun hanya pada kelompok dewasa muda yang perbedaannya bermakna. Tidak terdapat perbedaan bermakna kadar MDA antara kelompok latihan dan kontrol pada kedua usia. Kadar MDA pada kelompok juvenil meningkat dan menurun pada kelompok dewasa muda akibat latihan aerobik selama 8 minggu. Kesimpulan: Latihan aerobik dapat meningkatkan produksi NO dan NO bioavailability pada kelompok juvenil maupun dewasa muda. Peningkatan NO bioavailability terjadi melalui aktivitas spesifik enzim SOD. Diduga tingginya kadar MDA pada kelompok latihan dan kontrol juvenil terkait dengan usia dan stres fisik. Belum diketahui apakah peningkatan kadar MDA pada kelompok juvenil masih dalam kisaran normal atau tidak. Oleh karena itu, masih terdapat beberapa pertanyaan terkait manfaat latihan pada juvenil.

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ABSTRACT
Background: Hypertension and atherosclerosis are related to endothelial dysfunction, that characterized with decrease of NO production and bioavailability. Physical inactivity has contribute to endothelial dysfunction that can occur since childhood. However, until now, there were only few studies about the difference effect of aerobic training to vascular function in juvenile and young-adult rats. Therefore, this study aimed to know the effect of age related- exercise training to level of NO, MDA and specific SOD activity in abdominal aorta. Methode: Subjects were juvenile and young adult male wistar rats divided into 2 group: control and aerobic training. Aerobic training performed in 8 weeks with animal treadmill with age-dependent speed for 20 minutes intermittent exercise, 5x per week. Analysis of NO, MDA level, and SOD activity of abdominal aorta used t-test independent (normal distribution and homogen) or U-Mann Whitney (not normal distribution) Results: NO level and SOD specific activity in training group were higher than control group, in both juvenile and young adult group. But, only in young adult group that had significant result. There was no significant different of MDA level in training group compared to control group in both juvenile and young-adult group, but MDA level increased in juvenile group and decreased in young-adult group because of aerobic training for 8 weeks. Conclussion: Aerobic training can increase NO production and bioavaibility both in juvenile and young adult group. Increase of NO bioavailability was considered to the increase of SOD specific activity. We considered that the increase of MDA level in training and control juvenile group were related to age and physical stress. We didn?t know yet the increased level of MDA in juvenile group was still in normal range level or not. Therefore is still any question if training in juvenile rat was benefit or not.;Background: Hypertension and atherosclerosis are related to endothelial dysfunction, that characterized with decrease of NO production and bioavailability. Physical inactivity has contribute to endothelial dysfunction that can occur since childhood. However, until now, there were only few studies about the difference effect of aerobic training to vascular function in juvenile and young-adult rats. Therefore, this study aimed to know the effect of age related- exercise training to level of NO, MDA and specific SOD activity in abdominal aorta. Methode: Subjects were juvenile and young adult male wistar rats divided into 2 group: control and aerobic training. Aerobic training performed in 8 weeks with animal treadmill with age-dependent speed for 20 minutes intermittent exercise, 5x per week. Analysis of NO, MDA level, and SOD activity of abdominal aorta used t-test independent (normal distribution and homogen) or U-Mann Whitney (not normal distribution) Results: NO level and SOD specific activity in training group were higher than control group, in both juvenile and young adult group. But, only in young adult group that had significant result. There was no significant different of MDA level in training group compared to control group in both juvenile and young-adult group, but MDA level increased in juvenile group and decreased in young-adult group because of aerobic training for 8 weeks. Conclussion: Aerobic training can increase NO production and bioavaibility both in juvenile and young adult group. Increase of NO bioavailability was considered to the increase of SOD specific activity. We considered that the increase of MDA level in training and control juvenile group were related to age and physical stress. We didn’t know yet the increased level of MDA in juvenile group was still in normal range level or not. Therefore is still any question if training in juvenile rat was benefit or not., Background: Hypertension and atherosclerosis are related to endothelial dysfunction, that characterized with decrease of NO production and bioavailability. Physical inactivity has contribute to endothelial dysfunction that can occur since childhood. However, until now, there were only few studies about the difference effect of aerobic training to vascular function in juvenile and young-adult rats. Therefore, this study aimed to know the effect of age related- exercise training to level of NO, MDA and specific SOD activity in abdominal aorta. Methode: Subjects were juvenile and young adult male wistar rats divided into 2 group: control and aerobic training. Aerobic training performed in 8 weeks with animal treadmill with age-dependent speed for 20 minutes intermittent exercise, 5x per week. Analysis of NO, MDA level, and SOD activity of abdominal aorta used t-test independent (normal distribution and homogen) or U-Mann Whitney (not normal distribution) Results: NO level and SOD specific activity in training group were higher than control group, in both juvenile and young adult group. But, only in young adult group that had significant result. There was no significant different of MDA level in training group compared to control group in both juvenile and young-adult group, but MDA level increased in juvenile group and decreased in young-adult group because of aerobic training for 8 weeks. Conclussion: Aerobic training can increase NO production and bioavaibility both in juvenile and young adult group. Increase of NO bioavailability was considered to the increase of SOD specific activity. We considered that the increase of MDA level in training and control juvenile group were related to age and physical stress. We didn’t know yet the increased level of MDA in juvenile group was still in normal range level or not. Therefore is still any question if training in juvenile rat was benefit or not.]

Abstrak :
Latar belakang: USG Doppler kerap dipakai untuk skrining awal Chronic Limb Threatening Ischemia (CLTI) dan dapat juga memantau respons terapi selama follow-up. Di Rumah Sakit Dr. Cipto Mangunkusumo (RSCM), sebagai pusat rujukan nasional dan Pusat Pendidikan Subspesialis Bedah Vaskular Endovaskular, Trainee bedah vaskular-endovaskular menjalani pendidikan mereka. Penting bagi Trainee Bedah Vaskular untuk mengkorelasikan temuan klinis dengan hasil USG Doppler, sehingga supervisi  semester 4 terhadap semester 1 menjadi krusial. Namun, dampak pengalaman terhadap akurasi USG Doppler, terutama pada pasien Chronic Limb-Threatening Ischemia (CLTI), antara Trainee semester 1 dan 4 masih belum ada, termasuk kekurangan data dan SOP terkait durasi supervisi.

Metode: Penelitian ini menggunakan metode potong lintang untuk menguji diagnosis CLTI melalui USG oleh trainee semester 1 dan 4, dibandingkan dengan CT Angiografi (CTA) sebagai standar.

Hasil: Total ada 31 pasien (62 tungkai) yang dibagi ke dalam dua kelompok dan diamati menggunakan USG oleh trainee dari kedua semester tersebut. Hasil penelitian menunjukkan bahwa kesesuaian temuan oklusi arteri berdasarkan USG dibandingkan dengan CTA lebih tinggi pada trainee semester 4. Selain itu, korelasi dalam penentuan derajat stenosis antara USG dan CTA lebih kuat pada semester 4. Hasil uji diagnosis menunjukkan bahwa secara keseluruhan trainee semester 4 memiliki akurasi diagnosis USG yang lebih tinggi dibandingkan trainee semester 1 di semua segmen arteri tungkai bawah.

Kesimpulan: Terdapat perbedaan keluaran , akurasi USG oleh semester 1 dan 4 dengan angka yang tidak jauh berbeda dalam mendiagnosis CLTI, Pada Penelitian ini peneliti juga menyarankan perlunya supervisi antara semester 1 dan 4 agar ada transfer ilmu dan patient safety

 

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Doppler Ultrasound (USG) is frequently used for screening Chronic Limb Threatening Ischemia (CLTI)  and monitoring therapy response during follow-up. At Dr. Cipto Mangunkusumo Hospital (RSCM), a national referral center dan center Education of Vascular and Endovarcular Surgery, vascular-endovascular surgery trainees undergo their education. It is crucial for these trainees to correlate clinical findings with Doppler USG results, hence supervision of the forth to first semester is essential. However, the impact of experience on the accuracy of Doppler USG, especially in patients with Chronic Limb-Threatening Ischemia (CLTI), between first and fourth semester trainees is still unclear, including the lack of data and Standard Operating Procedures (SOPs) regarding the duration of supervision.

Method: This study employed a cross-sectional method to test PAD diagnosis through USG performed by first and fourth semester trainees, compared with CT Angiography (CTA) as the gold standard.

Results: A total of 31 patient (62 lower limb) were divided into two groups and observed using USG by trainees from both semesters. The study results indicated that the concordance of arterial occlusion findings based on USG compared with CTA was higher in fourth semester trainees. Furthermore, the correlation in determining the degree of stenosis between USG and CTA was stronger in the fourth semester. The diagnostic test results showed that overall, fourth semester trainees had higher USG diagnostic accuracy compared to first semester trainees in all lower limb arterial segments.

Conclusion: There are differences in the output and accuracy of ultrasound user in fourth dan first semester trainees which are not much different result in diagnosing CLTI,  in this study researchers also suggest the need for supervision between semesters first and fourth so that there will be a knowledge transfer and patient safety.

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Latar Belakang : Peningkatan resistensi vaskular paru (RVP) pasien stenosis mitral (SM) disebabkan oleh proses reaktif hipertensi pulmoner (HP) sehingga mempengaruhi luaran klinis pascabedah katup mitral. Endotelin-1 (ET-1) sebagai mediator vasoaktif berperan penting pada HP reaktif. Belum ada penelitian yang menghubungkan kadar ET-1 vena pulmoner (VP) dengan RVP. Tujuan Penelitian : Menilai korelasi kadar ET-1 VP terhadap RVP sebelum dan sesudah pembedahan katup mitral pada pasien SM dengan HP. Metode : Penelitian ini merupakan studi potong lintang pada 28 pasien SM berat dengan HP sedang dan berat yang menjalani pembedahan katup mitral di Pusat Jantung Nasional Harapan Kita dari bulan April hingga November 2014. Dilakukan analisa statistik untuk mencari korelasi antara kadar ET-1 VP dengan RVP sebelum dan sesudah pembedahan katup mitral. Hasil Penelitian : Terdapat korelasi antara kadar ET-1 VP dengan RVP prabedah (r=0,49, p=0,008), sedangkan dengan RVP pascabedah tidak berkorelasi bermakna (r=0,204, p=0,32). Analisa regresi linear antara kadar ET-1 VP dengan RVP prabedah setelah disesuaikan dengan variabel perancu hipertensi, diabetes melitus tipe 2, fibrilasi atrial, penggunaan penyakat beta dan diuretik didapatkan r=0,5 koefisien β 1,04 dengan interval kepercayaan (IK) 95% (0,401-1,691) p=0,003, sedangkan dengan RVP pascabedah setelah disesuaikan dengan variabel perancu hipertensi, penghambat ACE/ARB, penyakat beta, vasodilator, waktu cross clamp didapatkan r=-0,08 koefisien β -0,2 dengan IK 95 % (-0,99-0,5) p=0,5. Kesimpulan : Terdapat korelasi positif bermakna dengan kekuatan sedang antara kadar ET-1 VP dengan RVP prabedah, Peningkatan kadar ET-1 VP sebesar 1 pg/ml, akan meningkatkan RVP prabedah sebasar 1,04 WU. Kadar ET-1 VP tidak memiliki korelasi bermakna terhadap RVP pascabedah.

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Background : The increased of Pulmonary Vascular Resistance (PVR) in mitral stenosis (MS) patient occurs in reactive pulmonary hypertension, and it affects clinical outcome after mitral valve surgery. Endothelin-1 (ET-1) as vasoconstrictive agent have important role in reactive pulmonary hypertension so far there is no study that corelate pulmonary vein (PV) ET-1 with PVR in MS. Objectives : To study the correlation of PV ET-1 level with PVR measured by echo before and after mitral valve surgery in patient MS with pulmonary hypertension. Methods : Twenty eight MS patients with moderate and severe pulmonary hypertension who underwent mitral valve surgery at National Cardiovascular Centre Harapan Kita from April to November 2014. Statistical analysis was done to see the correlation of PV ET-1 level with PVR before and after mitral valve surgery. Blood sample was taken from VP in the operating room and analyzed with Quantikine® ELISA ET-1 Immunoassay. PVR was measured by PVR-AMS formula by echocardiography. Result : There was a correlation between PV ET-1 and PVR pre surgery (r=0,49, p=0,008), whereas, there was no significant correlation with PVR post surgery (r=0,204, p=0,32). Linear regression analysis was performed, PV ET-1 and PVR pre surgery were adjusted to confounding variables hypertension, diabetes mellitus, atrial fibilation, use of beta blocker and diuretic; r=0,5 β coefisien level 1,04 with confidance interval (CI) 95 % (0,401-1,691), p=0,003. PVR post surgery was adjusted to confounding variables hypertension, dislipidemia, use of ACE-I/ARB, beta blocker, vasodilator, cross clamp time, r=-0,08 β coefisien level -0,2 with CI 95 % (-0,99-0,5), p=0,5. Conclusion : There was a moderate positive correlation between PV ET-1 with PVR pre surgery, the increased of PV ET-1 level 1 pg/ml, would increase PVR level 1,04 WU. There was no significant correlation between PV ET-1 with PVR post surgery.

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Latar Belakang: Spektrum Plasenta Akreta (SPA) merupakan salah satu komplikasi obstetri dengan tingkat morbiditas yang tinggi. 3D Power Doppler telah banyak digunakan untuk meningkatkan diagnosis SPA, seperti menggunakan Plasenta Akreta Indeks, tetapi hanya mengukur secara kualitatif. Oleh karena itu, penelitian ini bertujuan untuk memahami hubungan kuantitatif indeks vaskularisasi plasenta terhadap temuan makroskopik, grading histopatologi, dan perdarahan intraoperatif pada kasus SPA. Tujuan: Mengetahui hubungan indeks vaskular (vascular index / VI), indeks aliran (flow index / FI), dan indeks aliran vaskular (vascular flow Index / VFI) dengan diagnosis klinis, jumlah perdarahan dan temuan histopatologi SPA di Rumah Sakit Cipto Mangunkusumo. Metode: Sebuah studi cross-sectional dilakukan pada 34 wanita, yang secara klinis didiagnosis dengan SPA. Power Doppler 3D yang dikombinasikan dengan perangkat lunak VOCAL II digunakan untuk mengukur tingkat indeks vaskularisasi (VI), indeks aliran (FI), dan indeks aliran vaskularisasi (VFI). Gambaran gross anatomy dan hasil histopatologi yang dikategorikan sebagai akreta, inkreta, dan perkreta. Tingkat kehilangan darah intra-operatif diukur dan diklasifikasikan sebagai perdarahan masif diatas 1500 ml. Data kemudian dianalisis menggunakan Statistical Package for Social Sciences (SPSS) versi 25. Hasil: Median (min-max) untuk semua indeks vaskularisasi sebagai berikut: VI = 44,2 (23,7-74,9), FI = 35,4 (24,9-57), dan VFI = 15,3 (8,5-41,7). Nilai FI ditemukan signifikan dalam membandingkan tahap makroskopis (p =0,015) dan memiliki korelasi positif sedang dalam kaitannya dengan perdarahan (r =0,449). hasil analisa AUC of ROC VI, FI, dan VFI nilai batas terbukti sangat terkait dengan kehilangan darah 1500cc yaitu dengan hasil FI dengan nilai AUC of ROC 0.784, nilai cut off ≥38.9, OR: 10.00 (IK95% [1.58-63.09], p =0.014), VI dengan nilai AUC of ROC 0.712, nilai cut off ≥60.4, OR: 7.00 (IK95% [1.23-39.56], p =0.031), dan VFI dengan nilai AUC of ROC 0.779, nilai cut off ≥23.2, OR: 9.16 (IK95% [1.53-54.59], p =0.015). Kesimpulan. Indeks Vaskularisasi Plasenta (FI) yang diukur dengan Power Doppler 3 dimensi dapat menjadi pemeriksaan tambahan Diagnostik SPA yang berpotensi dapat memprediksi kedalaman invasi SPA secara intra-pembedahan, jumlah perdarahan dan kemungkinan akan didapatkannya perdarahan masif pada pembedahan SPA Kata Kunci. Plasenta akreta, 3D Power Doppler, indeks vaskular, indeks aliran, indeks aliran vaskular, perdarahan intraoperasi, histologi akreta ......Background: Placenta Accreta Spectrum (PAS) is an obstetrical complication with a high level of morbidity. The 3D Power Doppler method has been widely used to improve the PAS diagnosis, such as using Placenta Accreta Index, but it only measures qualitative features. Therefore, this study aims to understand the relationship of quantitative placental vascular indices towards macroscopic findings, histopathological grading, and intra-operative blood loss in cases of PAS disorder. Objectives: Knowing the relationship between vascular index (VI), flow index (FI), and vascular flow index (VFI) with clinical diagnosis, amount of bleeding and histopathological findings of SPA at Cipto Mangunkusumo Hospital. Methods: A cross-sectional study was conducted in 34 women, who were clinically diagnosed with PAS. The 3D Power Doppler in combination with VOCAL II software was used to measure the level of vascularization index (VI), flow index (FI), and vascularization flow index (VFI). Gross anatomical appearance and histopathology results were categorized as accreta, increta, and percreta. Intra-operative blood loss level was measured and classified as massive hemorrhage if it was≥1500 ml. Data were then analyzed using Statistical Package for Social Sciences (SPSS) version 25. Results: The median (min-max) for all vascularity indexes as follows: VI = 44.2 (23.7-74.9), FI = 35.4 (24.9-57), and VFI = 15.3 (8.5-41.7). FI value was found to be significant in comparing gross pathological stages (p=0.015) and had a moderate positive correlation in relation to blood loss (r= 0.449). the results of the AUC of ROC VI, FI, and VFI analysis above the cut-off values were shown to be strongly associated with blood loss ≥1500cc the results obtained: FI with AUC of ROC value of 0.784, cut off value 38.9, OR: 10.00 (IK95% [1.58-63.09], p = 0.014), VI with AUC of ROC value of 0.712, cut off value 60.4, OR: 7.00 (IK95% [1.23-39.56], p = 0.031), and VFI with AUC of ROC value of 0.779, cut off value 23.2, OR: 9.16 (CI95% [1.53-54.59], p = 0.015). Conclusion: Flow index (FI) value from 3D Power Doppler ultrasound may become a potential diagnostic marker to predict the depth of PAS invasion prior to surgery, along with the level of blood loss intra-operatively. Keywords: Placenta accreta spectrum (PAS), Ultrasound markers, Vascularization, Macroscopic, Histopathology, Blood loss, 3D Power Doppler Biopsy, Vascular Index, Flow Index, Vascular Flow Index

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Latar belakang: Azoxymethane AOM dan dextran sodium sulfate DSS adalah senyawa kimia yang sering digunakan untuk menginduksi kanker kolorektal pada tikus. Penelitian sebelumnya menunjukkan bahwa azoxymethane dan DSS juga menyebabkan nefrotoksisitas. Omega 3 yang ditemukan pada minyak ikan diketahui memiliki efek protektif pada ginjal. Namun, omega 3 minyak ikan kaya masih sangat kurang dimanfaatkan di Indonesia. Untuk mempelajari fitur histopatologi ginjal pada tikus yang diinduksi AOM DSS setelah pemberian omega 3 minyak ikan kaya. Metode: Mencit eksperimental yang telah diinduksi menggunakan AOM 10 mg kg dan DSS 2 selama 2 minggu dialokasikan secara acak ke dalam 4 kelompok sebagai berikut. Kelompok Kontrol tikus tidak menerima minyak ikan, tikus Kelompok Dosis Rendah menerima 1,5 mg minyak ikan, tikus kelompok Dosis Menengah menerima 3 mg minyak ikan, tikus Kelompok Dosis Tinggi menerima 6 minyak ikan mg hari. Minyak ikan kaya omega 3 diberikan selama 12 minggu. Pemeriksaan patologi dilakukan untuk menilai degenerasi tubular dan kongesti vaskular. Hasil: Gambaran histopatologis yang ditemukan di ginjal adalah peradangan, degenerasi tubular, nekrosis, dan kongesti vaskular. Persentase 3 tubular degenerasi berat pada kelompok yang diberi minyak zaitun kaya omega 3 rendah, menengah, dan tinggi lebih rendah sebesar 17,5, 25, dan 37,5 masing-masing dibandingkan dengan kelompok kontrol. Pemberian omega 3 minyak ikan kaya menunjukkan persentase yang lebih sedikit dari tingkat kongesti 2 pembuluh darah moderat dibandingkan dengan kelompok kontrol namun, peningkatan dosis omega 3 minyak ikan kaya tidak menunjukkan persentase yang berbeda dari kemacetan pembuluh darah moderat di antara kelompok-kelompok. Kesimpulan: Hasil menunjukkan efek omega 3 minyak ikan kaya untuk mencegah nefrotoksisitas pada tikus yang diinduksi oleh azoxymethane dan DSS. ......Background: Azoxymethane AOM and dextran sodium sulfate DSS are chemical compounds frequently used to induce colorectal cancer in mice. Previous studies have shown that azoxymethane and DSS also cause nephrotoxicity. Omega 3 found on fish oil is known to have protective effect on kidney. However, omega 3 rich fish oil is still very underutilized in Indonesia.Aim To study the histopathologic features of kidney on mice induced AOM DSS after the administration of omega 3 rich fish oil. Method: The experimental mice that had been induced using AOM 10 mg kg and DSS 2 for 2 weeks were allocated randomly into 4 groups as follows Control Group mice recieved no fish oil, Low Dose Group mice recieved 1.5 mg day fish oil, Medium Dose Group mice recieved 3 mg day fish oil, High Dose Group mice recieved 6 mg day fish oil. The omega 3 rich fish oil were given for 12 weeks. Pathology examination was done to grade tubular degeneration and vascular congestion. Result: The histopathologic features found in the kidney were inflammation, tubular degeneration, necrosis, and vascular congestion. The percentage of severe 3 tubular degeneration on groups given low, medium, and high dose omega 3 rich olive oil were lower by 17.5 , 25 , and 37,5 respectively compared to control group. The administration of omega 3 rich fish oil showed less percentage of moderate 2 vascular congestion degree compared to control group however, increasing dose of omega 3 rich fish oil did not show different percentages of moderate vascular congestion among groups. Conclusion: The result indicates the effect of omega 3 rich fish oil on preventing nephrotoxicity in mice induced by azoxymethane and DSS.

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Latar belakang. Penggunaan kateter hemodialisis temporer pada kondisi kronik merupakan faktor risiko terjadinya stenosis vena sentral. Penelitian ini bertujuan untuk mengetahui hubungan penggunaan kateter hemodialisis temporer non-cuffed/non-tunneled double lumen catheter jangka panjang serta faktor risiko lainnya yang berperan dalam terjadinya stenosis vena sentral pada populasi pasien hemodialisis di RSUP dr Cipto Mangunkusumo RSCM .Metode. Dilakukan studi deskriptif analitik dengan desain kasus kontrol pada populasi pasien penyakit ginjal kronis stadium 4-5 yang menjalani hemodialisis di RSCM dan terdiagnosis stenosis vena sentral, baik secara klinis maupun radiologis pada periode tahun 2012-2016 yang dilakukan di Divisi Vaskular dan Endovaskular Departemen Ilmu Bedah FKUI-RSCM mulai bulan Maret 2016 sampai Juli 2016 yang memenuhi kriteria inklusi dan eksklusi. Sumber data diambil dari rekam medik data sekunder dengan mengambil seluruh kasus stenosis vena sentral total sampling dan kontrol dengan perbandingan 1:1 antara kasus dan kontrol. Analisis data berupa analisis univariat, bivariat dan multivariat dan diuji dengan SPSS version 17.0 for Windows. Hasil. Data subjek penelitian yang diperoleh sebanyak 126 subjek 63 kasus dan 63 kontrol . Durasi penggunaan kateter hingga terjadinya stenosis vena sentral rata-rata 469 hari. Stenosis vena sentral paling banyak terjadi pada vena brakiosefalika 36 subjek, 57,14 , vena subklavia 22 subjek, 34,92 dan vena jugularis interna 5 subjek, 7,94 . Dari hasil analisis multivariat, faktor yang berperan dalam terjadinya stenosis vena sentral yaitu penggunaan jenis kateter temporer p = 0,006, OR 5,97, IK 95 1,65 ndash;21,58 , sisi pemasangan kateter di sebelah kiri p = 0,007, OR 10,17, IK 95 2,01 ndash;52,34 dan penggunaan kateter >2 kali p = 0,006, OR 11,15, IK 95 1,65 ndash;51,05 . Simpulan. Penggunaan kateter non-cuffed/non-tunneled terutama pada kondisi kronik >1 minggu yang dipasang pada sisi kiri tubuh dan dengan riwayat >2 kali pemasangan berisiko tinggi menyebabkan terjadinya stenosis vena sentral.Kata kunci: stenosis vena sentral, kateter hemodialisis temporer, akses vaskular ......Background The use of temporary hemodialysis catheters in chronic condition is a risk factor for central venous stenosis. This study aims to determine the relationship of temporary hemodialysis catheter use non cuffed non tunneled double lumen catheter in chronic condition as well as other factors that play a role in the occurrence of central venous stenosis in hemodialysis patient population in Dr. Cipto Mangunkusumo Hospital RSCM .Method This was a descriptive analytic study with case control design conducted in the Division of Vascular and Endovascular Surgery Department of the Faculty of Medicine RSCM from March 2016 to July 2016. The study population was patients with stage 4 5 chronic kidney disease undergoing hemodialysis RSCM and diagnosed with central venous stenosis, both clinically and radiologically in the period of 2012 2016, which meet the inclusion and exclusion criteria. Source data were extracted from medical records secondary data by taking all cases of central venous stenosis total sampling and control with the ratio of 1 1 between cases and controls. Analysis of the data was presented in the form of univariate, bivariate and multivariate analysis and tested with SPSS version 17.0 for Windows.Results The data obtained by the research subjects were 126 subjects 63 cases and 63 controls . The average duration of catheter use until the occurrence of central venous stenosis was 469 days. Central venous stenosis is the most common among brachiocephalic vein 36 subjects, 57.14 , the subclavian vein 22 subjects, 34.92 and the internal jugular vein 5 subjects, 7.94 . From the results of the multivariate analysis, the factors that play a role in the occurrence of central venous stenosis were namely the use of temporary catheters p 0.006, OR 5.97, 95 CI 1.65 to 21.58 , catheter implantation on the left side ipsilateral to fistula p 0.007, OR 10.17, 95 CI 2.01 to 52.34 and the use of catheters 2 times p 0.006, OR 11.15, 95 CI 1.65 to 51.05 .Conclusions The use of non cuffed non tunneled catheters especially in chronic condition 1 week which is implanted on the left side of the body ipsilateral to fistula and with a history of 2 times catheter implantations cause central venous stenosis.Keywords central venous stenosis, temporary hemodialysis catheter