SKRIPSI

FAKULTAS KEDOKTERAN
UNIVERSITAS HASANUDDIN
November 2016

Ahmad Yani Sukarso/C11111152

Dr. dr. Andi Alfian Zainuddin, M.KM

FAKTOR-FAKTOR RISIKO KEJADIAN GAGAL GINJAL KRONIK/END-

STAGE RENAL DISEASE (ESRD) PADA PASIEN RAWAT JALAN DI UNIT
HEMODIALISA RSUD UNDATA KOTA PALU, SULAWESI TENGAH
TAHUN 2016 (xiv + 77 halaman + 9 gambar + 22 tabel + 3 grafik + lampiran)

ABSTRAK

Latar Belakang: Gagal ginjal kronik atau ESRD (End-Stage Renal Disease)
merupakan suatu kondisi klinis yang ditandai dengan penurunan fungsi ginjal yang
irreversible, yang membutuhkan terapi pengganti ginjal yang tetap untuk
mempertahankan kehidupan, berupa dialisis atau transplantasi ginjal. Berdasarkan
data epidemiologi dari National Kidney Foundation memaparkan bahwa terdapat
sekitar 10% dari populasi dunia terkena gagal ginjal kronik, yang menyebabkan
kematian pada 409.000 jiwa pada tahun 1990 menjadi 956.000 jiwa pada tahun
2013. Data epidemiologi di Indonesia berdasarkan Riskesdas 2013 memaparkan
prevalensi penyakit ginjal kronik di Indonesia adalah 0,2% dari total populasi.
Berdasarkan pemaparan di atas, penting untuk mengetahui faktor-faktor determinan
kejadian penyakit ginjal kronik (PGK) menjadi ESRD (End-Stage Renal Disease),
agar faktor-faktor ini dapat dimodifikasi untuk mencegah kejadian penyakit.
Sehingga upaya-upaya pencegahan, kontrol, edukasi, dan intervensi medis bisa
lebih maksimal, dan menghasilkan penurunan angka kejadian ESRD.
Tujuan: Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh
terhadap kejadian gagal ginjal kronik di RSUD Undata Kota Palu tahun 2016
Metode Penelitian: Penelitian ini merupakan jenis penelitian observasional
analitik dengan menggunakan desain case-control study. Penelitian ini melibatkan
96 responden yang terbagi dalam 32 orang kelompok kasus dan 64 orang kelompok
kontrol. Kasus adalah pasien yang terdiagnosis gagal ginjal kronik sedangkan
kontrol adalah pasien tanpa penyakit gagal ginjal kronik. Sampel dikumpulkan
menggunakan teknik consecutive sampling. Instrumen penelitian menggunakan
kuisioner dan analisis data dilakukan dengan program SPSS (Statistical Product
and Service Solution).
Hasil: Berdasarkan penelitian yang dilakukan, hasil analisis bivariat menunjukkan
bahwa adanya riwayat hipertensi merupakan faktor risiko yang berpengaruh
terhadap kejadian gagal ginjal kronik (p<0,05; OR 2,480 95% CI 1,060-5,803), dan
tekanan darah 160/100 mmHg memiliki hubungan bermakna terhadap
kecenderungan kejadian gagal ginjal kronik dibanding tekanan darah normal
(<120/<80 mmHg) serta tidak terdapat hubungan bermakna antara pola minum obat
antihipertensi terhadap kejadian gagal ginjal (p>0,05 OR 2,677 95% CI 0,738-
9,629). Selain hipertensi, faktor lain yang diteliti yaitu diabetes mellitus,

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hiperkolesterolemia, obesitas, dan riwayat merokok. Hasil analisis bivariat untuk
diabetes adalah tidak ada hubungan antara riwayat diabetes dengan kejadian gagal
ginjal kronik (p>0,05 OR 0,688 95% CI 0,257-1,841), selain itu tidak ada hubungan
antara kadar gula darah (p>0,05 OR 0,673 95% CI 0,194-2,333) dan pola
keteraturan berobat diabetes (p>0,05 OR 8,800 95% CI 0,722-100,255) terhadap
kejadian gagal ginjal. Analisis bivariat hiperkolesterolemia menunjukkan tidak ada
hubungan bermakna riwayat hiperkolesterolemia terhadap kejadian gagal ginjal
(p>0,05 OR 1,357 95% CI 0,457-4,028) dan tidak ada pula hubungan bermakna
antara pola pengobatan antihiperkolesterolemia yang dilakukan terhadap kejadian
gagal ginjal (p>0,05 OR 12,00 95% CI 0,956-150,688). Hasil analisis bivariat
riwayat obesitas menunjukkan tidak ada hubungan bermakna riwayat IMT 25
kg/m2 (obesitas) dengan IMT <25 kg/m2 (non-obes) terhadap kejadian gagal ginjal
kronik (p>0,05 OR 1,545 95% CI 0,616-3,878). Dari segi perilaku merokok
responden juga didapatkan hasil bahwa tidak ada hubungan bermakna antara
riwayat merokok terhadap kejadian gagal ginjal kronik (p>0,05 OR 1,396 95% CI
0,552-3,530), selain itu juga tidak terdapat hubungan antara jumlah konsumsi rokok
perhari (p>0,05 OR 7,500 95% CI 0,743-75,721) dan durasi merokok (p>0,05 OR
2,444 95% CI 0,405-14,748) terhadap kejadian gagal ginjal kronik.
Kesimpulan dan saran: Kesimpulan penelitian ini adalah faktor risiko yang
terbukti berpengaruh terhadap kejadian gagal ginjal kronik riwayat hipertensi dan
terbukti bahwa tekanan darah 160/100 mmHg berisiko mengalami gagal ginjal
kronik dibanding tekanan darah normal. Adapun faktor risiko lainnya seperti
riwayat diabetes mellitus, kadar gula darah, riwayat hiperkolesterolemia, pola
pengobatan hipertensi, diabetes, dan antihiperkolesterolemia, riwayat obesitas,
riwayat merokok, jumlah konsumsi rokok perhari, dan durasi merokok tidak
terbukti berpengaruh terhadap kejadian gagal ginjal kronik pada penelitian ini.
Saran agar dilakukan penelitian lebih lanjut dengan skala lebih besar tentang faktor
risiko gagal ginjal kronik ini, serta perlunya meneliti etiologi yang berperan
langsung terhadap kejadian penyakit. Selain itu perlunya memaksimalkan
penyuluhan tentang kesehatan ginjal sejak usia dini, serta edukasi kepada pasien
yang memiliki risiko agar mengontrol kesehatannya secara rutin.

Kata Kunci: Gagal Ginjal Kronik, End-stage Renal Disease (ESRD), Faktor
Risiko, Hipertensi, Diabetes Melitus, Hiperkolesterolemia, Indeks Massa Tubuh
(IMT), Perilaku Merokok

Daftar Pustaka: 26 (2001-2015)

viii
 ESSAY
FACULTY OF MEDICINE
HASANUDDIN UNIVERSITY
November 2016

Ahmad Yani Sukarso/C11111152

Dr. dr. Andi Alfian Zainuddin, M.KM

RISK FACTORS FOR INCIDENCE OF CHRONIC RENAL

FAILURE/END-STAGE RENAL DISEASE (ESRD) IN OUTPATIENTS ON
HEMODIALYSIS UNIT RSUD UNDATA PALU, SULAWESI TENGAH IN
2016
(xiv + 77 pages + 9 figures + 22 tables + 3 graphics + appendix)

ABSTRACT

Background: Chronic renal failure or ESRD (End-Stage Renal Disease) is a

clinical condition characterized by the irreversible decline in kidney function,
requiring renal replacement therapy that remains to sustain life, in the form of
dialysis or a kidney transplant. Based on epidemiological data from the National
Kidney Foundation explained that approximately 10% of the world population
affected by chronic kidney failure, which causes death in 409,000 inhabitants in
1990 to 956 000 inhabitants in 2013. Epidemiological data in Indonesia by
Riskesdas 2013 describes the prevalence of chronic kidney disease in Indonesia is
0.2% of the total population. Based on the explanation above, it is important to
know the factors determinant incidence of chronic kidney disease (CKD) to ESRD
(End-Stage Renal Disease), so that these factors can be modified to prevent the
incidence of the disease. So that the efforts of prevention, control, education, and
medical interventions can be more leverage, and result in decreased incidence of
ESRD.
Research Purposes: This study aims to determine the factors that influence the
incidence of chronic renal failure in the Hospital of Undata Palu in 2016.
Research Methods: This study is observational analytic study using a case-control
study design. The study involved 96 respondents were divided into 32 cases and 64
controls. Cases were patients diagnosed with chronic renal failure, while controls
were patients without chronic kidney disease. Samples were collected using
consecutive sampling technique. The research instrument used questionnaires and
data analysis was performed with SPSS (Statistical Product and Service Solution).
Results: Based on research that has been conducted, the results of bivariate analysis
showed that a history of hypertension is a risk factor that influenced the incidence
of chronic renal failure (p <0.05; OR 2.480 95% CI 1.060 to 5.803), and blood
pressure 160 / 100 mmHg have a significant relationship to the trend of the
incidence of chronic renal failure compared to normal blood pressure (<120 / <80
mmHg) and there is no significant relationship between drinking patterns of
antihypertensive drugs on the incidence of renal failure (p> 2.677 OR 0.05 95% CI
0.738 to 9.629) , In addition to hypertension, other factors studied were diabetes
mellitus, hypercholesterolemia, obesity, and smoking history. The results of the

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bivariate analysis for diabetes is no relationship between a history of diabetes in the
incidence of chronic renal failure (p> 0.688 OR 0.05 95% CI 0.257 to 1.841), other
than that there is no relationship between blood sugar levels (p> 0.05 OR 0.673
95% CI 0.194 to 2.333) and patterns of regularity of treatment of diabetes (p> 8.800
OR 0.05 95% CI 0.722 to 100.255) on the incidence of renal failure.
Hypercholesterolaemia bivariate analysis showed no significant relationship
history of hypercholesterolemia on the incidence of renal failure (p> 1.357 OR 0.05
95% CI 0.457 to 4.028) and there is also a significant relationship between
treatment patterns antihiperkolesterolemia conducted on the incidence of renal
failure (p> 0, 12.00 05 OR 95% CI 0.956 to 150.688). The results of the bivariate
analysis of a history of obesity showed no significant relationship history BMI
25 kg / m2 (obese) with BMI <25 kg / m2 (non-obese) on the incidence of chronic
renal failure (p> 0.05 1.545 95% CI OR 0,616- 3.878). In terms of smoking
behavior of respondents also showed that there was no significant relationship
between history of smoking on the incidence of chronic renal failure (p> 1.396 OR
0.05 95% CI 0.552 to 3.530), but it is also no correlation between the amount of
cigarette consumption per day (p > 7,500 OR 0.05 95% CI 0.743 to 75.721) and the
duration of smoking (p> 2.444 OR 0.05 95% CI 0.405 to 14.748) on the incidence
of chronic renal failure
Conclusions and Recommendations: The conclusion of this study is a proven risk
factor influenced the incidence of chronic renal failure is a history of hypertension
and proved that blood pressure 160 / 100 mmHg is at risk of chronic renal failure
compared to normal blood pressure. As for other risk factors such as history of
diabetes mellitus, blood sugar levels, a history of hypercholesterolemia, patterns of
treatment of hypertension, diabetes, and antihiperkolesterolemia, history of obesity,
history of smoking, the number of cigarette consumption per day, and the duration
of smoking is not proven effect on the incidence of chronic renal failure in this
study , suggestions for further research is doing research with a larger scale of the
risk factors of chronic renal failure, as well as the need to investigate the etiology
of which play a direct role on the incidence of the disease. Besides that, we need to
maximize education about kidney health from an early age, and education to
patients who have a risk in order to control their health routine.

Key Words: Chronic Renal Failure, End-stage Renal Disease (ESRD), Risk
Factors, Hypertension, Diabetes Mellitus, Hypercholesterolaemia, Body Mass
Indeks (BMI), Smoking behavior

Bibliography: 26 (2001-2015)