Profil Lipid Penderita Penyakit Ginjal Kronis pada Predialisis dan Hemodialisis

Source: OAI


mkn-jun2005- (2) Penderita dengan penyakit ginjal kronis (CKD) dilaporkan selalu menunjukkan adanya dislipidemia yang bervariasi terutama hipertrigliseridemia, merupakan salah satu dari banyak faktor risiko penyakit kardiovaskular dan penyebab kematian pada penderita CKD sebelum menjalani hemodialisis (HD) dan yang menjalani perawatan HD. Tujuan penelitian ini untuk melihat profil lipid (Trigliserid, Kolesterol total-TC, Low Density Lipoprotein–LDL-C and High Density Lipoprotein-HDL-C); perbedaan kadar profil lipid penderita CKD predialisis dan yang menjalani perawatan HD; perbedaan profil lipid penderita CKD HD 1-2 tahun dan 2-4 tahun dengan menggunakan rancangan cross sectional. Sampel darah diambil dari penderita yang didiagnosa CKD dari berbagai etiologi yang tidak menjalani program dialisis (predialisis) dan penderita HD. Darah diambil setelah berpuasa 12 jam kemudian sampel dikirim ke laboratorium untuk menentukan fungsi ginjal dan profil lipid. Hasil menunjukkan dari 84 penderita predialisis dan HD hanya 13 penderita (15.5%) menunjukkan hipertrigliseridemia, tidak ada perbedaan bermakna kadar penderita predialisis dan HD. Nilai rata-rata kadar TC penderita predialisis 215.13±77.78 mg/dl dan HD 171.05±41.52 mg/dl (p=0,002). Kadar LDL-C penderita predialisis 129.08±58.01 mg/dl dan HD 98.36±22.34 mg/dl (p=0,002). Kadar HDL-C penderita predialisis 33,73±13.90 mg/dl dan penderita HD 31.23±11.13 mg/dl (p=0.365). Hasil menunjukkan bertentangan dengan literatur bahwa insidens hipertrigliseridemia rendah. Kadar TC dan LDL-C secara bermakna rendah pada penderita CKD HD dibandingkan predialisis, sedangkan kadar HDL-C tidak ada perbedaan yang bermakna. Kadar LDL-C tinggi pada HD 2-4 tahun dibandingkan HD 1-2 tahun. Hasil ini menunjukkan bahwa faktor risiko terjadinya penyakit kardiovaskular di Indonesia rendah pada penderita CKD yang menjalani HD dibandingkan penderita predialisis. Patients with chronic kidney disease (CKD) have always been reported to have various levels of dyslipidemia especially hypertriglyceridemia, regarded as one of the many risk factors for cardiovascular disease (CVD) the main cause of death in CKD patients before receiving haemodialysis (HD) as well in patients on HD treatment. This study was consecutive to investigate the lipid profile (Triglyceride, total cholesterol-TC, Low Density Lipoprotein–LDL-C and High Density Lipoprotein-HDL-C); the differences of lipid profiles in patients with CKD before dialysis and those who receive haemodialysis treatment and differences of lipid profiles in patient with CKD who receive haemodialysis 1-2 years and 2-4 years, with a cross sectional design. Blood samples were withdrawn from consecutive patients who were diagnosed to have CKD due to various aetiologies and were not on a dialysis treatment program (predialysis), and like wise, also from haemodialysis patients. Blood was withdrawn after 12 hours fasting and samples were sent to the laboratory for renal function and lipid profile determination. The results showed that from 84 predialysis and HD patients only 13 patients (15.5%) had hypertriglyceridemia and there was no statistical difference between levels in predialysis and patients receiving HD. Mean TC in predialysis and HD patient were 215.13±77.78 mg/dl and 171.05±41.52 mg/dl respectively (p=0,002). LDL-C in predialysis and HD patients were 129.08±58.01 mg/dl and 98.36±22.34 mg/dl respectively (p=0,002). HDL-C in predialysis was 33,73±13.90 mg/dl and in HD patients 31.23±11.13 mg/dl (p=0.365). The results showed that, contrary to that in literature the incidence of hypertriglyceridemia was low. The levels of TC and LDL-C were significantly lower in HD compared to those of predialysis patients, while there was no difference in the levels of HDL-C. Level of the LDL-C were significantly higher in HD 2-4 years compared to those of HD patient 1-2 years. These further show that risk for CVD were lower in Indonesian CKD patients receiving haemodialysis compared to those in the predialysis stage.

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