HUBUNGAN GAGAL GINJAL KRONIK DENGAN INTERVAL QTc PADA PASIEN HEMODIALISIS DI RSUD RAA SOEWONDO PATI
DOI:
https://doi.org/10.31004/prepotif.v9i2.47192Keywords:
Gagal Ginjal Kronik, Interval QTc, Hemodialisis, Diabetes Mellitus, HipertensiAbstract
Pada tahun 2017, gagal ginjal kronik (GGK) menempati urutan ke 12 sebagai penyebab utama kematian secara global dan diperikirakan akan naik ke urutan 5 pada tahun 2040. Pada pasien GGK, prevalensi pemanjangan interval QTc meningkat secara progresif seiring dengan menurunnya fungsi ginjal. Interval QTc telah diakui sebagai parameter prognostik penting dalam menilai risiko aritmia ventrikel dan kematian jantung mendadak, terutama pada GGK. Penelitian ini bertujuan untuk mengetahui hubungan antara gagal ginjal kronik dengan pemajangan interval QTc pada pasien yang menjalani hemodialisis. Penelitian observasional dengan desain potong lintang dilakukan di RSUD RAA Soewondo Pati dalam periode September-November 2024. Digunakan teknik consecutive sampling untuk pengambilan data. Dilakukan elektrokardiografi saat pasien menjalani prosedur dialisis. Uji statistik menggunakan uji T tidak berpasangan. Dari 50 pasien gagal ginjal kronik 58% didominasi oleh laki-laki. Rentang usia pasien 43-65 tahun. Komorbid terbanyak pada pasien GGK adalah diabetes mellitus (38%) diikuti dengan hipertensi (30%). Interval QTc berada dalam rentang 323-610 ms dengan nilai rerata 438 ± 60 ms. Sebanyak 76% mengalami pemanjangan interval QTc saat dilakukaan prosedur hemodialisis. Diabetes mellitus dan hipertensi berhubungan secara signifikan dengan GGK (p = 0.049; PRR (95% CI) = 1,917 (1,031-3,563)) dan (p = 0.044; PRR (95% CI)) = 1,878 (1,072-3,292). Didapatkan hubungan yang secara statistik bermakna antara GGK dengan pemanjangan interval QTc (p = 0,024). Pasien dengan GGK ³ 6 bulan memiliki rerata pemanjangan interval QTc yang lebih besar yaitu 38 ms dibandingkan pasien GGK < 6 bulan.References
Assimon, M.M., Wang, L., Pun, P.H., Winkelmayer, W.C., Flythe, J.E. (2020). Use of QT Prolonging Medications by Hemodialysis Patients and Individuals Without End‐Stage Kidney Disease. Journal of the American Heart Association, 9(13). https://doi.org/10.1161/JAHA.120.015969
Bidani, A. K., & Griffin, K. A. (2004). Pathophysiology of Hypertensive Renal Damage. Hypertension, 44(5), 595–601. https://doi.org/10.1161/01.HYP.0000145180.38707.84
Chander, S., Luhana, S., Sadarat, F., Parkash, O., Rahaman, Z., Wang, H. Y., Kiran, F., Lohana, A. C., Sapna, F., & Kumari, R. (2024). Mortality and mode of dialysis: Meta-analysis and systematic review. BMC Nephrology, 25(1), 1. https://doi.org/10.1186/s12882-023-03435-4
Chen, A., Zou, M., Young, C. A., Zhu, W., Chiu, H.-C., Jin, G., & Tian, L. (2021). Disease Burden of Chronic Kidney Disease Due to Hypertension From 1990 to 2019: A Global Analysis. Frontiers in Medicine, 8, 690487. https://doi.org/10.3389/fmed.2021.690487
Di Iorio, B., & Bellasi, A. (2013). QT interval in CKD and haemodialysis patients. Clinical kidney journal, 6(2), 137–143. https://doi.org/10.1093/ckj/sfs183
Di Lullo, L., Gorini, A., Russo, D., Santoboni, A., & Ronco, C. (2015). Left Ventricular Hypertrophy in Chronic Kidney Disease Patients: From Pathophysiology to Treatment. Cardiorenal Medicine, 5(4), 254–266. https://doi.org/10.1159/000435838
Frąk, W., Dąbek, B., Balcerczyk-Lis, M., Motor, J., Radzioch, E., Młynarska, E., Rysz, J., & Franczyk, B. (2024). Role of Uremic Toxins, Oxidative Stress, and Renal Fibrosis in Chronic Kidney Disease. Antioxidants, 13(6), Article 6. https://doi.org/10.3390/antiox13060687
Guo, J., Liu, Z., Wang, P., Wu, H., Fan, K., Jin, J., … & Li, C. (2025). Global, regional, and national burden inequality of chronic kidney disease, 1990–2021: a systematic analysis for the global burden of disease study 2021. Frontiers in Medicine, 11. https://doi.org/10.3389/fmed.2024.1501175
Hage, F. G., de Mattos, A. M., Khamash, H., Mehta, S., Warnock, D., & Iskandrian, A. E. (2010). QT prolongation is an independent predictor of mortality in end-stage renal disease. Clinical Cardiology, 33(6), 361–366. https://doi.org/10.1002/clc.20768
Hidayat, M., Motulo, F., Chandra, S., Andamari, S., Sulungbudi, J., & Lesmana, R. (2023). Analysis of influencing factors in chronic kidney disease incidence in Indonesia. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 296–305. https://doi.org/10.20885/JKKI.Vol14.Iss3.art10
International Diabetes Federation. (2023). Diabetes and Kidney Disease. In: IDF Atlas Reports. IDF [serial online]. https://diabetesatlas.org/resources/idf-diabetes-atlas-reports/diabetes-and-kidney-disease/
Jarrar, F., Pasternak, M., Harrison, T. G., James, M. T., Quinn, R. R., Lam, N. N., Donald, M., Elliott, M., Lorenzetti, D. L., Strippoli, G., Liu, P., Sawhney, S., Gerds, T. A., & Ravani, P. (2025). Mortality Risk Prediction Models for People With Kidney Failure: A Systematic Review. JAMA Network Open, 8(1), e2453190. https://doi.org/10.1001/jamanetworkopen.2024.53190
Jha, R., Lopez-Trevino, S., Kankanamalage, H. R., & Jha, J. C. (2024). Diabetes and Renal Complications: An Overview on Pathophysiology, Biomarkers and Therapeutic Interventions. Biomedicines, 12(5), Article 5. https://doi.org/10.3390/biomedicines12051098
Kaesler, N., Babler, A., Floege, J., & Kramann, R. (2020). Cardiac Remodeling in Chronic Kidney Disease. Toxins, 12(3), 161. https://doi.org/10.3390/toxins12030161
Kiuchi, M. G., Ho, J. K., Nolde, J. M., Gavidia, L. M. L., Carnagarin, R., Matthews, V. B., & Schlaich, M. P. (2019). Sympathetic Activation in Hypertensive Chronic Kidney Disease—A Stimulus for Cardiac Arrhythmias and Sudden Cardiac Death? Frontiers in Physiology, 10, 1546. https://doi.org/10.3389/fphys.2019.01546
Kovesdy C. P. (2022). Epidemiology of chronic kidney disease: an update 2022. Kidney international supplements, 12(1), 7–11. https://doi.org/10.1016/j.kisu.2021.11.003
Liu, P., Wang, L., Han, D., Sun, C., Xue, X., & Li, G. (2020). Acquired long QT syndrome in chronic kidney disease patients. Renal failure, 42(1), 54–65. https://doi.org/10.1080/0886022X.2019.1707098
Mozos, I. (2014). Laboratory Markers of Ventricular Arrhythmia Risk in Renal Failure. BioMed Research International, 2014, 509204. https://doi.org/10.1155/2014/509204
Mulia, E. P. B., Nugraha, R. A., A'yun, M. Q., Juwita, R. R., Yofrido, F. M., Julario, R., & Alkaff, F. F. (2020). Electrocardiographic abnormalities among late-stage non-dialysis chronic kidney disease patients. Journal of basic and clinical physiology and pharmacology, 32(3), 155–162. https://doi.org/10.1515/jbcpp-2020-0068
Oktavia, D., Suhardjono, Nasution, S. A., & Setiati, S. (2013). The clinical factors' prediction of increased intradialytic QT dispersion on the electrocardiograms of chronic hemodialysis patients. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 24(2), 274–280. https://doi.org/10.4103/1319-2442.109571
Pattiiha, A., Yamin, M., Lydia, A., Abdullah, M. (2021). Proportion of Pre-dialysis Prolonged QT Dispersion in TwiceWeekly Chronic Hemodialysis Patients and Its Associated Factors. Jurnal Penyakit Dalam Indonesia, 8(2), 93-98. https://scholarhub.ui.ac.id/jpdi/vol8/iss2/12
Salman, I. M. (2015). Cardiovascular Autonomic Dysfunction in Chronic Kidney Disease: A Comprehensive Review. Current Hypertension Reports, 17(8), 59. https://doi.org/10.1007/s11906-015-0571-z
Sherif, K. A., Abo-Salem, E., Panikkath, R., Nusrat, M., & Tuncel, M. (2014). Cardiac repolarization abnormalities among patients with various stages of chronic kidney disease. Clinical Cardiology, 37(7), 417–421. https://doi.org/10.1002/clc.22277
Sohal, P. M., Goel, A., Gupta, D., Aslam, N., Sandhu, J., Sandhu, J. S., John, E. E., & Sharma, D. (2018). Effect of Hemodialysis on Corrected QT Interval and QTc Dispersion. Indian Journal of Nephrology, 28(5), 335–338. https://doi.org/10.4103/ijn.IJN_15_18
Thurlow, J. S., Joshi, M., Yan, G., Norris, K. C., Agodoa, L. Y., Yuan, C. M., & Nee, R. (2021). Global Epidemiology of End-Stage Kidney Disease and Disparities in Kidney Replacement Therapy. American journal of nephrology, 52(2), 98–107. https://doi.org/10.1159/000514550
Yehia, H., Youssef, G., Gamil, M., Elsaeed, M., & Sadek, K. M. (2023). Electrocardiographic substrates of arrhythmias in patients with end-stage and chronic kidney diseases: A case–control study. The Egyptian Heart Journal, 75(1), 13. https://doi.org/10.1186/s43044-023-00338-5
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