Korelasi Kadar Hepsidin dan Reticulocyte Hemoglobin pada Penderita Gagal Ginjal Terminal dengan Hemodialisis Reguler

Abstract

Background: Anemia is a complication that often occurs in CKD patients, especially in those who are undergoing reguler hemodialysis, known as renal anemia. Reticulocyte Hemoglobin (RET-He) represents the average value of the hemoglobin distributionin reticulocytes and can describe the availability of iron in bone marrow erythropoiesis. Hepcidin is a hormone that plays a role in iron regulation and metabolism.The correlation of hepcidin and Ret.He levels is not clearly known. Objective : To determine the correlation of hepcidin and reticulocyte hemoglobin (RET-He) levels in end-stage renal disease (ESRD) patients with regular hemodialysis Method : This study is an analytical observation and cross sectional design that were conducted at Adam Malik Hospital, in December 2015. A total of 31 samples of patients with ESRD undergoing regular hemodialysis over 3 months with a frequency of two times per week were included. All study subjects’ full blood count, Ret-He and Hepcidin serum were examined. Result : in this study, median of Ret.He level is 33,6 pg ( 28,2-38,7 pg) and median of hepcidin levels is 0,3 ng/ml (0.09- 4 ng/ml). In Spearman’s rho test there is no significant correlation between Hepcidin with Ret.He levels. (r = 0.135; p = 0467). Conclusion: There is no significant correlation between Hepcidin with Ret.He level in ESRD patients who are undergoing regular hemodialysis.

Latar belakang: Anemia merupakan komplikasi yang kerap terjadi pada pasien PGK, terlebih lagi pada yang menjalani hemodialisis reguler yang dikenal dengan anemia renal. Reticulocyte Hemoglobin(Ret.He) merepresentasikan nilai rata-rata distribusi kandungan hemoglobin di dalam retikulosit dan dapat menggambarkan ketersediaan besi dalam proses eritropoiesis di sumsum tulang. Hepsidin merupakan hormon yang berperan dalam regulasi dan metabolisme besi.Korelasi kadar hepsidin dan Ret.He belum diketahui secara jelas. Tujuan: Mengetahui korelasi kadar Hepsidin dan Ret.He pada penderita gagal ginjal terminal dengan hemodialisis reguler. Metode : Penelitian ini merupakan analitik observasional dengan pendekatan potong lintang yang dilakukan di RSUP H. Adam Malik Medan, pada bulan Desember 2015 – Maret 2016. Sebanyak 31 sampel penderita gagal ginjal terminal yang menjalani hemodialisis reguler lebih 3 bulan dengan frekuensi 2x/ minggu dan menandatangani informed consent memenuhi kriteria inklusi. Semua subjek penelitian diperiksa darah lengkap, Ret-He dan Hepsidin serum. Hasil : Pada penelitian ini, didapati median kadar Ret.He sebesar 33,6 pg (28,2 – 38,7 pg) dan median kadar Hepsidin 0,3 ng/ml (0,09-4 ng/ml). Pada uji spearman’s rhodidapat korelasi positif yang tidak signifikan antara kadar Hepsidin dan Ret.He(r= 0,135, p = 0,467). Kesimpulan: Terdapat korelasi yang tidak signifikan antara kadar Hepsidin dengan Ret.He pada penderita gagal ginjal terminal dengan hemodialisis reguler.