Pengaruh Prosedur Hemodialisis Terhadap Keadaan Interleukin-6 pada Fase Hemodialisis di Rumah Sakit Umum Pusat Haji Adam Malik Medan

Abstract

Introduction: Chronic kidney disease (CKD) is kidney damage characterized by the presence of protein in the urine or a decrease in the glomerular filtration rate (GFR). CKD is a global problem throughout the world, including Indonesia, which requires special attention. IL-6 is known to play a role in regulating hemostatic functions, including glucose metabolism, the hypothalamus-pituitaryadrenal (HPA) axis, influencing mood, fatigue, depression, and hematopoiesis. As an inflammatory cytokine, IL-6 is an inflammatory mediator that most plays a role in various conditions, such as infection, autoimmune disease, and cancer. In CKD patients undergoing dialysis (HD), elevated serum IL-6 levels beginning from the start of the treatment is a strong predictor of mortality. The study aimed to determine the association between hemodialysis procedures and interleukin-6 levels in regular hemodialysis CKD patients in Haji Adam Malik Central General Hospital. Methods: This is an analytical study with a cross-sectional design. A total of 20 study subjects met the inclusion criteria and exclusion criteria, underwent history taking, physical examination, anthropometry, and laboratory examination to measure hemoglobin, creatinine, albumin, and IL-6 levels. Data analysis was performed using SPSS. Results: The median level of IL-6 before hemodialysis was 10.39 pg/mL with the lowest level and the highest level being 1.50 – 74.79 pg/mL, the median level of IL-6 after hemodialysis was 29.13 pg/mL with the lowest level and the lowest level. the highest is 2.11 – 316.20 pg/mL. Based on the results of the analysis, the levels of IL-6 after hemodialysis were higher than the levels of IL-6 before hemodialysis, there was a statistically significant relationship between regular hemodialysis and interleukin-6 levels before and after in patients with kidney disease. Conclusion: Regular hemodialysis and interleukin-6 levels have a statistically significant relationship before and after hemodialysis in CKD patients.

Pendahuluan: Penyakit ginjal kronis (PGK) adalah kerusakan ginjal yang ditandai dengan adanya protein dalam urin atau penurunan laju filtrasi glomerulus (GFR). PGK merupakan masalah global di seluruh dunia termasuk Indonesia yang memerlukan perhatian khusus. IL-6 diketahui berperan dalam mengatur fungsi hemostatik, termasuk metabolisme glukosa, aksis hipotalamus-hipofisis- adrenal (HPA), mempengaruhi suasana hati, kelelahan, depresi, dan hematopoiesis. Sebagai sitokin inflamasi, IL-6 merupakan mediator inflamasi yang paling berperan dalam berbagai kondisi, seperti infeksi, penyakit autoimun, dan kanker. Pada pasien PGK yang menjalani dialisis (HD), peningkatan kadar serum IL-6 sejak awal pengobatan merupakan prediktor kuat mortalitas. Penelitian ini bertujuan untuk menentukan hubungan antara prosedur dan kadar IL-6 pada pasien dengan hemodialisis rutin di Rumah Sakit Umum Pusat Haji Adam Malik. Metode: Penelitian ini merupakan penelitian analitik dengan desain potong lintang. Sebanyak 20 subjek penelitian memenuhi kriteria inklusi dan kriteria eksklusi, menjalani anamnesis, pemeriksaan fisik, antropometri, dan pemeriksaan laboratorium untuk mengukur kadar hemoglobin, kreatinin, albumin, dan IL-6. Analisis data dilakukan dengan menggunakan SPSS. Hasil: Median kadar IL-6 sebelum hemodialisis adalah 10,39 pg/mL dengan kadar terendah dan tertinggi 1,50 – 74,79 pg/ mL, median kadar IL-6 setelah hemodialisis adalah 29,13 pg/mL dengan kadar terendah dan level terendah. tertinggi adalah 2,11 – 316,20 pg/mL. Berdasarkan hasil analisis kadar IL-6 setelah hemodialisis lebih tinggi dibandingkan kadar IL-6 sebelum hemodialisis, terdapat hubungan yang bermakna secara statistik antara hemodialisis reguler dengan kadar interleukin-6 sebelum dan sesudah pada pasien penyakit ginjal. . Kesimpulan: Hemodialisis rutin dan kadar interleukin-6 memiliki hubungan yang bermakna secara statistik sebelum dan sesudah hemodialisis pada pasien PGK.