PROFILE OF ANEMIA AND MALNUTRITITION ON CHRONIC HEMODIALYSIS PATIENTS IN SANGLAH HOSPITAL, DENPASAR-BALI INDONESIA

S WARDANI NI WAYAN1, Y KANDARINI2, P AYU NYOMAN3, R WIDIANA I GDE4

1Division Of Nephrology And Hypertension-Udayana University-Sanglah Hospital, Denpasar, Bali, Indonesia, Denpasar, Bali, Indonesia, Indonesia, 2Division Of Nephrology And Hypertension-Udayana University-Sanglah Hospital, Denpasar, Bali, Indonesia, Denpasar, Bali, Indonesia, Indonesia, 3Division Of Nephrology And Hypertension-Udayana University-Sanglah Hospital, Denpasar, Bali, Indonesia, Denpasar, Bali, Indonesia, Indonesia, 4Division Of Nephrology And Hypertension-Udayana University-Sanglah Hospital, Denpasar, Bali, Indonesia, Denpasar, Bali, Indonesia, Indonesia

Aim: To examine anemia profile and malnutrition using Malnutrition Inflammation Score (MIS), Interleukin-6 (IL-6) in regular hemodialysis.
Background: Anemia and malnutrition are common in CKD who undergo regular hemodialysis. Inflammation contribute to anemia and malnutrition in protein energy wasting (PEW).
Methods: A cross-sectional study of 70 patients above 18 years old, who undergone hemodialysis twice weekly for at least 3 months. Patients who hospitalized and had acute infections were excluded. Anemia was defined as hemoglobin concentrations <12 g/dl and malnutrition status was determined by MIS. IL-6 was examined with ELISA method.
Results: This study composed of 49 (70%) males and 21 (30%) females, aged 51.24 ± 11.82 years. URR (Urea Reduction Ratio) were 72.97 ± 9.10 percent, 14 (20%) subject have achieved target URR equal to 80 % or more. Mean serum albumin concentrations were 4.28 ± 0.39 g/dl and 14 (20%) of the patients had serum albumin below than 4 g/dl.  Mean of hemoglobin, transferrin saturation, and ferritin serum were 10.81 ± 1.73 mg/dl, 32.66±14.08%, and 828.70±625.34 ng/ml, respectively. Most of patients (75.7%) were anemic (hemoglobin <12g/dl), however 90% patients had transferrin saturations >20% and ferritin serum concentrations >500 ng/ml were 75.7%. This study also explored MIS and IL-6 concentrations to determine malnutrition and inflammation. We found 49 (70.0%) patients with malnutrition (using MIS more than 5 as cuff-of point derived from 25 percentile) and among these malnutrition patients there were 40 (71.4%) subject with inflammation (using IL-6 concentrations >18 ng/ml as cuff-of point derived from 25 percentile)
Conclusion: Most of our regular hemodialysis patients were anemic, malnourished and in condition of inflammatory state.
Key words: anemia, interleukin-6, malnutrition, regular hemodialysis


Biography:
History of Study: General doctor in Udayana University (Graduated 1997), Internist in Udayana University (Graduated 2008), Fellow of Nephrology and Hypertension, Department of Internal Medicine-Udayana University-Sanglah Hospital, Denpasar, Bali, Indonesia (2018-now)

History of Job: Non civil servant doctor at Lontar public health (1997-1999), civil servant doctor in Boejasin Hospital  South Kalimantan (2000-2004), internist at Sanjiwani Gianyar Hospital, Bali Indonesia (2008-now)

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