Skripsi

Analisis Pola Tidur Anak End-Stage Kidney Disease yang Menjalani Continuous Ambulatory Peritoneal Dialysis di Rumah Sakit Cipto Mangunkusumo = Analysis of Sleep Pattern for Pediatric End-Stage Kidney Disease undergoing Continuous Ambulatory Peritoneal Dialysis at Cipto Mangunkusumo Hospital.

Latar belakang: Penyakit ginjal kronis (PGK) merupakan penyakit dengan insidensi dan prevalensi terus meningkat setiap tahun. Anak PGK stage 5 atau End-Stage Kidney Disease (ESKD) dapat mengalami komplikasi, diantaranya adalah gangguan tidur. Secara umum telah diketahui bahwa tidur memiliki peran penting dalam pertumbuhan serta perkembangan anak dan adanya gangguan tidur dapat berakibat negatif bagi anak yang mengalami. Belum adanya data mengenai gangguan tidur serta faktor yang kemungkinan berpengaruh pada anak yang menjalani continuous ambulatory peritoneal dialysis (CAPD) di Indonesia menjadi alasan mengapa penelitian ini dilakukan. Metode: Penelitian dilakukan di unit dialisis Pusat Kesehatan Ibu dan Anak Rumah Sakit Cipto Mangunkusumo. Seluruh pasien anak ESKD yang menjalani CAPD dimasukkan menjadi subjek. Kriteria inklusi adalah anak yang telah menjalani CAPD minimal selama 1 bulan. Kriteria Eksklusi adalah terdapat konsumsi obat antikejang, antihistamin, antiansietas dan obat lain yang memiliki efek kantuk selama 3 hari sebelum wawancara dilakukan. Data terkait gangguan tidur didapat dengan melakukan wawancara menggunakan kuesioner Skala Gangguan Tidur untuk Anak (SDSC) sedangkan data data lain berupa usia, jenis kelamin, etiologi PGK, durasi CAPD, dan status gizi didapatkan dari rekam medis. Hasil: Terdapat 25 pasien PGK stage 5 yang menjalani CAPD di unit dialisis RSCM. Terdapat 5 pasien dieksklusi dengan rincian 2 pasien tidak memenuhi kriteria inklusi, 2 pasien mengonsumsi obat antikejang, dan 1 pasien dengan data yang tidak lengkap. Gangguan tidur diidentifikasi pada 11 dari 20 pasien (55%) dengan jenis gangguan tidur terbanyak berupa gangguan memulai serta mempertahankan tidur (4/11). Uji Mann Whitney dan Kruskal Wallis dilakukan dan tidak didapatkan bukti signifikan adanya hubungan antara gangguan tidur yang terjadi dengan usia (p value = 0,924), jenis kelamin (p value = 0,426), etiologi PGK (p value = 0,394), durasi CAPD (p value = 0,758), dan status gizi (p value = 0,332). Kesimpulan: Prevalensi gangguan tidur anak PGK stage 5 yang menjalani CAPD di RSCM sebesar 55%. Belum dapat dibuktikan kemungkinan adanya faktor yang bertanggung jawab atas gangguan tidur pada populasi anak tersebut berdasarkan variabel yang dianalisis. Hasil yang tidak signifikan antara hubungan gangguan tidur dengan variabel yang dianalisis dapat disebabkan oleh jumlah subjek yang sedikit atau terdapat faktor lain yang belum diidentifikasi.
Kata kunci: Gagal ginjal kronis anak stage 5. Continuous ambulatory peritoneal dialysis. Skala gangguan tidur untuk anak. Gangguan tidur



Introduction: Chronic kidney disease (CKD) is a disease with an increasing incidence and prevalence every year. Children with CKD stage 5 or End-Stage Kidney Disease (ESKD) can experience complications, including sleep disorders. In general, it is known that sleep has an important role in the growth and development of children and the presence of sleep disorders can have negative consequences for children who experience it. The absence of data on sleep disorders and factors that may affect children undergoing continuous ambulatory peritoneal dialysis (CAPD) in Indonesia is the reason why this study was conducted. Method: The study was conducted at the dialysis unit of the Maternal and Child Health Center, Cipto Mangunkusumo Hospital. All ESKD pediatric patients who underwent CAPD were included as subjects. Inclusion criteria were children who had undergone CAPD for at least 1 month. Exclusion criteria were the consumption of anti-seizure drugs, antihistamines, anti-anxiety drugs and other drugs that have a drowsy effect for 3 days before the interview was conducted. Data related to sleep disorders were obtained by conducting interviews using the Sleep Disturbance Scale for Children (SDSC) questionnaire while other data such as age, gender, etiology of CKD, duration of CAPD, and nutritional status were obtained from medical records. Result: There were 25 CKD stage 5 patients who underwent CAPD in the RSCM dialysis unit. There were 5 patients excluded with details of 2 patients not meeting the inclusion criteria, 2 patients taking anticonvulsant drugs, and 1 patient with incomplete data. Sleep disturbances were identified in 11 of 20 patients (55%) with the most common types of sleep disturbances being disturbances in initiating and maintaining sleep (4/11). Mann Whitney and Kruskal Wallis tests were conducted and there was no significant evidence of a relationship between sleep disturbances that occurred with age (p value = 0.924), gender (p value = 0.426), etiology of CKD (p value = 0.426). value = 0.394), duration of CAPD (p value = 0.758), and nutritional status (p value =0.332). Conclusion: The prevalence of sleep disorders in stage 5 CKD children undergoing CAPD at the RSCM is 55%. It has not been proven that there may be factors responsible for sleep disorders in this population of children based on the variables analyzed. The results that are not significant between the relationship between sleep disorders and the variables analyzed can be caused by the small number of subjects or other factors that have not been identified.
Keywords: Pediatric End-stage kidney disease. Continuous ambulatory peritoneal dialysis. Sleep Disturbance scale for children. Sleep disorder