Skripsi

Status Gizi pada Anak dengan Penyakit Ginjal Kronik Menjalani Peritoneal Dialisis dan Faktor yang Memengaruhinya = Nutritional Status in Children with End-Stage Renal Disease Undergo Continous Ambulatory Peritoneal Dialysis and Other Affected Factors.

Latar belakang: Penyakit ginjal kronik (PGK) merupakan penyakit yang sering dijumpai dan harus diwaspadai, terutama pada anak, melihat angka morbiditas dan mortalitas yang terus meningkat. Penyakit ginjal kronik pada anak memiliki pengaruh terhadap tumbuh kembang anak melalui perubahan fungsi tubuh dalam bermetabolisme. Hal ini menjadikan dampak negatif tumbuh kembang seperti perawakan pendek, retardasi pertumbuhan, hingga malnutrisi banyak ditemukan pada anak dengan penyakit ginjal kronik yang menjalani dialisis seperti Continous Ambulatory Peritoneal Dialysis (CAPD) atau dialisis peritoneal. Oleh karena itu, penelitian ini dilakukan untuk mencari pengaruh dari CAPD dan faktor pengaruh lainnya terhadap status gizi anak. Metode: Penelitian dilakukan dengan desain potong lintang dengan mengambil data sekunder berupa stadium dan durasi penyakit, regimen CAPD terakhir, faktor etiologi primer, serta komorbiditas dari rekam medis. Data status gizi anak diperoleh dengan melakukan pengukuran berat badan dan tinggi badan, jika diperlukan mengambil pengukuran lingkar lengan atas, lalu dimasukan ke aplikasi WHO Anthro dan WHO Antroplus. Data demografi berupa tingkat pendidikan ayah dan ibu, status ekonomi keluarga, usia, dan jenis kelamin diperoleh dari pengisian Case Report Form (CRF). Terdapat sebanyak 15 partisipan yang memenuhi kriteria inklusi dan eksklusi dari peneliitan ini. Hasil: Rerata penilaian status gizi dilihat dari indeks massa tubuh menurut umur (IMT/U)menunjukkan hasil antara -2 SD < x < 1 SD dengan interpretasi gizi baik, serta dilihat dari tinggi badan menurut umur menunjukkan hasil antara -3 SD < x < -2 SD dengan interpretasi perawakan pendek. Berdasarkan analisis bivariat, hanya ditemukan pengaruh signifikan antara usia dan pendidikan ibu dengan status gizi (p < 0.05) serta tidak ditemukan pengaruh bermakna antara durasi CAPD, siklus CAPD, jenis cairan CAPD, dwell time CAPD, volume pengsian CAPD, jenis kelamin, etiologi, dan komorbiditas (p > 0,05) pada anak dengan penyakit ginjal kronik yang sedang menjalani CAPD terhadap status gizinya. Kesimpulan: Status gizi pada anak PGK yang menjalani CAPD berdasarkan indeks massa tubuh dan tinggi badan menurut umur ditemukan hasil rata-rata gizi baik namun dengan perawakan pendek. Ditemukan pengaruh dari usia dan pendidikan ibuterhadap status gizi pada anak PGK yang menjalani CAPD. Namun, tidak ditemukannya pengaruh dari durasi CAPD, siklus CAPD, jenis cairan CAPD, dwell time CAPD, volume pengsian CAPD, jenis kelamin, etiologi, dan komorbiditas terhadap status gizi pada anak dengan PGK yang menjalani CAPD.
Kata kunci: Penyakit Ginjal Kronik Stadium terminal, Peritoneal Dialisis, Status gizi, Anak 0-18 tahun


Introduction: Chronic kidney disease (CKD) is a disease that is often encountered and must be watched out for, especially in children seeing the increasing morbidity and mortality rates. Chronic kidney disease in children has an influence on the growth and development of children through changes in body functions in metabolism. This makes the negative effects of growth and development such as short stature, growth retardation, and malnutrition are often found in children with chronic kidney disease who are undergoing dialysis such as Continuous Ambulatory Peritoneal Dialysis (CAPD) or peritoneal dialysis. Therefore, this study was conducted to find out the effect of CAPD and other influencing factors on children's nutritional status. Method: The study was conducted in a cross-sectional design by taking secondary data in the form of stage and duration of disease, the latest CAPD regimen, primary etiologic factors, and comorbidities from medical records. Data on the nutritional status of children is obtained by measuring weight and height, if necessary taking the circumference of the upper arm as well, then inputting it into the WHO Anthro and WHO Anthroplus applications. Demographic data in the form of education level of father and mother, family economic status, age, and gender were obtained from filling out the Case Report Form (CRF). There are 15 respondents who meet the inclusion and exclusion criteria of this study. Result: The mean nutritional status assessment seen from body mass index for age showed results between -2 SD < x < 1 SD with the interpretation of good nutrition and from height for age showed results between -3 SD < x < -2 SD with the interpretation of short stature. Based on bivariate analysis, only found a significant effect between age and mother’s education and nutritional status (p < 0.05) and found no significant effect between CAPD duration, CAPD cycle, type of CAPD fluid, CAPD dwell time, CAPD filling volume, gender, etiology, and comorbidities ( p > 0.05) in children with chronic kidney disease who are undergoing CAPD on their nutritional status. Conclusion: The nutritional status of CKD children undergoing CAPD based on body mass index and height according to age was found to be on average good nutrition but with short stature. It was found that the effect of age and mother’s education on nutritional status in CKD children undergoing CAPD. However, the effect of CAPD duration, CAPD cycle, CAPD fluid type, CAPD dwell time, CAPD filling volume, gender, etiology, and comorbidities on nutritional status in children with CKD undergoing CAPD was not found.
Keywords: End-Stage Renal Disease. Continous Ambulatory Peritoneal Dialysis, Nutritional Status, Children