Contributing Factors to Intradialytic Complications in Hemodialysis Patients

Main Article Content

Sandi Alfa Wiga Arsa
Anita Rahmawati
Corresponding Author:
Sandi Alfa Wiga Arsa | sandialfa.alfa6@gmail.com



Abstract

Introductioin : Intradialytic complications are still being debated among health workers in the Hemodialysis Unit in Hospitals, many factors can cause patients to experience complications during dialysis. This study aims to identify the factors that contribute to the incidence of intradialytic complications in order to minimize the incidence of complications.


Methode : This study used a research design in the form of analytic descriptive with cross-sectional. The sampling technique was a consecutive sampling of 120 patients. The chi-square statistical test aims to examine differences in proportions. If the results of the bivariate test have p <  0.25, then these variables can be included in the multivariate model using multiple logistic regression analysis.


Result : Candidate selection results, Hb (0,014), Fluid Compliance (0,221), Venous Access (0,236), IDWG (0,023), and Comorbid (0,006) have a p value less than 0.25. In the multivariate test obtained Comorbid (0,007; OR:2.361 ), IDWG (0,049;OR:-1,894), and Hb (0,047;OR: 0,922), it can be concluded that these three factors have a significant influence on the occurrence of intradialytic complications.The proportion of intradialytic problems that can be described by 5 variables, namely venous access, comorbidities, IDWG, HB, and adherence, is 24%, with the remaining 18% explained by other factors.


Conclusion : Comorbid, interdialytic weight gain, and hemoglobin goal accomplishment all have a significant role in the occurrence of intradialytic complication. The findings of this study can be utilized to raise awareness of intradialytic consequences. This vulnerable population need effective management to manage the problems they are experiencing.

Article Details

How to Cite
[1]
S. A. W. Arsa and A. Rahmawati, “Contributing Factors to Intradialytic Complications in Hemodialysis Patients”, Babali Nurs. Res., vol. 4, no. 4, pp. 636-650, Oct. 2023.
Section
Original Research

References

[1] K. L. Johansen et al., “US Renal Data System 2020 Annual Data Report: Epidemiology of Kidney Disease in the United States,” Apr. 2021. doi: 10.1053/j.ajkd.2021.01.002.
[2] F. B. Nerbass, H. do N. Lima, F. S. Thomé, O. M. Vieira Neto, J. R. Lugon, and R. Sesso, “Brazilian Dialysis Survey 2020,” Brazilian J. Nephrol., vol. 44, no. 3, pp. 349–357, Sep. 2022, doi: 10.1590/2175-8239-jbn-2021-0198.
[3] Y. K. Sari, N. A. Wulandari, S. Alfa, W. Arsa, I. Ratna, and A. Dewi, “Intradialytic Complication and Associated Factors Among Patients Undergoing Hemodialysis,” vol. 8, no. 3, pp. 378–385, 2021, doi: 10.26699/jnk.v8i3.ART.p378.
[4] M. Ali, A. Ejaz, H. Iram, S. A. Solangi, A. M. Junejo, and S. A. Solangi, “Frequency of Intradialytic Complications in Patients of End-Stage Renal Disease on Maintenance Hemodialysis,” Cureus, vol. 13, no. 1, pp. 4–10, 2021, doi: 10.7759/cureus.12641.
[5] Y. Armiyati, S. Hadisaputro, S. Chasani, and U. Sujianto, “Factors Contributing to Intradialytic Hypertension in Hemodialysis Patients,” South East Asia Nurs. Res., vol. 3, no. 2, p. 73, 2021, doi: 10.26714/seanr.3.2.2021.73-80.
[6] M. Kanbay et al., “An update review of intradialytic hypotension: Concept, risk factors, clinical implications and management,” Clin. Kidney J., vol. 13, no. 6, pp. 981–993, 2020, doi: 10.1093/CKJ/SFAA078.
[7] N. Nuriya and A. Taufik, “Effect Ultrafiltration Rate On Blood Pressure Chronik Kidney Disease Patient During Hemodyalisis: A Literature Review,” J. Bionursing, vol. 1, no. 2, 2019.
[8] L. I. Narouz and Z. M. El-sayed, “Prevalence and Risk Factors of Intradialytic Hypotension among Hemodialysis Patients at a University Hospital-Egypt,” J. Nurs. Heal. Sci., vol. 8, no. 1, pp. 61–68, 2019, doi: 10.9790/1959-0801046168.
[9] N. A. Muharrom, Suryono, and C. Komariah, “Hubungan Quick of Blood dengan Kejadian Hipertensi Intradialisis pada Pasien Penyakit Ginjal Kronik Stadium V di RSD dr. Soebandi Jember,” J. Agromedicine Med. Sci., vol. 4, no. 1, pp. 50–54, 2018.
[10] S. Alfa, W. Arsa, and M. Cha, “The Correlation of Self-Regulation Theory Constructs and the Incidence of Intradialytic Complications during Hemodialysis,” J. Ners dan Kebidanan, vol. 8, no. 2, pp. 153–160, 2021, doi: 10.26699/jnk.v8i2.ART.p153.
[11] J. Y. Kim, H. M. Seo, M. Kim, and H. Kim, “ORIGINAL ARTICLE A relationship of intradialytic blood pressure variability with vascular access outcomes in patients on hemodialysis,” 2019, doi: 10.1111/hdi.12720.
[12] S. M. Raja and Y. Seyoum, “Intradialytic complications among patients on twice-weekly maintenance hemodialysis : an experience from a hemodialysis center in Eritrea,” pp. 1–6, 2020.
[13] B. Bazargani et al., “Evaluation of the relationship between serum carnitine levels and intradialytic complications in children with kidney failure,” Pediatr. Nephrol., vol. 37, no. 9, pp. 2179–2183, 2022, doi: 10.1007/s00467-022-05449-w.
[14] G. Kale, M. Mali, A. Bhangale, J. Somani, and T. Jeloka, “Intradialytic hypertension increases non-access related hospitalization and mortality in maintenance hemodialysis patients,” Indian J. Nephrol., vol. 30, no. 2, p. 85, 2020, doi: 10.4103/ijn.IJN_153_19.
[15] A. P. A. Dewi and A. A. Parut, “PADA PASIEN YANG MENJALANI TERAPI HEMODIALISIS DI BRSU TABANAN - BALI DOMINANT COMPLICATIONS THAT OCCUR DURING INTRADIALISIS ON PATIENTS UNDERGOING HEMODIALYSIS THERAPY IN BRSU TABANAN - BALI I Gusti Ayu Puja Astuti Dewi 1 , Anselmus Aristo Parut 2 Dosen,” pp. 51–56, 2012.
[16] I. Ayu, A. Utami, D. Gede, D. Dharma, A. Agung, and W. Lestari, “Prevalensi dan komplikasi pada penderita gagal ginjal kronik yang menjalani hemodialisa di Rumah Sakit Umum Pusat Sanglah Denpasar tahun 2018,” vol. 11, no. 3, pp. 1216–1221, 2020, doi: 10.15562/ism.v11i3.691.
[17] R. P. dos Santos, A. R. da S. Carvalho, S. R. Alves, T. V. A. Lordani, M. de F. F. Vattimo, and L. A. B. Peres, “Complicações intradialíticas em pacientes com injúria renal aguda,” Acta Paul. Enferm., vol. 35, Nov. 2022, doi: 10.37689/acta-ape/2022AO0168345.
[18] M. Alostaz, S. Correa, G. S. Lundy, S. S. Waikar, and F. R. Mc Causland, “Time of hemodialysis and risk of intradialytic hypotension and intradialytic hypertension in maintenance hemodialysis,” J. Hum. Hypertens., Jan. 2023, doi: 10.1038/s41371-022-00799-2.
[19] M. Ghaleb and A. Sharaf, “The Effects of Nursing Interventions on Intradialytic Muscle Cramps among Patients Undergoing Maintenance Hemodialysis .,” IOSR J. Nurs. Heal. Sci., vol. 9, no. 1, pp. 8–21, 2020, doi: 10.9790/1959-0901070821.
[20] A. J. Collins et al., “US Renal Data System 2011 Annual Data Report,” Am. J. Kidney Dis., vol. 59, no. 1, p. A7, Jan. 2012, doi: 10.1053/j.ajkd.2011.11.015.
[21] R. Karasneh, S. Al-Azzam, S. M. Altawalbeh, O. Y. Alshogran, and S. Hawamdeh, “Predictors of symptom burden among hemodialysis patients: a cross-sectional study at 13 hospitals,” Int. Urol. Nephrol., vol. 52, no. 5, pp. 959–967, May 2020, doi: 10.1007/s11255-020-02458-2.
[22] B. Z. Desta, A. F. Dadi, and B. T. Derseh, “Mortality in hemodialysis patients in Ethiopia: a retrospective follow-up study in three centers,” BMC Nephrol., vol. 24, no. 1, p. 3, Jan. 2023, doi: 10.1186/s12882-022-03053-6.
[23] U. Zakauskiene, A. Vickiene, V. Vicka, D. Sukackiene, L. Rimsevicius, and M. Miglinas, “BLOOD PRESSURE DURING HEMODIALYSIS AS PREDICTOR OF MORTALITY IN END-STAGE RENAL DISEASE PATIENTS,” J. Hypertens., vol. 39, no. Supplement 1, p. e293, Apr. 2021, doi: 10.1097/01.hjh.0000747824.56248.58.
[24] F. Mujtaba, R. Qureshi, M. Dhrolia, K. Nasir, and A. Ahmad, “Frequency of Intradialytic Hypertension Using Kidney Disease: Improving Global Outcomes (KDIGO) Suggested Definition in a Single Hemodialysis Centre in Pakistan,” Cureus, vol. 14, no. 12, 2022, doi: 10.7759/cureus.33104.
[25] R. Yarragudi, A. Gessl, and A. Vychytil, “New‐Onset Diabetes Mellitus in Peritoneal Dialysis and Hemodialysis Patients: Frequency, Risk Factors, and Prognosis—A Review,” Ther. Apher. Dial., vol. 23, no. 6, pp. 497–506, Dec. 2019, doi: 10.1111/1744-9987.12800.
[26] Y.-W. Chu, W.-S. Wu, C.-F. Hsu, J.-J. Wang, S.-F. Weng, and C.-C. Chien, “Bidirectional association between ESRD dialysis and diabetes: National cohort study,” PLoS One, vol. 12, no. 3, p. e0173785, Mar. 2017, doi: 10.1371/journal.pone.0173785.
[27] F. Tinti et al., “Chronic Kidney Disease as a Systemic Inflammatory Syndrome: Update on Mechanisms Involved and Potential Treatment,” Life, vol. 11, no. 5, p. 419, May 2021, doi: 10.3390/life11050419.
[28] M. M. Y. Wong et al., “Interdialytic Weight Gain: Trends, Predictors, and Associated Outcomes in the International Dialysis Outcomes and Practice Patterns Study (DOPPS),” Am. J. Kidney Dis., vol. 69, no. 3, pp. 367–379, Mar. 2017, doi: 10.1053/j.ajkd.2016.08.030.
[29] L. Wijayanti, P. M. P. Winoto, and N. Nursalam, “How To Control Interdialytic Weight Gain (Idwg) Among Hemodialysis Patients?,” Nurse Heal. J. Keperawatan, vol. 10, no. 2, pp. 214–221, 2021, doi: 10.36720/nhjk.v10i2.343.
[30] M. P. Ramadhan, T. Herawati, M. Adam, and K. Yetti, “Interdialytic weight gain levels and blood pressure changes during fluid withdrawal in hemodialysis patients,” J. Public Health Africa, May 2023, doi: 10.4081/jphia.2023.2566.
[31] R. N. Foley, B. M. Curtis, and P. S. Parfrey, “Hemoglobin targets and blood transfusions in hemodialysis patients without symptomatic cardiac disease receiving erythropoietin therapy,” Clin. J. Am. Soc. Nephrol., vol. 3, no. 6, pp. 1669–1675, 2008, doi: 10.2215/CJN.02100508.
[32] PERNEFRI, “4 th Report Of Indonesian Renal Registry 2011 4 th Report Of Indonesian Renal Registry 2011,” pp. 13–15, 2011.
[33] N. Nurhasanah and H. Utami, “Faktor-Faktor Penunjang Terkendalinya Kadar Hemoglobin Target Pada Pasien Hemodialisia Dengan Terapi Erytropoietin,” Syntax Lit. ; J. Ilm. Indones., vol. 5, no. 11, p. 1371, 2020, doi: 10.36418/syntax-literate.v5i11.1786.
[34] T. Hara, Y. Kasahara, and T. Nakagawa, “Association between haemoglobin concentration and intradialytic hypotension in patients undergoing maintenance haemodialysis: a retrospective cohort study,” BMJ Open, vol. 12, no. 8, p. e064026, Aug. 2022, doi: 10.1136/bmjopen-2022-064026.