HUBUNGAN KUALITAS TIDUR DENGAN HIPERTENSI INTRADIALITIK DI RSUP DR. SARDJITO

Angelique Candra Fortuna, dr. Dwita Dyah Adyarini, SpPD, Subsp. G. H (K); dr. Siti Nur Rohmah, Sp.PD, Subsp. G. H (K)

2026 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Hemodialisis merupakan terapi utama pada pasien penyakit ginjal kronis tahap akhir (PGTA). Salah satu komplikasi yang sering terjadi adalah hipertensi intradialitik, yakni peningkatan tekanan darah sistolik >10 mmHg selama atau setelah prosedur dialisis, yang dapat meningkatkan risiko rawat inap bahkan kematian. Di sisi lain, gangguan tidur merupakan masalah umum pada pasien hemodialisis, dengan prevalensi hingga 75%. Kualitas tidur yang buruk diketahui dapat memicu aktivasi sistem saraf simpatis dan gangguan ritme sirkadian, yang secara teoritis dapat meningkatkan tekanan darah. Namun, hubungan antara kualitas tidur dan hipertensi intradialitik belum banyak diteliti secara spesifik.

Tujuan: Penelitian ini bertujuan untuk mengetahui apakah terdapat hubungan antara kualitas tidur dengan kejadian hipertensi intradialitik pada pasien PGK yang menjalani hemodialisis di RSUP Dr. Sardjito.

Metode: Penelitian ini merupakan studi observasional analitik dengan desain potong lintang (cross-sectional). Sebanyak 64 pasien hemodialisis rutin dipilih menggunakan metode purposive sampling. Kualitas tidur dinilai menggunakan kuesioner Pittsburgh Sleep Quality Index (PSQI), sementara tekanan darah diukur sebelum dan setelah hemodialisis untuk menilai hipertensi intradialitik berdasarkan kriteria KDIGO 2024. Data dianalisis menggunakan uji chi-square dan korelasi Spearman melalui SPSS.

Hasil: Mayoritas pasien (62,5%) memiliki kualitas tidur buruk. Sebanyak 35,9% pasien mengalami hipertensi intradialitik. Namun, hasil analisis menunjukkan tidak terdapat hubungan yang signifikan antara kualitas tidur dan hipertensi intradialitik (p=0,840). Meskipun secara teori kualitas tidur buruk dapat memicu hipertensi melalui aktivasi simpatis, dalam penelitian ini variabilitas tekanan darah lebih mungkin dipengaruhi oleh faktor lain seperti volume cairan dan tekanan darah sistolik post-dialisis.

Kesimpulan: Tidak ditemukan hubungan yang signifikan antara kualitas tidur dengan hipertensi intradialitik pada pasien hemodialisis. Penelitian selanjutnya disarankan untuk mempertimbangkan pengukuran longitudinal kualitas tidur dan tekanan darah, serta mengontrol lebih banyak variabel perancu seperti kadar elektrolit dan beban volume.

Kata Kunci: hemodialisis, hipertensi intradialitik, kualitas tidur, PSQI, penyakit ginjal kronis.

Background: Hemodialysis is the main therapeutic modality for patients with end-stage chronic kidney disease (CKD). One of the most frequently encountered complications is intradialytic hypertension, defined as an increase in systolic blood pressure of >10 mmHg during or after the dialysis procedure, which is associated with an increased risk of hospitalization and mortality. Meanwhile, sleep disorders are highly prevalent among hemodialysis patients, affecting up to 75% of this population. Poor sleep quality has been shown to induce sympathetic nervous system activation and disrupt circadian rhythms, which theoretically may contribute to elevated blood pressure. However, the association between sleep quality and intradialytic hypertension has not been extensively investigated.

Objective: This study aimed to determine whether there is an association between sleep quality and the occurrence of intradialytic hypertension among patients with chronic kidney disease undergoing hemodialysis at Dr. Sardjito General Hospital.

Methods: This was an observational analytic study with a cross-sectional design. A total of 64 patients undergoing routine hemodialysis were recruited using purposive sampling. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while blood pressure was measured before and after hemodialysis to identify intradialytic hypertension based on the KDIGO 2024 criteria. Data were analyzed using the chi-square test and Spearman correlation with SPSS software.

Results: The majority of patients (62.5%) had poor sleep quality. Intradialytic hypertension was observed in 35.9% of patients. However, statistical analysis demonstrated no significant association between sleep quality and intradialytic hypertension (p = 0.840). Although poor sleep quality may theoretically contribute to hypertension through sympathetic activation, in this study blood pressure variability was more likely influenced by other factors, such as fluid volume status and post-dialysis systolic blood pressure.

Conclusion: No significant association was found between sleep quality and intradialytic hypertension among hemodialysis patients. Future studies are recommended to employ longitudinal measurements of sleep quality and blood pressure and to control for additional confounding variables, including electrolyte levels and volume overload.

Keywords: hemodialysis, intradialytic hypertension, sleep quality, PSQI, chronic kidney disease.

Kata Kunci : hemodialisis, hipertensi intradialitik, kualitas tidur, PSQI, penyakit ginjal kronis