Perubahan status gizi pasien penyakit ginjal kronik (PGK) dengan hemodialisis yang mendapat konseling gizi berkesinambungan di RS Sr. Sardjito Yogyakarta

SAFRIDA, Prof.dr. H. Moch. Sya'bani, Sp.PD-KGH

2006 | Tesis | S2 Ilmu Kesehatan Masyarakat (Gizi dan Kesehatan)

Latar Belakang : Penyakit Ginjal Kronik (PGK) ditandai dengan penurunan fungsi ginjal dengan LFG < 15 ml/menit. Penilaian status gizi pada penderita PGK dengan hemodialisis dapat dilakukan dengan pengukuran secara antropometri dan biokimia. Konseling gizi bertujuan untuk mengubah pengetahuan, sikap dan perilaku makan pasien sehingga dapat meningkatkan asupan makanan dan memperbaiki status gizi. Pemantauan terhadap status gizi pada pasien PGK dapat dilakukan secara teratur 3-6 bulan sekali untuk mencegah progresifitas malnutrisi. Tujuan : Tujuan umum dari penelitan ini adalah untuk mengetahui perubahan status gizi pasien penyakit ginjal kronik dengan hemodialisis yang mendapat konseling gizi berkesinambungan di RS Dr. Sardjito Yogyakarta. Metode : Jenis penelitian quasi eksperimen dengan rancangan time series. Waktu penelitian Agustus 2004 sampai September 2005. Populasi penelitian adalah seluruh penderita yang menjalani hemodialisis di Instalasi Dialisis RS Dr. Sardjito. Pengambilan sampel secara purposive dengan kriteria inklusi, besar sampel sebanyak 58 orang. Variabel bebas adalah konseling gizi berkesinambungan, variabel terikat adalah asupan energi, protein dan perubahan status gizi dan variabel pengganggu adalah gangguan gastrointestinal. Alat pengumpul data yang digunakan pada penelitian ini adalah formulir Food Record, penimbangan, pita LILA, kaliper dan pengukuran kadar serum albumin. Hasil : Hasil penelitian menunjukkan ada peningkatan rata-rata asupan energi (p= 0,026), protein (p= 0,000) dan kadar serum albumin (p= 0,003) selama mendapat konseling gizi berkesinambungan. Penilaian antropometri berdasarkan LILA, IMT dan TLBK juga terjadi peningkatan selama mendapat konseling gizi berkesinambungan dengan nilai p =0,000. Kesimpulan : Hasil penelitian menunjukkan ada peningkatan asupan energi, protein dan kadar serum albumin dan penilaian status gizi berdasarkan LILA, IMT, dan TLBK pasien penyakit ginjal kronik dengan HD yang mendapatkan konseling gizi berkesinambungan di RS Dr. Sardjito.

Background: Chronic kidney disease is indicated from decreasing kidney function with glomerulus filtration pace<15ml/minute. Assessment of nutrition status of chronic kidney disease patients with hemodialysis can be conducted through anthropometric and biochemistry measurement. Nutrition counseling is intended to change patient's knowledge, attitude and eating behavior in order to increase food intake and improve nutrition status. Monitoring of nutrition status in chronic kidney disease patients can be done periodically once in 3 - 6 months to prevent malnutrition progression. Objective: The general objective of the study was to identify nutrition status changes in chronic kidney disease patients with hemodialysis who got continuous nutrition counseling at Dr. Sardjito Hospital, Yogyakarta. Method: The study was quasi experimental with time series design. It was carried out from Auguts 2004 to September 2005. Population were all patients having hemodialysis at Dialysis Installation of Dr. Sardjito Hospital. Samples were as many as 58 patients purposively taken with inclusion criteria. Independent variable was continuous nutrition counseling, dependent variable was energy, protein intake and nutrition status changes and confounding variable was gastrointestinal disorder. Data collection used Food Record form, weighing, upper arm circumference, caliper and albumin serum level measurement. Result: There was average increase of energy (p=0.026), protein (p=0.000) and albumin serum level (p=0.003) during continuous nutrition counseling. Assessment of upper arm circumference, body mass index, and thickness of subcutaneous fat show increase during continuous nutrition counseling with p value = 0,000. Conclusion: There was increase of energy, protein and albumin serum level and assessment of nutrition status based of upper arm circumference, body mass index, thickness of subcutaneous fat of chronic kidney disease patients with hemodialysis who got continuous nutrition counseling at Dr. Sardjito Hospital.

Kata Kunci : Status Gizi,Konseling,Pasien Ginjal Kronik, nutrition status, nutrition counseling, hemodialysis