HUBUNGAN TERAPI KALSIUM KARBONAT TERHADAP KADAR HORMON PARATIROID INTAK PADA PASIEN HEMODIALISIS RUTIN DI RUMAH SAKIT AKADEMIK UGM YOGYAKARTA

MARLINDA NURIKA Y, Dr. Tri Murti Andayani, Sp. FRS., Apt.

2014 | Tesis | S2 Ilmu Farmasi

Penyakit ginjal kronik menyebabkan hiperfosfatemia dan hipokalsemia, hal ini akan menstimulasi pengeluaran hormon paratiroid. Sehingga diperlukan terapi dengan pengikat fosfat yaitu CaCO3 karena jika keadaan ini tidak segera ditangani akan menyebabkan hiperparatiroidisme sekunder yang nantinya akan menyebabkan beberapa penyakit pada tulang atau disebut osteodistrofi renal. Penelitian ini digunakan untuk mengetahui hubungan antara terapi kalsium karbonat terhadap hormon paratiroid pada pasien hemodialisis rutin di Rumah Sakit Akademik UGM Yogyakarta. Penelitian ini termasuk penelitian non eksperimental dengan analisis deskriptif evaluatif dan pengambilan data dilakukan secara concurrent. Subyek penelitian adalah pasien yang telah menjalani hemodialisa lebih dari 3 bulan dan menggunakan CaCO3. Data diambil dari rekam medis pasien dan pengambilan darah pasien. Pengambilan data dilakukan pada bulan Maret-April 2014 dan didapatkan 24 subyek penelitian yang terdiri dari 15 pria (62,5%) dan 9 wanita (37,5%) dengan usia rata – rata 49,4±11,46 tahun. Rata-rata lama hemodialisis adalah 15,61±23,2 bulan. Rata-rata Ca 8,53 ± 1,08 mg/dl; P 5,46 ± 1,5 mg/dl; dan PTH intak 462,62 ± 594,54 pg/ml. Sebanyak 13 pasien (54%) memiliki kadar kalsium dalam batas normal, 12 pasien (50%) memiliki kadar fosfat dalam batas normal, dan 9 pasien (37,5%) memiliki kadar PTH intak dalam batas normal. Hasil uji spearman menunjukkan bahwa tidak ada hubungan yang bermakna antara kadar kalsium dengan kadar PTH intak (p=0,261) dan tidak terdapat hubungan antara kadar fosfat dan kadar PTH intak (p=0,058).

Chronic kidney disease causes hyperphosphatemia and hypocalcemia, this spending will stimulate parathyroid hormone. So that required treatment with phosphate binders i.e. CaCO3 because if this condition is not treated immediately will lead to secondary hyperparathyroidism which will cause some disease in the bone called renal osteodystrophy. This research is used to determine the relationship between calcium carbonate therapy on parathyroid hormone in patients on regular hemodialysis UGM Academic Hospital. This study included non-experimental study with a descriptive analysis of evaluative and concurrent data collection. Data collection was conducted in March- April, 2014 and obtained 24 study subjects consisted of 15 men (62.5%) and 9 women (37.5%) with a mean age - average 49.4 ± 11.46 years. The average length of hemodialysis was 15.61 ± 23.2 months. Average Ca 8.53 ± 1.08 mg/dl; P 5.46 ± 1.5 mg/dl; and intact PTH 462.62 ± 594.54 pg/ml. Calcium carbonate is effective in controlling calcium as many as 13 patients (54%) had higher levels of calcium in the normal range, CaCO3 is also effective in controlling phosphate as many as 12 patients (50%) had phosphate levels in the normal range, but CaCO3 less effective in controlling IPTH because only 9 patients (37.5%) were included in the normal range. Spearman test results showed that there was no significant correlation between intact PTH with calcium levels (p = 0.261) and phosphate (p = 0.058). This indicates that there is no relationship between CaCO3 against intact PTH.

Kata Kunci : Penyakit ginjal kronis, hormon paratiroid intak, kalsium, fosfat, kalsium karbonat