jurnal lia interna

7/25/2019 Jurnal Lia Interna

1/20

KONTROL TEKANAN DARAH SECARA INTENSIF PADA PENYAKIT GINJAL KRONIKHIPERTENSI

(HYPERTENSIVE CHRONIC KIDNEY DISEASE)

Pembimbing : dr. D!ri" Ni#m$ S%.PD$ KGEH

O"e& :

APRILIA RA'ANDANI JA'IN*+,

KEPANITERAAN KLINIK IL'- PENYAKIT DALA'FAK-LTAS KEDOKTERAN

-NIERSITAS YARSI*/


2/20

Pen01i2 gin3" 1r4ni1 m!"& 52m

1e!e&2n m!0r12

Anggrn %emerin2& Ameri1 5n251%eng4b2n %en01i2 gin3" !2di5m 1&ir

(ESRD) dn %en01i2 gin3" 1r4ni! d"&ber1i!r %5"5&n mi"0r d4"r

Di Ameri1 Seri12$ !e1i2r 67 dri in!iden1!5! ESRD ber1i2n dengn &i%er2en!i.

8eber% %ene"i2in mere14mend!i1n%eng5rngn 2rge2 2e1nn dr& %d

%!ien dengn %en01i2 gin3" 1r4ni! 1n 22%i

be"5m 9515% b512i.

LATAR 8ELAKANG


3/20

KRITERIA RESTRIKSI

KRITERIA INKL-SI

Sem5 %!ien d"m %ene"i2in inid"& ber15"i2 &i2m

ber5!i n2r + dn 2&5n$ 2e"& din021n memi"i1i %en01i2

gin3" 1r4ni! &i%er2en!i; (dengn2e1nn dr& di!24"i1 "ebi& dri


4/20

KRITERIA RESTRIKSIKRITERIA EKSKL-SI

Dibe2e! (GDP "ebi& dri , mg %erde!i"i2er$ 25 GDS "ebi& dri * mg%er de!i"i2er$ 25 1eb525&n 5n2512er%i 4b2 5n251 dibe2e!)

r!i4 %r42ein> 1re2inin "ebi& dri *$= gg" 3n25ng 14n2rindi1!i 5n251 %eng4b2n %d

%ene"i2in ini.

S-8JEK PENELITIAN


5/20

Pene"i2in ini memi"i1i d5 ;!e

DESAIN PENELITIAN

. ;!e %er94bn ?"

*. ;!e 14&4r2


6/20

F!e %er94bn di"151n dri Febr5ri r2 r2eri mm Hg!e!5i dengn 2rge2 2e1nn dr& !2ndr ,@ 4b2n2i&i%er2en!i "inn0 !e%er2i 1"4nidin 25 ;5r4!emide

. FASE PERCO8AANAAL


7/20

F!e 14&4r2 dim5"i %d b5"n A%ri" **. An2r 1&ir 2&% %er94bn %d 2ngg" 6

Se%2ember *$ dn ?" dri ;!e 14&4r2$ d"& m!2rn!i!i !ing12 !e"m ;!e 14&4r2 dirn9ng. P!iendengn ESRD 0ng be"5m didign4!i! di5ndng 5n251mend;2r1n diri d"m ;!e 14&4r2$ mere1 menerim%r42414" mn3emen berd!r1n ;!e %er94bn.

Ji1 %!ien 2id1 bi! men24"erir 2er%i rmi%ri" ber"i&1e Angi42en!in receptor blocker (AR8).

Ji1 2e1nn dr& 2rge2 2id1 di9%i dengn 24"ern!id4!i! rmi%ri"$ m1 4b2 2mb&n di2mb&1n$

2erm!51 ;5r4!emid$ beta blocker$ Ca channel blocker$"; adrenergic blocker$ dn !4di"24r "ng!5ng. Pd ?" ;!e 14&4r2$ 2e1nn dr& 2rge2 15rng dri

,@


8/20

SASARAN

S!rn 52m d"& %er1embngn dri %en01i2 gin3"1r4ni!$ 0ng dideni!i1n !ebgi %ening12n !ebe!r d5

1"i "i%2 dri 2ing12 1re2inin !er5m$ dign4!i! ESRD$ 251em2in.

Ser5m 1re2inin dini"i d5 1"i %d ?" dn !e2i% / b5"n. ESRD dideni!i1n 4"e& ini!i!i di"i!i! gin3" 25

2rn!%"n2!i gin3".


9/20

STUDI PENGUKURAN DANPENGAWASAN

Kr12eri!2i1 ?" diring1! 5n251 !em5 %!ien dn

men5r52 r!i4 %r42ein 1re2inin ( $** 25 $**$ 0ngdi515r dri *, 3m 5rin 2m%5ng$ dengn %r42ein dn1re2inin 0ng di515r d"m mi"igrm %er &ri)..

Ting12 2e1nn dr& dn &i%er2en!i di2en251n %d ?"dn 1em5din !e2i% * 2&5n %d %!ien 0ng be"5mmemi"i1i &!i" 52m.

-n251 2&% 53i 94b$ ?125 ;4""4?>5% dim5"i %d 2ngg"%eng91n. -n251 ;!e 14&4r2$ ?125 ;4""4?>5% dim5"i%d 1&ir dri ;!e %er94bn dn 2erm!51 %eri4de2rn!i!i.

D5r!i m1!im5m ;4""4?>5% d"& *$* 2&5n (3r1 n2r

?" %end;2rn di ;!e %er94bn ( A%ri"


10/20

ANALISIS STATISTIK


11/20

ANALISIS STATISTIK

meng&i25ng %r4bbi"i2! 15m5"2i; dri !25di &!i" mengg5n1n

K5r K%"n>'eier.

E;e1 dri 2e1nn dr& 2rge2 %d ;!e %er94bn die"5!i%engg5nn dengn regre!i %r4%4r!i4n" Co# dengn%en0e!5in !e"m "im ;124r>;124r d!r 2er2en25 (e1!1re!i%r42ein %d 5rin$ 5!i$ 3eni! 1e"min$ d 25 2id1 dn0ri?02 %en01i2 3n25ng$ dn 2e1nn r2eri r2 > r2).

Di2e"i2i &5b5ngn n2r e;e1 dri 2rge2 2e1nn dr& dn2ing12 e1!1re!i %r42ein. Tid1 d &5b5ngn 0ng !igni1nn2r 4b2 dn 2e1nn dr& 2rge2.


12/20

ASIL

Pd ?"$ 2e1nn dr& r2>r2 d"& =*@


13/20

ASIL !"ont#d$

Se"m ;!e 14&4r2$ %erbedn 2e1nn dr& 9515% 1e9i"$ 1ren !em5%!ien memi"i1i 2e1nn dr& 5m5m 2rge2$ berr2i 2e1nn dr& d"&6@+ di 1e"4m%41 14n2r4" in2en!i; dn 6,@+ mm Hg d"m 1e"4m%41

14n2r4" !2ndr.


14/20

ASIL !"ont#d$


15/20

ASIL !"ont#d$


16/20

ASIL !"ont#d$


17/20

PE%&AASAN


18/20

PE%&AASAN D"m 1ed5 ;!e$ 2id1 d %erbedn 0ng !igni1n n2r 1e"4m%41 d"m

ri!i14 &!i" %rimer (r!i4 rd d"m 1e"4m%41 14n2r4" in2en!i;$ $ 1re2inin "ebi& dri $** (r!i4 rd$ $6B P $).

8eber% n"i!i! men0rn1n gr 14n2r4" 2e1nn dr& in2en!i; 1n

bermn;2 d"m %!ien dengn %r42ein5ri ?". Se9r 1&5!5!$ 2erd%2

in2er1!i !igni1n n2r %r42ein5ri dn 2e1nn dr& 2rge2 (P $*

5n251 n2r 2ind1n). 'e!1i%5n demi1in$ 1ren e;e1 dri 14n2r4" 2e1nn

dr& 2id1 men9%i !igni1n!i 0ng bi1 %d 2ing12n %r42ein5ri$

!e&ingg &!i" 1e"4m%41 dingg% 2id1 me01in1n.

Terd%2 1e!5"i2n 5n251 !e9r 2e%2 mengiden2i1!i e;e1 0ng

meng5n25ng1n dri 14n2r4" 2e1nn dr& in2en!i; %d %!ien dengn

%r42ein5ri ?".


19/20

KESI%PULAN

Pd n"i!i! 1e!e"5r5&n$ 14n2r4"in2en!i; 2e1nn dr& 2id1

ber%engr5& !e9r !igni1n%d %er1embngn %en01i2gin3".Nm5n$ 2erd%2 %erbedn e;e1

14n2r4" 2e1nn dr& in2en!i;%d %!ien dengn dn 0ng2n% %r42ein5ri.


20/20

TERI'AKASIH..

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