Indonesian Journal of Kidney and Hypertension

The Impact of Icodextrin on Mortality of Peritoneal Dialysis Patients

Nur Samsu — 2025-12-24

Differences in Type Characteristics of Peritoneal Membrane Using Peritoneal Equilibrium Test in End Stage Renal Disease Patients Undergoing Peritoneal Dialysis at Hasan Sadikin Hospital, Bandung

Muhammad Fitriandi Budiman — 2025-12-24

Background: Peritoneal dialysis (PD) clears solutes and removes fluids from the patient's body. PD failure is primarily due to the clearing of solutes and the removal of fluids. Due to overhydration, the high peritoneal equilibrium test (PET) group is at greater risk of technical failure and death than other groups.

Objective: This study aimed to to determine the characteristics of PET in patients with end-stage renal failure undergoing peritoneal dialysis (PD) at Hasan Sadikin Hospital, Bandung.

Methods: This study is a retrospective, descriptive, and cross-sectional investigation.

Results: Of the 34 PD patients, the PET results were as follows: 47.1% for high average, 14.7% for high, 35.3% for low average, and 2.9% for low. There were no significant differences in most variables analyzed between the PET groups, including age, gender, etiology, comorbid diseases, history of hemodialysis (HD), residual renal function, and laboratory parameters such as hemoglobin, urea, creatinine, and albumin. The current blood glucose and body mass index (BMI) levels in the high PET group showed higher values and significant differences (p = 0.019 and p = 0.043, respectively).

Conclusion: Blood glucose and BMI may be important factors that distinguish patients with high PET from other PET groups.

Associated Factors with Erectile Dysfunction in Hemodialysis Patients at Dr. Reksodiwiryo Hospital Padang

Achmad Vidiansyah — 2025-12-24

Background: Erectile dysfunction (ED) is a common condition affecting a significant number of men worldwide, with its prevalence particularly high among patients with chronic kidney disease (CKD).

Objective: This study aims to investigate the association between ED and CKD in patients undergoing hemodialysis.

Methods: This study used a survey approach, designed with cross-sectional involving 24 male patients undergoing hemodialysis at the hospital from January to July 2024. Data were gathered using the IIEF-5 questionnaire as well as patient records. The severity of ED was classified based on IIEF-5 scores, and data analysis was conducted using SPSS.

Results: Most respondents (58.3%) were under 60 years old, with 58.3% having hemoglobin levels below 10 g/dL and 79.2% with a KT/V ratio under 1.8. ED prevalence was high at 95.8%, with severe ED affecting 54.2%. A significant correlation existed between KT/V and ED severity p<0.05, while hemoglobin levels showed no significant association p>0.05. The high prevalence of ED in CKD patients undergoing hemodialysis highlights the importance of regular screening and early intervention. The study indicates that sufficient hemodialysis, as measured by the Kt/V ratio, could be essential in reducing the severity of ED in this group. However, hemoglobin levels did not show a significant connection to ED severity, which contrasts with certain earlier research findings.

Conclusion: Erectile dysfunction is common among CKD patients undergoing hemodialysis, with insufficient dialysis being a key contributing factor. This highlights the need to maintain adequate dialysis to reduce the severity of ED in these individuals.

Understanding Readmission Risks in End-Stage Kidney Disease: A Study from Wangaya Hospital

Ni Nyoman Gita Kharisma Dewi — 2025-12-24

Background: End-stage kidney disease (ESKD) is a growing health burden. Poor patient knowledge and treatment adherence contribute to increased morbidity, as reflected in readmission rates.

Objective: This study aimed to identify factors associated with readmission among ESKD patients in Bali.

Methods: A retrospective cohort study was conducted at Wangaya Hospital. Adult patients (≥18 years) diagnosed with ESKD, with or without dialysis, between 2022 and 2024 were included. Patients with incomplete records or a solitary kidney were excluded. Bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression) were used to assess associations, with significance set at p <0.05.

Results: A total of 199 patients met the inclusion criteria; 61.8% were male, with a median age of 57 years (range: 22–88 years). Readmission rates within and beyond one month were 18.6% and 15.1%, respectively. Reduced eGFR was significantly associated with 30-day readmission (p = 0.041). For readmission beyond 30 days, significant predictors included diabetes mellitus (p = 0.014), neurologic disorders (p < 0.001), and adherence (p = 0.019).

Conclusion: eGFR predicts early readmission, while diabetes mellitus, neurological disorders, and treatment adherence influence later readmissions. Identifying these factors is vital for improving patient education and reducing healthcare burdens.

The Correlation of Volume Overload Measured by Bio Impedance Analysis and Intradialytic Hypertension in End Stage Kidney Disease Patients at Bandung Hasan Sadikin Hospital

Muhammad Iqbal — 2025-12-24

Abstract

Background: Assessing dry weight is essential for calculating the ultrafiltration volume during dialysis. Volume overload affects hemodynamic stability including intradialytic hypertension (IDH). Using Bio Impedance Analysis (BIA) to guide fluid assessment enhances the accuracy of fluid overload evaluation.

Objective: Find the correlation between volume overload and IDH in patients undergoing chronic dialysis at Bandung Hasan Sadikin Hospital.

Methods: This is a cross-sectional study to evaluate the correlation of volume overload and IDH in patients undergoing chronic dialysis at Bandung Hasan Sadikin Hospital. Exclusion criteria was patient below the age of 18 years old, unable to performed BIA measurement. Blood pressure before, during and after dialysis session was recorded to asses IDH. BIA was measured after dialysis session. Point biserial correlation used to analyze correlation between volume overload and intradialytic hypertension. The data were analysed with SPSS version 23.0. The statistical significance was set at P<0.05.

Result: Ninety-seven patients enrolled, the average age was 49,9 ± 12.3 years old, 55,7% was male. There were 23,7% of patients with IDH with increasing systolic blood pressure of 19.21 mmHg (10-66). A significant correlation was observed between the incidence of IDH and the percentage of volume overload after dialysis with R coefficient 0,238 (p 0,014).

Conclusion: The majority (59.87%) of patients undergoing chronic hemodialysis had a greater dry weight based on BIA examination, 23,7% had IDH and its occurrence has a significant correlation with the percentage of volume overload after dialysis.

Keywords: volume overload, dry weight, BIA, IDH.

Finerenone in Diabetic-Kidney Disease, Renal and Cardiovascular Outcome: A Meta-Analysis of Independent Trial Registries

Felicita Gracia — 2025-12-24

Background: Diabetic kidney disease (DKD) remains a frequent complication of type 2 diabetes, which significantly increases cardiovascular risk. Despite existing treatments, a substantial risk of disease progression still remains, leading to further exploration in Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist.

Objective: This meta-analysis evaluates finerenone’s effects on the improvement of cardiorenal outcomes in DKD.

Methods: A Systematic Review and Meta-Analysis (PROSPERO CRD420251122382) followed PRISMA guidelines. PubMed, ScienceDirect, and Epistemonikos utilized and used keywords “Finerenone AND Diabetes AND Chronic Kidney Disease AND Outcomes.” RCTs comparing finerenone to placebo in DKD, reporting renal or cardiovascular outcomes, were included. Data extraction covered study characteristics and outcomes. RevMan 5.4 analyzed data using a random-effects model. Risk of bias (RoB2) and certainty of evidence (GRADE-PRO) were assessed.

Results: Three RCTs (19,027 participants) were included for renal outcomes, and two RCTs (13,026 participants) for cardiovascular outcomes. Finerenone significantly reduced the odds of sustained eGFR decline ≥40% (OR 0.83, p=0.0003) and≥57% (OR 0.86, p=0.0001), as well as the major composite kidney outcome (OR 0.76, p<0.0001). ESKD odds reduction (21%) was not statistically significant. For cardiovascular outcomes, finerenone significantly reduced hospitalization for heart failure (OR 0.78, p=0.0001). Trends towards reduced cardiovascular death (OR 0.88, p=0.09) were noted. Studies had low bias risk, and most outcomes showed moderate evidence certainty.

Conclusions: Finerenone is associated with significant renoprotection and significantly reduces heart failure hospitalizations in DKD. Finerenone as an effective nonsteroidal mineralocorticoid receptor antagonist for comprehensive management, improving cardiorenal outcomes in this high-risk group.

Mechanical and Technical Complication in Patient with Continous Ambulatory Peritoneal Dialysis (CAPD) with Encapsulated Peritoneal Sclerosis

Theodore Dharma Tedjamartono — 2025-12-24

Continuous Ambulatory Peritoneal Dialysis (CAPD) relies on an intraperitoneal catheter for the inflow and outflow of dialysate fluid; therefore, mechanical complications are often encountered. Encapsulated peritoneal sclerosis (EPS) is one of the rare complications in CAPD patients, but it has high mortality and morbidity rates. A case of a patient with EPS was reported in a 53-year-old man in the form of a problem with the dwelling of the CAPD. Patients complain of a longer duration of dwelling with a positive fluid balance. There are no complaints of fever or abdominal pain. Abdominal inspection shows symmetrical, no mass, no wound or pus from the CAPD tip. The patient had a history of recurrent peritonitis. CAPD Cuff was released due to laparoscopy findings with grade IV adhesions in the omentum and peritoneum; it also showed omental cakes and peritoneal fluid with debris. Diagnosis of EPS was established based on the presence of clinical symptoms due to intestinal obstruction and structural disorders due to peritoneal fibrosis, like thickening and adhesions of the intra-abdomen, accompanied by findings of fibrous cocoon or omental cakes in the intestine, with laparotomy and/or laparoscopy. CAPD is related to various complications of infections and non-infections. Although complications related to infections are more often found, non-infection complications such as EPS can also occur in CAPD Patients; therefore, clinicians need to be aware of this complication, especially in patients with a history of recurrent peritonitis.