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Penyakit Ginjal Kronik merupakan salah satu penyakit tidak menular yang prevalensinya terus meningkat dari tahun ke tahun. Penurunan fungsi ginjal menjadi penyakit ginjal kronik tahap akhir mengakibatkan pasien harus menjalani terapi penganti ginjal semur hidup. Terapi yang paling banyak digunakan saat ini adalah hemodialisis. Meskipun alat hemodialisis telah banyak dan canggih, namun ketahanan hidup pasien PGK masih rendah. Salah satu penyebab rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis adalah komorbiditas atau penyakit penyerta. Komorbiditas yang saat ini paling umum pada pasien PGK yang menjalani hemodialisis adalah diabetes mellitus. Desain penelitian ini menggunakan desain kohort restrospektif. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan dan 1 tahun pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus lebih rendah dibandingkan pasien dengan komorbiditas bukan diabetes mellitus. Probabilitas ketahanan hidup 3 bulan, 6 bulan, 9 bulan, 1 tahun dan pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus adalah dalah 69%, 55% 34%, dan 34% sedangkan komorbiditas bukan diabetes mellitus adalah 76%, 61%, 53% dan 51%. Secara bivariat, pasien PGK yang menjalani hemodialisis dengan komorbiditas diabetes mellitus memiliki risiko untuk meninggal 1.75 kali lebih cepat dibandingkan dengan pasien komorbiditas bukan diabetes mellitus. Sementara itu dari analisis multivariat didapatkan variabel konfonder yang mempengaruhi rendahnya ketahanan hidup pasien PGK yang menjalani hemodialisis pada pasien dengan komorbiditas diabetes mellitus adalah akses vaskular.
Chronic kidney disease (CKD) is one of the no-communicable diseases which increase every years. The decline of kidney function will progress to End Stage Renal Disease (ESRD). The ESRD patients has to undurgo dialysis therapy during their lives. the most dialysis therapy is hemodialysis. Although the machine of hemodialysis are quiet a a lot and sophisticate, the survival of CKD patients is still low. One of the causes of low survival PGK patient on maintenance hemodialysis is the comorbid or present disease. Nowadays the most common comorbid for CKD patient with hemodialysis is diabetes mellitus. Research design is using Kohort Retrospective. The probability of survival of 3 months,6 months, 9 months and 1 year CKD patients on maintenance hemodialysis with comorbid diabetes mellitus is lower than patients without comorbidities of diabetes mellitus. The probability ofsurvival of 3 months, 6 months, 9 months, 1 year and CKD patients on maintenance with comorbid diabetes mellitus are 69%, 55% 34%, and 34% while one not comorbid diabetes mellitus are 76%, 61%, 53 % and 51%. In bivariate analysis,CKD patients on maintenance hemodialis with comorbid diabetes mellitus have a risk of dying 1.75 times faster than patients without comorbiddiabetes mellitus. Meanwhile obtained from multivariate analysis confonder variables that affect the low survival of CKD patients on maintenance in patients with comorbid diabetes mellitus is a vascular access.
Type 2 diabetes mellitus is a non-communicable disease that can be treated, and its consequences can be prevented or delayed through proper diet, physical activity, medication, as well as regular screening and treatment of complications. However, this disease is often diagnosed several years after onset, by which time complications and comorbidities may have developed, making it one of the top 10 causes of hospitalizations. This study aims to determine the effect of severity and comorbidity on the length of hospital stay among patients with type 2 diabetes mellitus in advanced referral health facilities (FKRTL) among BPJS Kesehatan participants in 2023, controlled for variables such as FKRTL type, FKRTL ownership, segmentation, care class, age, and gender. This research used 2023 BPJS Kesehatan sample data with a cross-sectional study design. The analysis included univariate, bivariate, and multivariate methods. Bivariate analysis showed a significant relationship between severity and length of stay (p-value = 0.001), while comorbidities were not significantly associated with length of stay (p-value = 0.285). Moderate to severe severity and comorbidities with a CCI score of ≥1 were associated with a higher risk of prolonged hospitalization and a lower risk of short hospitalization compared to the ideal length of stay (RRR = 4.95; 95% CI = 0.82–29.85; RRR = 0.46; 95% CI = 0.29–0.72 | RRR = 1.11; 95% CI = 0.25–4.92; RRR = 0.67; 95% CI = 0.41–1.10). Multivariate analysis controlling for FKRTL type, FKRTL ownership, segmentation, care class, age, and gender showed that the association between severity and length of stay remained significant after controlling for FKRTL type and FKRTL ownership, while the association between comorbidity and length of stay remained insignificant even after adjusting for control variables. Efforts to enhance clinical early detection programs for the severity level and comorbidities of type 2 diabetes mellitus are necessary to prevent prolonged hospital stays due to complications and disease severity, which contribute to a significant healthcare burden.
