The Correlation of Diabetes Mellitus and Hypertension Comorbidity in Patient with Chronic Kidney Disease Undergoing Hemodialysis with The Incidence of Pneumonia in Moewardi General District Hospital Surakarta

Abstract

ABSTRACT

Introduction: Chronic Kidney Disease is the disease which is not communicable that is its prevalence increase continually mainly in Indonesia. Data until 2018 states that there are 500,000 CKD sufferers in Indonesia. CKD patients have various kinds of comorbids and according to records, Hypertension (HT) and Diabetes Mellitus (DM) are the two most common comorbid diseases. Generally, CKD patients, especially those already at the End Stage will be treated with Hemodialysis (HD). The presence of comorbid diseases and HD is a factor that can cause a person to become infected, one of which is pneumonia which was studied in this study. This study aims to determine and compare the existence of a relationship between comorbid DM and HT in CKD patients who undergo HD with the incidence rate of pneumonia.

Methods: Method of this research use analytical observational by design of Cross Sectional Study. Sample of this research is 180 patient of CKD Medical Record in Dr Moewardi State Hospital that is distributed average well become 4 groups: CKD Patient by DM, CKD Patient by HT, CKD Patient by DM and HT, from 2016-2020. The Sampling Technique use purposive sampling by criteria of inclusion and exclusion that have been established. Variable of DM and HT become independent Variable, the occurrence of Pneumonia as Dependent Variable.

Results: There is a significant relation between CKD and DM to the occurrence of Pneumonia (P=0,029), there is not a relation statistically according to bivariat analysis between CKD and HT (P=0,466), meanwhile according to multivariat analysis, be gotten whereas patient of CKD and HT have the risk more than without HT but still under the risk of Pneumonia if there is Comorbid DM (3-4 x bigger). Beside that, there is not relationship significantly between double co morbid DM and HT tto the occurrence of Pneumonia (P=0,145).

Conclusions: There is a relation between Comorbid DM or HT and the occurrence and the occurrence of Pneumonia to CKD patient. Comorbid of DM will make the increasing of risk of patient of CKD who have Pneumonia namely 3,7 times bigger be compared by non-DM and HT make the risk of Pneumonia 2 time bigger be compared by non-HT. Comorbid DM is more increase the risk about Pneumonia occurrence be compared by Comorbid HT.

Keywords: Chronic kidney disease, diabetes mellitus, hypertension, hemodialysis, pneumonia.