Analysis of Pre-Hemodialysis Urea Level and Mortality in Stage 5 Chronic Kidney Disease Patient at RSUD Dr. H. Abdul Moeloek Bandar Lampung
DOI:
https://doi.org/10.53366/jimki.v12i3.1034Keywords:
chronic kidney disease, hemodialysis, pre-hemodialysis urea, mortalityAbstract
Background: Chronic kidney disease (CKD) stage 5 is the final phase that requires patients to undergo hemodialysis as the main treatment. Monitoring blood urea levels before hemodialysis is an important aspect because these values can reflect the risk of death in patients. Based on this, the study aims to examine the relationship between pre-hemodialysis urea levels and mortality rates in CKD stage 5 patients at Dr. H. Abdul Moeloek Regional General Hospital in Lampung Province.
Method: This study applied a quantitative observational design with a retrospective cohort approach. The data analyzed were obtained from secondary sources, namely, medical records of patients diagnosed with stage 5 CKD. The sample included 150 patients who received hemodialysis in 2023–2024, selected through consecutive sampling. Data were analyzed univariately; normality was assessed using the Shapiro-Wilk test, and bivariate analysis was conducted using the Mann-Whitney Test.
Results: The mean pre-hemodialysis urea level in deceased patients was higher than in discharged patients. The Mann-Whitney test showed a significant difference in urea levels between the two groups (p=0.0001), indicating a relationship between pre-hemodialysis urea levels and patient mortality.
Discussion: The findings suggest that pre-hemodialysis urea levels can serve as an indicator of mortality risk in patients with stage 5 CKD. Patients with higher urea levels tend to have a greater risk of death.
Conclusion: There is a significant correlation between pre-hemodialysis urea levels and mortality in patients with stage 5 CKD. Patients with higher urea levels have a higher risk of death.
References
1. Kemenkes. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Penyakit Ginjal Kronik. 2023.
2. WHO. The World Health Organization: Global Kidney Disease Report. 2021.
3. Kemenkes. Laporan Riskesdas 2018 Nasional.pdf [Internet]. Lembaga Penerbit Balitbangkes. 2019. Available from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf
4. Kemenkes. Survei Kesehatan Indonesia (SKI) dalam Angka. 2023.
5. Senanayake S, Gunawardena N, Palihawadana P, Bandara P, Haniffa R, Karunarathna R, et al. Symptom burden in chronic kidney disease; a population based cross sectional study. BMC Nephrol. 2017 Jul;18(1):228.
6. Mallamaci F, Tripepi G. Risk Factors of Chronic Kidney Disease Progression : Between Old and New Concepts. 2024;1–12.
7. Kim S, Nigatu Y, Araya T, Assefa Z, Dereje N. Health related quality of life ( HRQOL ) of patients with End Stage Kidney Disease ( ESKD ) on hemodialysis in Addis Ababa , Ethiopia : a cross-sectional study. 2021;1–6.
8. Tanaka S, Ninomiya T, Taniguchi M, Tokumoto M, Masutani K, Ooboshi H, et al. Impact of blood urea nitrogen to creatinine ratio on mortality and morbidity in hemodialysis patients: The Q-Cohort Study. Sci Rep [Internet]. 2017;7(1):1–9. Available from: http://dx.doi.org/10.1038/s41598-017-14205-2
9. Stosovic M, Stanojevic M, Simic-Ogrizovic S, Jovanovic D, Djukanovic L. Relation between serum urea and mortality of hemodialysis patients. Ren Fail. 2009;31(5):335–40.
10. Kim HY, Bae EH, Ma SK, Jin DC, Kim SW. Pre-Hemodialysis Blood Urea Nitrogen To Creatine Ratio For Prediction Of Mortality In Hemodialysis Patients. Nephrol Dial Transplant [Internet]. 2018 May 1;33(suppl_1):i536–i536. Available from: https://doi.org/10.1093/ndt/gfy104.SP558
11. Rout P, Foris LA, Katta S, Bashir K. Uremia. StatPearls; 2024.
12. El Chamieh C, Liabeuf S, Massy Z. Uremic Toxins and Cardiovascular Risk in Chronic Kidney Disease: What Have We Learned Recently beyond the Past Findings? Toxins (Basel). 2022 Apr;14(4).
13. Cozzolino M, Magagnoli L, Ciceri P. From Physicochemical Classification to Multidimensional Insights : A Comprehensive Review of Uremic Toxin Research. 2025;
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Vira Kamalia Niswah, Ade Yonata, Ramadhana Komala, Iswandi Darwis
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.