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Validitas diagnostik skor CAVeA2T2 dalam memprediksi kegagalan fistula arterivena radiosefalika pada pasien gagal ginjal stadium terminal di Rumah Sakit Umum Pusat Sanglah

Abstract

Introduction: Chronic kidney disease is a global public health problem with increasing prevalence and incidence and poor prognosis. As a result, more patients will be in terminal stage kidney failure and require placement of vascular access for hemodialysis. Mature and functional arteriovenous fistula (AVF) is considered the best modality for access to hemodialysis. But it is estimated that about one third of the AVF will fail to achieve functional access. The aim of this study was to examine CAVeA2T2 scores in predicting failure of arteriovenous fistula radiochepalica, significant factors related to failure of arteriovenous fistula so that it can be used to predict failure using a scoring system to predict primary failure and secondary failure fistula.

Methods: This study using diagnostic test evaluation method using ROC curve analysis on months 1 and 3, total 50 populations obtained by means of Purposive sampling quota period April 2018 to December 2018 and failure of Hemodialysis as gold standard.

Results: Results of the CAVeA2T2 score where the maximum score of 7 was analyzed using the ROC curve, the cutoff point was obtained at month 1 ≥5 with AUC 0.8987 and at 3 months ≥ 4 with AUC 0.3966 sensitivity and specificity CAVeA2T2 score of 91.3% and 75% in month 1 , in the 3rd month 85.7% and 87.5% were obtained.

Conclusion: CAVeA2T2 score has a considerably goo sensitivity and specificity so it can be used to predict failure of arteriovenous radiochepalic fistula.

 

Pendahuluan: Penyakit gagal ginjal kronis merupakan masalah kesehatan masyarakat global dengan prevalens dan insiden yang meningkat serta prognosis buruk. Akibatnya lebih banyak pasien yang akan berada pada gagal ginjal stadium terminal dan memerlukan penempatan akses vaskular untuk hemodialisa. Fistula arterivena yang matur dan fungsional dianggap sebagai modalitas terbaik untuk akses hemodialisa. Namun diperkirakan sekitar sepertiga fistula arterivena akan gagal mencapai akses yang fungsional. Penelitian ini bertujuan untuk menguji skor CAVeA2T2 dalam memprediksi kegagalan arteriovenous fistula radiosefalika dan faktor-faktor risiko yang signifikan dan berkaitan dengan kegagalan arteriovenous fistula sehingga dapat digunakan untuk memprediksi kegagalan pada primary dan secondary failure fistula.

Metode: Penelitian ini menggunakan metode evaluasi uji diagnostik yang dianalisis dengan kurva ROC pada bulan ke 1 dan ke 3. Sebanyak 50 sampel didapatkan dengan cara  purposive sampling quota, periode April sampai Desember 2018 dan kegagalan hemodialisis sebagai baku emas.

Hasil: Berdasarkan hasil skor CAVeA2T2 dengan skor maksimal 7, didapatkan nilai cutoff point ≥ 5 dengan AUC 0,8987 pada bulan ke 1 dan ≥ 4 dengan AUC 0,3966 pada bulan ke 3. Sensitivitas dan Spesifisitas skor CAVeA2T2 sebesar 91,3% dan 75% pada bulan ke 1, dan 85,7% dan 87,5% pada bulan ke 3.

Kesimpulan: Hasil uji diagnostik menunjukkan skor CAVeA2T2 memiliki nilai sensitivitas dan spesifisitas yang baik sehingga dapat digunakan untuk memprediksi kegagalan arteriovenous fistula radiocephalica pada bulan ke 1 dan ke 3.

References

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How to Cite

Juanda, A., Yasa, K. P. ., & I Gede Raka Widiana. (2022). Validitas diagnostik skor CAVeA2T2 dalam memprediksi kegagalan fistula arterivena radiosefalika pada pasien gagal ginjal stadium terminal di Rumah Sakit Umum Pusat Sanglah. Medicina, 53(3), 177–181. https://doi.org/10.15562/medicina.v53i3.743

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