Lifestyle of Chronic Kidney Failure Patients before Undergoing

Hemodialysis in Medan, Indonesia

Cholina Trisa Siregar

, Novi Yulisa Harahap

, Siti Zahara Nasution

, Zulkarnain

M. Pahala Hanafi Harahap

and Muhammad Taufik

Faculty of Nursing, Universitas Sumatera Utara, Medan, Indonesia

Faculty of Psychology, Universitas Sumatera Utara, Medan, Indonesia

Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Sumatera Utara, Medan, Indonesia

Keywords: Healthy lifestyle, Renal dialysis, Habits, Humans

Abstract: Changes in a person's lifestyle or habits can result in changes in body rhythm and can cause balance

disorders, resulting in a decrease in bodily functions. The aim of the study was to describe the habits of the

patients before chronic kidney failure. Design with sampling using purposive sampling. The inclusion

criteria of this study were chronic kidney failure patients who underwent hemodialysis for less than 6

months, had chronic kidney failure not due to diabetes mellitus and hypertension. The number of samples is

50 respondents. Data collection tools using questionnaires made based on the literature Result: The study

obtained data on the lifestyle of patients before suffering from chronic kidney failure that is an unhealthy

lifestyle as many as 44 people (88%). This lifestyle is judged by 4 habits, namely the habit of consuming

food that is not good as many as 45 people (90%), amounting to 45 people (90%) lack of physical activity,

bad daily life of 40 people (80%) and resting less by 37 people (74%). A healthy lifestyle requires the

attention of health workers, especially for patients who are at risk of decreased organ function.

1 INTRODUCTION

Changes in the body's homeostasis can be caused by

a decrease in kidney function, a continued decline in

kidney function resulting in chronic kidney failure

that is at risk of causing a high rate of morbidity and

mortality. Decreased kidney function requires

permanent kidney replacement therapy, namely

dialysis or kidney transplantation (Gansevoort et al.,

2013). Chronic kidney failure has increased and is

becoming a very serious health problem in the

world. Chronic renal failure caused the death of the

27th sequence in the world in 1990 and increased to

18th in 2010 (Mills et al., 2015). Chronic kidney

failure sufferers who undergo dialysis therapy or

kidney transplantation are more than 2 million and

only around 10% experience it routinely, so that

millions of people die every year because they don't

have access to treatment (Ri, 2018). Basic health

data (Kesehatan, 2018) patients with chronic failure

based on the most age is 65-74 years, the most sex is

Male (4.17%). According to the Indonesian Minister

of Health that risk factors for chronic kidney failure

can be caused by hypertension (25.8%), obesity

(5.40%), diabetes mellitus (2.3%)(Ri, 2018).

Indonesian Renal Registry (IRR), 2015 data on risk

factors for chronic kidney failure that occur in young

adults is caused by Diabetes Mellitus, hypertension,

smoking habits and consumption of supplement

drinks.

Chronic kidney failure can be caused by changes

in modern lifestyle that do not pay attention to health

such as lack of activity, consuming unhealthy eating

and drinking (Susanto, 2003). Changes in lifestyle of

patients with chronic kidney failure are caused by a

lot of the wrong lifestyle by consuming energy

drinks, lack of rest, consuming excessive

supplement drinks and foods containing

preservatives consuming fast food, stressful

busyness, sitting all day in the office, often drinking

coffee, energy drinks, rarely consuming water is a

bad habit is a risk factor for kidney damage (White

et al., 2009). The economic level can affect the

pattern or type of food consumed, changes in

lifestyle or habits of a person must be able to change

the way of thinking by changing one's paradigm

138

Trisa Siregar, C., Yulisa Harahap, N., Zahara Nasution, S., Zulkarnain, ., Pahala Hanaﬁ Harahap, M. and Tauﬁk, M.

Lifestyle of Chronic Kidney Failure Patients before Undergoing Hemodialysis in Medan, Indonesia.

DOI: 10.5220/0010137600002775

In Proceedings of the 1st International MIPAnet Conference on Science and Mathematics (IMC-SciMath 2019), pages 138-142

ISBN: 978-989-758-556-2

(Suhardjo, 2008).

This habit change resulted in a decrease in

kidney function and increased mortality and

morbidity in the world (Howden et al., 2013).

Chronic kidney failure has a risk of 3 to 4

contracting infectious diseases such as influenza,

pneumococcal pneumonia, hepatitis and other

diseases due to decreased immune system (Naqvi &

Collins, 2006). (Levey & Coresh, 2012) said the

decline in the ability of the kidneys to perform their

functions causes a high risk of complications such as

cardiovascular, acute kidney injury, infection,

cognitive impairment, and impaired physical

function . Complications can occur at any stage of

decline in kidney function and cause death.

Chronic kidney disease in addition to causing

physiological changes also affects psychological and

social changes in patients such as the addition of

funds for hemodialysis actions that patients undergo

(Muehrer et al., 2011). Increasing the number of

hemodialysis patients each year also causes many

complications such as increased interdialytic weight

gain, nutrition, skin problems, and insomnia during

or after undergoing hemodialysis sessions. Other

complications experienced by patients when

undergoing hemodialysis are interradial

hypertension, hypotension, muscle cramps, access

problems, chills, headaches, nausea and vomiting,

itching, and others. This condition can result in a

decrease in the quality of life of the patient.

Hemodialysis therapy indirectly affects the quality

of life of patients, such as physical, psychological,

spiritual health, socioeconomic status and changes in

the functioning of family (Cavalli, et al., 2010).

2 METHODS

The design used in this research is exploratory

descriptive with a retrospective approach. This study

aims to explore information about the lifestyle of the

patient before undergoing chronic kidney failure.

Sampling using a purposive sampling method

involving 50 respondents. Criteria for inclusion are

chronic kidney failure patients who have just

undergone 6 months of hemodialysis, the cause of

chronic kidney failure due to diabetes mellitus and

hypertension. This research was conducted from

March to July 2019. The instrument used was a

questionnaire consisting of data on the

characteristics of respondents and the lifestyle of

patients before experiencing chronic kidney failure.

The research questionnaire uses the Guttman scale,

the statement yes given a score of 1 and given a

value of 0 for no. Rating categories consisting of

nutrients are stated in statements number 1, 2, 3, 4, 5

and 6; bad habits statements number 7, 8, 9, 10, 11,

12 and 13; physical activity statements number 14

and 15; Ability to break statement number 16.

The research instrument was based on a literature

review and validation was tested with the CVI

(Content Validity Index). The CVI result of the

instrument is 1.00 so that the patient's lifestyle

questionnaire before experiencing conic kidney

failure is declared valid and can be used for

research. The reliability test of the lifestyle

instrument of the patient used KR 21 involving 30

people who had the same criteria as this study. If the

KR 21 test results are obtained by 0.90 or more, then

the lifestyle instrument is declared reliable for this

study. Data collection was carried out when the

respondent was undergoing hemodialysis therapy

and respondents who were unwilling were not

included in the study sample. Data analysis uses a

frequency distribution to see the highest data that

causes kidney function decline. The data submitted

by the patient is kept confidential and this study has

received ethical tests from the Faculty of Nursing,

University of North Sumatra.

3 RESULTS

3.1 Characteristics of Respondents

Table 1 depicts the highest age data for middle adult

as many as 37 (74%) respondents, 14 majority

respondents with no work status as many as 35

(70%), most male sex as much as 32 (64%).

Table 1. Characteristics of respondents in the hemodialysis

room in Medan City in 2019

Characteristics respondent f %

Age:

Teena

6 12

Youn

Adul

7 14

Middle Adul

37 74

Occupation

Wor

15 30

Does not wor

35 70

Gender:

Female 18 36

Male 32 64

Table 1 shows the majority of male respondents as

many as 64 people (54.7%), age range 41-60 years

as many as 66 people (56.4%), 53 senior high school

Lifestyle of Chronic Kidney Failure Patients before Undergoing Hemodialysis in Medan, Indonesia

139

education (45.3%), 48 self-employed (41%), the

married status of 108 people (92.3%).

3.2 Patient's Lifestyle before

Experiencing Chronic Kidney

Failure.

Table 2 Ilustrates the lifestyle of respondents before

experiencing the highest chronic kidney failure,

which is a bad lifestyle of 44 people (88%).

Table 2. Lifestyle of patients before chronic renal failure

Medan City in 2019

Lifestyle f %

Well

Not Good

Table 3. Lifestyle categories of patients before

experiencing chronic kidney failure in Medan City in 2019

Table 3 illustrates 4 lifestyle categories of

patients before experiencing chronic kidney failure,

namely Nutrition 90% is not good and 10% is good,

Bad Habits 80% is not good and 20% is good,

Physical Activity 90% is not good and 10% is good,

Resting Habits 74% not good and 26% good.

Table 4. Data on cross-tabulation of patient lifestyle

before experiencing chronic kidney failure in Medan City

in 2019

G = good

NG = Not good

Table 4 illustrates the cross table data between work

and 4 aspects of the patient's lifestyle. based on 4

aspects. The results of cross-tabulation of jobs with

the highest nutritional value that is not working with

aspects of poor nutrition that is equal to 32 (64%);

the results of the work of cross-tabulation of jobs

with bad habits the highest value is work and bad

habits that are not good is 29 (58%); cross-tabulation

of the highest value of work with physical activity is

32 (64%; the highest value of cross-tabulation

between work with the habit of resting the highest

value is working with bad rest habits that are 25

(50%).

4 DISCUSSION

The results of this study obtained patient lifestyle

data before experiencing chronic kidney failure

which was studied as many as 50 patients with 4

lifestyle factors of patients before experiencing

chronic kidney failures such as Nutrition, Bad

Habits, Physical Activity, and resting habits. Patients

with chronic kidney failure mostly have a history of

bad lifestyle. The results of this study are similar to

Dewi’s research, from 40 patients who were

examined from 3 lifestyle factors of chronic kidney

failure such as Physical Activity, Substance Use, and

Diet Patterns, having 23 patients (57.5%) having

unhealthy lifestyles before undergoing hemodialysis

therapy (Publikasi, 2018) .

Consuming bad nutrients is influenced by the

work environment that makes them not care about

good nutrition patterns, eating fast food such as

canned foods, fried foods, packaged rice and

everyday cooking using flavoring. Modern lifestyles

change lifestyles such as eating fast food, canned

foods, bottled chili sauce, canned drinks, fruits and

vegetables that use preservatives, foods rich in fat,

foods rich in cholesterol. People who do not pay

attention to the composition of nutrients contained in

daily food will be more susceptible to disease than

those who are careful in consuming food. Foods that

contain high carbohydrate content but lack of fiber

such as fast food, accelerate the accumulation of fat

in the body that triggers obesity. Obese individuals

are prone to type 2 diabetes mellitus and

cardiovascular disease. Fat accumulation in the

abdominal area is one of the risk factors that trigger

diabetes mellitus. An increase in diabetics will

increase the number of people with kidney disease

due to complications from diabetes, namely diabetes

nephropathy (Ortiz et al., 2014).

Bad habits are carried out such as drinking

alcohol from family and environmental factors that

make them try to drink alcohol and wine so that it is

addictive. Promotions and invitations of friends to

try herbal medicines such as body administrators,

IMC-SciMath 2019 - The International MIPAnet Conference on Science and Mathematics (IMC-SciMath)

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body massagers, to cure diseases and beautify

themselves and types of herbal medicines that are

often consumed, supplement drinks consumed by

male patients work as drivers and consume water

that does not meet the body's needs

Environmental factors including exposure to

heavy metals such as lead, cadmium, arsenic, use of

chemicals for plants (agrochemicals) and some

Chinese herbal medicines, use of nonsteroidal anti-

inflammatory drugs, and infectious diseases

leptospirosis, hantavirus, leprosy, and malaria are

endemic diseases in Indonesia. a cause of chronic

kidney failure (Soderland, et al., 2010). The

statement of Bruno & Langford that a bad lifestyle

is seen from the use of substances is risky behavior

such as smoking, using drugs not in accordance with

the rules that have been given, the use of chemicals

that are harmful to the body (Stack & Murthy,

2010). This behavior, if carried out by individuals in

the long term, can result in disruption of kidney

work that ends with chronic kidney failure. The

results of this study indicate that people who take

herbal medicines are 11.76 times more at risk of

developing chronic kidney failure compared to those

who do not consume herbal medicines (Gluba-brz, et

al., 2017). Previous studies also mentioned that

consumption of herbal medicines is a risk factor for

kidney failure. The results of research on the

majority of patients before experiencing chronic

kidney failure are the physical activity of patients is

not good because of the work factors that make them

unable to do exercise every day and work at home.

The results of this study are similar to Dewi's

research, from 40 patients examined in 19 patients

whose physical activity was 47.5% and 21 patients

whose physical activity was not good, 52.5%.

Individuals who have low physical activity are at

risk of experiencing various diseases such as

diabetes, hyperlipidemia, hypertension, and obesity

(Publikasi, 2018).

Adequate rest is needed by our body. Lack of

sleep can cause the body limp, no enthusiasm,

irritability, and stress. Prolonged stress can result in

a persistent increase in blood pressure (Sorat, 2019).

Factor research results that resulted in respondents

not paying attention to resting habits due to factors

working and often out at night with friends so that

the decreasing sleep act does not meet the body's

needs.

5 CONCLUSION

A healthy lifestyle is important to prevent a decline

in organs. Unhealthy lifestyles such as the intake of

nutrients that do not fit the body's needs, poor

abusive habits, lack of physical activity and resting

habits that do not meet the body's needs are the

cause of chronic kidney failure.

ACKNOWLEDGEMENTS

The authors thank the Ministry of Research,

Technology, and Higher Education, the Republic of

Indonesia for funding this research through Research

Grant in 2019

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