Widiasih, Esti and Wahyu Subagio, Hertanto and Lestariningsih, Lestariningsih (2024) PENGARUH SUPLEMENTASI SINBIOTIKTERHADAP PERBAIKAN GUT DISBIOSIS, DERAJAT UNFLAMASI, MALNURISI DAN KONSTIPASI PASIEN PGK-HD (Kajian terhadap Kadar Fecal SCFA dan TNF-α, Skor DMS dan Berat SMM, Skor Brisol dan Konstipasi). Doctoral thesis, Universitas Diponegoro.

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Abstract

Latar Belakang : Gut Dysbiosis yang terjadi pada pasien PGK-HD berperan menyebabkan inflamasi, malnutrisi dan konstipasi. Sinbiotik diduga memiliki kemampuan yang baik untuk memperbaiki Gut Dysbiosis pada pasien PGK-HD. Tujuan penelitian ini untuk menganalisis pemberian suplementasi sinbiotik terhadap gut dysbiosis, derajat inflamasi, malnutrisi dan konstipasi pasien PGK-HD
Metode : Penelitian Double Blind RCT Pre-Test dan Post-Test Design, 50 pasien PGK-HD dibagi menjadi dua kelompok 25 perlakuan dan 25 kontrol, diberikan suplementasi sinbiotik selama 6 minggu. Data dasar demografi, antropometri, asupan makanan, kadar Fecal SCFA, TNF-⍺, Skor DMS, Berat SMM, Skor Bristol dan Konstipasi diukur dan dianalisis. Analisis statistik menggunakan uji beda sesuai dengan skala variabel dan distribusi data menggunakan SPSS 26.0 for window.
Hasil : Kadar fecal SCFA sesudah perlakuan lebih tinggi bermakna pada kelompok sinbiotik daripada kontrol (p=0,007). Selisih penurunan kadar TNF-⍺ sesudah perlakuan bermakna pada kelompok sinbiotik daripada kontrol (p=0,001). Selisih kenaikan berat SMM sesudah perlakuan lebih tinggi bermakna pada kelompok sinbiotik dibanding kontrol (p=0,007). Penurunan skor DMS sesudah perlakuan bermakna pada kelompok sinbiotik dibanding kontrol (p=0,029). Peningkatan skor Bristol sesudah perlakuan bermakna pada kelompok sinbiotik dibanding kontrol ( p <0,001), skor konstipasi sesudah perlakuan lebih turun bermakna pada kelompok sinbiotik dibanding kontrol (p <0,001),
Kesimpulan : Suplementasi sinbiotik 6 minggu pada pasien PGK-HD efektif memperbaiki Gut Dysbiosis melalui peningkatan kadar SCFA, memperbaiki inflamasi dengan penurunan kadar TNF-⍺, mencegah malnutrisi dan memperbaiki konstipasi.
Kata Kunci : Hemodialisis, Sinbiotik, Fecal SCFA, TNF-⍺, malnutrisi, konstipasi

ABSTRACT
Background: Gut dysbiosis that occurs in CKD-HD patients plays a role in causing inflammation, malnutrition and constipation. Synbiotics are thought to have a good ability to improve gut dysbiosis in CKD-HD patients. The aim of this study was to analyze synbiotic supplementation on gut dysbiosis, degree of inflammation, malnutrition and constipation in CKD-HD patients. Method: Double Blind RCT Pre-Test and Post-Test Design, 50 CKD-HD patients were divided into two groups, 25 treatment and 25 controls, given synbiotic supplementation for 6 weeks. Basic data on demographics, anthropometry, food intake, fecal SCFA levels, TNF-⍺, DMS Score, SMM Weight, Bristol Score and Constipation were measured and analyzed. Statistical analysis uses a difference test according to the variable scale and data distribution with SPSS 26.0 for window. Results: Fecal SCFA levels after treatment were significantly higher in the synbiotic group than in the control (p=0.007). The difference in decreasing TNF-⍺ levels after treatment was significant in the synbiotic group compared to the control (p=0.001). The difference in SMM weight gain after treatment was significantly higher in the synbiotic group compared to the control (p=0.007). The DMS score after treatment decreased significantly in the synbiotic group compared to the control (p=0.029). The Bristol score after treatment increased significantly in the synbiotic group compared to the control (p<0.001), the constipation score after treatment decreased significantly in the synbiotic group compared to the control (p<0.001),
Conclusion: 6 weeks of synbiotic supplementation in CKD-HD patients is effective in improving gut dysbiosis by increasing SCFA levels, improving inflammation by reducing TNF-⍺ levels, preventing malnutrition and improving constipation.
Keywords: Hemodialysis, Synbiotics, Fecal SCFA, TNF-⍺, malnutrition, constipation

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