Survival Analysis of Chronic Kidney Disease (CKD) Patients Undergoing Hemodialysis at RSUD Ratu Zalecha Martapura

Nasywa Nabilah Azzahro; Dewi Anggraini

doi:10.20956/j.v22i1.44666

Authors

Nasywa Nabilah Azzahro Program Studi Statistika, Fakultas MIPA, Universitas Lambung Mangkurat
Dewi Anggraini Program Studi Statistika, Fakultas MIPA, Universitas Lambung Mangkurat

DOI:

https://doi.org/10.20956/j.v22i1.44666

Keywords:

Chronic Kidney Disease, Hemodialysis, Survival Analysis, Cox Proportional Hazard Regression, Ties

Abstract

The kidneys play an important role in excreting the body's metabolic waste. The progressive decline in kidney function triggers Chronic Kidney Disease (CKD) which can be fatal if it’s not treated by undergoing regular hemodialysis or kidney transplantation. Research related to the effectiveness of the survival time of CKD patients is still limited, therefore this study aims to analyze the survival of CKD patients undergoing hemodialysis at Ratu Zalecha Martapura Hospital using survival analysis. The data collection method used purposive sampling. The research data were obtained from secondary source of medical records of 335 CKD patients who underwent hemodialysis during the observation in period from January 2022 until October 2024. The survival analysis methods used include Kaplan-Meier and Log-Rank tests for estimation of the survival function and Cox Proportional Hazard regression models by comparing 3 methods of handling co-occurrence (ties) namely Breslow, Efron, and Exact to identify factors that affect patient survival. The results showed that CKD patients without comorbidities had a higher survival chance than patients with hypertension, diabetes mellitus, and cardiovascular disease. In comparing the methods of handling ties, Exact method was the most appropriate for the data with the smallest Akaike Information Criterion (AIC) value of 481.3439. In addition, it was found that the factors that significantly influenced the length of CKD patient’s survival were hypertension status, diabetes mellitus status, and cardiovascular status.

References

[1] Abdullah, M. N., Irawan, N., & Irhamah. 2020. Pendekatan Bayesian untuk Analisis Survival pada Kasus Demam Berdarah Dengue Pasien RSUD Dr. Soetomo Surabaya. Jurnal Sains dan Seni ITS, Vol. 9, No. 2, D138-D145.

[2] Collect, D. 2015. Modelling Survival Data in Medical Research. CRC Press.

[3] Dinas Kesehatan Provinsi Kalimantan Selatan. 2023. Jumlah Penderita Gagal Ginjal Kronik. https://data.kalselprov.go.id/dataset/data/1327/bar. [2024]

[4] Hosmer, D. W., Lemeshow, S., & May, S. 1999. Applied Survival Analysis Regression Modelling of Time-to-event Data. John Wiley & Sons.

[5] Indonesian Renal Registry. 2023. 13th Annual Report of Indonesian Renal Registry 2020. IRR Perhimpunan Nefrologi Indonesia.

[6] Klein, J. P., & Moeschberger, M. L. 2003. Survival Analysis Techniques For Censored and Truncated Data. Springer.

[7] Kleinbaum, D. G., & Klein, M. 2012. Survival Analysis: A Self-Learning Text Third Edition. Springer.

[8] Lenny, Wayan, I., & Arifuddin. 2024. Faktor-Faktor Berhubungan dengan Terjadinya Gagal Ginjal Kronik di Perawatan Penyakit dalam RSUD Undata Provisi Sulawesi Tengah. Jurnal Kolaboratif Sains, Vol. 7, No. 6, 2015-2021.

[9] Menteri Kesehatan Republik Indonesia. 2023. KMK No. HK.01.07-MENKES-1634-2023 tentang “Pedoman Nasional Pelayanan Kedokteran Tata Laksana Ginjal Kronik”. https://kemkes.go.id/app_asset/file_content_download/17019170696571318d16eff8.41286905.pdf. [10 September 2024]

[10] Therneau, T. M., & Grambsch, P. M. 2000. Modeling Survival Data: Extending the Cox Model. Springer-Verlag, Inc.

[11] Muhani, N., & Sari, N. 2020. Analisis Survival pada Penderita Gagal Ginjal Kronik dengan Komorbiditas Diabetes Melitus. Jurnal Unhas Media Kesehatan Masyarakat Indonesia, Vol. 16, No. 2, 216-224.

[12] Cheressia, N. A., Susanto, G., Wahyudi, D. A., & Wulandari, R. Y. 2024. Penyakit Komorbid Dan Survival Rate Pada Pasien Gagal Ginjal Kronik Diruang Hemodialisa RSUD Dr Abdul Moeloek Provinsi Lampung. Health Research Journal of Indonesia (HRJI), Vol. 3, No. 1, 29-37.

[13] Rantepadang, A. 2021. Perbandingan Kualitas Hidup Pasien Gagal Ginjal Kronik Antara Komorbid Faktor Diabetes Melitus dan Hipertensi pada Pasien yang Menjalani Hemodialisa. Nutrix Jurnal, Vol. 5, No. 2, 1-7.

[14] Oladuti, O. M., & Olopha, P. O. 2022. Comparison of Survival Estimation Methods in the Analysis of Breast Cancer Data. Asian Pacific Journal of Cancer Care, Vol. 7, No. 4, 601-605.

[15] Zega, N. N., Mustafid, & Wuryandari, T. 2023. Penerapan Regresi Cox Proportional Hazard pada Kejadian Bersama (Ties) dengan Metode Breslow, Efron, dan Exact (Studi Kasus: Pasien Demam Berdarah Dengue di RSI Sultan Agung Semarang). Jurnal Gaussian, Vol. 12, No. 4, 520-530.