Relationship between Hemodialysis Frequency and Urea Reduction Ratio (URR) Results in CKD Patients

  • Nuniek Setyo Wardani Universitas Binawan
  • Nyoto Heriyanto Universitas Binawan
  • Moch Robby Fajar Cahya Universitas Binawan
  • Sondang Manurung Universitas Binawan
  • Intan Parulian Universitas Binawan
Keywords: hemodialysis, kidneys, URR

Abstract

Chronic Kidney Disease (CKD) is an irreversible condition characterized by structural and functional abnormalities of the kidneys. Patients in the early stages of CKD usually do not experience any complaints until a decline in kidney function necessitates hemodialysis. Patients undergoing hemodialysis gradually experience a reduction in urea levels. Daily dietary habits and patient compliance play a crucial role in regulating urea levels. The aim of this study is to determine the relationship between the frequency of hemodialysis and the URR (Urea Reduction Ratio) results in CKD patients at RSUD Tarakan.This research was carried out from August 2024 to January 2025. It is a descriptive correlational study employing a cross-sectional approach with total sampling, involving 93 respondents. The results showed that the majority of respondents (82.8%) regularly underwent hemodialysis twice a week, and their average URR increased by 79.6%. Cross-tabulation analysis yielded a p-value of 0.026 (< 0.05), indicating a significant relationship between hemodialysis frequency and URR values in patients at RSUD Tarakan. The strength of the association was determined to be r = 0.231, implying a low/weak correlation between the hemodialysis frequency and URR values.It is recommended that the hospital provide educational sessions or seminars on the importance of hemodialysis to enhance patient motivation for undergoing the procedure.

References

Amalia, A., & Apriliani, N. M. (2021). Analysis of the Effectiveness of Single Use and Reuse Dialyzer in Chronic Kidney Failure Patients at Mardi Waluyo Hospital, Blitar City. Journal of Science and Health, 3(p-ISSN:2303-0267, e-ISSN:2407-6082). https://doi.org/10.25026/jsk.v3i5.572

Anggraini, D. (2022). Clinical Aspects and Laboratory Examination of Chronic Kidney Disease. An-Nadaa Journal of Public Health, 9(2), 236. https://doi.org/10.31602/ann.v9i2.9229

Ani Indriastutik, W. A. F. I. H. (2022). Differences in Hemoglobin Levels Pre and Post HD in Chronic Kidney Disease Patients Undergoing Hemodialysis Using Reuse Dialyzer at Dr. Saiful Anwar Hospital Malang. Media Husada Scientific Health Journal, 11(2), 120–134.

Ashar, V., M. Riduansyah, Subhannur Rahman, & Angga Irawan. (2023). The Relationship Between Hemodialysis Frequency and Stress Levels in CKD Patients Undergoing Hemodialysis at Ulin Hospital Banjarmasin. Nursing Science Journal (NSJ), 4(2), 123–132. https://doi.org/10.53510/nsj.v4i2.218

Aufa, M., Angfakh, R., Wildan, M., & Cahyono, H. D. (2024). The Relationship Between Hemodialysis Frequency and Quality of Life in Chronic Kidney Disease Patients. Jurnal Keperawatan Malang (JKM), 09(01), 89–99. https://doi.org/10.36916/jkm

Cahyani, Eka, A. A. A., Prasetya, Didik, Abadi, Fairuz, M., Prihatiningsih, & Diah. (2022). Diagnosis Description of Pre-Hemodialysis Patients at Wangaya Hospital in 2020-2021. Jurnal Ilmiah Hospitality 661, 11(1). http://stp-mataram.e-journal.id/JIH

Dwi, R., & Aminah, S. (2023). The Relationship Between Knowledge Level and Quality of Life in Hemodialysis Patients at RS Islam Jakarta in 2023. Innovative: Journal Of Social Science Research, 3(Vol. 3 No. 2 (2023): Innovative: Journal Of Social Science Research (Special Issue)), 14647–14656.

Endro Haksara, & Ainnur Rahmanti. (2021). Effectiveness of Quick of Blood (Qb) Regulation on Plasma Urea Reduction Ratio in CKD Patients Undergoing Hemodialysis at RST Dr. Soedjono Magelang. Jurnal Keperawatan Sisthana, 6(1), 1–7. https://doi.org/10.55606/sisthana.v6i1.70

Euphora, N. L., & Samira, J. (2023). The Relationship Between Duration of Hemodialysis and Nutritional Status in Chronic Kidney Failure Patients. Indonesian Journal of Applied Science and Technology, 4(1), 96–107.

Fardiansyah, M. A., Harun, O., Aribowo, P., & Rahmadani, S. (2024). The Relationship Between Blood Flow Rate (Qb) and Adequacy in Patients Undergoing Hemodialysis Therapy. Scientific Journal of Nursing, 10(1), 141–147. https://doi.org/10.33023/jikep.v10i1.1950

Fatonah, L., Andayani, T. M., & Yasin, N. M. (2021). The Relationship Between Hemodialysis Effectiveness and Quality of Life in Chronic Kidney Disease Patients in Yogyakarta. Journal of Pharmacy and Indonesian Pharmaceutical Sciences, 8(1), 22–28. https://doi.org/10.20473/jfiki.v8i12021.22-28

FKUNDIP. (2019). Understanding Chronic Kidney Disease and Its Treatments.

Florentianus Tat. (2023). Nursing Ethics Textbook. In W. P. Adeningsih & Rachmadiansyah (Eds.), Tangguh Denara Jaya (1st ed., Vol. 1). Tangguh Denara Jaya.

Gliselda, V. K. (2021). Diagnosis and Management of Chronic Kidney Disease (CKD). Medika Hutama Journal, 2(04 July), 1135–1141.

Harefa, C., Purjianti, S., Dachi, F., Khairiyah, M., Siahaan, J., & Kaban, K. B. (2023). The Relationship Between Family Support and Quality of Life of Hemodialysis Patients At RSU Royal Prima Medan. Malahayati Nursing Journal, 5(7), 2212–222. https://doi.org/10.33024/mnj.v5i7.9763

Hasanah, U., Hammad, H., & Rachmadi, A. (2020). The Relationship Between Urea and Creatinine Levels and Fatigue in Chronic Kidney Disease (CKD) Patients Undergoing Hemodialysis at the Hemodialysis Unit of RSUD Ulin Banjarmasin. Citra Keperawatan Journal, 8(2), 86–92. https://doi.org/10.31964/jck.v8i2.158

Hidayat, A. A. (2017). Nursing and Health Research Methodology (U. T (ed.)). Salemba Medika.

Hinkle, J. L., & Cheever, K. H. (2018). Medical-Surgical Nursing (L. Gray (ed.); 14th Edition). Julie K. Stegman. https://lccn.loc.gov/2017026661

IRR. (2018). 11th Report of Indonesian Renal Registry 2018. Indonesian Renal Registry (IRR), 14–15.

Kaban, K. B., Marbun, E. K., Nasution, R. S., Aulia, F. N., Harefa, R. J., & Karmelinda, K. (2024). The Relationship Between Quick of Blood (QB) and Hemodialysis Adequacy in Patients Undergoing Hemodialysis Therapy in the HD Room. MAHESA: Malahayati Health Student Journal, 4(6), 2446–2459. https://doi.org/10.33024/mahesa.v4i6.14577

Kalonio, D. E., Ratulangi, J. I. L., Tuegeh, N. M. R. N. P. J., Habibah, N., Gurning, S. H., Martawinarti, N., Brata, A., Hamka, Kusumawardani, N., Saptaningrum, E., Fione, V. R., Horhoruw, A., Feriadi, E., Shufyani, F., Simarmata, Y. B. C., & Barung, E. N. (2024). Anthology of Pharmacotherapy for the Urinary System. www.mediapustakaindo.com

Karim, U. N., Shobah, M. N., & Dewi, A. (2023). The Effect of Post-Hemodialysis in Chronic Kidney Disease (CKD) Patients on Compliance with Nursing Management. Jurnal Keperawatan, 15(2), 601–606. https://doi.org/10.32583/keperawatan.v15i2.964

Karyadi. (2022). Quick Blood is Related to Kt/V. Indonesian Journal of Medicine and Health, 2(3), 597–603.

Khaerudin, F., Gartika, N., & Wilandika, A. (2019). The Relationship Between Hemodialysis Adequacy (Urea Reduction Rate) and Fatigue Levels in End Stage Renal Disease (ESRD) Patients. Jurnal Keperawatan ’Aisyiyah, 6(2), 41–51. https://doi.org/10.33867/jka.v6i2.138

KUSTIYAH, S. (2021). Urea Levels Before and After Hemodialysis in Kidney Failure Patients. Jurnal Laboratorium Medis, 02(2685–8495), 104–108. https://ejournal.poltekkes-smg.ac.id/ojs/index.php/JLM/

Listuhayu, D., Kurniawan, T., & Nursiswati, N. (2023). Self-Management Education in Patients With Chronic Kidney Disease: A Case Study. SENTRI: Jurnal Riset Ilmiah, 2(8), 2912–2921. https://doi.org/10.55681/sentri.v2i8.1305

Liyanage, T., Toyama, T., Hockham, C., Ninomiya, T., Perkovic, V., Woodward, M., Fukagawa, M., Matsushita, K., Praditpornsilpa, K., Hooi, L. S., Iseki, K., Lin, M. Y., Stirnadel-Farrant, H. A., Jha, V., & Jun, M. (2022). Prevalence of Chronic Kidney Disease in Asia: A Systematic Review and Analysis. BMJ Global Health, 7(1). https://doi.org/10.1136/bmjgh-2021-007525

Marni, L., Asmaria, M., & Yessi, H. (2022). Nursing Care Management for Chronic Kidney Disease Patients in Mawar Aisyah Room Pariaman. Kesehatan Saintika Meditory, 325–330. https://jurnal.syedzasaintika.ac.id

Maya Febrianasari, Endrat Kartiko Utomo, D. L. M. P. (2025). The Relationship Between Family Support and Quality of Life in Chronic Kidney Disease Patients in the Hemodialysis Room. Journal of Professional Nursing Research, 2(5474), 1333–1336.*

Mentari, D., & Nugraha, G. (2023). Understanding Anemia: Pathophysiology, Classification, and Diagnosis (M. Presilla (ed.); 1st ed.). BRIN.

Naryati, Aisyah, Widakdo, G., Nuraenah, Handayani, R., Waluyo, I. K., Mahmudah, A., & Adelia, A. (2023). Enhancing Hemodialysis Nurse Adequacy Skills. Tata Mutiara Hidup Indonesia.

Naryati, N., Widakdo, G., Aisyah, A., Nuraenah, N., Fadhillah, H., Mahmud, U. H., Waluyo, I. K., & Heryadi, R. (2023). The Impact of Integrated Education on Hemodialysis Patient Care Adequacy Management at Islamic Hospital Jakarta Cempaka Putih. Malahayati Nursing Journal, 5(10), 3613–3621. https://doi.org/10.33024/mnj.v5i10.12153

Novinka, C., Gea, D., Fadsya, F., Sari, N., Tarigan, R. M. B., & Nababan, T. (2022). Relationship Between Hemodialysis Adequacy and Quality of Life of Chronic Renal Failure Patients at RSU Royal Prima Medan in 2022. Jurnal Keperawatan Dan Fisioterapi (JKF), 5(1), 1–8. https://doi.org/10.35451/jkf.v5i1.1114

Nurhamibah, F., & Slametiningsih. (2022). The Relationship Between Duration of Hemodialysis and Emotional Mental Disorders in Chronic Kidney Failure Patients Undergoing Hemodialysis at Yarsi Hospital Jakarta Pusat in 2022. 9, 1–8.

Pebrianti, S., Shalahuddin, I., & Eriyani, T. (2024). Thirst Management in Chronic Kidney Disease (CKD) Patients Using the Sipping Ice Technique. Journal of Creativity in Community Service (PKM), 7(7), 1–12. https://doi.org/10.33024/jkpm.v7i7.14834

PERNEFRI. (2020). Integrated Collaboration for Excellent Kidney Care. In S. P.-K. dr. Iri Kuswadi, S. P.-K. dr. Heru Prasanto, S. P.-K. dr. Metalia Puspitasari, M.Sc., & S. P. dr. Yulia Wardhani (Eds.), Sustainability (Switzerland).

Pratikaning Sari, R. S., Sumiatin, T., Su’udi, & Novita Agnes, Y. L. (2023). Lifestyle Description Causing Chronic Kidney Disease in the Hemodialysis Unit of RSUD Dr. R. Koesma Tuban. Jurnal Mahasiswa Kesehatan, 5(1), 12–25. https://doi.org/10.30737/jumakes.v5i1.4943

Putri, S. I., Dewi, T. K., & Ludiana. (2023). The Application of Slow Deep Breathing to Fatigue in Chronic Kidney Failure Patients in the HD Unit of RSUD Jendral Ahmad Yani Metro in 2022. Scientific Journal of Nursing, 3.

Ramadhan, M. P., Yetti, K., Herawati, T., Adam, M., & Masfi, A. (2023). Description of Intradialytic Complications in Hemodialysis Patients Based on Interdialytic Weight Gain (IDWG). Nursing Update, 14(1), 142–148.

Rasianti Puspita Sari, & Sitti Rahma Soleman. (2024). Quality of Life Description in Chronic Kidney Failure Patients Undergoing Hemodialysis at RSUD Ibu Fatmawati Soekarno Surakarta. Protein: Journal of Nursing and Midwifery Sciences, 2(4), 123–132. https://doi.org/10.61132/protein.v2i4.683

Regita, A. (2020). Description of Intradialytic Hypotension Incidents in Hemodialysis Patients at RS PGI Cikini. 1(1), 11–15.

Rembune, Z., Syapitri, Alifah Alwani Lubis, & Saragi, M. P. D. (2022). Career Aspirations of Final-Year Students at BPI UIN Sumatera Utara in Job Searching. Journal of Education and Counseling, 4(6), 2950–2956.

Samosir, A. H., Wahyuni, S., Gabena Indrayani Dalimunthe, Yuniarti, R., & Peri. (2024). Analysis of the Influence of Patient Characteristics on Drug Side Effects in Stage V Chronic Kidney Failure Patients Undergoing Hemodialysis. Scientific Journal of Science and Technology, 3(September), 441–453.

Saragih, A. M., Wahyuni, S., Yuniarti, R., Indrayani, G., & Peri. (2024). Characteristics Description of Stage V Chronic Kidney Failure Patients Undergoing Hemodialysis. Scientific Journal of Science and Technology, 15(1), 37–48.

Setyawati, N. F., Yuliawuri, H., Raudah, S., Pristina, N., Kaisar, M. M. M., Sucipto, A., Mudhawaroh, Asriati, Ardiansyah, R. T., Achmad, B. K., Maranata, Ningtyas, N. W. R., Yuliana, L., Prihartanti, N. G., Nursoliha, I., & Astuti, H. (2023). Health Research Methodology. Eureka Media Aksara. http://www.nber.org/papers/w16019

Somji, S. S., Ruggajo, P., & Moledina, S. (2020). Adequacy of Hemodialysis and Its Associated Factors Among Patients Undergoing Chronic Hemodialysis in Dar es Salaam, Tanzania. International Journal of Nephrology, 2020. https://doi.org/10.1155/2020/9863065

Suciana, F., Hidayati, I. N., & Kartini. (2020). Correlation Between Duration and Frequency of Hemodialysis. Journal Kesehatan, 15(1), 13–20.

Sugiyono. (2017). Quantitative, Qualitative, and R&D Research (25th ed.). Alfabeta Bandung.

Susanto, F. H. (2020). Chronic Kidney Disease and Hypertension (Vol. 19, Issue 5).

Susilawati, F., & Sudrajat, A. (2024). Comparison of Urea and Creatinine Levels in Chronic Kidney Failure Patients Pre and Post Hemodialysis Therapy. Public Health Journal, 8(3), 4819–4825. https://doi.org/10.31004/prepotif.v8i3.33280

Syahputra, E., Laoli, E. K., Alyah, J., HSB, E. Y. B., Tumorang, E. Y. E. br., & Tiarnida Nababan. (2022). Family Support is Related to the Quality of Life of Chronic Kidney Failure Patients Undergoing Hemodialysis Therapy. Journal of Professional Nursing Research, 4(3).

Syuryani, N., Arman, E., & Putri, G. E. (2021). Differences in Urea Levels Before and After Hemodialysis in Chronic Kidney Failure Patients. Jurnal Kesehatan Saintika Meditory, 4(2), 117. https://doi.org/10.30633/jsm.v4i2.1292

Utami, I. A. A., Santhi, D. G. D. D., & Lestari, A. A. W. (2020). Prevalence and Complications in Chronic Kidney Failure Patients Undergoing Hemodialysis at Sanglah General Hospital Denpasar in 2018. Intisari Sains Medis, 11(3), 1216–1221. https://doi.org/10.15562/ism.v11i3.691

Wayunah, W., Prabowo, R. K., Fatimah, I., & Saefulloh, M. (2023). Quick of Blood as One of the Factors Influencing Hemodialysis Adequacy. Healthy Behavior Journal, 1(2), 2–9.

Widodo, S., Ladyani, F., Asrianto, L. O., Rusdi, Khairunnisa, Lestari, S. M. P., Wijayanti, D. R., Devriany, A., Hidayat, A., Dalfian, Nurcahyati, S., Sjahriani, T., Armi, Widya, N., & Rogayah. (2023). Research Methodology.

Wilson, S., Mone, P., Jankauskas, S. S., Gambardella, J., & Santulli, G. (2021). Chronic Kidney Disease: Definition, Updated Epidemiology, Staging, and Mechanisms of Increased Cardiovascular Risk. Journal of Clinical Hypertension, 23(4), 831–834. https://doi.org/10.1111/jch.14186

Yuyun Solihatin, Aida Sri Rahmawati, S. (2019). Quality of Life in Hemodialysis Patients at the Hemodialysis Unit of RS Jasa Kartini Tasikmalaya. Healthcare Nursing Journal, 1(2), 55.

Zuliani, Malinti, E., Faridah, U., Sinaga, R. R., Rahmi, U., Malisa, N., Mandias, R., Matongka, S. F. Y. H., & Suwarto, T. (2021). Disorders of the Urinary System. In Deepublish (Issue August).

Published
2025-06-01
How to Cite
Wardani, N. S., Heriyanto, N., Cahya, M. R. F., Manurung, S., & Parulian, I. (2025). Relationship between Hemodialysis Frequency and Urea Reduction Ratio (URR) Results in CKD Patients. Indonesian Journal of Global Health Research, 7(3), 729-740. https://doi.org/10.37287/ijghr.v7i3.5999