Proses Asuhan Gizi Terstandar pada Pasien Anemia dengan AKI dd ACKD, Suspek Sepsis, Wound Dehisensi dd Fistula Enterokutan: Laporan Kasus
DOI:
https://doi.org/10.55123/insologi.v4i3.5325Keywords:
Acute Kidney Injury (AKI), Acute on Chronic Kidney Disease (ACKD), Enterocutaneous FistulaAbstract
Introduction: Acute Kidney Injury (AKI) is a sudden decline in kidney function, whereas Acute on Chronic Kidney Disease (ACKD) refers to an acute deterioration superimposed on pre-existing chronic kidney disease. Both conditions are associated with high mortality rates, especially when accompanied by other complications such as sepsis and postoperative conditions. Wound dehiscence is a postoperative complication characterized by the reopening of a surgical wound. This risk increases in patients with compromised immune status, sepsis, and chronic illnesses such as Chronic Kidney Disease (CKD). The aim of this case study is to provide nutritional care for a patient with Acute Kidney Injury (AKI) differential diagnosis of Acute on Chronic Kidney Disease (ACKD), suspected sepsis, wound dehiscence, suspected enterocutaneous fistula, and anemia, tailored to the patient’s clinical condition and nutritional needs. Case Presentation: An 18-year-old female student, referred to as Patient A, was diagnosed with Acute Kidney Injury (AKI) dd Acute on Chronic Kidney Disease (ACKD), suspected sepsis, wound dehiscence, suspected enterocutaneous fistula, and anemia. The patient had undergone exploratory laparotomy due to perforated appendicitis. Conclusion: The nutritional intervention provided was effective in improving the nutritional status of the patient with Acute Kidney Injury (AKI) dd Acute on Chronic Kidney Disease (ACKD), suspected sepsis, wound dehiscence, suspected enterocutaneous fistula, and anemia.
Downloads
References
Barchitta M, Maugeri A, Favara G, Magnano San Lio R, Evola G, Agodi A, et al. (2019). Nutrition and Wound Healing: An Overview Focusing on the Beneficial Effects of Curcumin. Int J Mol Sci, 20(5)
Berk. K, Smith. L, Olieman. J, Ligthart-Melis,G. Earthman, C. (2023). ody composition and functional status tools for nutritional assessment of hospitalized adults: a systematic review, 54, P700
Brennfleck FW, Junger HHG, Przemyszlaw S, Mauerer C, Brunner SM, Schlitt HJ, Hornung M. (2020). Management of Open Abdominal Wounds With Intestinal Fistula Formation Using a Combination of Negative Pressure Wound Therapy With Instillation and Dwell Time and New Generation Fistula Devices: A Case Report. Wounds, 32(12), E62-E66.
Borregaard, N., & Herlin, T. (2022). Neutrophil granulocytes and their role in inflammation. Nature Reviews Immunology, 22(3), 165–179. https://doi.org/10.1038/s41577-021-00651-8
Christian J, Wolfgang W, Michael. (2022). Causal Relationship Between Hypoalbuminemia And Acute Kidney Injury. World Journal Of Nephrology. 6(4), 176-187
Defranky T, Dyah K, Guati N, Ida B, Eka. (2021). Korelasi Antara Kadar Seng Serum Dengan Kadar Interleukin-6 Dan Skor PELOD-2 Pada Sepsis. Sari Pediatric. 23(4), 262-9
Douville, N. J., Bastarache, L., Bertucci Richter, E. (2024). Genetic variants associated with sepsis associated acute kidney injury. PLoS ONE, 19(12), e0311318. https://doi.org/10.1371/journal.pone.0311318
ESPEN (European Society for Clinical Nutrition and Metabolism). (2021). ESPEN guidelines on clinical nutrition in hospitalized patients. Clinical Nutrition, 40(10), 5614–5620. https://doi.org/10.1016/j.clnu.2021.07.001
Fatur A. (2021). Asuhan Keperawatan Pada Tn. L Dengan Gangguan Pemenuhan Kebutuhan Keamanan Akibat Patologi Sistem Integumen: Wound Dehiscence Di Rsu Aliyah 3. Karya Tulis Ilmiah, Politeknik Kesehatan Kendari
Gameiro, J., Gonçalves, M., Pereira, M., Jorge, S., & Lopes, J. A. (2018). Acute kidney injury in sepsis: Clinical and laboratory characteristics, outcomes, and impact of obesity. BMC Nephrology, 19(1), 1–9. https://doi.org/10.1186/s12882-018-1067-0
Irena G, Genevieve B. (2016). Enterocutaneous Fistula: Proven Strategies and Updates. Clinics in Colon and Rectal Surgery, 29(2), 130-137
Jeong, S. Y., Kim, H. J., & Park, J. H. (2020). Nutritional management of enterocutaneous fistula patients: challenges and strategies. Clinical Nutrition Research, 9(3), 165-174.
Kaushal, G., Anand, S., Ranjan, R., & Bani, R. (2023). Nutritional management in the compromised gut: Short bowel syndrome, enterocutaneous fistula, and stoma. Journal of Nutritional Research, 11(8), 45–52. https://jnutres.com/articles/nutritional-management-in-the-compromised-gut-short-bowel-syndrome-enterocutaneous-fistula-and-stoma
Lim, J. U., Lee, J. H., Kim, J. S., Hwang, Y. I., Kim, T. H., Lim, S. Y., & Rhee, C. K. (2017). Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. International journal of chronic obstructive pulmonary disease, 12, 2465.
McDowell MA, Fryar CD, Ogden CL, Flegal KM. (2021). Anthropometric reference data for children and adults: United States, 2003–2006. Natl Health Stat Report, (10), 1–48.
Nanda Rachmad Putra Gofur. (2020). Sebuah Tantangan Baru : Manajemen Dan Diagnose Fistula Enteroktan. Universitas Airlangga
Nathania, M., & Andayani, D. E. (2021). Medical Nutrition Therapy In Enterocutaneous Fistula: A Step-By-Step Approach. World Nutrition Journal, 5(1). https://doi.org/10.25220/WNJ.V05.i1.0002
Penny H, Flores R, Pennington E, Pedersen A, Tran S. (2022). The role of macronutrients and micronutrients in wound healing: a narrative review. J Wound Care. 31(5), 14–22.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2017). Fundamentals of Nursing. Elsevier Health Sciences.
Platek M, Hertroijs D, Nicholson J, Parekh N. (2024). Sensitivity and Specificity of Malnutrition Screening Tools Used in the Adult Hospitalized Patient Setting A Systematic Review. Top Clin Nutr, 20(30), 289–301
Schneider, A., Smith, R., Johnson, L., & Kim, H. (2023). Nutritional management of patients with enterocutaneous fistula and renal impairment: A clinical review. Clinical Nutrition, 42(1), 45–52. https://doi.org/10.1016/j.clnu.2022.09.010
Santoso, S., & Nainggolan, O. (2017). Sepsis: Diagnosis dan Penatalaksanaan Terkini. Jakarta: EGC.
Soemarko, D. S. (2012). Nutrisi Klinik dan Dietetika. Jakarta: EGC.
Tang. Q, Zhi-Wu. H, Hua-Jian. R, Lei. W. (2020). Nutritional Management Of Patients With Enterocutaneous Fistulas: Practice And Progression. Frontiers In Nutrition, 7
Wessels, I., Maywald, M., & Rink, L. (2021). Zinc as a gatekeeper of immune function. Nutrients, 13(11), 4354. https://doi.org/10.3390/nu13114354
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Alfi Miftahul Nikmah, Dwi Sarbini, Agus Prastowo
This work is licensed under a Creative Commons Attribution 4.0 International License.
Hak cipta pada setiap artikel adalah milik penulis.
Penulis mengakui bahwa INSOLOGI (Jurnal Sains dan Teknologi) sebagai publisher yang mempublikasikan pertama kali dengan lisensi Creative Commons Attribution 4.0 International License.
Penulis dapat memasukan tulisan secara terpisah, mengatur distribusi non-ekskulif dari naskah yang telah terbit di jurnal ini kedalam versi yang lain, seperti: dikirim ke respository institusi penulis, publikasi kedalam buku, dan lain-lain. Dengan mengakui bahwa naskah telah terbit pertama kali pada INSOLOGI (Jurnal Sains dan Teknologi).
