FAKTOR-FAKTOR YANG MEMPENGARUHI TINGKAT ANEURISMA PADA AKSES AV FISTULA DENGAN TEKNIK KANULASI DI AREA MENETAP PADA PASIEN RUTIN HEMODIALISIS DI RSUD PROF. DR. MARGONO SOEKARJO PURWOKERTO

Abstract

Background: AV fistula aneurysm is a frequent complication in hemodialysis patients using permanent AV fistula access. Its development is influenced by several factors, including repeated cannulation in the same AV fistula area. Severity ranges from mild to severe and may cause long-term discomfort, increase infection risk, and lead to surgery for aneurysm removal. Objective: To identify factors influencing aneurysm grade in routine hemodialysis patients undergoing fixed-site cannulation in the same area of an AV fistula at RSUD Prof. Dr. Margono Soekarjo Purwokerto. Methods: This analytic observational study used a cross-sectional approach. Data normality was assessed using the Kolmogorov-Smirnov test, and relationships between variables were analyzed using Spearman's rho with SPSS version 20.0 for Windows. Results: All variables had Kolmogorov-Smirnov Asymp. Sig. (2-tailed) values above 0.05, indicating normally distributed data. Spearman's rho showed Sig. (2-tailed) values below 0.05 for cannulation technique, cannulation distance, pre-hemodialysis blood pressure, post-hemodialysis blood pressure, AV fistula position, and duration of tourniquet use in relation to aneurysm grade. No meaningful relationship was found for AV fistula duration. Conclusion and recommendation: Aneurysm grade was associated with cannulation technique, distance from the anastomosis, blood pressure before and after hemodialysis, AV fistula position, and duration of tourniquet use as a post-hemodialysis compression device. The Dialysis Unit of RSUD Prof. Dr. Margono Soekarjo Purwokerto is developing the Multiple Single Cannulation Technique (MuST) to reduce aneurysm progression.