Diagnosis dan Manajemen Stenosis Vena Sentral pada Pasien Dialisis: Tinjauan Praktis
DOI:
https://doi.org/10.59784/glosains.v7i1.665Keywords:
Stenosis vena sentral, hemodialisis, akses vaskular, kateter vena sentral, venografi, angioplasti transluminal perkutanAbstract
Latar belakang: Stenosis vena sentral (SVS) merupakan komplikasi iatrogenik penting pada pasien dialisis yang berkontribusi terhadap disfungsi akses vaskular, morbiditas, serta peningkatan biaya perawatan.
Tujuan: Tinjauan ini bertujuan untuk menganalisis secara komprehensif epidemiologi, patofisiologi, manifestasi klinis, pendekatan diagnostik, serta strategi manajemen SVS pada pasien dialisis, dengan penekanan pada implikasi praktik klinis nefrologi.
Metode: Artikel ini disusun sebagai tinjauan naratif berbasis literatur yang diperoleh melalui pencarian sistematis pada basis data PubMed, Scopus, dan Google Scholar untuk publikasi tahun 2015–2025 menggunakan kata kunci “central venous stenosis”, “hemodialysis”, dan “vascular access”. Artikel yang diseleksi meliputi penelitian observasional, uji klinis, pedoman praktik, dan tinjauan sistematis yang relevan dengan populasi dialisis dewasa.
Hasil: Dari hasil seleksi, 24 artikel memenuhi kriteria inklusi dan dianalisis secara kualitatif. Luaran yang ditargetkan dalam tinjauan ini adalah sintesis bukti mengenai faktor risiko utama (terutama penggunaan kateter vena sentral dan kanulasi vena subklavia), akurasi modalitas diagnostik, efektivitas intervensi endovaskular, angka kekambuhan, serta strategi pencegahan berbasis pelestarian akses vaskular.
Kesimpulan: Tinjauan ini menegaskan bahwa pencegahan melalui pembatasan penggunaan kateter, pemilihan lokasi kanulasi yang tepat, serta deteksi dini pada pasien berisiko tinggi merupakan komponen kunci dalam praktik nefrologi. Artikel ini menyediakan kerangka praktis untuk pengambilan keputusan klinis yang terintegrasi dalam pengelolaan akses vaskular jangka panjang pada pasien dialisis.
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