Analysis of Drug Costs and Types of Drugs Prescribed for Stage 5 Chronic Kidney Failure Patients on Hemodialysis at dr. R. Goeteng Taroenadibrata Regional General Hospital
Keywords:
Analysis, Drug Costs, Drugs Prescribed, Stage 5 Chronic KidneyAbstract
Stage 5 Chronic Kidney Disease (CKD), particularly those undergoing haemodialysis (HD), presents a significant economic burden, especially in low- and middle-income countries where healthcare resources are limited. This condition requires frequent and costly treatments to manage, leading to high healthcare expenditures. The aim of this study was to analyse the types and costs of medications most commonly prescribed to stage 5 CKD patients undergoing HD at dr. R. Goeteng Taroenadibrata Regional General Hospital. A descriptive-analytic study was conducted with a cross-sectional approach, using retrospective data from medical records and payment documents for stage 5 CKD patients receiving HD between July and December 2023. A total of 85 patients were selected based on inclusion and exclusion criteria. Descriptive analysis was performed using SPSS software. Results showed that Heparin inj 5000 IU/mL was the most frequently prescribed medication, accounting for 17.43% of all prescriptions, primarily for the prevention and treatment of thromboembolism. Other drugs such as furosemide, folic acid, and amlodipine were also commonly prescribed. The most expensive medication was Epoetin Alfa 3000 IU/mL, with an average cost of IDR 3,112,500 over 182 prescribing episodes. This study highlights the importance of understanding drug expenditure in HD treatment, which can inform budget planning and resource allocation in hospitals
References
1. Elshahat S, Cockwell P, Maxwell AP, Griffin M, O’Brien T, O’Neill C. The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review. PLoS ONE. 2020;15(3):1–19.
2. Dipiro J.T, Gary C.Yee, L.Michael Posey, Stuart T.Haines, Thomas D.Nolin VE. Pharmacotherapy A Pathophysiologic Approach Eleventh Edition. 2020. 732–820 p.
3. Liyanage T, Toyama T, Hockham C, Ninomiya T, Perkovic V, Woodward M, et al. Prevalence of chronic kidney disease in Asia: A systematic review and analysis. BMJ Global Health. 2022;7(1):1–9.
4. Kemenkes RI. Riskesdas 2018. Badan Penelitian dan Pengembangan Kesehatan. 2018.
5. KDIGO. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. IFAC Proceedings Volumes (IFAC-PapersOnline). 2013;3(1):1–150.
6. Gusev E, Solomatina L, Zhuravleva Y, Sarapultsev A. The pathogenesis of end‐stage renal disease from the standpoint of the theory of general pathological processes of inflammation. International Journal of Molecular Sciences. 2021;22(21).
7. Cahyani A.A.A.E, Didik Prasetya, Moh Fairuz Abadi DP. Gambaran Diagnosis Pasien Pra-Hemodialisa di RSUD Wangaya Tahun 2020-2021. Jurnal Ilmiah Hospitality 661. 2022;5(2):37–42.
8. Adha D, Efendi Z, Afrizal A, Sapardi VS. Hubungan Dukungan Keluarga Dan Lama Hemodialisis Dengan Depresi Pada Pasien Gagal Ginjal Kronik (GGK) Yang Menjalani Hemodialisis Di Unit Hemodialisa. Jurnal Kesehatan Mercusuar. 2021;3(2):60–7.
9. IRR. 11th Report of Indonesian renal registry 2018. Indonesian Renal Registry (IRR). 2018.
10. Azalea M, Murti Andayani T, Satibi. Analisis Biaya Pengobatan Penyakit Ginjal Kronis Rawat Inap Dengan Hemodialisis Di Rumah Sakit Cost Analysis of Inpatient Hemodialysis in the Treatment of Chronic Kidney Disease At Hospital. Jurnal Manajemen dan Pelayanan Farmasi . 2016;6(2):141–50.
11. Fauziah, Wahyono D, Budiarti LE. Cost of Illness Dari Chronic Kidney Disease dengan Tindakan Hemodialisis. Jurnal Manajemen dan Pelayanan Farmasi. 2015;5(3):149–58.
12. Alya Azzahra, Woro Supadmi. Biaya Medis Langsung pada Pasien Penyakit Ginjal Kronik di Rumah Sakit PKU Muhammadiyah Bantul. AKFARINDO. 2024;9(1):32–8.
13. Jha V, Al-Ghamdi SMG, Li G, Wu MS, Stafylas P, Retat L, et al. Global Economic Burden Associated with Chronic Kidney Disease: A Pragmatic Review of Medical Costs for the Inside CKD Research Programme. Advances in Therapy. 2023;40(10):4405–20.
14. Katz-Greenberg G, Shah S. Sex and Gender Differences in Kidney Transplantation. Seminars in Nephrology. 2022;42(2):219–29.
15. Ahmed SB, Ramesh S. Sex hormones in women with kidney disease. Nephrology Dialysis Transplantation. 2016;31(11):1787–95.
16. Kao HY, Chang CC, Chang CF, Chen YC, Cheewakriangkrai C, Tu YL. Associations between Sex and Risk Factors for Predicting Chronic Kidney Disease. International Journal of Environmental Research and Public Health. 2022;19(3):1–11.
17. Webster AC, Nagler E V., Morton RL, Masson P. Chronic Kidney Disease. The Lancet. 2017;389(10075):1238–52.
18. PERNEFRI. 13th Annual Report of Indonesian Renal Registry 2020. Indonesian Renal Registry (IRR). 2020;13:11.
19. Adem M, Mekonen W, Ausman A, Ahmed M, Yimer A. Prevalence of chronic kidney disease and its associated factors among diabetes mellitus patients in Dessie Referral Hospital, South Wollo, Ethiopia. Scientific Reports. 2024;14(1):1–11.
20. Gultom MD, Sudaryo MK. Hubungan Hipertensi dengan Kejadian Gagal Ginjal Kronik di RSUD DR. Djasamen Saragih Kota Pematang Siantar Tahun 2020. Jurnal Epidemiologi Kesehatan Komunitas. 2023;8(1):40–7.
21. Rini Nindela, Sigit Nur Prastowo, Eka Febri Zulissetiani, Selly Marisdina, Siti Sarahdeaz, Fazzaura Putri. Impact of Age Initiation and Duration of Hemodialysis on Impaired Cognitive Function Experienced by Chronic Kidney Disease (CKD) Patients. Jurnal Profesi Medika: Jurnal Kedokteran dan Kesehatan. 2024;18(1):36–43.
22. Zhao JL, Qiao XH, Mao JH, Liu F, Fu HD. The interaction between cellular senescence and chronic kidney disease as a therapeutic opportunity. Frontiers in Pharmacology. 2022;13(August):1–14.
23. Leyane TS, Jere SW, Houreld NN. Oxidative Stress in Ageing and Chronic Degenerative Pathologies: Molecular Mechanisms Involved in Counteracting Oxidative Stress and Chronic Inflammation. International Journal of Molecular Sciences. 2022;23(13).
24. Ailsa Dzakiyah Dzahabiyah Hibatulloh, Fiora Ladesvita. Relationship between Blood Pressure and Multimorbidity with Glomerular Filtration Rate (GFR) in Patients with Chronic Renal Failure. Jurnal Berita Ilmu Keperawatan. 2023;16(1):77–88.
25. Yuniarti W. Anemia Pada Pasien Gagal Ginjal Kronik Anemia In Chronic Kidney Disease Patients. Journal Health And Science ; Gorontalo Journal Health & Science Community. 2021;5(2):341–7.
26. House AA, Wanner C, Sarnak MJ, Piña IL, McIntyre CW, Komenda P, et al. Heart failure in chronic kidney disease: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International. 2019;95(6):1304–17.
27. Saputra SI, Berawi KN, Hadibrata E, Kedokteran F, Lampung U, Fisiologi B, et al. Hubungan Diabetes Melitus dengan Kejadian Gagal Ginjal Kronik. Medula. 2023;13:787–91.
28. Imelda F, Susalit E, Marbun MBM, Rumende CM. Gambaran Klinis dan Kualitas Hidup Pasien Penyakit Ginjal Tahap Akhir yang Menjalani Hemodialisis Dua Kali Dibandingkan Tiga Kali Seminggu. Jurnal Penyakit Dalam Indonesia. 2017;4(3):128.
29. Angga Andreas Wantoro, Debilly Yuan Boyoh. Penggunaan Dializer Re-use pada Pasien Hemodialisa terhadap Nilai Urea Reduction Ratio (URR) di Rumah Sakit Advent Bandung. Skolastik Keperawatan. 2021;3(2):70–9.
30. Firsa Novellasari, Delina Hasan., Nurita Andayani. Analisis Efektivitas Biaya Dialiser Single Use dan Reuse Layanan Hemodialisa Pasien Gagal Ginjal dan Pengaruhnya terhadap Quality of Life di RSUD Sekarwangi. Cakrawala - Repositori IMWI. 2023;6(6):2594–603.
31. Rohn H, Lisman T, Benko T, Witzke O. Evaluation of hemostasis in patients with end- stage renal disease. PLoS ONE. 2019;(February):1–13.
32. Lu H, Liao K. Increased risk of deep vein thrombosis in end-stage renal disease patients. BMC Nephrology. 2018;19(204):1–9.
33. Pavlou EG, Georgatzakou HT, Fortis SP, Tsante KA, Tsantes AG, Nomikou EG, et al. Coagulation Abnormalities in Renal Pathology of Chronic Kidney Disease : The Interplay between Blood Cells and Soluble Factors. MDPI journal pharmaceutics. 2021;11(1309):1–17.
34. Hughes S, Szeki I, Nash MJ, Thachil J. In-Depth Review Anticoagulation in chronic kidney disease patients — the practical aspects. Clin Kidney Journal. 2014;7(August):442–9.
35. Erlanda W, Karani Y. Penggunaan Antikoagulan Pada Penyakit Ginjal Kronik. FK Unand. 2018;7(Supplement 2):168–75.
36. Kemenkes RI. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Penyakit Ginjal Kronik. 2023. p. 1–289.
37. Pugh D, Gallacher PJ, Dhaun N. Management of Hypertension in Chronic Kidney Disease. Drugs. 2019;79(4):365–79.
38. Ku E, Lee BJ, Wei J, Weir MR. Hypertension in CKD: Core Curriculum 2019. American Journal of Kidney Diseases. 2019;74(1):120–31.
39. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;45(24):1–24.
40. Garini A. Kadar Hemoglobin Pada Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisis. JPP (Jurnal Kesehatan Poltekkes Palembang). 2018;13(2):111–6.
41. Insani N, Manggau MA, Kasim H. Analisis Efektivitas Terapi Pada Pasien Anemia Gagal Ginjal Hemodialisis di RSUP dr. Wahidin Sudirohusodo Makassar. Majalah Farmasi dan Farmakologi. 2018;22(1):13–5.
42. Adnan, Azizah AWN. Profil Terapi Antianemia Pada Pasien Penyakit Ginjal Kronis Dengan Hemodialisis Di Rumah Sakit Umum Daerah Panembahan Senopati Bantul. JCPS (Journal of Current Pharmaceutical Sciences). 2023;6(2):629–37.
43. Flythe JE, Assimon MM, Tugman MJ, Narendra JH, Singh SK, Jin W, et al. Efficacy, Safety, and Tolerability of Oral Furosemide Among Patients Receiving Hemodialysis: A Pilot Study. Kidney International Reports. 2022;7(10):2186–95.
44. Lee HJ, Lee H, Oh SH, Park J, Park S, Jeon S, et al. Chronic kidney disease (CKD) patients are exposed to more proton pump inhibitor (PPI)s compared to non-CKD patients. PLoS ONE. 2018;1–10.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Bella Aisya Fitri, Fauziah, Khamdiyah Indah Kurniasih (Author)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
