Pengaruh Range of Motion Intradialisis terhadap Kadar Ureum pada Pasien Hemodialisa

  • Danny Putri Sulistyaningrum Program Studi D-3 Keperawatan, STIKES Telogorejo Semarang
  • I’ien Noer’aini Program Studi D-3 Keperawatan, STIKES Telogorejo Semarang
Keywords: hemodialysis, intradialysis range of motion, ureum


Hemodialysis is the process of removing body toxins, as well as the correction of water, electrolytes, and acid-base bodies through a dialiser machine. One of the complications is fatigue as a result of a buildup of metabolic waste that disrupts the work of the cerebral cortex system and motor neurons. This condition needs an appropriate intervention in the form of intradialysis range of motion (ROM) whose aim is to increase muscle blood flow so that urea clearance reaches a maximum. This study aimed to identify the effect of intradialysis ROM to urea levels of hemodialysis patients. This study used quasi experiment pre-post test with control group involving 32 respondents by consecutive sampling technique. Data collection tool is observation sheets containing patient data characteristics and urea levels pre-intervention intervention. Analysis statistical this study using Unpaired T test. The results showed no effect of intradialysis ROM to urea levels to hemodialysis patients (p = 0.213; α = 0.05).


Abou, H., & Azayiem, E. (2015). Factors affecting fatigue in chronic renal failure patients under hemodialysis treatment at qena university hospital in upper. Journal of Biology, Agriculture and Healthcare, 5, 42–50.
Adam, J. K., Mtech, S. S., & Sbn, M. N. (2017). Impact Of Airogym Exercise On Solute Removal And Oedema On End-Stage Kidney Disease Patients : A Randomised Controlled Trial. Journal Medical Technology SA, 31(1), 1–8.
Afshar, R., Emany, A., Saremi, A., Shavandi, N., Sanavi, S. (2011). Effects of intradialytic aerobic training on sleep quality in hemodialysis patients. Iran J Kidney Dis. 5(2):119-23.
Artom, M., Moss-morris, R., Caskey, F., & Chilcot, J. (2014). Fatigue in advanced kidney disease. Kidney International, 86, 497–505. doi:10.1038/ki.2014.86.
Bayliss, D. (2006). Starting and managing an intradialytic exercise program. Nephrology News and Issues, 20, 47- 49.
Berry, M. J., Rejeski, W. J., Adair, N. E., Ettinger,, W. H., Zaccaro, D. J., & Sevick, M. A. (2003). A Randomized, Controlled Trial Comparing Long-term and Short-term Exercise in Patients With Chronic Obstructive Pulmonary Disease. Journal of Cardiopulmonary Rehabilitation, 23(1), 60–68. doi:10.1097/00008483-200301000-00011
Bohm, C. J., Ho, J., & Duhamel, T. A. (2010). Regular physical activity and exercise therapy in end-stage renal disease : how should we “move” forward? JNephrol, 23, 235–243.
Bonner, A., Wellard, S., & Caltabiano, M. (2008). Levels of fatigue in people with ESRD living in far North Queensland. Journal of Clinical Nursing, 17, 90–98. doi:10.1111/j.1365-2702.2007.02042.x.
Boundless. (2016). Blood flow to an active muscle changes depending on exercise intensity and contraction frequency and rate. boundless-anatomy-and-physiology-textbook/cardiovascular-system-blood-vessels-19/blood-flow-through-the-body-185/blood-flow-in-skeletal-muscle-921-5579/
Daugirdas, J. T., Blake, P. G., Ing, T. S. (2015). Handbook of dialysis (5th ed). Philadelphia: Lippincott Williams & Wilkins.
Davis, M & Walsh, D (2016). Mechanisms of fatigue. The Journal of Supportive Oncology, 8, 164–174.
Georgios, T., Victoria, A., Evangelos, F., Savvas, P., & Sofia, Z. (2015). Assessment of quality of life and fatigue among haemodialysis patients. American Journal of Nursing Science, 4, 66–73. doi:10.11648/j.ajns.s.2015040201.22.
Girija, K., & Radha, R. (2013). Beneficial effect of physical activity in hemodialysis patients. Universal Journal of Engineering Science, 1, 40–44. doi:10.13189/ujes.2013.010204.
Gordon, P. L., Doyle, J. W., & Johansen, K. L. (2011). Postdialysis fatigue is associated with sedentary behavior. Clinical Nephrology, 75, 426–433.
Groussard, C., Rouchon-Isnard, M., Coutard, C., Romain, F., Malardé, L., Lemoine-Morel, S., … Boisseau, N. (2015). Beneficial effects of an intradialytic cycling training program in patients with end-stage kidney disease. Applied Physiology, Nutrition, and Metabolism, 40(6), 550–556. doi:10.1139/apnm-2014-0357
Herlina, S. (2013). Pengaruh progressive muscle relaxation (PMR) terhadap tingkat fatigue pada pasien gagal ginjal kronis yang menjalani hemodialisa di Rumah Sakit Pusat Angkatan Darat Gatot Soebroto Jakarta. Tesis. Fakultas Ilmu Keperawatan Universitas Indonesia.
Himmelfarb, J. & Sayegh, M. H. (2010). Chronic kidney disease, dialysis, and transplantation: companion to Brenner & Rector’s the kidney (3th ed). Philadelphia: Elsevier Saunders.
Indonesian Registry Renal / IRR. (2014). 7th Report Of Indonesian Renal Registry 2014.
Jameson, J. L & Loscalso, J. (2013). Harrison: nefrologi dan gangguan asam – basa. Jakarta: EGC.
Jung, T., & Park, S. (2011). Intradialytic exercise programs for hemodialysis patients. Chonnam Medical Journal, 47, 61–65. doi:10.4068/cmj.2011.47.2.61.
KDOQI. (2015). Clinical practice guideline for hemodialysis adequacy : 2015 update. Am J Kidney Dis, 66, 884–930. doi:10.1053/j.ajkd.2015.07.015.
Ladesvita, F. (2016). Perbandingan efektifitas latihan range of motion (ROM) dengan latihan pedal intradialisis terhadap adekuasi hemodialisa pada pasien hemodialisa kronik. Tesis. Fakultas Ilmu Keperawatan Universitas Indonesia: Tidak dipublikasikan.
Leehey, D. J & Moinuddin, I. (2013). Handbook of nephrology. Philadelphia: Lippincott Williams & Wilkins.
Letchmi, S., Das, S., Halim, H., Zakariah, F. A., Hassan, H., Mat, S., Packiavathy R. (2011). Fatigue experienced by patients receiving maintenance dialysis in hemodialysis units. Nursing and Health Sciences, 13, 60–64. doi:10.1111/j.1442-2018.2011.00579.x.
Magee, C. C., Tucker, J. K., and Singh, A. K. (2016). Core concepts in dialysis and continuous therapies. New York: Spinger USA.
Mahrova, A., & Svagrova, K. (2013). Exercise therapy – additional tool for managing physical and psychological problems on hemodialysis. doi:10.5772/53058.
Mohamed, H., & Soliman, M. (2015). Effect of intradialytic exercise on fatigue, electrolytes level and blood pressure in hemodialysis patients : a randomized controlled trial. Journal of Nursing Education and Practice, 5, 16–28. doi:10.5430/jnep.v5n11p16.
Mohseni, R., Zeydi, A. E., Ilali, E., Adib-hajbaghery, M., & Makhlough, A. (2013). The effect of intradialytic aerobic exercise on dialysis efficacy in hemodialysis patients: a randomized controlled trial. Oman Medical Journal, 28, 345–349. doi:10. 5001/omj.2013.99.
Nurchayati, S. (2011). Analisis faktor – faktor yang berhubungan dengan kualitas hidup pasien penyakit ginjal kronik yang menjalani hemodialisis di Rumah Sakit Islam Fatimah Cilacap dan Rumah Sakit Umum Daerah Banyumas. Tesis. Fakultas Ilmu Keperawatan Universitas Indonesia.
Painter, P., & Marcus, R. L. (2012). Assessing Physical Function and Physical Activity in Patients with CKD. Clinical Journal of the American Society of Nephrology, 8(5), 861–872. doi:10.2215/cjn.06590712
Parker, K., Zhang, X., Lewin, A., & MacRae, J. M. (2015). The association between intradialytic exercise and hospital usage among hemodialysis patients. Applied Physiology, Nutrition, and Metabolism, 40(4), 371–378. doi:10.1139/apnm-2014-0326
Ribeiro, R., Coutinho, G. L., Iuras, A., Barbosa, A. M., Souza, J. A. C. de, Diniz, D. P., & Schor, N. (2013). Effect of resistance exercise intradialytic in renal patients chronic in hemodialysis. Jornal Brasileiro de Nefrologia, 35(1), 13–19. doi:10.5935/01012800.20130003
Sajadi, A., B, F. F., S, E. Z., Durmanesh, B., & Zare, M. (2010). Factors affecting fatigue in chronic renal failure patients treated with hemodialysis. Iranian Journal of Critical Care Nursing, 3, 33–38.
Salhab, N., Karavetian, M., Kooman, J., Fiaccadori, E., & El Khoury, C. F. (2019). Effects of intradialytic aerobic exercise on hemodialysis patients: a systematic review and meta-analysis. Journal of nephrology, 32(4), 549–566. doi:10.1007/s40620-018-00565-z
Sastroasmoro, S & Ismael, S. (2014). Dasar – dasar metodologi klinis. Jakarta: Binarupa Aksara.
Sheng, K., Zhang, P., Chen, L., Cheng, J., Wu, C., & Chen, J. (2014). Intradialytic exercise in hemodialysis patients: A systematic review and meta-analysis. American journal of nephrology, 40(5), 478–490.
Sheerwood, L. (2011). Fisiologi manusia: dari sel ke sistem (edisi 6). Jakarta: EGC.
Sodikin & Suparti, Sri. (2015). Fatigue pada pasien gagal ginjal terminal (GGT) yang menjalani hemodialisis di RSUD Prof. Dr. Margono Soekardjo Purwokerto. Seminar Nasional Hasil - Hasil Penelitian dan Pengabdian LPPM Universitas Muhammadiyah Purwokerto, 9, 57–67.
Sugiyono. (2011). Metode penelitian kuantitatif, kualitatif. Bandung: Alfabeta.
Sulistini, R. (2012). Faktor – faktor yang mempengaruhi fatigue pada pasien hemodialisis. Tesis. Fakultas Ilmu Keperawatan Universitas Indonesia.
Trisha, L. P., & Edwin, B. T., E, Cheryl., King-Van, V. (2006). Exercise training during hemodialysis improves dialysis efficacy and physical performance. Arch Phys Med Rehabil, 87, 680–687. doi:10.1016/j.apmr.2005.12.044
Turner, N., Lameire, N., Goldsmith, D. J., Winearls, C. G., Himmelfarb, J., Remuzzi, G. (2016). Oxford Textbook of Clinical nephrology (4th ed). United States: Oxford University Press.
United States Renal Data System / USRDS. (2015). 2015 URSDS annual data report volume 2: ESRD in the United States.
How to Cite
Sulistyaningrum, D., & Noer’aini, I. (2020). Pengaruh Range of Motion Intradialisis terhadap Kadar Ureum pada Pasien Hemodialisa. Jurnal Keperawatan, 12(2), 261-268.