Jurnal Analis Medika Biosains (JAMBS) Vol.
No.
March 2026, pp.
E-ISSN: 2656-2456
http://jambs.
poltekkes-mataram.
id/index.
php/home DOI: 10.
32807/jambs.
Analysis Of The Effect Of Hemodialysis Frequency On Hemoglobin.
Ureum.
Creatinine And Albumin Levels In Chronic Kidney Failure Patients At Praya Hospital Yunan Jiwintarum1.
Kurnia Anindita2.
Erlin Yustin Tatontos3 123Jurusan Teknologi Laboratorium Medis.
Poltekkes Kemenkes Mataram.
Indonesia Email: kurnianindita0212@gmail.
Article Info
ABSTRACT
Article history :
Chronic Kidney Disiase (CKD) is a progressive loss of kidney function characterized by the inability of the kidneys to excrete waste and maintain metabolic balance.
When kidney function declines, erythropoietin production decreases, resulting in anemia.
other complication, such a hypoalbuminemia, are also common.
Urea and creatinine levels are vital parameters of assessing kidney function.
Hemodialysis is a common therapy for CKD patients.
therefore, evaluating laboratory parameters such as haemoglobin, urea, creatinine, and albumin levels according to the frequency of hemodialysis is essential to determine treatment effectiveness.
This analytical observational study with a cross-sectional design evaluated the effectiveness of bi-weekly hemodialysis among 32 chronic kidney disease patients at Praya General Hospital in May 2025.
The results indicated that while routine hemodialysis significantly reduced urea levels 9 mg/dL to 17.
6 mg/dL and creatinine from 10.
mg/dL to 2.
5 mg/dL, these metabolic waste parameters tended to increase slightly after six months.
In contrast, hemoglobin levels remained relatively stagnant at 2Ae8.
3 g/dL, signifying persistent moderate anemia despite regular treatment.
Notably, albumin levels showed a steady and gradual improvement over the six-month period, rising from 3.
4 g/dL to 4.
g/dL, which suggests an enhanced protein status in patients adhering to the prescribed hemodialysis frequency.
Received : Oct, 20th 2025 Revised : Mar, 29th 2026 Accepted : Mar, 31th 2026 Keyword :
Chronic Kidney Disiase Hemodialysis Frequency Hemoglobin
Urea
Creatinine Albumin
INTRODUCTION
Chronic Kidney Failure (CKF) remains a major health issue globally, affecting approximately 10% of the population.
In Indonesia.
CKF prevalence among adults reaches The kidneys play a vital role in waste excretion, electrolyte regulation, and erythropoietin production.
When kidney function declines, patients develop anemia and hypoalbuminemia due to reduced erythropoietin synthesis and protein loss.
Elevated urea How to cite: Jiwintarum.
Anindita.
, & Tatontos.
Analysis Of The Effect Of Hemodialysis Frequency On Hemoglobin.
Ureum.
Creatinine And Albumin Levels In Chronic Kidney Failure Patients At Praya Hospital.
Jurnal Analis Medika Biosains (JAMBS), 13.
, 33Ae38.
Retrieved https://jambs.
id/index.
php/home/article/view/569 and creatinine levels indicate reduced filtration capacity.
The accumulation of these uremic toxins not only signifies declining renal function but also contributes to systemic complications that diminish the patient's quality of life.
Hemodialysis (HD) is the main therapy for CKF patients to remove metabolic waste and excess fluid.
While the clinical goal of dialysis is to replace renal filtration, the adequacy of this process is highly dependent on the regularity and frequency of the sessions.
The frequency of HD may influence biochemical markers such as hemoglobin, urea, creatinine, and albumin.
In many regional settings, such as in Indonesia, a twice-weekly schedule is the standard protocol.
however, its long-term impact on maintaining stable laboratory parameters requires localized evaluation to ensure treatment effectiveness.
Therefore, this study aimed to analyze the effect of hemodialysis frequency specifically twice per week on these laboratory parameters in CKF patients treated at Praya Hospital.
MATERIALS/METHOD
This analytical observational study employed a cross-sectional design and was conducted at the Clinical Pathology Laboratory of Praya General Hospital in May 2025.
The study population consisted of 32 chronic kidney failure (CKF) patients who had been undergoing routine hemodialysis twice weekly for a minimum of six months, selected through purposive sampling based on specific inclusion criteria.
Utilizing secondary data sourced from patient medical records, the research focused on hemodialysis frequency as the independent variable and its effect on dependent variables, including hemoglobin, urea, creatinine, and albumin The collected data were analyzed descriptively to evaluate longitudinal changes in these laboratory parameters before, during, and after the six-month treatment period.
RESULTS AND DISCUSSION
The following results were obtained from the research conducted:
Table 1.
Hemoglobin levels in CKD patients before HD, after the first HD and after hemodialysis in months 1-6 with a frequency of HD twice a week.
Hemoglo bin Level Hemoglobin Level after Hemoglo Level in the 1st Month Hemoglo Level in the 2nd Month Hemoglo Level in the 3rd Month Hemoglo Level in the 4th Month Hemoglo bin Level in the 5th Month Hemoglo bin Level in the 6th Month The average hemoglobin before hemodialysis was 8.
3 g/dL and after six months remained 2 g/dL, indicating mild-to-moderate anemia.
This suggests that hemodialysis twice a week helps stabilize hemoglobin levels but does not normalize them, possibly due to persistent erythropoietin deficiency.
Table 2.
Urea levels in CKD patients before HD, after the first HD and after HD in the 3rd and 6th months with a frequency of HD twice a week.
Urea levels before the first HD Urea levels after the first HD Urea levels in the 3rd month after undergoing Urea levels in the 6th month after undergoing Urea levels significantly decreased from a mean of 137.
9 mg/dL before HD to 17.
6 mg/dL after HD, and then slightly increased to 24.
6 mg/dL at six months.
Similarly, creatinine levels decreased from 11.
4 mg/dL to 2.
1 mg/dL after HD, followed by a mild rebound at later stages.
These results demonstrate the efficacy of HD in toxin removal but highlight the need for consistent sessions to maintain biochemical stability.
Table 3.
Creatinine levels in CKD patients before HD, after the first HD and after HD in the 3rd and 6th months with a frequency of HD twice a week.
Creatinine levels before first HD
Creatinine levels after first HD
9,06
1,51
Creatinine levels in the 3rd month after undergoing HD
1,46
Creatinine levels in the 6th month after undergoing HD
2,04
Based on the data presented in Table 3, the mean creatinine levels in patients with Chronic Kidney Disease (CKD) showed a dramatic reduction from 9.
06 mg/dL before the first hemodialysis (HD) session to 1.
51 mg/dL immediately afterward.
Subsequent monitoring in the 3rd month indicated a relatively stable trend with a slight decrease to 1.
mg/dL.
However, by the 6th month, there was a noticeable increase in creatinine levels 04 mg/dL, despite patients maintaining a routine twice-weekly hemodialysis This phenomenon suggests that while twice-weekly hemodialysis is highly effective for the immediate removal of creatinine as a metabolic waste product, there is a tendency for "rebound" or gradual accumulation over a longer six-month period, highlighting the necessity for consistent dialysis sessions and regular monitoring of biochemical parameters to ensure long-term patient stability.
Table 4.
Albumin levels in CKD patients after the first HD and after HD in the 3rd and 6th months with a frequency of HD twice a week Albumin levels after first Albumin levels in the 3rd month after undergoing HD Albumin levels in the 6th month after undergoing HD Based on the data presented in Table 4, the average albumin levels in Chronic Kidney Disease (CKD) patients showed a steady and positive improvement over the six-month observation period.
The mean albumin level started at 3.
7 g/dL after the first hemodialysis (HD) session and increased to 4.
1 g/dL by the 3rd month.
By the 6th month, the levels continued to rise, reaching an average of 4.
4 g/dL, which falls within the normal physiological range CONCLUSIONS This study concludes that a twice-weekly hemodialysis frequency is effective in reducing urea and creatinine levels and maintaining stable albumin concentrations, but does not significantly improve hemoglobin levels.
To address the persistent anemia observed in these patients, clinical management should include regular hemoglobin monitoring and the consideration of adjunct erythropoietin therapy to supplement the dialysis process.
REFERENCE