EVALUASI EFEKTIVITAS DIURETIK PADA PASIEN SIROSIS HATI DENGAN KOMPLIKASI ASITES YANG DIRAWAT DI RSUP DR. SARDJITO YOGYAKARTA

The principal of ascites therapy is to make turn sodium balance into negative, as example by using a diuretic agent specially for moderate and heavy ascites. The use of diuretic agent in the therapy of ascites should be done regarding the low efficacy of sodium restriction and bed rest (Kashani, et al., 2007). The objectives of this research are to examine the profil of diuretic`s use and to evaluate the effectivity of diuretic agent to the respon of patient who have cirrhosis hepatic with ascites and its characteristic at RSUP Dr. Sardjito Yogyakarta. This research is an observasional type by collecting the data retrospectively in Medical Record Instalation of RSUP Dr. Sardjito Yogyakarta during January-Desember 2009. The evaluation of effectivity of diuretic`s therapy is based on the response of patient on achieving daily loss of body weight until on fifth day of diuretic agent administration 0,3-0,5 kg/day (for patient without peripheral edema) and 0,5-1,0 kg/day (for patient with peripheral edema). Beside that, evaluation of abdominal girth and urine volume has been done too. The data is processed by using analytical descriptive method. On 35 patients who have cirrhosis hepatic with ascites, there are 8 patients (22,86%) received single diuretic spironolacton and 27 patients (77,14%) received combination of diuretic agent spironolacton-furosemid. In relation with patient`s characteristic (peripheral edema and Child Pugh Score), there is no significant difference between two groups, which p=0,477 and p=0,229 respectively. The average of daily loss of body weight on group who use spironolactone: 0,5 kg/day (without peripheral edema) and (0,92±0,14) kg/day (with peripheral edema), there is significant difference between both of them (p=0,002). Besides, the average of daily loss of body weight on group who use combination of spironolactone and furosemide: (0,54±0,13) kg/day (without peripheral edema) and (0,96±0,29) kg/day (with peripheral edema), there is significant difference between both of them (p=0,006). The same result is found in the average of daily loss of abdominal girth and daily elevation of urine volume between two groups, for both without and with peripheral edema. The diuretic therapy is effective to low ascites that is happened on patient who suffer cirrhosis hepatic. This result is based on the response achieved (daily loss of body weight) for both group who received spironolacton and combination of spironolacton-furosemid