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Chronic renal failure patients undergoing hemodialysis often experience sleep problems. This condition can affect the patient's quality of life physically and mentally. This study examined the relationship between the level of spirituality, coping mechanisms, and sleep disturbances in chronic renal failure patients undergoing hemodialysis. Psychological factors such as the level of spirituality and coping mechanisms can affect patients' adaptation to stress due to chronic illness, including sleep disturbances. Using a cross-sectional design, this study involved several patients who were in the hemodialysis room of the hospital. The purposive sampling method was used to conduct this study on seventy samples. Data processing was done with the chisquare test. The results showed that the sign value of 0.034 < 0.005 and 0.038 < 0.05, which indicates that H0 is rejected and Ha is accepted. There is a relationship between age, gender, level of spirituality, coping mechanisms, sleep disorders in chronic renal failure patients undergoing hemodialysis. In addition, adaptive coping mechanisms were also found to have a positive correlation with good sleep quality. This study concludes that increasing spirituality with adaptive coping mechanisms can contribute to the improvement of sleep quality in chronic renal failure (CKD) patients undergoing hemodialysis.

Nephrons are the smallest functional units in the kidneys that are responsible for filtering blood, regulating fluid balance, and excreting waste through urine. When nephrons are damaged or diseased, kidney function can be significantly impaired. Nephron damage is usually caused by various factors, such as hypertension, diabetes, kidney infections, or certain drug toxicity. In the early stages, nephron damage can cause a decrease in glomerular filtration rate (GFR). As a result, metabolic waste products such as urea and creatinine accumulate in the blood, known as azotemia. Over time, progressive damage to the nephrons can trigger chronic kidney disease (CKD). In more severe cases, when most of the nephrons are no longer functioning, the kidneys lose their ability to maintain the body's homeostasis. This results in electrolyte imbalance, metabolic acidosis, and excess fluid buildup, known as end-stage renal disease (ESRD). At this stage, patients require renal replacement therapy such as dialysis or kidney transplantation to survive. Prevention of nephron damage is very important, including through the management of comorbidities such as diabetes and hypertension, adequate fluid intake, and avoiding exposure to toxic substances that damage the kidneys. Thus, the risk of kidney failure can be minimized.

Chronic kidney disease, commonly abbreviated as CKD, is a condition characterized by a gradual decline in kidney function over a period of three months or more. Between 2018 and 2021, there was a specific increase in cases of kidney failure. According to statistics, 1,602,059 Indonesian residents, including 33,828 in West Java, were affected by kidney failure in 2018. This number is projected to continue rising (Riskesdas, 2020). Globally, the number of End-Stage Renal Disease (ESRD) patients reached 3,200,000 in 2020. Kidney disease typically affects individuals between the ages of 46 and 50. The objective of this literature review is to determine the quality of life of patients with chronic kidney disease (CKD). This review utilized Google Scholar and EBSCO databases, employing keywords such as "Chronic Kidney Disease" AND "Management of patients with kidney failure". Fifteen journals meeting the inclusion criteria were selected, published between 2020 and 2024. The predominant study design was cross-sectional, with stratified and purposive sampling methods commonly used. This review employed descriptive and analytical observational methods, utilizing the chi-square test. This literature review demonstrates that sociodemographic factors, including age, education, occupation, and ethnicity, significantly impact the quality of life of end-stage renal disease patients undergoing dialysis. Furthermore, the study highlights a strong association between clinical status and psychological distress among these patients. To enhance the quality of life of these individuals, comprehensive healthcare interventions, particularly psychological support and education, are essential.

Chronic Kidney Disease (CKD) is a clinical condition characterized by an irreversible decline in kidney function to a degree that requires permanent renal replacement therapy, in the form of dialysis or kidney transplantation. One of the clinical syndromes that occurs in kidney failure is uremia. This is caused by decreased kidney function. CKD disease will cause kidney function and role to continue to decline (progressive) and cannot return (irreversible) (Sherwood, 2016). This study aims to determine the effect of Murotal Al-Qur'an distraction therapy on reducing anxiety levels in CKD patients undergoing hemodialysis at Toto Kabila Regional Hospital. This research uses a quantitative research design with a Quasy Experimental research design involving an intervention group and a control group. The population in this study were all CKD patients undergoing hemodialysis at Toto Kabila Regional Hospital. The sample in this research consisted of 15 respondents, the data collection technique was making observations and using a questionnaire sheet. Based on the results of the analysis in the treatment group, the results showed that the level of moderate anxiety was 5 respondents (62.5%), and mild anxiety was 3 respondents (37.5%). In the control group, the results showed that the level of moderate anxiety was 5 respondents (71.4%), and the results of severe anxiety were 2 respondents (28.6%). The results of statistical tests in the treatment group obtained a P-value of 0.01 and in control group 0.03 which means <0.05 so it can be concluded that Ha is accepted which means there is an effect of Murotal Al-Quran Distraction Therapy on reducing anxiety levels in CKD patients undergoing hemodialysis at Toto Kabila Regional Hospital.

Background : One of the most prominent negative impacts in patients with kidney failure undergoing hemodialysis is fatigue. Breathing and range of motion exercises are therapies that can be applied to reduce fatigue in patients with chronic kidney failure. Objective: to provide breathing and range of motion exercise interventions in patients with chronic renal failure. Method: used in this study is a case study. Assessment of Mrs. S conducted for 3 consecutive days. Results: After the intervention for 3 days, the results showed that the level of fatigue and anxiety in Mrs. S decreased. Conclusions and suggestions: The interventions given have an effect on reducing the level of anxiety and fatigue of patients. It is expected that nurses can provide optimal nursing care to patients with chronic kidney failure to improve the quality of life of patients.

Liver cirrhosis and nephrolithiasis are significant health problems with different pathophysiological mechanisms. Liver cirrhosis, the final stage of chronic liver disease, is characterized by fibrosis and regenerative nodules, leading to severe complications, including portal hypertension and liver failure. Nephrolithiasis, commonly known as kidney stones, is a common urological condition characterized by the formation of stones in the renal system. Although these conditions are distinct, metabolic and physiological changes in cirrhotic patients may predispose to nephrolithiasis.  It was reported that a man came to the emergency room of RSUD Dr. Suhatman MARS with complaints of left-sided low back pain that had been felt for 1 week. The complaint was accompanied by shortness of breath which was getting worse over time. The patient also felt cough, headache, nausea, fatigue, urine slightly coloured like tea, weight loss. The patient has a history of untreated kidney stones. The patient has a history of hepatitis 31 years ago. The main objective of investigating the coexistence of liver cirrhosis and nephrolithiasis is to understand the relationship between these two conditions and to develop effective management strategies that can address their combined impact on patients.      

Chronic Kidney Failure is a condition when kidney function is impaired because it cannot filter blood normally. Patients with kidney failure will experience impaired function of regulating fluid and electrolyte balance. This condition can occur over the years which is progressive and irreversible, requiring hemodialysis therapy. Kidney damage can reduce a person's quality of life. Quality of life includes physical dimensions, psychological dimensions, social dimensions, and environmental dimensions. Objective: Knowing the description of quality of life in chronic renal failure patients undergoing hemodialysis at RSUD Ibu Fatmawati Soekarno Surakarta. Method: This type of research uses descriptive methods with a quantitative approach. The patient sample size was 44 respondents with Accidental Sampling. Measurement of quality of life using the Kidney Disease Quality of Life Short Form 1.3 (KDQOL SFTM 1.3) questionnaire. Result: The results of this study indicate that chronic renal failure patients undergoing hemodialysis have a good quality of life as many as 15 respondents (34,1%) and very good 23 respondents (52,3%) while 6 respondents (13,6%) have a moderate quality of life. Conclusion: Chronic renal failure patients have a good quality of life at RSUD Ibu Fatmawati Soekarno Surakarta.

Pruritus, or itching, is a common symptom in seniors that has a significant impact on their quality of life. Primary skin disorders such as xerosis, atopic dermatitis, and scabies, as well as systemic diseases such as cancer, chronic renal failure, cholestasis, hyperthyroidism, diabetes mellitus, iron deficiency anemia, and certain medications, can cause this condition. Chronic pruritus, which is common in individuals over 60 years of age, can cause discomfort, sleep disturbances, and psychological stress. This activity uses the PDCA (Plan-Do-Check-Act) methodology to screen for pruritus intensity in the elderly in St. Anna. One individual (2.4%) reported mild pruritus, while 12 individuals (29.3%) reported severe pruritus. Routine assessment using the 12-PSS provides important information for managing pruritus in the elderly, meeting clinical and research needs, and improving patient care and quality of life.

Cases of Chronic Kidney Failure (CRF) every year increase, CRF is a progressive kidney function disorder and requires treatment in the form of kidney transplantation, peritoneal dialysis, hemodialysis and outpatient for a long time. Patients undergoing hemodialysis experience various problems arising from malfunctioning of the kidneys, affective coping mechanisms are needed in undergoing the treatment process. Objective: Identify coping mechanisms for chronic renal failure patients in the hemodialysis unit of NTB Provincial Hospital. Research method: descriptive research using a cross sectional approach.  The sample in this study was 69 respondents, data collection method using Jalowiec Coping Scale questionnaire. Results: most respondents used maladaptive coping, which was 37 people (53.6%). Conclusion: still a large percentage of patients in the maladaptive category so that appropriate interventions are needed to improve the coping of individual CRF patients.

Cases of Chronic Kidney Failure (CRF) every year increase, CRF is a progressive kidney function disorder and requires treatment in the form of kidney transplantation, peritoneal dialysis, hemodialysis and outpatient for a long time. Patients undergoing hemodialysis experience various problems arising from malfunctioning of the kidneys, affective coping mechanisms are needed in undergoing the treatment process. Objective: Identify coping mechanisms for chronic renal failure patients in the hemodialysis unit of NTB Provincial Hospital. Research method: descriptive research using a cross sectional approach.  The sample in this study was 69 respondents, data collection method using Jalowiec Coping Scale questionnaire. Results: most respondents used maladaptive coping, which was 37 people (53.6%). Conclusion: still a large percentage of patients in the maladaptive category so that appropriate interventions are needed to improve the coping of individual CRF patients.

Chronic Kidney Disease (CKD) This is a gradual and irreversible kidney disorder that affects the body's capacity to regulate metabolism, fluids, and electrolytes, leading to the development of uremia. Hemodialysis (HD) patients with chronic renal failure are subject to fluid, dietary and pharmaceutical restrictions as well as activity and medication limits. Weight gain, edema, and high blood pressure will occur if fluid balance is not maintained or if there is excess fluid between dialysis sessions. But limiting fluids while receiving hemodialysis can have a number of negative consequences on the body, one of which is thirst and dry mouth (xerostomia), caused by decreased salivary gland production. This scientific study uses a descriptive methodology along with nursing care strategies to apply the "sipping ice cubes therapy" strategy to reduce thirst in CKD patients receiving hemodialysis. Evidence-based practice of nursing This procedure is carried out in the Nursing Room of RSUD Dr. dr. Aloei Saboe Gorontalo City on December 26 2022 and January 26 2023. According to researchers, the administration of the innovative therapy "Sipping Ice Cubes Therapy" can significantly reduce thirst levels in CKD (Chronic Kidney Disease) patients. It can be seen from the 6 respondents who were given the innovative therapy "sipping ice Cubes Therapy" all of which gave a positive response after evaluation, both direct evaluation after giving therapy or evaluation after 3 days of giving the implementation of "sipping ice Cubes Therapy"

Chronic renal failure is a progressive and continuous destruction of kidney structures. Chronic renal failure occurs in susceptible individuals, analgesic nephropathy, destruction of renal papillae associated with daily use of analgesic drugs for years. Whatever the cause, there is a progressive deterioration of kidney function which is characterized by a progressive decrease in the Glomelurus Filter Rate (GFR) (Corwin, 2009). Chronic kidney failure is a failure of kidney function to maintain metabolism and fluid and electrolyte balance due to progressive destruction of kidney structures with manifestations of accumulation of residual metabolites (uremic toxicants) in the blood (Muttaqin & Sari, 2011). as well as electrolytes and acid-base composition of body fluids, removing metabolic wastes that are no longer needed by the body, regulating blood pressure and hormonal function. Chronic Kidney Disease (CKD) is the final stage of chronic kidney failure where GFR <15 ml/min/1.73m2 so that the body fails to maintain metabolism and fluid and electrolyte balance, causing uremia, namely retention of urea and other nitrogenous wastes in the blood (Smeltzer et al. al, 2008; National Kidney Foundation in Kallenbach, et al, 2005). With the increasingly real decline in kidney function or worsening of symptoms of uremia, renal replacement therapy is required for survival, namely dialysis and organ transplantation. There are two methods of dialysis, one of which is Hemodialysis (Potter, 2005; Smelzer, 2008).     

The main function of the kidneys under normal conditions is to regulate fluids and electrolytes and the acid-base composition of body fluids, remove metabolic wastes that are no longer needed by the body, regulate blood pressure and hormonal function. Chronic Kidney Disease (CKD) is the final stage of chronic kidney failure where GFR <15 ml/min/1.73m2 so that the body fails to maintain metabolism and fluid and electrolyte balance, causing uremia, namely retention of urea and other nitrogenous wastes in the blood (Smeltzer et al. al, 2008; National Kidney Foundation in Kallenbach, et al, 2005). With the increasingly real decline in kidney function or worsening of symptoms of uremia, renal replacement therapy is required for survival, namely dialysis and organ transplantation. There are two methods of dialysis, one of which is Hemodialysis (Potter, 2005; Smelzer, 2008). Cases of chronic kidney failure in the world have increased by more than 50%, in the United States which is a very developed country every year there are about 20 million adults suffering from chronic kidney failure and undergoing hemodialysis in more than 100,000 patients, while in Indonesia, according to the Indonesian Kidney Diatrans Foundation, YDGI), in 2007 there were about 100,000 chronic kidney failure patients but only a few patients were able to undergo hemodialysis. Kidney replacement therapy in Indonesia was started in 1972 in Jakarta (Dr. Cipto Mangunkusumo Hospital/FKUI), in Bandung in 1976 (Hasan Sadikin Hospital/FK UNPAD).