• Title/Summary/Keyword: 급성 신부전

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$^{99m}Tc$-MDP Bone Scan in the Cases of Muscle Necrosis Associated with Acute Renal Failure (급성(急性) 신부전(腎不全)이 동반(同伴)된 근양사(筋壤死)에 있어서의 $^{99m}Tc$-MDP 골주사(骨走査))

  • Moon, H.B.;Han, J.S.;Kim, S.Y.;Cho, B.Y.;Lee, J.S.;Koh, C.S.;Cho, K.S.
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.61-66
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    • 1980
  • We studied four patients with muscle necrosis associated with acute renal failure to evaluate the diagnostic value of the bone scan in this disease. The illness followed carbon monoxide poisoning in two patients, acute physical exertion in one and contaminated intramuscular injection in the other. Whole-body rectilinear bone scans using technetium 99m-methyldiphosphonate were done. In all patients, increased muscle labelling at the regions of suspected muscle injury was showed, and in one, it was after normalization of serum muscle enzyme levels. In one patient, the bone scan was rechecked 8 months later and showed no residual abnormality. Above all, the site and precise extent of muscle injury could be detected and the degree of muscle labelling seemed to correlate with the severy of muscle injury. These findings suggest that isotope scanning may be useful in the diagnosis of patients with acute muscle necrosis.

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Beneficial Effect of Paljeong-san Pharmacopuncture Treatment Combined with Peritoneal Injection on Glycerol-Induced Acute Renal Failure in Rabbits (팔정산(八正散) 약침(藥鍼) 및 복강(腹腔) 주입 병용 시술이 글리세롤로 유발된 토끼의 급성 신부전에 미치는 영향)

  • Lim, Chi-Yeon;Kim, Min-Ho;Lee, Geum-San;Kim, Hyung-Woo;Kim, Bu-Yeo;Yun, Yeo-Choong;Cho, Su-In
    • Journal of Pharmacopuncture
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    • v.13 no.3
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    • pp.73-80
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    • 2010
  • Purpose: The present study was carried out to determine if Paljeong-san extract (PJS) treatment exerts beneficial effect against the glycerol-induced acute renal failure in rabbits. Material and Method: PJS was selected in the basis of invigorating kidney which can eliminate pathogens. Rabbits were treated with PJS pharmacopuncture on Shin-shu ($BL_{23}$) point for 5 days right after the injection of 50% concentration of glycerol ($5m{\ell}/kg$ body weight). Results and Conclusions: Glycerol injection caused an increase in serum creatinine and BUN level and urine glucose secretion, which were accompanied by a reduction in GFR. PJS Pharmacopuncture treatment combined with peritoneal injection showed beneficial effect on glycerol-induced acute renal failure by inhibition of serum creatinine increase and GFR decrease.

Two Cases of Yersinia Pseudotuberculosis Infection with Acute Renal Failure in Pusan Province (부산지역에서 발생한 Yersinia Pseudotuberculosis 감염에 의한 급성 신부전 2례)

  • Kim, Seong-Hoon;Yu, Whang-Jae;Park, Su-En;Park, Jae-Hong;Kim, Su-Yung
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.187-191
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    • 1998
  • Yersinia pseudotuberculosis, a gram-negative coccobacillus, is a member of the enterobacteriaceae family, and the illness has fever, abdominal pain, diarrhea, mesenteric lymphadenitis, terminal ileitis, arthropathy, erythema nodosum. Specially in children, it is known as an important cause of acute renal failure due to acute tubulointerstitial nephritis. It has been recognized in a worldwide distribution. For the first time, the cases of acute renal failure caused by this organism were reported in Japan in 1980's. In Korea, the first case accompanying with ARF was reported in 1988. Since that, many cases have been reported in Seoul area, but no case in other places. So we report 2 cases of Y.P. infection accompanying with ARF in Pusan area, for the first time in other place than Seoul area.

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The Experiences of Pump-driven Continuous Venovenous Hemofiltration Therapy in Pediatric Patients (소아에서 펌프를 이용한 지속적 정정맥 여과법을 시행한 경험 3례)

  • Lim Yean-Jung;Hahn Hye-Won;Lee Byung-Sun;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.251-258
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    • 2002
  • We report the experiences of pump-driven continuous venovenous hemofiltration therapy in three children with acute renal failure. The all three patients required mechanical ventilation and needed the support of vasopressors. Renal replacement therapy was needed to meet the metabolic and fluid balance, but intermittent hemodialysis and peritoneal dialysis were not feasible because of hemodynamic instability and concurrent infection. We instituted pump-driven continuous venovenous hemofiltratlon (CVVH), and immediate improvement of pulmonary edema and successful removal of retained fluid were observed. Urea clearance also was satisfactory. During the filter running time, significant thromboembolic event or rapid drop of systemic blood pressure were absent. We concluded that the CVVH is an effective and safe method of renal support for critically ill pediatric patient.

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A Case Report of Drug-Induced Acute Renal Failure Treated with Herbal Medicine (약인성 급성 신부전 환자의 한약치료에 대한 증례 보고)

  • Kim, Min-ji;Park, Sung-woon;Seo, Yoon-jeong;Ryu, Jae-hwan
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.755-762
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    • 2016
  • Objective: To report the effects of Siryeng-tang (柴苓湯) and Chijasi-tang (梔子豉湯) on a patient with drug-induced acute renal failure. Methods: A female patient was diagnosed with acute renal failure. The symptoms decreased urine output, tachycardia, dyspnea, and chest discomfort. The patient was treated with Siryeng-tang for one day and Chijasi-tang for about 5 days. Results: After taking Siryeng-tang, urine output increased and the values for blood urea nitrogen and creatinine were decreased to normal. Taking Chijasi-tang improved other related symptoms. Conclusions: Siryeng-tang and Chijasi-tang can improve the symptoms of acute renal failure.

A case of vancomycin-induced drug hypersensitivity syndrome (반코마이신 투여 후 발생한 약물 과민성 증후군 1예)

  • Min, Kyung Sun;Choi, Woo Yeon;Song, Eun Song;Han, Dong Kyun;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1228-1231
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    • 2008
  • Drug hypersensitivity syndrome (DHS) has rarely been reported in association with vancomycin treatment. Here, we describe an 11-year-old girl who developed fever and a maculopapular rash on day 18 of intravenous vancomycin for treatment of infective endocarditis. The patient presented with fever, a maculopapular skin rash, hepatitis, and acute renal failure caused by vancomycin-induced DHS. The symptoms resolved in less than 24 h after withdrawal of vancomycin and treatment with corticosteroids. We present this case of DHS associated with vancomycin.

A Case of Hemolytic Uremic Syndrome in a Child with Ischemic Colitis (허혈성 대장염에 동반된 용혈성 요독 증후군 1례)

  • Kim Yang-Hyun;Ahn Sun-Young;Park Ji-Min;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.86-90
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    • 2004
  • Hemolytic uremic syndrome(HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia and the most common pathogen is Escherichia coli (E. coli) O157 : H7. Ischemic colitis, which rarely occurs in children, is due to the reduced local blood flow to the intestine, tissue necrosis and secondary bacterial infection. We describe a patient who was admitted with abdominal pain, vomiting and hematochezia, and diagnosed as ischemic colitis by barium enema. This patient showed hemolytic anemia, thrombocytopenia and progressive renal failure and was subsequently diagnosed as hemolytic uremic syndrome. After hemodialysis, the patient showed improvement of symptoms and resolution of renal failure and ischemic colitis.

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Two Cases of Acute Renal Failure due to Rhabdomyolysis Complicating Doxylamine Succinate Intoxication (독시라민 과다복용에 의한 횡문근 용해 및 급성 신부전 2례)

  • Jung Jae Kwon;Kim Sung Ho;Kim In Seek;Kim Seon Woong;Ju Dong Wook;Lee Duk Hyun;Kim Jong Kun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.15-19
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    • 2004
  • Doxylamine succinate is an antihistamine used primarily as a sleep-induction. It can be gotten without a doctor's prescription in Korea, so it' s overdoses were frequently encountered. There were several reports that the overdoses of doxylamine might cause rhabdomyolysis, but few cases have been reported that it is related to acute renal failure (ARF). In cases that ARF occur, most of them are not severe enough to require hemodialysis. We experienced two cases of severe rhabdomyolysis complicating ARF after doxylamine overdose and treated with hemodialysis. Clinicians should be aware of the potentially lethal complications of rhabdomyolysis in patients who ingest doxylamine succinate and the needs for prompt intervention and careful assessment of renal function.

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A Clinical Study of Acute Poststreptococcal Glomerulonephritis with Nephrotic Syndrome (신증후군을 동반한 연쇄상구균 감염후 급성사구체신염의 임상적 고찰)

  • Moon Sang-Ae;Yook Jin-Won;Kim Ji-Hong;Lee Jae-Seung;Jeong Hyun-Joo;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.123-129
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    • 1999
  • Purpose: Acute poststreptococcal glomerulonephritis(APSGN) is a renal disease which is characterized by glomerular proliferation and inflammatory changes due to immune reaction. Although the 95% of patients with APSGN seems to recover fully and present as benign course, the remaining patients show poor prognosis. Therefore comparative retrograde study between APSGN with and without nephrotic syndrome was done to find out the any prognostic indicator to predict the outcome in patients with APSGN. Methods: We had retrospectively analyzed seventy-one patients who were diagnosed as APSGN clinically from Mar.1989 to Feb.1999 in Yonsei university medical center. Sixty-four of the patients was APSGN without nephrotic syndrome(Group A) and seven patients were in APSGN with nephrotic syndrome(Group B). Results: Patients who were diagnosed as APSGN with nephrotic syndrome were seven(9.9%) out of seventy-one. In the comparative study, sex ratio was 1:1 in group A and 1.9: 1 in group B, onset mean age was $8.9{\pm}2.6$ in group A and $8.8{\pm}2.6$ in group B. Following clinical profiles were compared but there were no significant difference between these two groups: WBC count($9413{\pm}2964\;vs\;9368{\pm}2650(/mm^3)$), hemoglobin($10.6{\pm}1.2\;vs\;10.0{\pm}0.9(gm/dL)$), ASO($746.1{\pm}640.7\;vs\;614.9{\pm}475.9(IU/ml)$), $C_3(20.1{\pm}17.0\;vs\;16.9{\pm}13.1(mg/dL)$), $C_4(22.8{\pm}9.5\;vs\;22.6{\pm}6.9(mg/dL)$), BUN($25.8{\pm}26.1\;vs\;28.1{\pm}14.5(mg/dL)$), creatinin($0.8{\pm}0.3\;vs\;0.8{\pm}0.3(mg/dL)$), $C_{cr}(80.6{\pm}28.8{\pm}62.4{\pm}31.4(ml/min/1.73\;m^2$)), the duration of edma, gross hematuria, and hypertension. However, we found that there were a significant difference in the duration of proteinuria($1.95{\pm}2.27\;vs\;13.3{\pm}21.1(months)$)(P<0.05), decreased $C_3$ duration($1.9{\pm}2.9\;vs\;7.3{\pm}5.0(weeks)$)(P<0.05) and especially it was proloned according to the amount of early urine protein excretion. Conclusion: Our study showed markedly prolonged duration of proteinuria and decreased $C_3$ duration in patients with APSGN with nephrotic syndrome. We were not able to find the definite prognostic factor that will guide the outcome of patients with APSGN accompaning nephrotic syndrome, but above findings seemed to represent as a relative indication of the outcome of the disease. All patients recovered completely and we did not experience any cases that progressed into the renal failure.

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The Role of Plasma B-type Natriuretic Peptide Measurements in the Differential Diagnosis of Acute Dyspnea (급성호흡곤란의 감별진단에서 혈장 B-type Natriuretic Peptide의 역할)

  • Moon, Ji Yong;Bae, Joong Ho;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.6
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    • pp.656-663
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    • 2005
  • Background : The B-type natriuretic peptide (BNP) is a cardiac neurohormone that is specifically secreted from the ventricles in response to volume expansion and a pressure overload. Differentiating congestive heart failure from the pulmonary causes of dyspnea is very important for patients presenting with acute dyspnea. Methods : A retrospective study was carried out on 261 patients who were admitted to the emergency department of Hanyang University Hospital due to acute dyspnea from March to July 2004. The serum BNP levels of the patients were measured using the ELISA method. Results : The BNP levels were 382, 111-1140 pg/ml (median, interquartile range) in the heart failure group (n=119) and 29, 7-81 pg/ml in the non-heart failure group (n=142). The BNP levels according to the subgroups of heart failure were 820, 354-1620 pg/ml, 1650, 239-1990 pg/ml, and 378, 106-1120 pg/ml for the chronic obstructive pulmonary disease (COPD) with combined left heart failure (n=5), cor pulmonale (n=3), and left heart failure groups (n=111), respectively. The BNP levels according to the subgroups of non-heart failure were 39, 21-101 pg/ml, 59, 10-129 pg/ml, and 15, 6-47 pg/ml for the COPD (n=20), other pulmonary diseases (n=56), and other causes groups (n=66), respectively. The BNP levels were significantly different according to the underlying etiology (p<0.001), and were significantly higher in the COPD patients with left heart failure than in those without (p=0.002). When the patients with no cardiovascular risk factor such as diabetes mellitus, hypertension, smoking or renal failure were analyzed, the BNP levels were also significantly higher in the patients with heart failure than in those without(p<0.001). When 133 pg/ml was designated as the BNP cut-off level the sensitivity for predicting heart failure was 73 percent and the specificity was 87 percent. Conclusion : BNP measurements are useful for determining the presence of heart failure in the patients presenting with acute dyspnea. The possibility of heart failure must be seriously considered in patients with high BNP levels even when they have a pre-existing pulmonary disease such as COPD or no risk factors for heart failure.