• Childhood Kidney Diseases
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• v.18 no.2
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• pp.64-70
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• 2014

Purpose: The aims of this study were to assess the clinical and laboratory profiles of chronic kidney disease-mineral bone disorder (CKD-MBD) and to assess the effects of treatment of active vitamin D analogs on severe hyperparathyroidism (SHPT) in pediatric patients on chronic peritoneal dialysis. Methods: This is a retrospective study included 53 patients who had been undergoing dialysis for more than 1 year, between January 2003 and December 2012. Results: Even after treatment with phosphate binders and active vitamin D analogs, the $mean{\pm}standard$ deviation of the percentage of time during peritoneal dialysis that the patients' serum concentrations of phosphorus, corrected total calcium, and parathyroid hormone (PTH) fell within the Kidney Disease Outcomes Quality Initiative recommended ranges was $25.06{\pm}17.47%$, $53.30{\pm}23.03%$, and $11.52{\pm}9.51%$, respectively. Clinical symptoms or radiological signs of CKD-MBD were observed in 10 patients (18.9%). There were significant differences in percentage of time that the serum intact PTH concentration was outside of the recommended range between patients with and without symptoms or signs of CKD-MBD (below recommended range, $11.74{\pm}7.37%$ vs. $40.77{\pm}25.39%$, P <0.001; above the recommended range, $63.79{\pm}27.86%$ vs. $37.09{\pm}27.76%$, P =0.022). Of the 25 patients with SHPT, high-dose alfacalcidol treatment was required in 13 patients that controlled SHPT in 7 of these patients, without marked complications. Conclusion: Despite our efforts to manage CKD-MBD, patients' met the recommended ranges from relevant guidelines at a low frequency. The treatment of high-dose active vitamin D analogs was required in about half of the patients with SHPT and effective in about half of them.

• Journal of Chest Surgery
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• v.42 no.1
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• pp.41-45
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• 2009

Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.

• Journal of Physiology & Pathology in Korean Medicine
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• v.18 no.4
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• pp.1207-1212
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• 2004

Twenty-one diabetic nephropathy patients with normal serum BUN(Blood Urea Nitrogen), creatinine levels and ten chronic renal failure patients with abnormal high BUN, creatinine levels were investigated to evaluate the renal function change after long term herb medicine administration. The hospitalized patients were administrated three times a day with herb medicine, which were prescribe frequently in practical oriental medicine such as many hospital and local clinics. Blood Urea Nitrogen, creatinine and glomerular filtration rate (GFR) were measured immediately after 7days medication. Serum BUN, creatinine levels in diabetic nephropathy patients changed from 17.63±4.38㎎/㎗, 1.09±0.26㎎/㎗(mean±SD) of pre-medication levels to 14.13±3.24 1,20±0.37, 14.75±2.21 1.23±0.55, 12.34±2.89 1.18±0.42 at 7th, 14th, 21th days after herb medicine administration respectively. Also 24hr urine total protein changed from 632.25±254.43㎎/㎗ of pre-medication levels to 623.18±231.56㎎/㎗ after herb medicine administration(P>0.05). Serum BUN, creatinine levels and GFR in chronic renal failure patients changed from 67.45±13.86㎎/㎗, 6.74±2.91㎎/㎗, 13.73±4.21㎖/min pre-medication levels to 61.23±17.75 6.43±2.29 15.49±3.56, 58.84±19.36 5.83±2.51 16.38±2.85, 56.39±20.33 5.64±2.52 16.73±3.40 at 7th, 14th, 21th days after herb medicine administration respectively. Therefore, there was not clinically remarkable difference in the serum BUN, creatinine, GFR levels between pre-medication and post-medication in both Group.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.6
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• pp.652-657
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• 2000

The kidneys play a vital role in the maintenance of normal body fluid volumes and in the composition of the extracellular fluid compartments. There are normally more than 2 million functioning glomeruli that regulate total body water and solute concentrations. As renal failure progresses, there is a decrease in the number of functioning nephrons. Chronic renal failure(CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Azotemia is an elevation in blood urea nitrogen(BUN) and serum creatinine levels subsequent to a decreased glomerular filtration rate(GFR), which results in uremia. This loss of renal function can cause functional and metabolic abnomalities of body. For this problem, oral & maxillofacial surgeons have demanded to routinely treat patients with CRF. However, there has not been a reported case of orthognathic surgery by bilateral sagittal split ramus osteotomy(BSSRO) in patients with CRF, which can cause multiple complications in healthy patients. We report developmental mechanism of complication associated with CRF and preop. and postop. care of orthognathic surgery by BSSRO in Cl III patient with severe chronic renal failure.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.442-449
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• 2004

This study was designed to evaluate the effects of oriental medicine and acupuncture therapy on a chronic renal failure patient suffering complications from diabetes mellitus. Methods: The clinical data was analyzed on a patient with chronic renal failure complicated by diabetes mellitus whose main symptoms were edema and numbness of lower limbs, anorexia, indigestion, nausea, vomiting, and general weakness. The patient was admitted to the internal medicine department of Wonkwang University Oriental Jeonju Medicine Hospital on July 31, 2004, and remained until August 17, 2004. He was treated with herbal medicine(Palmijiwhangtanggamibang) and acupuncture therapy. Results: After treatment, improvement was seen in symptoms and laboratory examinations(creatinine clearance). Conclusions: This study suggests that oriental medicine therapy is significantly effective in the treatment of a chronic renal failure complicated by diabetes mellitus.

• Journal of the Korean Dietetic Association
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• v.24 no.2
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• pp.117-140
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• 2018

The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.549-561
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• 1995

This study was designed to identify the relation-ship of perceived social support on self-esteem and hopelessness in patients with chronic renal failure who are hemodialysis. The subjects of this study were the 50 patients who were registered in the hemodialysis department of the two hospitals. The data were collected using a questionnaire and The period of the data collection was from August 9 to 16, 1993. The instruments for this study were the perceived social support scale designed by Park Ji-Won, the self -esteem scale designed by Rosenberg and the hopelessness scale designed by Beck et al. The data were analyzed using frequencies, percentages, t-test, ANOVA, and .Pearson correlation coefficient. The results are summarized as follows ; 1. The degree of support according to the type of perceived social support ranged down in the fol-lowing order from high to low the mean emotion-al support 21.12, the mean informational support 19.58, the mean appraisal support 17.00, the mean material support 15.22, the man self-esteem was 32.00 and the mean hopelessness was 60.48. 2. Test for hypothesis ; Hypothesis 1, "The higher the level of perceived social support in patients on hemodialysis, the higher their level of self-esteem will be. " was not supported(r=.05, p=0.74). Hypothesis 2, "The higher the level of perceived social support in patients on hemodialysis, the lower their level of hopelessness will be. " was supported(r=-0.53, p=0.00). 3. The relations between general characteristics and the level of perceived social support, self-esteem, and hopelessness ; (1) The 'Gender'(P=0.04), 'Occupation'(P=0.04), 'Education'(P=0.00), 'Married state'(P=0.00) 'Duration of Hemodialysis'(P=0.00) and 'In-come'(P=0.00) of the subjects were related to perceived social support and showed a statistically significant difference. (2) No general characteristics of the subjects were related self-esteem in a statistically significant way. (3) The 'Education'(P=0.00) , 'Income'(P=0.00) of the subjects were related to hopelessness and showed a statistically significant difference. Thus, it is concluded that social support must be included in nursing interventions for patients with chronic renal failure on hemodialysis.

• Journal of Yeungnam Medical Science
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• v.18 no.2
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• pp.226-238
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• 2001

Background: Anemia in chronic renal failure plays an important role in increasing morbidity of dialysis patients. The causes of the anemia are multifactorial. With using of erythropoietin(EPO) most of uremia-induced anemia can be overcome. However, about 10% of renal failure patients shows EPO-resistant anemia. Hyporesponsiveness to EPO has been related to many factors: iron deficiency, aluminum intoxication, inflammations, malignancies and secondary hyperparathyroidism. So I evaluated the improvement of EPO responsiveness after correction of above several factors. Materials and Methods: Seventy-two patients on hemodialysis over 6 months were treated with intravenous ascorbic acid(IVAA, 300 mg t.i.w. for 12 weeks), After administration of IVAA for 12 weeks, patients were classified into several groups according to iron status, serum aluminum levels and i-PTH levels. Indivisualized treatments were performed: increased iron supplement for absolute iron deficiency, active vitamin D3 for secondary hyperparathyroidism and desferrioxamine(DFO, 5 mg/kg t.i.w.) for aluminum intoxication or hyperferritinemia. Results: 1) Result of IVAA therapy for 12 weeks on all patients(n=72). Hemoglobin levels at 2, 4, 6 week were significantly elevated compared to baseline, but those of hemoglobin at 8, 10, 12 week were not significantly different. 2) Result of IVAA therapy for 20 weeks on patients with 100 ${\mu}g/l$ ${\leq}$ ferritin < 500 ${\mu}g/l$ and transferrin saturation(Tsat) below 30%(n=30). After treatment of IV AA for 12 weeks, patients were evaluated the response of therapy according to iron status. Patients with 100 ${\mu}g/l$ ${\leq}$ ferritin < 500 ${\mu}g/l$ and Tsat below 30% showed the most effective response. These patients were treated further for 8 weeks. Hemoglobin levels at 2, 4 week were significantly increased compared to baseline with significantly reduced doses of EPO at 2, 4, 6, 10, 12, 16, 20 week. Concomitantly significantly improvement of Tsat at 2, 6, 16, 20 week compared to baseline were identified. 3) Result of IVAA therapy for 12 weeks followed by DFO therapy for 8 weeks on patients with serum aluminum above 4 ${\mu}g/l$(n=12) Hemoglobin levels were not significantly increased during IVAA therapy for 12 weeks but dosages of EPO were significantly decreased at 2, 4, 6, 8 week during DFO therapy compared to pre-treatment status. Conclusion: IVAA can be helpful for the treatment of the anemia caused by functional iron deficiency and can reduce the dosage of EPO for anemia correction. And administration of low dose DFO, in cases of increased serum aluminum level, can reduce the requirement of EPO.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.95-103
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• 1998

Purpose : To find and solve the common problems of peritoneal dialysis(PD) by analysing the clinical data of pediatric PD performed in Korea. Methods : 264 cases of CAPD and acute PD had been performed from Nov.1987 to Oct. 1997 in 17 institutions of pediatric nephrology in Korea. Results : CAPD was performed in 114 cases. The mean age of the patients was $10.5{\pm}6.6$ years and male to female ratio was 1.4:1. The original renal diseases of ESRD were proven in 92 cases($80\%$). The common renal disease of ESRD were FSGS($17\%$), reflux nephropathy ($11\%$), chronic glomerulonephritis($9.6\%$). Mean duration of CAPD was $20{\pm}16.9$ months. Peritonitis was the most common complication and incidence was one episode/18.2 patient-months. Other complications were exit site infection in 10 cases, obstruction in 7 cases, leakage of dialysate in 6 cases. The most common etiologic organism of peritonitis was staphylococcus aureus and the next was staphylococcus coagulase(-). Acute PD was performed in 150 cases. Most common underlying causes were congenital heart disease, hemolytic uremic syndrome, sepsis and dehydration. The mean duration was $10.3{\pm}11.3$ days. The most common complication was peritonitis($20.6\%$). The most common etiologic organism was staphylococcus aureus and coagulase(-), acinetobactor and pseudomonas. Conclusion : Reflux nephropathy should be emphasized in early diagnosis and treatment to prevent ESRD. Incidence of congenital anomaly($7\%$) as a original disease of ESRD was relatively low in Korea. Growth status was not significantly improved after CAPD. In acute PD, the incidence of peritonitis was rapidly increased at 2weeks after beginning of dialysis.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.645-655
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• 2020

This is a descriptive study investigating the relationships between sexual function, depression, and sleep quality in male hemodialysis patients. The participants of this study consisted of 134 outpatients who were diagnosed with end stage chronic kidney disease and who had undergone hemodialysis. The data were collected from June 10, 2019, to October 30, 2019. The collected data were then analyzed using descriptive statistics, the mean from independent sample t-tests, one-way analysis of variance (ANOVA), the Scheffe test, and Pearson's correlation coefficient using SPSS version 21.0. The lower the overall satisfaction, the lower the sexual function and the higher the degree of depression (r=.-19, p=.028). The greater the depression, the lower the quality of sleep (r=.60, p<.001). This study shows it is necessary to develop a program including symptom management to reduce depression in male hemodialysis patients. When developing nursing interventions to improve sexual function and quality of sleep, it will be necessary to develop a program that includes people who help the subjects.