• Title/Summary/Keyword: 만성신부전환자

Search Result 134, Processing Time 0.055 seconds

특집 : 올바른 신장합병증 관리를 위해 - 신장은 우리 몸에 어떤 기능을 할까? 노폐물 걸러주고, 하나 떼어내도 생존

  • 사단법인 한국당뇨협회
    • The Monthly Diabetes
    • /
    • s.261
    • /
    • pp.8-9
    • /
    • 2011
  • 건강보험심사평가원(원장 강윤구)에 따르면 최근 5 년간 만성신부전 환자가 37.1%로 증가한 것으로 나타났다. 매년 (5년간 연평균) 약 8.2%씩 증가하고 있으며, 진료비 또한 10.2%씩 늘어난 것으로 나타났다. 해가 갈수록 증가하는 이유는 당뇨병과 고혈압 등 만성질환자가 증가하는 것이 원인으로 추정하고 있다.

  • PDF

Restless Legs Syndrome and Quality of Life in Hemodialysis Patients (혈액투석을 받는 만성신부전 환자에서 하지불안증후군과 삶의 질)

  • Choi, Hyun-Seok;Kang, Seung-Gul;Boo, Chang-Su;Lee, Heon-Jeong;Cho, Won-Yong;Kim, Hyoung-Kyu;Kim, Leen
    • Sleep Medicine and Psychophysiology
    • /
    • v.14 no.2
    • /
    • pp.99-106
    • /
    • 2007
  • Objective: Restless legs syndrome (RLS) is known to be associated with chronic renal failure (CRF) patients on hemodialysis, however the prevalence of RLS in CRF patients on hemodialysis is variable due to different diagnostic criteria or dialysis technique. A few reports have indicated the association between RLS symptom and lower life quality in CRF patients on hemodialysis. This study aims to investigate the prevalence of RLS and its association with the quality of life in CRF patients of a single dialysis unit in Korea. Methods: A total of 83 Korean CRF patients on hemodialysis in the Korea University Hospital were examined. International Restless Legs Syndrome Study Group (IRLSSG) criteria and International Restless Legs Scale (IRLS) were used to determine the diagnosis and severity of RLS. Questionnaires including Athens Insomnia Scale (AIS), Epworth sleepiness scale (ESS), and Medical Outcome Study Form-36 (SF-36) were administered to all the patients for the assessment of sleep and quality of life. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were also measured for depression and status of mental illness by psychiatrist. Results: Of the 83 patients, 31 (37.3%) patients were found to have RLS and 43 (51.8%) patients met at least one of the RLS diagnostic criteria. The AIS (t=2.40, p=0.019), ESS (t=2.41, p=0.018), HDRS (t=3.85, p<0.001) and CGI (t=3.52, p=0.001) were higher in the subjects with RLS compared to other subjects. The SF-36 scores were significantly lower in the patients with RLS except physical functioning and bodily pain. Total (p=0.005), physical component (p=0.019), and mental component scores (p=0.019) of SF-36 were significantly lower in patients with more severe RLS symptoms. Conclusion: There was significant relationship between RLS and poor quality of sleep and life. More severe RLS symptom was proven to be an important factor to make a quality of life worsen.

  • PDF

Juvenile Nephropathy in a Jindo Dog (진도견에서 발생한 소아 신증)

  • Park, Hyung-Jin;Lee, Ji-Yoon;Choi, Ho-Jung;Song, Kun-Ho;Son, Hwa-Young;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
    • /
    • v.30 no.3
    • /
    • pp.201-205
    • /
    • 2013
  • An 1-year-old intact male Jindo dog weighing 20 kg was referred with 7-day history of vomiting, anorexia, and lethargy. The dog was diagnosed with chronic kidney disease (CKD) based on clinical signs, urinalysis, serum biochemistry, radiology and abdominal ultrasonography. Ten days of conservative therapy was given, but there were no signs of improvement. The patient was euthanized and necropsy was conducted. Renal histopathology was consistent with juvenile nephropathy and this is the first report of juvenile nephropathy in a Jindo dog.

지속성 복막 투석 환자의 골밀도와 이와 관련된 영양소 섭취, 식행동, 우울정도에 관한 연구

  • 손숙미;박진경
    • Proceedings of the KSCN Conference
    • /
    • 2004.05a
    • /
    • pp.417-417
    • /
    • 2004
  • 지속성복막투석환자의 경우 투석에 의해 단백질 대사물질의 배설은 효과적으로 이루어지나 오랫동안의 만성신부전으로 인한 인의 배설 저하에 따라 골밀도가 대부분 저하되어 있으며 신성골이영양증을 수반하는 경우가 많다. 본 연구에서는 종합병원 신장내과 클리닉에 정기적 checkup을 받고 있는 지속성복막투석환자를 대상으로 골밀도를 측정하였으며 요추(L2-L4)와 대퇴부(femoral neck, trochanter)의 평균 골밀도의 T값이 모두 -1 미만인 군을 골감소증군으로 하였고(N=86) 1군데라도 T값이 -1 이상인 군은 정상군으로(N=32) 분류하여 영양소섭취량, 식행동, 우울정도에 따른 차이를 보고자 하였다.(중략)

  • PDF

Predicting the Progression of Chronic Renal Failure using Serum Creatinine factored for Height (소아 만성신부전의 진행 예측에 관한 연구)

  • Kim, Kyo-Sun;We, Harmon
    • Childhood Kidney Diseases
    • /
    • v.4 no.2
    • /
    • pp.144-153
    • /
    • 2000
  • Purpose : Effects to predict tile progression of chronic renal failure (CRF) in children, using mathematical models based on transformations of serum creatinine (Scr) concentration, have failed. Error may be introduced by age-related variations in creatinine production rate. Height (Ht) is a reliable reference for creatinine production in children. Thus, Scr, factored for Ht, could provide a more accurate predictive model. We examined this hypothesis. Methods : The progression of of was detected in 63 children who proceeded to end-stage renal disease. Derivatives of Scr, including 1/Scr, log Scr & Ht/Scr, were defined fir the period Scr was between 2 and 5 mg/dl. Regression equation were used to predict the time, in months, to Scr > 10 mg/dl. The prediction error (PE) was defined as the predicted time minus actual time for each Scr transformation. Result : The PE for Ht/Scr was lower than the PE for either 1/Scr or log Scr (median: -0.01, -2.0 & +10.6 mos respectively; P<0.0001). For children with congenital renal diseases, the PE for Ht/Scr was also lower than for the other two transformations (median: -1.2, -3.2 & +8.2 mos respectively; P<0.0001). However, the PEs for children with glomerular diseases was not as clearly different (median: +0.9, +0.5 & +9.9 respectively). In children < 13 yrs, PE for Ht/Scr was tile lowest, while in older children, 1/Scr provided the lowest PE but not significantly different from that for Ht/Scr. The logarithmic transformation tended to predict a slower progression of CRF than actually occurred. Conclusion : Scr, floored for Ht, appears to be a useful model to predict the rate of progression of CRF, particularly in the prepubertal child with congenital renal disease.

  • PDF

Quality of Life in Pre-dialysis patients with Chronic Kidney Disease at Glomerular Filtration Rates (투석 전 만성 신부전 환자의 사구체 여과율에 따른 삶의 질)

  • Kim, Hye Won;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
    • /
    • v.15 no.2
    • /
    • pp.82-89
    • /
    • 2013
  • Purpose: To examine the quality of life in pre-dialysis patients with chronic kidney disease. Methods: The subjects were 91 patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic and clinical characteristics, and quality of life (QOL) were collected between July 19 and 23, 2010. The relationship between QOL and various Stages of dependence on glomerular filtration rates (GFRs) and factors related to QOL were investigated. Collected data was analyzed with the SPSS WIN 12.0 program. Results: There was a significant difference in the quality of life of the subjects in different stages (F=18.12, p<.001). The Scheffe post hoc test confirmed that patients at higher stages had a lower level quality of life. In addition, GFRs, uremic symptoms, gender and age predicted value accounted for 38.5% of the variance on QOL (F=25.09, p<.001). Conclusion: Strategies to develop a systematic management program for improving QOL of pre-dialysis patients are urgently needed.

Angiotensin Converting Enzyme Gene Polymorphism in Alport Syndrome (알포트증후군 환자에서 안지오텐신전환효소 유전자 다형성의 의의)

  • Kim Ji-Hong;Lee Jae-Seung;Kim Pyung-Kil
    • Childhood Kidney Diseases
    • /
    • v.8 no.1
    • /
    • pp.18-25
    • /
    • 2004
  • Purpose : Alport syndrome is clinically characterized by hereditary progressive nephritis causing ESRD with irregular thickening of the GBM and sensory neural hearing loss. The mutations of type IV collagen gene(COL4A5) located on the long arm of X chromosome is considered responsible for most of the structural abnormalities in the GBM of Alport patients. Since no definite clinical prognostic predictor has been reported in the disease yet, we designed this study to evaluate the significance of genetic polymorphism of the angiotensin converting enzyme in children with Alport syndrome as a prognostic factor for disease progression. Methods : ACE I/D genotype were examined by PCR amplification of the genomic DNA in 12 patients with Alport syndrome and 12 of their family members. Alport patients were divided into two groups; the conservative group, those who had preserved renal function for more than 10 years of age, the early CRF group, those who had progressed to CRF within 10 years of age. Results : The mean age of onset was $3.45{\pm}2.4$ years in the conservative group, $4.4{\pm}1.2$ years in the early CRF group. Sex ratios were 5:3 and 2:1 in each group. Among 12 cases of patients, 4 cases were in early CRF group and their mean duration of onset to CRF was 4.5 yews(8.9 years of age). Eight patients(67%) were in the conservative group and they had normal renal function for more than 10 years of age(mean duration of renal preservation was 10.6 years). The incidence of II type ACE gene were in 25.0%(3 cases), ID type in 41.7%(5 cases), DD type in 33.3%(4 cases). There was no significant difference between Alport patient and normal control(II type 44.3%, ID type 40.9%, DD type 14.8%). The incidence of DD type of early CRF group were higher than that of the conservative group(75% vs 12.5%)(p<0.05). There was no difference in ACE gene polymorphism between normal Alport family members and control group. Conclusion : Even though there was no significant difference of ACE polymorphism between Alport patients and the normal control group, the incidence of DD type is significantly increased in early CRF group which means DD type of ACE polymorphism has a possibility of being a predictor for early progression to CRF in Alport patients.

  • PDF

당뇨병환자의 신장이야기-당뇨병환자의 신장합병증 치료

  • Gang, Jong-Myeong
    • The Monthly Diabetes
    • /
    • s.214
    • /
    • pp.15-18
    • /
    • 2007
  • 당뇨병은 혈액 속에 포도당이 높아져 이에 따른 각종 합병증 때문에 심각한 후유증을 초래할 수 있는 질환이다. 이 중에서 신장 합병증은 중요한 당뇨병 합병증 가운데 하나이다. 당뇨병성 신증은 거의 모든 당뇨병환자에게서 나타난다. 당뇨병성 신증의 마지막은 신장 기능이 거의 다 망가져 혈액투석이나 복막투석을 받는 말기신부전 환자의 가장 흔한 원인이 바로 당뇨병이므로 당뇨병의 신장 합병증을 줄이는 것이 환자의 삶의 질과 직결되는 문제라 할 수 있다. 신장합병증은 초기에는 증상이 잘 나타나지 않아 항상 주의가 필요하다. 신장이 손상되기 시작하면 단백뇨가 계속 나오고 혈압이 오르며 빈혈이 발생하고 몸이 붓는다. 이런 현상은 포도당의 대사물질이 사구체에 쌓이기 때문이다. '사구체'란 신장 안에서 오줌을 거르는 일을 하는 모세혈관 조직으로 일단 손상되면 회복되지 않고 진행되며 이 상태를 그대로두면 결국 더 이상 신장에서 혈액의 노폐물을 걸러내지 못하는 만성 신부전증으로 진행하게 되는 것이다.

  • PDF