• Title/Summary/Keyword: 만성신부전

Search Result 202, Processing Time 0.025 seconds

특집 : 올바른 신장합병증 관리를 위해 - 전문의 인터뷰 "신장 나쁘면 미리 준비해야 합니다" - 중앙대학교병원 신장내과 유석희 교수

  • Kim, Min-Gyeong
    • The Monthly Diabetes
    • /
    • s.261
    • /
    • pp.18-21
    • /
    • 2011
  • 만성신부전증 환자 절반가량에서 당뇨병이 원인인 것으로 드러나면서 당뇨병성 신증에 대한 심각성이 제기되고 있다. 당뇨병에 의한 말기신부전은 생명을 이어가려면 투석과 신장이식이 불가피한 질병으로 일상에 불편을 가져오는 것은 물론 결국 사망에 이르게 하는 치명적인 질환이다. 중앙대학교 병원 신장내과 유석희 교수는 "당뇨로 인한 반성신부전은 다른 원인으로 인해 발생하는 신부전보다 생존율이 낮다"며 "당뇨병이 오래된 환자일수록 신장합병증이 발병률이 높아지는데, 당뇨병환자가 늘 혈당관리에만 매달리다보면 신장기능이 나빠지는 신호를 놓칠 수 있다"고 전했다.

  • PDF

Effects of Antihypertensive Drugs on Renal Function and Glomerular Morphology in Chronic Renal Failure Rats (만성신부전 백서에서 항고혈압제의 종류에 따른 신부전의 진행과 사구체의 형태학적 변화)

  • Hong Sung-Jin;Kim Kyo-Sun;Kim Pyung-Kil;Park Kyung-Hwa;Kim Kee-Hyuck
    • Childhood Kidney Diseases
    • /
    • v.6 no.2
    • /
    • pp.169-177
    • /
    • 2002
  • Purpose: Hypertension accelerates the progression of chronic renal disease, whether it results from, or causes, the renal disease. Therefore, the control of hypertension is one of the important factors that retard the rate of renal deterioration. We compared the effects of different antihypertensive agents on renal function and glomerular morphology In subtotal nephrectomized rats. Materials and methods: After induction of chronic renal failure with 5/6 nephrectomy, the rats were divided into three groups; control group (Group C), enalapril group (Group E), and nicardipine group (Group N). Systolic blood pressure was measured by tail cuff method every 4 weeks until 12 weeks after nephrectomy. At 12 weeks after nephrectomy, all rats were placed in metabolic cages for 24 hour urine collections to measure urinary protein and creatinine excretion. After urine collection and blood sampling for serum creatinine, all rats were sacrificed. The renal tissue was processed for morphometric study with light microscope and electron microscope. Results: 1. The blood pressure of Group C increased progressively, but both enalapril and nicardipine prevented the development of hypertension, and the two drugs were equally effective in maintaining normal blood pressure throughout the study. 2. Twenty-four hour urinary protein excretion was lower in Group E compared to Group C and Group N 3. Mesangial expansion score in both treated groups were significantly lower than the control group. Mean glomerular volume in Group E was significantly reduced compared to Group C and Group N. There was no significant difference in mean glomerular volume between Group C and Group N. 4. There was no significant difference in podocyte structural changes, estimated by filtration slit length density, among control, enalapril and nicardipine treated groups. Conclusion: Control of hypertension with enalapril or nicardipine afforded considerable protection from mesangial expansion in the rat remnant kidney model. But protein excretion and glomerular growth were significantly reduced in Group E compared to Group N. There was no significant difference in podocyte structural changes among the 3 groups.

  • PDF

The Experience of Life Reconstruction in Hemodialysis Patients with Chronic Renal Failure (만성신부전 혈액투석 환자의 삶의 재구성 경험에 관한 현상학적 연구)

  • Kim, Yun-Jeong;Kwon, Su-hye
    • Journal of Digital Convergence
    • /
    • v.15 no.9
    • /
    • pp.321-333
    • /
    • 2017
  • This study was a qualitative study using Colaizzi's phenomenological study method to understand the experience of reconstructing life through hemodialysis in chronic renal failure patients and to clarify the meaning of their vivid experience. The participants were eight chronic renal failure patients receiving hemodialysis. Data were collected through individual in - depth interviews with participants. The five categories that were found in the study were 'The beginning of unexpected difficulties', 'Burden of survival brought on by hemodialysis', 'The driving force of recovery', 'Choices and concentration of today in order', ' Every day life which must be woven sincerely'. The results of this study will help clinicians better understand the physical and mental suffering experienced by patients with chronic renal failure receiving hemodialysis and how they are constantly trying to adapt to a changed lifestyle. Also it might provide basic data for the development of efficient nursing intervention for the health management of hemodialysis patients.

Evaluation of Therapeutic Effect of the Extract from Rhubarb (Rheum officinalis) in Dogs with Chronic Renal Failure (개의 만성 신부전에서 대황 추출물의 치료학적 효과의 평가)

  • Kim, Ye-Won;Hyun, Changbaig
    • Journal of Veterinary Clinics
    • /
    • v.29 no.6
    • /
    • pp.435-440
    • /
    • 2012
  • This study was designed to evaluate the clinical efficacy and safety of Rhubarb extracts ($Rubenal^{(R)}$) in dogs with chronic renal failure (CRF). Client-owned 40 dogs with CRF graded International renal interest Society (IRIS) II-III were enrolled in this study. The dogs were equally allocated and blindly administered with $Rubenal^{(R)}$ or placebo. The following items were evaluated at day 0, 30, 90 and 180: body condition score (BCS), clinical score (appetite, polydipsia/polyuria, quality of life score), hemogram (WBC, RBC, PCV), serum biochemistry (ALT/AST, ALP, Creatinine/BUN, total protein, albumin), serum electrolyte (Na, K, Cl, Ca, P), systolic blood pressure, urinalysis (UPC, USG) and IRIS stage. In this study, we found that the $Rubenal^{(R)}$ preparation was well tolerated by dogs and induced no adverse effects. Statistically significant improvements were observed in clinical score (quality of life score by vet and clients), serum BUN and creatinine levels, serum phosphorus concentration, level of proteinuria, and the IRIS score of CRF in dogs after 6 month of treatment of $Rubenal^{(R)}$. Those findings suggested that the Rhubarb extracts can improve the clinical signs of CRF (i.e. azotemia, hypertension, proteinuria, hyperphosphoremia) and the quality of life (i.e. BCS, clinical score) and can retard the progression of CRF in dogs. Therefore the Rhubarb extracts can be a good supplementary drug for treating dogs with subclinical and clinical renal diseases. However, care should be taken for interpreting our result, because this study is not double-blinded controlled study but pilot study.

Continuous Renal Replacement Therapy of Chronic Kidney Disease with Uncontrolled Azotemia in Six Dogs (개선되지 않는 질소혈증 동반한 만성신부전 환자에서 지속적 신대체 요법의 적용)

  • Han, Sei-Myoung;Kim, Jong-Taek;Lee, Jong-Bok;Seo, Kyoung-Won;Song, Woo-Jin;Ryu, Min-Ok;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
    • /
    • v.32 no.5
    • /
    • pp.440-444
    • /
    • 2015
  • The purpose of this case report was to present the treatment of continuous renal replacement therapy (CRRT) in dogs with end-stage CKD with uncontrolled uremia. Hemodialysis were carried out 6 patients who failed to improve clinical status with conventional management for CKD. Four dogs with urea reduction ratio (URR) range of 57-72% and 1 dog with URR of 37.3% showed good outcome with decreasing tendency of pre-dialysis Therefore, we suggest that CRRT could be recommended for use in CKD dogs with uncontrolled azotemia or uremia and should be monitor carefully throughout the CRRT.

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

Diagnosis and Management of Feline Hyperthyroidism Complicated with Chronic Kidney Disease (고양이에서 만성 신부전에 병발한 갑상선 기능 항진증의 진단과 치료)

  • Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
    • /
    • v.27 no.6
    • /
    • pp.723-725
    • /
    • 2010
  • A 14-year-old spayed, mixed breed, female cat was admitted for evaluation of a polyphagia, hyperactivity and chronic weight loss. Physical examination revealed a tachycardia and mild elevated systemic blood pressure. This cat had azotemia and mild increased total thyroxin (TT4) and free thyroxin concentration. However triiodothyronine (T3) level was normal, the T3 suppression test for definite diagnosis were made. No changes of TT4 serum concentration before and after the exogenous T3 administration in this cat showed hyperthyroidism. This cat was diagnosed as mild hyperthyroidism concurrent with chronic kidney disease (CKD) and antithyroid drug, methimazole, was used for medical management. This is first case report describing clinical and laboratory characteristic features of feline hyperthyroidism complicated with CKD and its clinical outcome using medical management in our country.