• Title/Summary/Keyword: 말기 신부전

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Kidney Transplantation in End-Stage of Renal Failure with Secondary Hyperparathyroidism (속발성 부갑상선 기능항진증을 동반한 말기 신부전의 치료를 위한 신장이식)

  • Kwak, Ho-Hyun;Nam, Hyun-Suk;Kim, Yun-Tai;Park, In-Chul;Han, Jeong-Hee;Woo, Heung-Myong
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.522-528
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    • 2007
  • A 3-year-old male Maltese dog(weighing 2.5 kg) was referred with an excessive movement of mandible and depression. Comprehensive diagnostic investigation revealed an end-stage of renal disease with secondary hyperparathyroidism. The renal allograft was performed after the condition of dog was stabilized by hemodialysis and medical treatment. After transplantation, the renal function of this dog was returned to normal. thereafter, the dog died suddenly without apparent clinical signs. The subsequent pathological studies revealed the actual etiology of death was not clearly identified However acute pancreatitis caused by abrupt introduction of food after prolonged luting might be involved in the etiology. This case study showed the necessity of pancreatic function test in postoperative management after renal transplantation.

Prevalence of Musculoskeletal Pain in Patients With End-Stage Renal Failure Receiving Hemodialysis (말기 신부전 환자의 근골격계 통증 발생 실태 -혈액투석 환자를 대상으로-)

  • Park, Hee-Jung;Kim, Suhn-Yeop
    • Journal of Korean Physical Therapy Science
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    • v.17 no.3_4
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    • pp.1-9
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    • 2010
  • Purpose: The objectives of this study were to investigate the current status of the pain in and the dysfunction related to the musculoskeletal system experienced by patients with end-stage renal failure receiving hemodialysis. Methods: A questionnaire survey was given to 107 patients undergoing hemodialysis in M Hospital. The survey was conducted by using a brief pain inventory(BPI) to investigate the body parts in pain, degree of pain, difficulty in daily life, correlation with hemodialysis and the degree of satisfaction with their own health. Results: The investigation of the patients undergoing hemodialysis showed that 89(83.2%) of the 107 patients experienced pain in their musculoskeletal system. Their pain's incidence was highest in the knees(46.1%) and 68.5% of the patients reported that the most severe pain they had experienced within the past 24 hours was at a level between "moderate" and "severe." The limitation of daily life by pain is high most as 47.7% in the accomplishment of works. Conclusion: Most hemodialysis patients experience musculoskeletal related pain that affects their daily life. Hemodialysis patient management programs should include an assessment and management of such pain.

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The Influence of Hemosialysis to the Face Color of Patients in End Stage Renal Disease (말기신부전 환자의 혈액투석 치료가 안면 색에 미치는 영향)

  • Lee, Se-Hwan;Cho, Dong-Uk
    • The KIPS Transactions:PartB
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    • v.17B no.6
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    • pp.437-444
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    • 2010
  • In this paper, we propose a method of analysing the relation between the patient's face color and his(her) kidney disease using image processing technology. This method is based on the ocular inspection which is one of the most famous diagnosis methods used in the oriental medical system. The way of processing and analysing the face image, which is for visualization and objectification of the color difference, is included. The objects are selected from the patients who suffer the kidney disease and use the hemodialyzer. Their facial images and clinical data are collected. From these data, we propose a hypothesis that the color of the patient's face is changed according to the patient's kidney state. At the same time, we present two algorithms of extracting the specific part of face which can identify the state of the patient's kidney and tracing the history of the color's change. This proposed method is evaluated through the practical experiments and their analysis.

The Comparison Study of Quality of Life between Hemodialysis Patients and Depressive or Anxious Psychiatric Patients (혈액투석 환자와 우울 또는 불안장애 환자의 삶의 질 비교연구)

  • Kim, Ji-Woong;Shin, Sang-Eun;Kim, Hyung-Ki;Jang, Eun-Young;Jung, Gun;Lee, Kye-Seong
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.170-181
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    • 2003
  • Objectives: The purpose of this study was to evaluate the quality of life in hemodialysis patients and compare it with those of depression or anxiety patients. Methods: Quality of life in hemodialysis patients(n=33) and depression or anxiety patients(n=34) was evaluated. we performed Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF), Beck Depression Inventory(BDI), State-Trait Anxiety inventory(STAI) to both hemodialysis patients and depression or anxiety patients. Results: The WHOQOL mean scores showed no differences between hemodialysis patients and depression or anxiety patients. Among WHOQOL domains, psychological domain score of WHOQOL was significantly higher in hemodialysis patients than in depression or anxiety patients. Anxiety score of hemodialysis patients was significantly lower than that of depression or anxiety patients, while depression score showed no difference. Conclusion: These results show that psychological domain score of WHOQOL was higher and anxiety score was lower in hemodialysis patients than in depression or anxiety patients. However, there were no significant differences in total QOL and depression between hemodialysis patients and depression or anxiety patients, and the prevalences of depression and anxiety were higher in hemodialysis patients than those of general population. This suggest that hemodialysis patients need more specialized help for psychiatric problems.

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Pediatric Peritoneal Dialysis in Korea : Practical Solution to the Problems of Peritoneal Dialysis for Children (한국 소아복막투석의 현황 - 다기관 공동연구 결과보고 -)

  • Kim Pyung-Kil
    • 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.

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A Case of Hemolysis after Minor ABO Mismatched Kidney Transplantation (ABO 부적합 신이식 후 발생한 용혈 1례)

  • Hahn HyeWon;Ha Il Soo;Cheong Hae Il;Choi Yong
    • Childhood Kidney Diseases
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    • v.6 no.1
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    • pp.120-122
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    • 2002
  • A 9-year-old boy of B blood group with end-stage renal disease due to IgA nephropathy received group O kidney transplantation from his father On day 9, he developed intravascular hemolysis, and anti-B autoantibody formation was confirmed. We diagnosed as immune hemolytic anemia due to passenger lymphocyte from donor, and cyclosporine withdrawl was done. Anemia resolved spontaneously, but on day 18, graft dysfunction developed, and graft biopsy revealed acute allograft rejection. Although hemolysis due to autoantibody is very rare and often mild, and the role of hemoglobinuria on acute rejection in this case is not certain, we recommend consideration of aggressive management on severe hemolysis after minor mismatched kidney transplantation. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 120-2)

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A Case of Phlegmasia Cerulea Dolens as a Complication Caused by Placement of Inferior Vena Cava Filter (하대정맥 필터 삽입 후 합병증으로 발생한 Phlegmasia Cerulea Dolens 1예)

  • Cho, Young Sin;Kim, Jong Hwa;Lee, Ho Sung;Choi, Jae Sung;Na, Ju Ock;Seo, Ki Hyun;Kim, Yong Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.225-229
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    • 2008
  • Inferior vena cava filters are increasingly being used as an alternative to anticoagulation therapy for the prevention of pulmonary embolism. However, using an Inferior vena cava filter may result in clinically significant complications. Phlegmasia cerulea dolens is a rare disease that presents with acute complete venous occlusion due to extensive thrombosis in the lower extremity. It is characterized by intense pain, edema, decreased pulses and a cyanotic extremity. We report here on a case of phlegmasia cerulea dolens that was accompanied with disseminated intravascular coagulation (DIC) as a complication of the placement of an inferior vena cava filter in a patient who had been previously diagnosed with pulmonary embolism, and the patient had recently developed a cerebral hemorrhage due to a traffic accident.

Exenatide: a New Agent for the Treatment of type 2 Diabetes Mellitus as Adjunctive Therapy

  • Yoo, Ju-No;Yoo, Dong-Joo;Yoo, Bong-Kyu
    • Korean Journal of Clinical Pharmacy
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    • v.15 no.2
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    • pp.165-172
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    • 2005
  • 엑세나타이드는 2005년 4월에 미국 FDA로부터 허가된 새로운 계열의 당뇨병치료제로서 적응증은 멧포르민이나 설포닐유레아계열의 당뇨병치료제로서 치료를 받고 있음에도 불구하고 혈당이 목표치로 저하되지 않는 제2형 당뇨병환자에게 기존의 치료법에 부가적으로 사용하는 것으로 제한되어 있다. 엑세나타이드는 39개의 아미노산으로 구성되어 있으며 미국 캘리포니아주에 자생하는 도마뱀의 타액에서 유래된 물질과 조성과 기능이 유사하도록 합성된 펩타이드 약물이다. 이 약물은 혈중포도당의 농도에 의존적으로 인슐린분비를 촉진하며, 비정상적으로 높은 혈중 글루카곤농도를 저하시키며, 음식물의 위통과시간을 연장하며, 식욕을 저하시키는 등의 여러 가지 기전을 통하여 혈당을 조절하는 것으로 알려져 있다. 멧포르민으로 1일 1500 mg을 사용하고 있는데도 불구하고 당화혈색소가 7%를 초과하는 제2형 당뇨병환자 336명을 대상으로 부가적으로 30주간 엑세나타이드 $5{\mu}g$또는 $10{\mu}g$을 1일 2회 피하주사 한 임상시험결과에 의하면, 당화혈색소가 7% 미만인 환자의 비율은 intent-to-treat 로서 각각 27%와 40%로 나타났다. 이는 기존의 치료법과 위약으로 치료받은 군에서의 13%에 비하여 통계적으로 매우 유의성 있는 결과인 것으로 분석되었다(p<0.01). 또 다른 임상시험에서는 상기 임상시험과 유사한 임상시험계획을 바탕으로 하여 설포닐유레아로 치료받고 있었지만 당화혈색소가 7%를 초과하는 제2형 당뇨병환자를 대상으로 임상시험을 실시하였으며, 그 결과에 의하면 엑세나타이드와 설포닐유레아의 병용치료 시 혈당조절에 매우 유리한 것으로 나타났다. 멧포르민과 설포닐유레아의 병용요법으로 치료받고 있던 당뇨병환자를 대상으로 실시한 임상시험에서도 동일한 결과가 나타났다. 이 약의 부작용은 치료개시 후 나타나는 메스꺼움이 문제로 지적되었으며 저 혈당현상은 큰 문제가 되지 않는 것으로 나타났다. 이 약은 인슐린 대용약물이 될 수 없으며 당뇨병성 케토산증의 치료에 사용할 수 없다. 또한 이 약물은 심한 신부전이 있거나 말기신장질환 환자에게 사용해서는 안 된다.

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A Case of Conjunctival and Corneal Calcification in a Child on Peritoneal Dialysis (소아 복막 투석 환자에서의 결막과 각막의 석회 침착 1례)

  • Lee, Yeoun-Joo;Lim, Gin-A;Lee, Joo-Hoo;Prak, Young-Seo;Kim, Myoung-Joon
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.239-244
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    • 2008
  • Calcification in patients with endstage renal disease on renal replacement therapy can occur in extraskeletal area such as conjunctiva and cornea. Conjunctival and corneal calcification(CCC) has mostly has been reported in adults with endstage renal disease on hemodialysis. CCC seems to be associated with the duration of renal replacement therapy, and high Ca$\times$P value. We report a 10-year-old girl who was on peritoneal dialysis for 31 months and presented with CCC on both eyes. Her corneal calcification was resolved after the epithelial debridement and ethylenediaminetetraacetic acid(EDTA) soaking therapy.

The Effect of Social Support and Health Literacy on Sick Role behavior in Hemodialysis Patients (혈액투석 환자의 사회적 지지와 건강정보 이해능력이 환자역할행위 이행에 미치는 영향)

  • Hur, Ji-Yeun;Sim, Jeoung-Ha
    • Journal of the Korea Convergence Society
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    • v.11 no.9
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    • pp.395-404
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    • 2020
  • This was a descriptive study to investigate the effect of social support and health literacy on sick role behaviors in hemodialysis patients. A total of 149 outpatients receiving regular hemodialysis at four dialysis centers located in J city were surveyed. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple linear regression. Factors including social support (β=.37, p<.001), health literacy (β=.16, p=.035), and religion (others) (β=-.25, p=.001) had an effect on sick role behavior. The explanatory power of model in this study was 22.0%. Therefore, the improvement of sick role behavior in patients undergoing hemodialysis requires specific strategies and interventions that are effective in increasing the social support and health literacy.