• Title/Summary/Keyword: 복막투석

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혈액투석 및 복막투석 환자에서의 carumonam(AMA-1080)의 약동 학적 변화에 관한 연구

  • 김성권;조종태;신상구;이경훈
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1992.05a
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    • pp.59-59
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    • 1992
  • 간헐적 혈액투석 또는 지속적 복막투석 요법을 받고 있는 만성 신부전 환자에서 carumonam의 약동학적 변화를 분석하여 이 환자들에서 적절한 투여용법을 고안하고, 이들 특수 질환군에서의 임상시험모형을 도굴하고자 하였다. 혈액투석환자는 carumonam 1g을 20분간 지속 정주 후 약물의 분포기 종료가 예상되는 시간에 혈액투석을 4-5시간 시행하였으며, 혈액, 투석액, 뇨를 경시적으로 채취하였다. 지속적 복막투석 환자군에 있어서는 1일 3회(6, 6, 12시간) 복막 투석을 시행하는 환자를 대상으로 carumonam 1g을 정주하고 24시간동안 혈액 및 투석액, 뇨를 경시적으로 채취하였다. 혈액, 투석액 및 뇨중 carumonam의 농도는 HPLC방법으로 측정하였으며, 경시적인 혈장 carumonam 농도변화 및 투석에 따른 약물의 제거를 혈액 투석환자는 2 compartmental model, 복막투석환자에서는 bidirectional 2 compartmental model에 의해 그 약동학적 성상을 분석하였다.

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Therapeutic Efficacy and Complications of Automated Peritoneal Dialyzer in Dogs with Renal Failure (신부전 개에서 자동 복막투석기를 이용한 복막투석에 대한 평가)

  • Kwon, Heejung;Choi, Wonjin;Lee, Dong-Guk;Tan, David;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.399-403
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    • 2015
  • Peritoneal dialysis (PD) is a treatment for renal failure and acute poisoning, and uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances are exchanged from the blood. In this study, we evaluated the therapeutic efficacy and complications of automated peritoneal dialyzer (APD) in dogs with renal failure. PD was performed in 10 dogs using a swan neck catheter (Neonatal, Coviden) and automatic APD. The efficacy for each dog was assessed by calculating urea reduction ratio (URR) and creatinine reduction ratio (CRR). Mean concentrations of pre-dialysis creatinine and blood urea (BUN) were $7.09{\pm}3.84$ and $145.8{\pm}48.5$, respectively. The mean number of peritoneal dialysis cycles applied was $6{\pm}1$ cycles. Peritoneal dialysis resulted in a significant decrease in BUN concentration in 7/10 dogs, while a significant decrease in creatinine concentration in 9/10 dogs. The mean of URR was higher than that of CRR ($0.39{\pm}0.16$ vs $0.38{\pm}0.13$). The mean CRR and URR per dialysis cycles were $0.064{\pm}0.023$ and $0.065{\pm}0.023$, respectively. Complications found in this study were catheter occlusion, subcutaneous dialysate leakage, septic peritonitis, hypoalbuminemia and overhydration. This study found PD using a swan neck catheter and APD machine showed acceptable efficacy for successful peritoneal dialysis in dogs. However, close monitoring is required to minimize the risk of complication.

The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis (복막 투석중인 만성 신부전 환자의 혈압 조절에 관한 연구)

  • Jung, Hang-Jae;Bae, Sung-Hwa;Park, Jun-Bum;Jo, Kyoo-Hyang;Kim, Young-Jin;Do, Jun-Young;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.333-341
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    • 1999
  • Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

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Peritoneal Dialysis in Dogs: 20 cases (2006-2008) (개에서 복막투석 적용: 20 증례 (2006-2008))

  • Nam, So-Jeong;Choi, Ran;Oh, Won-Seok;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.23-28
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    • 2009
  • Peritoneal dialysis (PD) is a clinical technique that therapeutically removes toxic solutes from body fluids and normalizes endogenous solutes whose aberrant concentrations disrupt normal physiology. This study retrospectively evaluated clinical outcomes and complications of PD in 20 dogs with renal failure. Blood works (total count of red blood cells (RBC), packed cell volume (PCV), the serum biochemical, and electrolyte values related to renal insufficiency) and complications associated with peritoneal dialysis, and clinical outcomes were recorded before and after PD. Additionally, creatinine reduction ratio (CRR) and urea nitrogen reduction ratio (URR) were calculated for evaluating the efficacy of PD. PD resulted in a significant (p < 0.05) reduction in blood urea nitrogen (BUN) concentration in 19 dogs, while a significant (p < 0.05) reduction in creatinine concentration in 17 dogs. The complications of PD were hypoalbuminemia (12/20, 60%), anemia (10/20, 50%), subcutaneous dialysate leakage (9/20, 45%), bacterial peritonitis (6/20, 30%), dialysate retention (5/20, 25%) and limb edema (4/20, 20%). This study demonstrated that PD was effective in reducing the magnitude of azotemia in dogs with renal failure especially in acute phase, although the complication rate was high but manageable.

IPAA의 효과를 고찰하기 위한 분류분석방법들의 비교연구

  • Lee, Seung-Yeon;Lee, Eun-Ju;Choe, Ho-Sik
    • Proceedings of the Korean Statistical Society Conference
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    • 2005.05a
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    • pp.291-298
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    • 2005
  • 지속성 외래 복막투석은 말기 신부전 환자들에게 널리 시행하는 신 대체 요법으로, 복막투석 환자에게서 주된 합병증으로 일어나는 단백질-열량 영양실조를 치료하기 위하여 아미노산을 복강 내로 주입하는 치료방법이다. 이현석 등(2004)의 연구에서는 아미노산 복막 투석액(IPAA)이 영양실조 환자들에게 실제로 영양상태에 미치는 영향을 평가하기 위하여 지속성 외래 복막투석 환자 43명을 12개월 동안 3개월 주기로 관측하여 얻어낸 반복측정자료를 바탕으로 IPAA의 효과 여부에 따라 반응군과 비반응군을 분류하였다. 본 논문에서는 이러한 두 그룹을 효과적으로 분류할 수 있는 분류기준변수들을 찾아내고 이 분류기준변수의 값을 바탕으로 새로운 환자에게 IPAA의 투여 여부를 진단할 수 있는 여러 분류방법들을 고찰하여 비교 연구하였다. 모수적인 방법으로 선형판별분석, 이차판별분석 및 로지스틱 판별분석을 소개하고 비모수적인 방법으로 support vector machine(SVM)을 소개하여 분류분석의 결과를 비교하여 두 그룹을 최소한의 오류로 분류하는 방법을 제안하였다.

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Dependence of Elderly Peritoneal Dialysis Patients and Burden on Family Caregivers (노인 복막투석 환자의 의존성과 가족의 부담감)

  • Kim, Hyewon
    • Journal of Digital Convergence
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    • v.10 no.9
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    • pp.429-434
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    • 2012
  • This study was performed to examine the relationship between dependence of elderly peritoneal dialysis patients and burden on family caregivers. The subjects for this study were 50 elderly patients on Continuous ambulatory peritoneal dialysis(CAPD) who were registered in a hospital in Seoul and 50 their family caregivers. The data were collected from April 4 to August 15, 2011. The collected data were analyzed by the SPSS WIN 12.0 program. The mean score of dependence was 139.6 which means their experience of high level dependence. The mean score of burden was 84.2 which means their family caregivers experience of high level burden. Positive correlation was found between dependence of elderly peritoneal dialysis patients and burden on their family caregivers (r=.61, p=.000). It is considered that the study emphasizes for the healthcare providers to recognize dependence as the important nursing issue for elderly CAPD patients. And it is necessary to develop an nursing intervention for decreasing dependence of elderly CAPD patients and burden on their family caregivers.

Outcomes of Chronic Peritoneal Dialysis by Various Modalities in Korean Children - A Single Center Study (소아 환자에서 다양한 복막투석 방법간의 결과 비교-단일기관 연구)

  • Lee, Sung-Ha;Baek, Jae-Suk;Lee, Hyun-Kyung;Han, Kyoung-Hee;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.255-263
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    • 2007
  • Purpose : A single center cross sectional retrospective study was performed to compare the outcomes of different peritoneal dialysis(PD) modalities in Korean children. Methods : Among children dialyzed with PD between the year 2004 and 2007, 35 children had reliable data on PD adequacy after 3 to 15 months of dialysis. Subjects were grouped by their modalities; 17, 13 and 5 children were on continuous ambulatory PD(CAPD), continuous cyclic PD(CCPD) and nightly intermittent PD(NIPD), respectively. Body weight and height, number of patients taking anti-hypertensives and laboratory data including biochemical and hemoglobin levels were compared. Dialysis adequacy including weekly Kt/Vurea, creatinine clearance (Ccr) and daily water removal were also compared. Patients were sub-grouped by their peritoneal permeability characteristics. Results : The percentage of patients taking anti-hypertensives, monthly change in Z-scores of body weight and height and laboratory data did not differ among the groups. Patients on CAPD and CCPD showed similar dialysis adequacies. Weekly dialytic Ccr was significantly lower in the NIPD group compared to the others. But total Ccr was not different when residual renal function was added. Weekly dialytic Ccr by CAPD was significantly higher than that of CCPD in low and low-average transporters. Conclusion : We propose that modality can be selected flexibly according to the patients' preferences. And peritoneal permeability characteristics provide valuable information for adjusting PD prescriptions in ultrafiltration failure or in inadequate dialysis. Further study of other clinical performance measures should be performed to clarify the comparable outcomes in different PD modalities.

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혈액 투석 및 지속성 복막투석 환자에서 Carumonam (AMA-1080)의 약동학적 특성에 관한 연구

  • 김성권;이정상;한진석;조종태;임동석;이경훈;장인진;신상구
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.333-333
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    • 1994
  • 목적 : 만성신부전환자에서 carumonam의 약동학적 특성을 검토하고, 동시에 투석에 의한 carumonam의 제거 양상을 분석하여 이들 환자에서 carumonam의 적절한 투여용량 및 용법을 고안하고자 하였다. 방법 : 혈액투석(HD) 또는 지속성 복막투석(CAPD)을 받고 있는 14명의 말기 신부전중 환자를 대상으로 하였다. HD환자에서는 carumonam 1 g을 20분간 지속정주하고 4시간 이후 혈액투석을 4 또는 5 시간 시행하였으며 투약 후 36시간까지 경시적으로 혈액 및 투석액을 채취하여 체액내 약물 농도를 측정하였다. CAPD환자는 1일 3회 (6.6, 12 시간) 투석액을 교환하는 환자를 대상으로 하였고 투석직후 carumonam 1g을 지속정주하고, 투약후 36시간 후까지 경시적으로 혈액 및 투석액을 채취하여 CAPD 환자에서 carumonam의 약동학적 특성을 검토하였다. 체내 동태는 HD의 경우 dialyser를 포함하는 2-compartmental model에 의한 분석을 시행하였고, CAPD를 시행받는 환자의 경우에는 체액과 투석액사이에 bidirectional clearance 개념을 도입한 모델을 이용하여 분석하였다.

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Efficacies of the Modified Ultrafiltration and Peritoneal Dialysis in Removing Inflammatory Mediators After Pediatric Cardiac Surgery (소아 개심술 후 변형 초여과법과 복막투석의 염증 매개체 (inflammatory mediator)의 감소에 대한 효과)

  • 성시찬;정민호
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.745-753
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    • 2001
  • capillary leak syndrome and organ dysfunction in infants. Removing harmful cytokines and complement anaphylatoxins after cardiopulmonary bypass may attenuate this response. This study was conducted to see if the modified ultrafiltration and postoperative peritoneal dialysis can reduce plasma inflammatory mediators in pediatric cardiac surgery. Material and Method: 30 infants (age 1.1 to 12.6 months) who underwent closures of ventricular septal defect using cardiopulmonary bypass (CPB) were enrolled in this study. These patients were divided into three groups; 10 patients selected randomly underwent modified ultrafiltration (Group U), 10 with small body weights ($\leq$5 kg) received postoperative peritoneal dialysis (Group P), and 10 patients did not undergo modified ultrafiltration nor receivcd peritoneal dialysis (Group C). Serum samples were obtained before and after CPB, and after peritoneal dialysis. Effluents sample were also obtained after modified ultrafiltration or peritoneal dialysis. C3a and interleukin-6 (IL-6) were measured by radioimmunoassay and enzyme-linked immunosorbent assay respectively. Result: There was no differences in CPB time, aortic cross-clamping title, and lowest temperature during CPB. The effluents of peritoneal dialysis contained significant amount of C3a and IL-6, but there was no definitive decrease of serum concentration of C3a and IL-6. The effluents of modified ultrafiltration had some amount of C3a and negligible IL-6, and there was no decrease of serum concentration of these (actors. Conclusion: The effluents of peritoneal dialysis contained significant amount of proinflammatory cytokine, IL-6 and complement, C3a. However this study failed to elucidate the decrease in serum levels of these factors. The modified ultrafiltration also was not able to reduce the serum levels of C3a or IL-6 in our study as well.

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