• The Korean Journal of Pharmacology
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• v.18 no.2
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• pp.103-117
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• 1982

In an effort to provide evidence as to the regulatory role of the central dopaminergic system on the renal function, the effects of centrally administered dopamine and its specific antagonist haloperidol were investigated. Haloperidol (HA) given intracerebroventricularly (i.c.v.) induced antidiuresis in doses of 15 and $50{\mu}g/kg$. With $15{\mu}g/kg$ sodium reabsorption in the tubules was increased, while with $50{\mu}g/kg$ free-water reabsorption was increased. However, a marked diuresis with increased sodium and potassium was observed with $150{\mu}g/kg$. Hemodynamic changes were not evident, indicating that the diuresis is of tubular origin. Dopamine (DA), on the other hand, produced antidiuresis when given i.c.v. in a dose-related fashion. With smaller doses of 5 and $15{\mu}g/kg$ the antidiuresis was related to increased reabsorption of sodium in the tubules, but higher doses of 50 and $150{\mu}g/kg$ the decreases in renal blood flow and glomerular filtration rate were evident in addition to the tubular action. After pretreatment with $150{\mu}g/kg$ HA, the effects of $15{\mu}g/kg$ DA was abolished, but the antidiuretic actions of 50 and $150{\mu}g/kg$ were not blocked, and the natriuretic diuretic action of HA was overcome and became inconspicuous. These observations indicate that the central dopaminergic system influences the renal function by producing antidiuresis, and HA elicits diuresis and natriuresis by competitively antagonizing DA specifically on the central dopaminegic receptors. The antidiuresis observed with smaller doses of HA can be best explained by the facts that there are more than two types of DA-receptors in the brain and that the presynaptic autoreceptors on the dopaminergic neurones which affect the dopamine release at the synapse are more sensitive than the postsynaptic receptors. Overall, these data provide an evidence indicating that the central dopaminergic system plays a role in the regulation of renal function in the rabbit.

• Childhood Kidney Diseases
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• v.1 no.1
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• pp.38-45
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• 1997

Purpose : Vesicoureteral reflux(VUR) in childhood may be the primary cause of recurrent urinary tract infection and renal scarring. Renal ultrasonography, DMSA, and voiding cystourethrogram are the standard clinical methods for detection of vesicoureteral reflux. But these methods have many disadvantages such as invasiveness and high cost. So, we studied to observe the significance of urine ${\beta}_2$-microglobulin in association with other non-radiologic methods for predictng vesicoureteral reflux. Methods : We evaluated 40 patients with urinary tract infection who were admitted to Korea university Hospital from July 1993 to June 1994. Among them, 24 patients revealed urinary tract infection and vesicoureteral reflux(group A), 16 patients revealed only urinary tract infection(group B). Both groups were compared by presence of fever, hematuria, and proteinuria, positivity of CRP, and level of BUN, Cr, GFR by 99mTc-DTPA, urine ${\beta}_2$-microglobulin, 24 hours urine albumin. Results : 1) Among 24 patients who had vesicoureteral reflux, 14 had unilateral VUR, 10 had bilateral VUR, three kidneys with grade I, nine with grade II, eleven with grade III, eleven with grade IV by classification of International Reflux Study Committee. Among them, 14 patients had renal scar, five with type A, five with type B, four with type C, none with type D by Smellie's classification. 2) The mean of GFR, BUN, Cr, 24hrs urine albumin and the presence of hematuria and proteinuria showed no significant difference between group A and group B. The mean of urine ${\beta}_2$ microglobulin in group A and group B were $283.6{\pm}195.8{\mu}g/l$ and $78.7{\pm}48.5{\mu}g/l$ respectively, showing that group A had a higher value than group B (p<0.01). In case of ${\beta}_2$ microglobulin > $120{\mu}g/l$ and CRP(+), the sensitivity was 93.3% and the specificity is 77.8% for detecting of VUR. In case of ${\beta}_2$-microglobulin>$120{\mu}g/l$ and fever(+), the sensitivity was 92.2%, and the specificity was 62.5% for detecting of VUR Conclusions : If the level of urinary ${\beta}_2$-microglobulin is more than 120ug/l in children with urinary tract infection in association with fever(+) or CRP(+), it can predict VUR. So we can use it for early detection of VUR.

• Korean Journal of Clinical Pharmacy
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• v.22 no.2
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• pp.103-112
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• 2012

Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.55-61
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• 1989

While cisplatin has been widely used in the treatment of a variety of cancers, nephrotoxicity is one of the major problems which frequently limit clinical usefulness of cisplatin. This study has been conducted to investigate nephrotoxicity of cisplatin in terms of changes in glomerular filtration rate (GFR) and effective renal plasma flow (EFPF) measured by the simultaneous use of $^{99m}Tc-DTPA$ and $^{131}I-OIH$, before and after administration of cisplatin, in 12 patients with lung cancer and four patients with esophageal cancer. Cisplatin was administrated at total doses of $75\sim100mg/m^2$ with two hour hydration and diuresis method. GFR determined by the use of $^{99m}Tc-DTPA$ had a good correlation with 24-hour creatinine clearance rate (r=0.77, p<0.001). GFR and filtration fraction decreased immediately after administration of cisplatin, however, they showed a tendency to be in completely recovered four weeks after administration. ERPF was not changed immediately after and four weeks after administration of cisplatin. GFR before and immediately after administration of cisplatin were analyzed with regard to age, sex, performance status, previous adminstration of cisplatin and method of administration. None of these factors had any influence on the rate of decrease in GFR except method of administration. Administration of cisplatin as a single dose lowered GFR more compared with that as divided doses. In this study, we have also demonstrated that the simultaneous use of $^{99m}Tc-DTPA$ and $^{131}I-OIH$ was a useful tool for the measurement of GFR and ERPF respectively.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.3
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• pp.203-213
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• 2017

Serum creatinine-based eGFR and serum cystatin C-based eGFR are the most popular methods for measuring renal function. Thyroid hormone is known to affect serum creatinine-based eGFR and serum cystatin C-based eGFR; however, the clinical significance of thyroid dysfunctional patients of renal function evaluation has not been fully elucidated to date. This study examined the effect of thyroid hormone on serum creatinine-based eGFR and serum cystatin C-based eGFR. Moreover, we also evaluated the correlation analysis between serum creatinine-based eGFR and serum cystatin C-based eGFR in patients with thyroid dysfunction. A total of 442 patients with hypothyroidism and 284 patients with hyperthyroidism were investigated. A correlation analysis between thyroid hormone and serum creatinine- (and cystatin C-) based eGFR was performed. A correlation analysis between thyroid hormone and serum cystatin-C based eGFR indicated that serum cystatin-C based eGFR is more of an independent biomarker than serum creatinine-based eGFR in thyroid dysfunction patients. Therefore, serum cystatin C-based eGFR more accurately reflects renal function than serum creatinine-based eGFR in thyroid dysfunction patients.

• The Korean Journal of Pharmacology
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• v.18 no.1
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• pp.1-10
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• 1982

In an attempt to delineate the role of beta-adrenoceptors found to be existing in the brain tissue in the central regulation of renal function, isoproterenol, a ${\beta}-adrenergic$ agonist, was administered directly into a lateral ventricle of the rabbit brain and the changes of renal function were observed. Also, the effects of propranolol, a specific ${\beta}-adrenergic$ blocking agent, and its influence upon the isoproterenol action were studied. Isoproterenol, in doses ranging from 5 to $50\;{\mu}g/kg\;i.c.v.$, elicited antidiuresis which seemed to be related to the decreased renal hemodynamics brought about by the systemic hypotension. With moderate doaes of $15\;{\mu}g/kg$ the antidiuresis was less prominent and there was a tendency toward natriuresis, but with higher doses the natriuretic effect became less evident, overrun by the systemic hypotension. Propranolol, $500\;{\mu}g/kg\;i.c.v.$, produced little effect on the renal function, but it eliminated the antidiuretic action of $50\;{\mu}g/kg$ isoproterenol i.c.v. and reversed it to a diuretic and natriuretic one, along with increases in renal plasma flow and glomerular filtration rate. The systemic hypotension also was markedly attenuated by propranolol pretreatment. Thus, it was evident that the renal action of i.c.v. isoproterenol was not blocked by propranolol and became explicit only when the hypotensive action of isoproterenol which seems to he propranolol-sensitive is removed. Various possibilities to account for this disparity in sensitivity were discussed. It is suggested from these observations that the central ${\beta}-adrenoceptors$ might also be involved in the regulation of renal function along with ${\alpha}-adrenoceptors$, though less significant than the latter.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.145-154
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• 2019

This study examined the relationship between the estimated glomerular filtration rate (eGFR) and urine microalbumin/creatinine ratio (uACR) with ferritin in Korean adults. This study included 4,948 adults aged ${\geq}20years$ from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) data. A covariance test adjusted for covariates was performed for the ferritin levels in relation to the decreased eGFR (eGFR<$60ml/min/1.73m^2$) and elevated uACR ($uACR{\geq}30mg/g$). Several key findings were made in the present study. First, after adjusting for the related variables, the ferritin level was higher in the decreased eGFR group [$103.04{\pm}6.59mL/min/1.73m^2$; 95% confidence interval (CI), 90.12~115.96] than in the normal eGFR group ($84.87{\pm}1.16mL/min/1.73m^2$; 95% CI, 82.59~87.14; P=0.007). Second, after adjusting for the related variables, the ferritin level ($M{\pm}SE$) was similar in the normal uACR group ($85.70{\pm}1.20mg/g$; 95% CI, 83.35~88.05) and elevated uACR group ($82.72{\pm}4.09mg/g$; 95% CI, 74.71~90.73) (P=0.487). Chronic kidney disease was positively associated with the ferritin level in Korean adults but albuminuria was not.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.3
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• pp.208-216
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• 2021

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to investigate the status of renal function in patients with COVID-19. The study surveyed a total of 649 patients hospitalized with COVID-19 at a hospital located in southern Gyeonggi Province, South Korea over a one month period in January 2021. The parameters analyzed were blood urea nitrogen (BUN), creatinine, sodium, potassium, chloride, and estimated glomerular filtration rate (eGFR). The BUN and creatinine of the COVID-19 patients were found to be higher than the normal reference range, specially in males, and in the elderly (60s and 80s or older). The serum electrolyte levels of the patients were observed to be within the reference intervals. Of the subjects, males over 80 years of age had a Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) of 60 mL/min/1.73 m² or less. Recent research suggests that some severe cases of COVID-19 are showing signs of kidney damage, even in those with no prior underlying kidney disease. Thus, assessment of kidney function using multiple indicators could help diagnose abnormal renal function in patients with COVID-19.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.170-179
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• 1999

Purpose: To evaluate whether or not sodium restriction had its own beneficial effect and increased the efficiency of the anti-hypertensive drugs on the progression of renal failure. Methods: We studied using the excision remnant kidney model. Treatment groups were as follows: 5/6 nephrectomy and a 0.49% (normal-high) sodium diet (NN); 5/6 nephrectomy and a 0.25% (normal-low) sodium diet (LN); 5/6 nephrectomy, a 0.49% sodium diet and enalapril (NNE); 5/6 nephrectomy, a 0.49% sodium diet and nicardipine (NNN); 5/6 nephrectomy, a 0.25% sodium diet and enalapril (LNE); 5/6 nephrectomy, a 0.25% sodium diet and nicardipine (LNN). Both diets were isocaloric and had the same content of protein, phosphorus and calcium. Proteinuria, remnant kidney weight, mesangial expansion scores, and glomerular volume were assessed. Results: Blood pressure tended to be lower in LN compared to NN (P<0.05). NN developed progressive hypertension. LNE, LU, NNE, and NNN reduced blood pressure. LNE, LNN, NNE, NNN, and LN had significantly less proteinuria than NN at 16 weeks (P<0.05). At 24 weeks, LN developed proteinuria (82 mg/day), which were lessened in LNE (54 mg/day) and not lessened in LNN (76 mg/day). Mesangial expansion scores were significantly less in LN rats compared to those in NN rats. Glomerular volumes at 24 weeks in LN rats were significantly less compared to those at 16 weeks in NN rats. Mesangial expansion scores and glomerular volumes at 4, weeks, 12 weeks, and 24 weeks were not different among LN, LNE, and LNN groups. Conclusion: Dietary salt restriction lessens renal damage, at least in part, by inhibiting compensatory renal growth and reducing blood pressure. Enalapril was particularly successful in reducing proteinuria and glomerular injury when combined with dietary salt restriction.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.10-17
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• 2004

Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) nephritis has a variable range of prevalence from 25 to 50% among HSP patients and is a common cause of chronic glomerulonephritis in children. In our study, we evaluated the distribution and the association of the angioten-sinogen(AGT) M235T polymorphism with the clinical manifestations, particularly proteinuria in children with HSP with or without nephritis. Methods : The AGT M235T polymorphism was determined in children with HSP nephritis (n=33) or HSP without nephritis(n=28) who had been diagnosed at Busan Paik hospital from January 1996 to June 2001. The M235T polymorphism of the AGT gene was determined by PCR amplification of the genomic DNA. Results : The M235T polymorphism of AGT gene frequency was MM 75%, MT : 25%, TT : 0% in HSP and MM : 64%, MT : 36%, TT : 0% in HSP nephritis, there was no significant differences in the genotype and allele frequencies between the two groups. No significant differences in clinical manifestations at onset and last follow-up were seen between the two genotypes. When statistical analysis was done according to the presence of the M allele, the amount of 24-hour urinary protein excretion and the incidence of moderate to heavy proteinuria(>500 $mg/m^2/day$) at onset and at last follow-up were higher in the MT genotype than in those of in the MM genotype but these difference were not statistically significant. Conclusion : We suggest a lack of association between M235T polymorphism of the AGT gene and clinical manifestations in children with HSP nephritis. However, further follow-up studies based on sufficient number of patients and long term follow up periods are necessary to confirm the role of M235T polymorphism of AGT gene in children with HSP nephritis.