• Title/Summary/Keyword: 사구체질환

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A Clinical and Pathological Analysis of Children with Membranoproliferative Glomerulonephritis According to the Clinical Manifestations at Presentation (발견 양상에 따른 소아 막증식성 사구체신염의 임상적 및 병리조직학적분석)

  • Jeon Chang-Ho;Kang Mi-Seon;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.186-194
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    • 2004
  • Purpose: Membranoproliferative glomeulonephritis(MPGN) has been diagnosed in an increasing number of asymptomatic cases. These cases have been detected by school urinary screening test even though the total cases of MPGN show a decreasing trend. We have analyzed the clinical and pathological characteristics of children with MPGN according to the clinical manifestations at the time of disease presentation. Methods: A total of 18 patients who had been diagnosed with idiopathic MPGN by percutaneous renal biopsy from January 1990 to February 2004 were involved in our study. The patients were divided into 2 groups as the school urinary screening(A) group and the symptomatic(S) group according to the clinical manifestations at the time of disease presentation. Results: Out of the total 18 patients, 8(44.4%) were in the S group and 10(55.6%) were in the A group. The mean serum total protein, albumin and $C_3$ levels in the S group were significantly lower than those levels of the A group, respectively($4.9{\pm}1.2\;g/dL,\;vs\;7.0{\pm}0.5\;g/dL\;P=0.002,\;2.8{\pm}0.9\;g/dL\;vs.\;4.1{\pm}0.3\;g/dL\;P=0.002,\;63.9{\pm}36.4\;mg/dL\;vs.\;100.8{\pm}39.5\;g/dL\;P=0.041$). The mean total protein amount of 24 hour collected urine in the S group were significantly higher than that of the A group($3684.0{\pm}2601.3\;mg/m^2\;vs.\;559.4{\pm}4.6.9\;mg/m^2$, respectively, P=0.001). Hypocomplementemia was observed in 11(61.1%) out of 18 patients at the time of disease onset, 7(87.5%) in the S group and 4(40%) in the A group. However the hypocomplementemia was decreased in 6(33.3%) out of 18 patients at the time of final follow-up, 3(37.5%) in the S group and 3(30%) in the A group. According to the pathologic type, hypocomplementemia was observed 8 patients(61.5%) with type I disease, 1 patients (100%) with type II disease, 2 patients(50%) in type III disease at the disease onset, but 4 patients(30.8%) in type I disease, 1 patient(100%) in type II disease, 1 patient(33.3%) with type III disease at the time of last follow-up. The incidence of cellular crescent formation and tubular atropy. as observed on light microscopy, were higher in the S group compared to the A group. Mean grade of capillary wall thickening and, mesangial proliferation were significantly higher in the S group. Conclusion: MPGN, as diagnosed in patients with only asymptomatic urinary abnormalities, has been increasing, it is more frequent in asymptomatic patients than in patients with presenting symptoms. Our result suggests that MPGN should be considered in the renal biopsy diagnosis regardless of serum $C_3$ level when urinary abnormalities are found by school urinary screening test.

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Hemolytic-uremic Syndyome Associated with Bloody Diarrhea (혈변을 동반한 용혈성 요독 증후군 5례)

  • Kim Jung-Sim;Park Eun-Jung;Chung So-Hee;Ko See-Hwan;Uhm Mee-Ryung;Park Moon-Su;Lee Heung-Jea;Jin Dong-Kyu
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.170-175
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    • 1997
  • Purpose : Hemolytic uremic syndrome(HUS), known as a most common cause of childhood renal failure in western countries, has been a relatively rare disease in Korea. Although the reported cases were not related to any specific cause in Korea, there was an outbreak of HUS with bloody diarrhea in Japan last year. We report here that we experienced the several typical HUS last year. Patients : From Jan.1996 to Dec. 1996, five patients were diagnosed as HUS at Samsung Seoul Medical Center, Dept. Pediatrics. Results : 1) The age of onset was below 3 years in 3 cases and above 9 years in 2 cases. 2) All the cases happened between summer and autumn. Three patients had domestic travel and 4 patients drank well or spring water before the symptoms. 3) The clinical manifestation was generalized edema, oliguria, anuria and hematuria. The bloody diarrhea were present in 5 cases and 1 patient had operation with the impression of appendicitis. 4) There was no bacteria which was isolated from the blood or stool samples. 5) Renal biopsies were performed in 2 cases, because of protracted clinical course. One showed microthrombotic angiopathy and the other cortical necrosis with necrotizing glomeruli. 6) Complete recovery was the outcome in 4 cases and one case progressed to chronic renal failure. Conclusion : In conclusion, typical HUS associated with bloody diarrhea, epidemic and good prognosis can be found in Korea and careful surveillance of the pre-clinical cases will be necessary.

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Construction of the Transgenic Drosophila melanogaster Expressing a Human Megsin Gene. (인간 신장질환 유발인자가 발현하는 형질전환 초파리 구축)

  • Goo, Tae-Won;Kwon, Ki-Sang;Kwon, O-Yu
    • Journal of Life Science
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    • v.17 no.5 s.85
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    • pp.719-722
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    • 2007
  • IgA nephropathy(IgAN) is considered to be a multifactorial disease with genetic and environmental factors contributing to its pathogenesis. The genes involved in susceptibility and progression of the disease have not yet been clearly elucidated. Megsin is an important candidate gene, predominantly expressed in glomerular mesangium and upregulated in IgAN. To understand biological function of megsin, in this work we have produced transgenic D. melanogaster fly over-expressing human megsin(actin-gal4>UAS-Megsin fly). Introduced human megsin was confirmed by RT-PCR and Western blotting, respectively. Its phenotype is melanin deficiency-abdomen and the megsin gene is stably transferred to the next generations.

A Case Report Unilaterally Involved Glomerulocystic Kidney Disease (단측에 발생한 사구체낭성신질환 1례)

  • Oh Seung-Jin;Yook Jin-Won;Kim Ji-Hong;Chung Hyun-Ju;Kim Myung-Joon;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.221-226
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    • 1999
  • Glomerulocystic kidney disease(GCKD) is a rare form of renal cystic disease defined histopathologically by containing dilated Bowman's space with variable atrophy of glomerular tufts, which may occur as sporadically or as familial cases and can be presented as a major component of heritable syndromes. It has not been recognized in Korean children but only one report of adult case has been reported having GCKD. We experienced a case of GCKD in a 10-year-10-month-old boy, who was admitted for hypertension. Abdominal ultrasonography and computed tomography revealed clustered numerous small cysts in left kidney and renal biopsy findings was consistent with the GCKD showing cystic dilatation of Bowman's space with intact glomerular structure.

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A Case of Familial IgA Nephropathy (가족성 IgA 신병증 1례)

  • Kim, Yu-Jin;Kim, Wun-Kon;Yoon, Shin-Ae;Lee, Jin-Seok;Ha, Tae-Sun
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.81-85
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    • 2011
  • IgA nephropathy is the most common form of primary glomerulonephritis and chronic glomerular disease worldwide including Korea. Familial gathering of IgA nephropathy suggests that genetic factors contribute to the development of this disease. Although there have been many reports on familial IgA nephropathy with genetic analysis and their pedigrees, there has been few reports in Korea. We reported a partial familial IgA nephropathy pedigree with a brief review of the literatures.

A Case of Membranoproliferative Glomerulonephritis Type II(Dense-Deposit Disease) (막증식성 사구체신염 제 II 형(Dense-Deposit Disease) 1례)

  • Lee Suk-Jin;Moon Jae-Hoon;Kang Mi-Seon;Song Min-Seob;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.204-210
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    • 2003
  • Membranoproliferative glomerulonephritis type II(MPGN II), also called dense deposit disease, was first described by Berger and Galle in 1963. The diagnosis of MPGN II is based on electron-microscopic finding of an intensely electron-dense substance which replaces the lamina densa of the glomerular basement membrane. Although the etiology and pathogenesis of MPGN II are unknown, it frequently progresses to end-stage renal failure. Typically in MPGN II, hypocomplementemia due to activation of the alternative complement pathway is present. In addition, the association of MPGN II with partial lipodystrophy and complement abnormalities is well documented. The relationship between these associated features and the patient's renal functional outcome is not clear. With respect to the therapy for MPGN II, an alternate-day prednisolone regimen was shown to be effective. Various treatment modalities, including immunosuppression with corticosteroids, cytotoxic drugs and cyclosporin A, anticoagulants and antiplatelet therapies are used, either alone or in combination, with varying degrees of success. The purpose of this paper is to present a case of MPGN II from a 7 years old girl with paroxysmal supraventricular tachycardia(PSVT).

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Treatment of chronic kidney disease in children (소아의 만성신장질환의 치료)

  • Lee, Joo Hoon
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1061-1068
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    • 2009
  • The treatment of pediatric patients with chronic renal disease comprises management of nutritional imbalance, fluid, electrolyte, and acid-base disturbances, mineral bone disease, anemia, hypertension, and growth retardation. The treatment also includes administration of appropriate renal replacement therapy, if required. Adequate dietary intake of carbohydrates, fats, and proteins and caloric intake must be encouraged in such patients to ensure proper growth and development. In addition, fluid, electrolyte, and acid-base status must be regularly monitored and should be well maintained. Serum calcium, phosphorus, and parathyroid hormone levels must be maintained at their target range, which are determined on the basis of the glomerular filtration rate, to avoid the development of mineral bone disease. This can be achieved by using phosphorus binders and vitamin D analogues. An erythropoiesis-stimulating agent must be administered along with iron supplementation to maintain the hemoglobin level of the patients between 11-12 g/dL. Hypertension must be controlled with adequate water and sodium balance and appropriate antihypertensive agents. Administration of recombinant human growth hormone is recommended to improve the final adult heights.

The Relationships between Knowledge of the Kidney, Self-efficacy, and Kidney Function in Pre-dialysis Patients with Chronic Renal Insufficiency (투석 전 만성신장질환자의 신장 지식, 자기효능감, 신장 기능의 관계)

  • Cha, Eunji;Park, Hyojung
    • Korean Journal of Adult Nursing
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    • v.27 no.5
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    • pp.505-514
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    • 2015
  • Purpose: The purpose of this study was to examine their levels of knowledge of the kidney, self-efficacy, and kidney function in pre-dialysis patients with chronic renal insufficiency. Methods: A total of 142 pre-dialysis patients with chronic renal insufficiency were recruited from a nephrology clinic of a hospital in Korea. Participants' knowledge of the kidney, self-efficacy, and kidney function were measured, and the correlations between these factors were computed. Results: The levels of knowledge of the kidney were moderate, with a mean score of $12.30{\pm}5.35$. Knowledge level was significantly correlated with age, education level, occupation, income, physical symptoms, and information resources (p<.05). The mean score for self-efficacy was $6.06{\pm}2.00$. Self-efficacy was significantly associated with patients' age, education level, occupation, income, cigarette use, and information resources (p<.05). The mean score for kidney function was $35.66{\pm}18.68mL/min/1.73m^2$. Kidney function was significantly correlated with use of medications and drinking behavior (p<.05). Knowledge of the kidney was significantly correlated with self-efficacy (r=.31, p<.001), but not with kidney function. There was a significant correlation between self-efficacy and kidney function (r=.30, p<.001). Multiple regression analysis revealed that self-efficacy and drinking behavior accounted for 11% of the variance in kidney function of pre-dialysis patients with chronic renal insufficiency. Conclusion: Nursing interventions are necessary to increase self-efficacy among pre-dialysis patients with chronic renal insufficiency in order to maintain their kidney function.

Thin Glomerular Basement Membrane Disease with Herlyn-Werner-Wunderlich Syndrome : Uterus Didelphys, Blind Hemivagina and Ipsilateral Renal Agenesis (비박형 사구체 기저막 질환이 동반된 중복 자궁 일측성 폐쇄질 및 동측 신장 무형성 증후군 ( Herlyn - Werner- Wunderlich syndrome ) 1례)

  • Kim, Myoung-Soo;Park, Yong-Jun;Park, Young-Jun;Park, Noh-Hyuck;Song, Ji-Sun;Kim, Pyung-Kil
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.299-305
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    • 2007
  • Herlyn-Werner-Wunderlich syndrome(HWWs) is a rare variant of Mullerian ductal anomalies characterized by the presence of a hemivaginal septum, a didelphic uterus, and ipsilateral renal agenesis. It usually presents after menarche with progressive pelvic pain, and palpable mass due to hemihematocolpos. If a cystic mass is detected behind the urinary bladder in children, in association with the absence of a kidney, the diagnosis of uterus didelphys with imperforate vagina and hydrocolpos should be considered. When renal agenesis is found in asymptomatic children, the small size and the tubular shape of the uterus makes it almost impossible to evaluate uterine anomalies, so follow-up should be performed until the end of puberty. Appropriate preoperative diagnosis and treatment will prevent unnecessary procedures and offer relief of symptoms. We report one case of didelphic uterus with blind hemivagina and ipsilateral renal agenesis with biopsy- proven thin glomerular basement membrane disease which is not related to the above syndrome.

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Association between hyperuricemia and metabolic syndrome (고요산혈증과 대사증후군과의 연관성)

  • Park, Yun-jin
    • Journal of the Korean Applied Science and Technology
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    • v.39 no.5
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    • pp.674-682
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    • 2022
  • This study aims to examine the relationship between hyperuricemia and metabolic syndrome, which is a risk to health, and to analyze the effect of hyperuricemia on the body. The analysis data were downloaded and used for the 8th 2nd (2020) data of the National Health and Nutrition Survey, and in this study, 2,320 men and 2,893 women were finally analyzed. For the analysis of the data, Chi-square test and t-test were used for the difference values according to collected general characteristics and hyperuricemia, and the risk of eGFR rise was analyzed by regression analysis, and Pearson correlation was used to confirm the correlation with each variable. Through this study, it was found that hyperuricemia is significantly related to metabolic syndrome, and through this, preemptive management is needed to prevent metabolic syndrome from worsening into vascular diseases including kidney diseases. Therefore, it is proposed to develop a health program suitable for the patient's age through this study.