• Title/Summary/Keyword: 신투석

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Peritoneal Protein Loss in Nephrotic Syndrome on Peritoneal Dialysis (복막 투석 중인 신증후군 환자의 복막을 통한 단백 소실)

  • Ahn, Yo-Han;Jung, Eui-Seok;Lee, Se-Eun;Lee, Hyun-Gyung;Lee, So-Hee;Kang, Hee-Gyung;Ha, Il-Soo;Jung, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.189-196
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    • 2009
  • Purpose : The pathophysiologic mechanism of nephrotic syndrome is not yet known clearly. At least in some cases, certain 'circulating factors' are thought to increase the glomerular protein permeability. Considering the systemic effect of the circulating factor on peritoneal membrane, we evaluated the loss of protein through peritoneal membrane in patients on peritoneal dialysis due to the end stage renal disease (ESRD) caused by steroid resistant nephrotic syndrome (SRNS). Methods : We retrospectively reviewed the medical records of 26 pediatric patients on peritoneal dialysis ensued during the period from 2001 to 2007 at our clinic. Twelve patients had SRNS, while 14 patients had ESRD caused by the congenital anomalies of urinary system. Results : While the other parameters including nPNA indicating the adequacy of protein intake were similar between the two groups, serum albumin was lower in SRNS patients than the non-SRNS patients ($3.7{\pm}0.3$ g/dL vs. $4.0{\pm}0.4$ g/dL, P=0.021). Peritoneal protein loss was higher in SRNS patients than in non-SRNS patients ($3,044.4{\pm}837.6\;mg/m^2$/day vs. $1,791.6{\pm}1,244.0\;mg/m^2$/day, P=0.007). The protein permeability of the peritoneal membrane measured by the ratio of total protein concentration in dialysate to plasma was twice as high in SRNS patients as the non-SRNS ($1.06{\pm}0.46%$ vs. $0.58{\pm}0.43%$, P=0.010). After 1 year, peritoneal protein loss increased in both patient groups, but to a significantly greater degree in non-SRNS patient (P=0.023). Conclusion : The results of our study support the notion that in nephrotic syndrome there are some 'circulating factors' with the systemic effect. Since the greater protein loss through peritoneal membrane in SRNS was confirmed in this study, more meticulous nutritional support and close monitoring on the nutrition are required in these patients.

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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Clinical Hemodialysis Cases with Estimation of the Adequacy in Four Dogs (혈액투석 4마리 개의 증례에서 투석적절성 평가)

  • Lee, Chang-Min;Lim, Chae-Young;Kim, Seung-Gon;Kang, Min-Hee;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.436-439
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    • 2015
  • Four cases of acute or acute-on-chronic kidney injury were referred for hemodialysis therapy. All cases had a history of uremic syndrome including refractory vomiting, anorexia, diarrhea and depression. They already had been treated with conventional therapies but the intractable clinical signs were remained without response of medications. Intermittent hemodialysis (IHD) sessions were executed in four cases. This study describes the clinical signs and biochemical features of four hemodialysis patients with dialysis adequacy indexed by Kt/V. This report introduced the estimation of hemodialysis adequacy method with clinical cases for establishment of standardization of hemodialysis therapy assess in dogs.

특집 : 올바른 신장합병증 관리를 위해 - 신장합병증의 치료 I - 혈액투석과 복막투석으로 치료

  • Kim, Min-Ok
    • The Monthly Diabetes
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    • s.261
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    • pp.22-23
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    • 2011
  • 당뇨병은 전 세계적으로 급격하게 증가하면서 심각한 대혈관 및 미세 혈관 합병증들의 원인이 되고 있으며 대다수 선진국에서 당뇨병은 만성 신질환 및 말기 신부전의 가장 중요한 원인으로 알려져 있다. 당뇨병성 신증은 단백뇨를 특징으로 하며 30% 정도의 환자에서는 혈뇨도 관찰된다. 그래서 당뇨병성 신증의 발병 검진은 미세알부민뇨 검사로 하는 것이 가장 이상적이며 제 1형 당뇨병환자는 일반적으로 당뇨병 발병 5년 이후에 하며 위험인자가 있는 환자는 더 조기에 한다. 제 2형 당뇨병환자는 당뇨병 진단 시점부터 매년 하는 것을 원칙으로 한다.

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Evaluation on the Electro-electrodialysis for hydrogen production by thermochemical water-splitting IS process (열화학적 수소제조 IS 프로세스의 효율향상을 위한 전해-전기투석의 실험적 평가)

  • Hong, Seong-Dae;Kim, Jeong-Geun;Lee, Sang-Ho;Choi, Sang-Il;Bae, Ki-Kwang;Hwang, Gab-Jin
    • 한국신재생에너지학회:학술대회논문집
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    • 2006.06a
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    • pp.13-16
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    • 2006
  • Electro-electrodialysis (EED) experiments were carried out for the HI concentration from HIx $(HI-H_2O-I_2)$ solution to improve the Hl decomposition reaction in the thermochemical water-splitting is (iodine-Sulfur) process. EED cell is composed of the collector electrode and electrolyte. Nafion 117 which was cation exchange membrane used as an electrolyte, and the activated carbon cloth used as an electrode. The HI concentration experiment was carried out using the HIx solution and molar ratio of the $I_2$ were varied from 1 to 3 mole. The cell voltages were decreased as temperature increase. And, membrane properties such as transport number of proton and electro-osmosis coefficient were decreased as temperature increase

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Chronic Dialysis in Infants and Children Under 2 Years of Age (2세 미만 만성 신부전 환아에서의 만성 투석)

  • Sohn, Young-Bae;Nam, Sook-Hyun;Kwak, Min-Jung;Kim, Su-Jin;Jin, Dong-Kyu;Paik, Kyung-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.41-50
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    • 2007
  • Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

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Evaluation of Reverse Electrodialysis System with Various Compositions of Natural Resources (다양한 농도 공급원의 조합을 통한 역전기투석 장치의 성능 평가)

  • Kwon, Kilsung;Park, Byung Ho;Kim, Dukhan;Kim, Daejoong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.39 no.6
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    • pp.513-518
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    • 2015
  • Salinity gradient power (SGP) has attracted significant attention because of its high potential. In this study, we evaluate reverse electrodialysis (RED) with various compositions of available resources. The polarization curve (I-V characteristics) shows linear behavior, and therefore the power density curve has a parabolic shape. We measure the power density with varying compartment thicknesses and inlet flow rates. The gross power density increases with decreasing compartment thickness and increasing flow rate. The net power density, which is the gross power density minus the pumping power, has a maximum value at a compartment thickness of 0.2 mm and an inlet flow rate of 22.5 mL/min. The power density in RED is also evaluated with compositions of desalination brines, seawater, river water, wastewater, and brackish water. A maximum power density of $1.75W/m^2$ is obtained when brine discharged from forward osmosis (FO) and river water are used as the concentrated and the diluted solutions, respectively.

Effect of Flow Channel Shape on Performance in Reverse Electrodialysis (유로 형상이 역전기투석 장치의 성능에 미치는 영향)

  • Kwon, Kilsung;Kim, Deok Han;Kim, Daejoong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.41 no.5
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    • pp.347-352
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    • 2017
  • Reverse electrodialysis (RED), which generates electrical energy from the difference in concentration of two solutions, has been actively studied owing to its high potential and the increased interest in renewable energy resulting from the Paris Agreement on climate change. For RED commercialization, its power density needs to be maximized, and therefore various methods have been discussed. In this paper, the power density was measured using various flow shapes based on the aspect ratio, opening ratio, and number of distribution channels. We found that the power density is enhanced with a decrease in the aspect ratio and an increase in the opening ratio and number of distribution channels.

The Effects of Catheter Revision and Mupirocin on Exit Site Infection/Peritonitis in CAPD Patients (복막 투석 환자에서 도관 관련 감염 및 복막염에 대한 Mupirocin과 도관 전환술(Catheter revision)의 효과)

  • Park, Jun-Beom;Kim, Jung-Mee;Choi, Jun-Hyuk;Jo, Kyu-Hyang;Jung, Hang-Jae;Kim, Yeung-Jin;Do, Jun-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.347-356
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    • 1999
  • Background: Exit site/tunnel infection causes considerable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. Materials and Methods: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI. we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were TI symptoms (purulent discharge, abscess lesion around exit site). we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. Results: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt. mon and 1 per 2l.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus (26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. aureus(MRSA) (13 cases, 24%). Seven patients(5: MRSA. 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, P<0.01). Conclusions: In summary, revision technique can be regarded as an effective method for refractory ESI/TI before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

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