• Title/Summary/Keyword: 이식 신장 기능부전

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특집 : 미세혈관 합병증 - 미세혈관 합병증에 의한 당뇨병성 신증 - 투석, 신장이식 불러오는 만성신장병

  • Song, Jun-Ho
    • The Monthly Diabetes
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    • s.259
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    • pp.17-21
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    • 2011
  • 당뇨병성 신증은 당뇨병의 대표적인 합병증으로 지속적인 고혈당으로 인하여 신장에 있는 미세혈관이 손상을 받아 오랜 시간에 걸쳐 신장의 기능부전을 초래하는 합병증을 말한다. 현재 국내에서 말기신부전증을 일으키는 가장 흔한 질환이 당뇨병이다.

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Experiences of Patients on the Waiting List for Deceased Donor Kidney Retransplantation (신장 재이식 대기자의 경험)

  • Jeon, Mi kyeong;Kim, Keum Soon
    • Journal of Korean Critical Care Nursing
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    • v.8 no.1
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    • pp.11-24
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    • 2015
  • Purpose: The purpose of this study was to explore the experience of patients on the waiting list for kidney retransplantation. Methods: The data were collected by individual in-depth interviews of nine patients who were dialyzed after primary kidney graft dysfunction and were waiting for deceased donor kidney retransplantation. All interviews were audio-taped and transcribed, and were analyzed using a phenomenological method. Results: The findings included 5 theme clusters and 13 sub-themes. The 5 clusters were 'Diagnosed with chronic renal failure and dialysis: Broken daily life and crisis', 'Kidney transplantation: The only way to escape from dialysis', 'Kidney graft failure: Inevitable moving backward to hemodialysis', 'Self-management of re-dialysis patients: Growth through pain', and 'The waiting for kidney retransplantation: To try again in the hope of getting a new life'. Conclusion: This study provides a deep understanding of patients with dialysis who are waiting for deceased donor kidney retransplantation. On the basis of the findings of this study, health professionals can provide customized information and develop effective nursing interventions to improve the self-management of these patients.

Endocrine dysfunction after bone marrow transplantation during childhood and adolescence (소아 및 청소년기에서 골수이식 후에 발생할 수 있는 내분비 기능 부전)

  • Jin, Hye Young;Choi, Jin-Ho;Im, Ho-Joon;Seo, Jong-Jin;Moon, Hyung-Nam;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.420-427
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    • 2010
  • Purpose : Several complications can occur in patients who received bone marrow transplantation (BMT) during childhood and adolescence. This study aims to investigate endocrine dysfunctions after BMT so that better care can be provided to care for long-term survivors of BMT. Methods : One hundred patients (61 males, 39 females) were included in this study. Clinical parameters such as initial diagnosis, age at BMT, conditioning regimen, presence of graft-versus-host disease (GVHD), growth pattern, thyroid function, and pubertal status were retrospectively reviewed to evaluate risk factors associated with endocrine dysfunction. Results : Height standard deviation score (SDS) at BMT, after 1 year of BMT, and at the last visit were $0.08{\pm}1.04$, $-0.09{\pm}1.02$, and $-0.27{\pm}1.18$, respectively (P =0.001). Height SDS significantly decreased in patients who received total body irradiation (TBI) (P =0.017). One of the patients who received TBI demonstrated growth hormone deficiency. Thirty (31.9%) of 94 patients had compensated hypothyroidism. Incidence of compensated hypothyroidism was higher among those who had GVHD (odds ratio 2.82, P =0.025). Of the 32 patients (17 males, 15 females) who were over 14 years in male and 13 years in female at the last visit, 16 (3 males, 13 females) had increased luteinizing hormone (LH) or follicle-stimulating hormone (FSH). Abnormal elevation of LH or FSH was more common in females (odds ratio 30.3, P =0.001). Conclusion : The most common endocrine dysfunction was ovarian insufficiency. Regular check-up for endocrine function needs to be required due to high incidence of endocrine dysfunction in patients with BMT.

Lived Experience of Kidney Transplant Recipients with Kidney Graft Failure (이식신장의 기능부전을 경험한 환자의 질병체험)

  • Hwang, Younghui;Min, Kyoungok;Son, Haeng-Mi
    • Journal of Korean Academy of Nursing
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    • v.54 no.1
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    • pp.93-105
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    • 2024
  • Purpose: The study aimed to understand the semantic structure and nature of the disease experience of kidney transplant recipients with kidney graft failure by applying phenomenological research methods. Methods: Data were collected between February and September 2021 through individual in-depth interviews with 12 kidney transplant recipients with kidney graft failure. Colaizzi's phenomenological analysis was used to analyze the meaning of the participants' illness experiences. Results: 5 theme clusters and 15 themes were derived. The five theme clusters are as follows: (1) First transplant giving me a second life; (2) Body and mind becoming sick again; (3) Waiting for a re-transplant with hope and worry; (4) Life supported by gratefulness; (5) Having control over my own life. Conclusion: This study shows that kidney transplant recipients with kidney graft failure experience physical and psychological difficulties during the long disease period and require help from many people, including family members, friends, colleagues, and health care providers, to overcome their difficulties.

Transfusion Associated Graft-Versus-Host Disease After Open Heart Surgery (개심술 후 발생한 수혈 관련 이식편대숙주병 -1례 보고-)

  • 전양빈;이창하;이재웅;박철현;박국양
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.471-474
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    • 2002
  • Transfusion associated graft-versus-host disease is a rare but fatal disease reported after open heart surgeries mainly in Asian people. It can be prevented by pretransfusion gamma irradiation of the fresh whole blood. In this presentation, we report a case of transfusion associated graft-versus-host disease following coronary artery bypass surgery in a 61 year-old male patient. Postoperatively the patient was transfused urgently with 2 units of fresh whole blood from his two sons. He was discharged on postoperative 10 day with only symptom of mild diarrhea. Two days after discharge, he was readmitted because of persistent diarrhea, systemic erythema and high fever. On laboratory examinations, he showed findings of failure in liver, kidney, gastrointestinal tract, and bone marrow. Hemodynamically he deteriorated acutely and died of multiple organ failure on 17th postoperative day. This has been our first experience since we started open heart program at our hospital and we changed our policy for the transfusion of the fresh whole blood after this event.

Combined Heart and Kidney Transplantation in Patient with Postpartum Cardiomyopathy and Renal Failure (분만 후 발생한 심근병증 및 만신신부전 환자의 심장-신장 동시이식 수술 체험 1예)

  • Lee Seung-Cheol;Hahm Shee-Young;Kim Jae-Joong;Han Duck-Jong;Song Meong-Gun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.714-717
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    • 2006
  • Heart and kidney transplantation has made great progress in the modern era. Coupled with the growing successes in individual solid organ transplantation, there has also been an increase in the number of multiple organ transplants, such as heart-kidney transplantation. This trend has been in part due to a better understanding of immunobiology, advances in surgical technique and postoperative care, and an often-common pathologic association between dual-organ failure. This pathologic course is representative for end-stage heart failure leading to secondary renal dysfunction or failure, or for end-stage renal failure as a cause for (uremic) cardiomyopathy. However, refractory cardiac failure has long been considered a contraindication to kidney transplantation. Additionally, cardiac transplantation has been denied for patients with end-stage renal disease. Over recent years, combined heart-kidney transplantation has been offered to select patients who were once denied transplantation. We report the first experience of combined heart-kidney transplantation with one year follow-up results.

Periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplant surgery (투석을 받고 있으며 신장 이식 수술 전 구강내 평가를 위해 의뢰된 말기 신장 질환 자의 치주 상태)

  • Youn-Kyung Choi;Hye-Mi Jeon;Ji-Young Joo;Hyun-Joo Kim;Eun-Young Kwon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.2
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    • pp.46-54
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    • 2024
  • Purpose: The purpose of this study was to compare the periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to renal transplantation surgery with those having normal kidney function. Materials and Methods: Patients who had been undergoing dialysis for end-stage renal disease and been referred to the Dental Clinic Center by the Department of Nephrology at University Hospital for intraoral evaluation prior to kidney transplantation surgery. For comparison of periodontal status, subjects without abnormalities in kidney function were matched with the patients by age and gender and selected as healthy controls. The patients' age, gender, comorbidities, type of dialysis received, and duration of dialysis were investigated by reference to their medical records, and data on their periodontal status were analyzed via the relevant periodontal records. Results: A total of 102 patients, including 51 dialyzed patients and 51 healthy control group subjects, participated in this study. In the patients with end-stage renal disease undergoing dialysis with periodontal probing depth of 5 mm or more, percentage of sites with clinical attachment level of 4 mm or more, percentage of teeth with bleeding on probing, number of missing teeth, and ratio of moderate to severe periodontitis were all significantly greater than in the healthy controls. Conclusion: The periodontal status of end-stage renal disease patients undergoing dialysis and referred for intraoral evaluation prior to kidney transplantation was worse than that of healthy controls.

Surgical Treatment of Metastatic Tumor in Proximal Femur with Recycling Autograft Prosthetic Composite after Wide Excision (근위 대퇴골 전이성 종양의 수술적 치료로서 광범위 절제술 후 재활용 자가골을 이용한 복합 고관절 성형술)

  • Kim, Jae-Do;Park, Pil-Jae;Kwon, Young-Ho;Jang, Jae-Ho;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.71-81
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    • 2005
  • Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

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Surgical Treatment of Metastatic Tumor in Pelvis (골반부 전이성 종양의 수술적 치료)

  • Kim, Jae-Do;Park, Woong;Jo, Myung-Rae;Son, Jung-Whan;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.61-70
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    • 2004
  • Purpose: We studied to decide the operative indication of the metastatic tumor in pelvis according to the oncologic results, the Eastern Cooperative Oncologic Group (ECOG) performance status and complication. Materials and methods: From May 1994 to May 2003, 9 patients who were performed on palliative treatment and 10 paitents on operative treatment due to metastatic tumor of pelvic bone were investigated. On palliative/operative group, the mean age of patients was 57.6/48.0 years old and the ratio of male to female was 5:4/7:3. Primary origins were 3 cases from kidney, 3 from cervix and 2 of lung, 2 of myeloma, 2 of Non-Hodgkin's Lymphoma, and 1 from breast, bladder, testis, prostate, stomach, liver and retroperitoneal leimyosarcoma respectively. The palliative treatment was performed in 5 cases with radiotherapy, 1 with chemotherapy, 2 with combined chemo-radiotherapy and 1 with percutaneous cementation. The operative methods were 1 case of bone cement insertion after curettage, 2 of Girdlestone with internal hemipelvectomy and 7 of reconstruction after wide excision. Reconstructions were done.: 1 case of bone cementation, 5 of autograft prosthesis composite with irradiation or pastuerization and 1 of saddle prosthesis. We have observed the oncologic results, the ECOG performance status and complication. Results: The oncologic results of palliative/operative groups are NED 0/1, AWD 2/6, DOC 1/2 and DOD 6/1. The ECOG performance status was changed from 1.5 into 4.3 in palliative group and from 2.6 into 2.2 in operative group. The complications were 3 cases of the prosthesis failure and 2 of infection. Conclusion: The indication of operation of metastatic pelvic tumor is decided in consideration of the patient's condition, the grade of malignancy in primary tumor and the life expectancy.

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