• Journal of Nutrition and Health
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• v.10 no.4
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• pp.68-83
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• 1977

영양실태조사 및 사람을 대상으로 하는 많은 영양적 연구에서 요중(尿中) 여러 성분(成分)들의 배설량을 측정하기 위해 만 하루의 소변을 완전히 채취하기는 매우 어려우므로 임의시간(任意時間)의 소변을 채취하여 사용한다. 이 경우엔 흔히 요성분(尿成分)의 농도는 요중(尿中) 크레아티닌을 양(量)을 기준으로 하여 표시되는데, 크레아티닌은 요중(尿中) 일일(一日) 배설량이 개인에 따라 알정하고 요양(尿量)에는 상관없이 비교적 일정한 속도로 배설 된다고 간주되기 때문이다. 그러나 비교적 높은 발생율을 갖는 세균재(細菌在) 요도염(尿道炎)에서는 감염균(感染菌)이 크레아티닌을 파괴할 가능성이 있고 따라서 이 경우의 요중(尿中) 크레아티닌의 여러 용도(用途)는 비합리적으로 될 수 있다. 본 연구에서는 이 가설을 규명하려고 한다. 첫 실험에서는 감염균(感染菌)이 요소(尿素)를 암모니아로 파괴함으로써 형성되는 요(尿)의 알칼리성에 대한 크레아티닌의 안정성(安定性)을 알아 보았다. 건강인(健康人)의 요중(尿中) 크레아티닌과 완충액에 용해시킨 순수 크레아티닌을 pH $4.5{\sim}9.0$으로 조정하여 $37^{\circ}C$에서 6일간 배양시켰다. 잔존한 크레아티닌을 측량한 결과, 크레아티닌은 완충용액이나 요(尿)에서서 모두 산성 pH에서 보다 알칼리 pH에서 더욱 안정(安定)함을 보여주었다. 1일간 배양 후엔 거의 변화(變化)가 없었고 6일 후에나 $4.2{\sim}8.0%$의 감소율을 나타냈을 뿐이다. 두번째 실험에서는 감염균이 크레아티닌을 성장(成長)을 위한 질소급원으로 사용하는지를 결정하기 위해 세균성(細菌性) 요도염(尿道炎)에서 자주 발견되는 13종류(種類)의 박테리아를 건강인(健康人)의 요(尿)와 크레아티닌을 질소급원으로 하는 합성배지(合成培地)에 $37^{\circ}C$로 배양하였다. 대부분의 박테리아는 크레아티닌함양(含量)을 감소시키지 않았다. 그러나 Pseudomonas aeruginosa와 Klebsiella pneumoniae는 합성배지중(合成培地中)의 크레아티닌을 상당량 파괴시켰고, 그 파괴율은 그들 성장율과 평행하였다. 배양 6일후에는 크레아티닌이 Pseudomonas aeruginosa에 의해 처음 양(量)(500mg/100m1) 의 12.8%가, Kleobsiella pneumoniae에 의해서는 11.8%가 감소되었다. 감소율은 크레아티닌의 처음 농도가 낮을수록 커져서 50mg/100ml 일 때는 각각 21.1%와 28.2%이었다. 더욱이 Klebsiella pneumoniae는 황산암모늄과 요소(尿素)같은 다른 질소급원이 크레아티닌과 공존(共存)할 때에도 크레아티닌을 어느 정도 파괴함을 보여 주었다. 결론으로, 세균성(細菌性) 요도염(尿道炎)환자의 요(尿)의 알칼리성은 요중(尿中) 크레아티닌양(量)에 중요한 영항을 주지 못한다. 그러나 본(本) 연구(硏究)에서 사용된 Klebsiella pneumoniae와 가능하게는 Pseudomonas aeruginosa 같은 몇 감염균(感染菌)은 크레아티닌을 그들 성장(成長)의 질소급원으로 사용하여 요중(尿中) 크레아티닌양(量)을 저하시킬지도 모른다. 특히 요(尿)에 요소(尿素), 요산(尿酸)같은 다른 질소급원이 크레아티닌에 비해 비교적 낮은 비율로 존재할 때에, 예(例)를 들면 저(低)단백식사(食事)인 경우, 감염균에 의한 크레아티닌의 파괴율이 더 클 것으로 기대된다.

• Journal of Chest Surgery
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• v.38 no.2 s.247
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• pp.146-151
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• 2005

Background: Preoperative elevated serum creatinine values are associated with increased risk for both morbidity and mortality in patients undergoing on-pump coronary artery bypass surgery (CABG). We investigated the postoperative changes of renal function and proper management in the patients. Material and Method: Among 74 consecutive patients who underwent isolated on-pump CABG, 17 patients with increased serum creatinine level $(creatinine\;\geqq\;1.5\;mg/dL)$ within preoperative one week wereincluded in the study. Seven patients showed pre­operative serum creatinine level of 2.0 mg/dL or higher, and 3 of them had been undergoing hemodialysis. Preoperative hemodialysis was performed in the 3 patients due to end-stage renal failure (ESRD) the day before the operation. We started peritoneal dialysis immediately after the cardiopulmonary bypass in patients with ESRD or postoperative acute renal failure if it was necessary to remove intravascular volume and lower serum creatinine level. Result In most of the patients with CABG, postoperative serum creatinine level increased and recovered to the preoperative level at the discharge. In 2 of the 4 patients with serum creatinine level of 2.0 mg/dL or higher and 3 patients with ESRD, intravascular volume, serum creatinine level and serum electrolyte were controlled with peritoneal dialysis. Conclusion: Postoperative serum creatinine level increased transiently in most of CABG patients, and intravascular volume and serum creatinine level were controlled by peritoneal dialysis only in the patients with acute renal failure postoperatively and those depending on hemodialysis.

• Journal of Chest Surgery
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• v.38 no.12 s.257
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• pp.828-834
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• 2005

Background: Off-pump coronary artery bypass grafting (OPCAB) has shown better outcome in chronic renal failure (CRF) patients by avoiding the effects of cardiopulmonary bypass. We evaluated renal function after OPCAB in CRF patients. Material and Method: 656 patients underwent OPCAB between January, 2001 and December, 2004. Data were collected in 26 CRF patients (Cr > 1.7 mg/dL). Preoperative/postoperative creatinine (Cr) levels, creatinine clearance and postoperative data were evaluated. We divided the patients into group 1 (Cr < 3 mg/dL) and group 2 (Cr $\geq$ 3 mg/dL). Result: Three patients started dialysis after surgery. Preoperative mean creatinine level (4.19$\pm$3.4 mg/dL) was elevated to 4.36$\pm$2.7 mg/dL at the third postoperative day and decreased below Preoperative level at the fifth postoperative day. In group 1 (mean Cr level=1.87$\pm$0.25 mg/dL), Cr level reached its peak level of 2.19$\pm$0.52 mg/dL at the fourth postoperative day (p=0.017), with subsequent decrease. Patients without pre- or postoperative dialysis (n=15) showed peak Cr elevation on postoperative day four (p=0.017) and subsequent decrease (p=0.01). Postoperative creatinine clearance showed reverse correlation with creatinine level. Conclusion: Creatinine level was elevated at third/fourth postoperative day, but decreased 5 days after surgery. Thus, if urgent dialysis is not indicated, postoperative renal replacement therapy in CRF patients may be better to be considered after four days observation.

• 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.

• Analytical Science and Technology
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• v.25 no.1
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• pp.83-90
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• 2012

The objective of the study was to estimate the measurement uncertainty associated with determination of creatinine (Cr) in urine samples by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Centrifuged urine samples (10 ${\mu}L$) were diluted with 390 ${\mu}L$ of distilled water. To 20 ${\mu}L$ aliquots of diluted urine samples, 30 ${\mu}L$ of internal standard solution (Cr-$d_3$, 5 ${\mu}g/mL$) and 10 ${\mu}L$ of acetonitrile were added and filtered. The samples (1 ${\mu}L$) were introduced into LC-MS/MS with no further pretreatment. Cr was separated on a multi-mode ODS column (Scherzo SM-C18, 75 ${\times}$ 2.0 mm I.D., 3 ${\mu}m$) and quantified by LC-MS/MS operating in MRM mode (Cr, m/z 114.0${\rightarrow}$ 86.0; Cr-$d_3$, m/z 117.0${\rightarrow}$ 89.1). The four factors that contribute uncertainty to the final result were extracted and evaluated. The principal factors of contribution to combined standard uncertainty were sample dilution, calibration curve and repeatability, while the preparation of standard solution was only a minor factor. Relative extended uncertainty of the measured concentration was 14.2% in a real urine sample.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.150-156
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• 2008

Purpose : Many results have reported a correlation between the spot urine protein/creatinine ratio(P/C ratio) and 24-hour urinary protein(24UP) amount. This study was designed to evaluated correlation between 24UP amounts and P/C ratio in children and to find the factors that affect this correlation. Methods : 210 patients who visited the Department of Pediatrics in Busan Paik Hospital from september 2003 to december 2007 were included in this study. All the patients were divided into I, II, III/A, B, C group[I:24UP(mg/$m^2$/day)]<100, II: 100$\leq$24UP<1,000, III: 24UP$\geq$1,000, A: Cr excretion(mg/kg)<15, B: 15$\leq$Cr excretion<25, C: Cr excretion$\geq$25)]. Pearson correlation analysis was performed between 24UP and P/C ratio to evaluate the relationship. We defined fractional difference between 24UP and P/C ratio, and then performed multiple regression analysis. Results : There was a strong positive linear correlation between 24UP and P/C ratio in all patients, and the correlation was also good in each group. The factors affecting accurate quantitation of proteinuria using spot urine P/C ratio was creatinine excretion. Conclusion : Spot urine P/C ratio is a useful test to predict proteinuria roughly. Therefore, we expect that urine P/C ratio can be used as parameter instead of 24UP, if we set cutoff value of P/C ratio considered to creatinine excretion according to age and sex in large pediatric population.

• Journal of the Korean Electrochemical Society
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• v.15 no.4
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• pp.249-255
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• 2012

The planar-type amperometric creatinine biosensor employing an additional enzyme layer containing creatine kinase and adenosine triphosphate was developed to eliminate severe interference from creatine. In the additional enzyme layer, an interfering substance, creatine is converted to noninterfering product, phosphocreatine. Furthermore, the carbon electrode electroplated with Pt black(Pt-B) was employed to fabricate creatinine biosensors with improved sensor performance(e.g., sensitivity, reliability, and reproducibility). The creatinine levels in an unknown sample were determined within less than 5% errors using creatinine microsensors equipped in a flow-cell cartridge.

• Korean Journal of Clinical Pharmacy
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• v.21 no.3
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• pp.208-214
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• 2011

목적: 이 연구의 목적은 한국인 성인 환자를 대상으로 아미카신 1일 1회 요법을 시행하였을 때의 약동학적 파라미터를 평가하고, 신기능에 따른 아미카신의 약동학적 파라미터를 비교함으로써 최적의 개인화 약물요법을 설계할 수 있도록 하는 것이다. 방법: 그람 음성균 감염에 대해 1일 1회 요법으로 아미카신을 투여 받았던 353명의 한국 성인 환자를 대상으로 항정상태에서 아미카신의 농도를 2회(약물 투여 전 1시간 이내, 약물투여 종료 후 0.5~1시간 이내) 측정하였다. 각 환자의 약동학적 파라미터(분포용적, 청소율, 반감기) 및 혈중 최고 농도, 최저 농도는 환자의 나이, 체중, 신장, 성별, 혈중 크레아티닌 농도, 투여된 약물용량, 측정된 약물의 혈중농도, 감염의 종류 등을 감안하여 산출하였다. 크레아티닌 청소율에 따라 환자를 4군으로 분류하여 아미카신의 약동학적 파라미터를 비교분석하였다. 결과: 본 연구에서 아미카신 혈중 최저, 최고 농도의 평균 ${\pm}$ 표준편차는 각각 $1.14{\pm}1.95mg/L$, $26.35{\pm}9.28mg/L$이며, 청소율, 분포용적 및 반감기의 평균 ${\pm}$ 표준편차는 각각 $55.40{\pm}23.72mL/hr/kg$, $0.35{\pm}0.12L/kg$, 그리고 $5.22{\pm}3.34hrs$로 산출되었다. 크레아티닌 청소율에 따른 아미카신의 청소율, 분포용적 및 반감기의 유의한 차이가 관찰되었다. 종합적으로 아미카신의 혈중 최저 농도는 크레아티닌 청소율이 40 mL/min 미만인 경우 40 mL/min 이상인 경우에 비해 유의하게 증가하였다. 결론: 아미카신의 약동학적 파라미터들은 신기능에 따라 유의한 차이가 있으므로 최적의 치료효과를 위해서는 환자의 크레아티닌 청소율에 따른 개인화 약물요법이 필요하다.

• Transactions of the Korean Society of Mechanical Engineers B
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• v.39 no.12
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• pp.921-925
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• 2015

The number of people suffering from renal disease increases every year. One of the most common treatments (clinical care options) for renal diseases is hemodialysis. However it takes a long time and has a high cost. Therefore, the importance of artificial kidney research has risen. Filtering creatinine from blood is one of the prime renal functions. Thus, we designed a novel two channel microfluidic chip focused on that function. In order to bond the individual polydimethylsiloxane layers, we have developed a housing system using acrylic plastic frame. This method has significant advantages in changing filter membranes. We use anodic aluminum oxide for the filter membrane. We analyzed the difference in the absorbance values for various creatinine concentrations using the Jaffe reaction. For the purpose of acquiring a standard equation to quantify the creatinine concentration, we interpolated the measured data and confirmed the concentration of the filtered solution. Through this experiment, we determined how the filtration efficiency depended on the flow rate and creatinine concentration.

• Journal of Veterinary Clinics
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• v.20 no.4
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• pp.431-436
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• 2003

The purpose of this study is to evaluate urine protein-to-creatinine ratio as a parameter for early detection of nephrotic syndrome and as a parameter for monitoring effectiveness in early course of treatment. Nine healthy dogs were sensitized by intravenous injection with 1 $\mu$g of endotoxin and 5 mg of native bovine serum albumin. After 1 week, 120 mg of cationized bovine serum albumin was injected intravenously 5 times a week. Among nine dogs, five dogs were confirmed as having developed glomerulonephritis and nephrotic syndrome by increase of urine protein-to-creatinine ratio(>1.0), hypoalbuminemia (<1.5 g/dl), hypercholesterolemia (> 240 mg/dl) and azotemia (BUN>40 mg/dl). During the induction of glomerulonephritis and the progression to nephrotic syndrome, the increase of urine protein-to-creatinine ratio was firstly detected. 1 to 4 weeks later, hypoalbuminemia, hypercholesterolemia, and azotemia were detected. Prednisolone (2.2 mg/kg, bid) was administered orally to the dogs with induced nephrotic syndrome. In early stage of treatment, the increase of serum albumin and decrease of serum cholesterol were detected. 1 to 4 weeks later, decrease of urine protein-to-creatinine ratio was detected. It was concluded that urine protein-to-creatinine ratio is a useful parameter for early detection of nephrotic syndrome, and serum albumin and cholesterol are useful parameters for the monitoring in early course of treatment in nephrotic syndrome.