• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.95-100
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• 1992

The radioisotopic measurement of glomerular filtration rate (GFR) has required analysis of serial blood or urine samples over several hours, and does not allow measurement of separate renal function unless separate catherterization of individual ureters is done. Gates described isotopic method for the measurement of global and unilateral GFR based on the determination by scintillation camera of the fraction of the injected dose of $^{99m}Tc-diethylenetriaminepentaacetic$ acid (DTPA) present in the kidneys 2-3 minutes after its administration. We calculated GFR according to Gates' method in 58 adult patients with various levels of global renal function using $^{99m}Tc$ DTPA and validated this technique by correlation with 24 hour creatinine clearance. A good correlation was observed between 24 hour creatinine clearance and GFR calculated by Gates' formula, with an r value of 0.91 (p<0.01). We concluded that determination of GFR according to the Gates' formula allows good and reproducible prediction of GFR with great rapidity and simplicity rendering this technique suitable for clinical practice.

• Journal of Korean Physical Therapy Science
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• v.11 no.1
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• pp.28-35
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• 2004

The purpose of the present study was to investigate the effectiveness of silver spike point (SSP) low frequency electrical stimulation on glomerular filtration rate (GFR), specifically, such as diuretic action in 24 hour urine and in plasma analysis from normal volunteer. The current of 1 Hz continue type (CT) of SSP low frequency electrical stimulation significantly decreased in plasma creatine from normal volunteer. However, the urine creatinine clearance (Ccr) was significantly increased by SSP low frequency electrical stimulation in normal volunteer. These results suggest that the SSP low frequency electrical stimulation, especially current of 1 Hz continue type, significantly regulates urine creatinine clearance and glomerular filtration rate from normal volunteer. Therefore, the SSP low frequency electrical stimulation is a good regulator through a diuretic action of hypertension.

• YAKHAK HOEJI
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• v.39 no.2
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• pp.103-112
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• 1995

Population pharmacokinetics for gentamicin were compared with 24 American patients (16 male and 8 female) and 16 Korean-American appendicitis patients(12 male and 4 female). Two to six blood specimens were collected from all patients at the following times: just before a regularly scheduled infusion and at 1/2 hour after the end of a 1/2 hour infusion. Nonparametric expected maximum(NPEM) algorithm for population modeling was used. The estimated parameters were the elimination rate constant(K), the slope of the relationship between K versus creatinine clearance(KS), the apparent volume of distribution(V), the slope of the relationship between V versus weight(VS), gentamicin clearance(CL) and the slope of the relationship between CL versus creatinine clearance and the VS(CS). The output includes a 3-dimensional plot of the joint probability density function(PDF), two marginal PDF, means, medians, modes, variance, skewness, kurtosis, and CV%. The mean K(KS) were 0.424$\pm$0.139(0.00429$\pm$0.00164) and 0.411$\pm$0.135 hr$^{-1}$ (0.00475$\pm$0.00180[hr.mL/min/1.73m$^{2}]^{-1}$) for American and Korean-American populations, respectively. The mean V(VS) were not different at 15.6$\pm$4.77(0.233$\pm$0.0526) and 15.1$\pm$3.84L(0.239$\pm$0.0492 L/kg) for American and Korean-American populations, respectively (P>0.2). The mean CL (CS) were 6.28$\pm$1.85(0.0634$\pm$0.0191) and 5.70$\pm$1.77 L/hr(0.0701$\pm$0.0215 L/kg[hr.mL/min/1.73m$^{2}$)] for American and Korean-American populations, respectively. There are no differences in gentamicin pharmacokinetics between American and Korean-American Appendicitis patients.

• Childhood Kidney Diseases
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• v.2 no.2
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• pp.133-137
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• 1998

Purpose : To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. Methods : 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine ${\beta}_2$-microglobulin/creatinine(${\beta}_{2}MG/cr$) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. Results : There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine ${\beta}_{2}MG/cr$ and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change. Conclusion : There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.57-64
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• 2013

Purpose: In children, 24-hour urine collections are unreliable for evaluating glomerular filtration rate (GFR) because of the difficulty of regulating voiding and the daily variation of urinary creatinine up to 25%. Additionally, creatinine clearance (Ccr) based on urinary creatinine is considered inaccurate. The purpose of this study was to compare estimated GFR determined using Ccr, formulas with serum cystatin C and creatinine, and $^{99m}Tc$-mercaptoacetyltriglycine (MAG3) dynamic renal scintigraphy. Methods: This retrospective study included 101 patients (age, <18 years) who visited Chung-Ang University Hospital between July 2011 and August 2012. GFR was estimated using 24-hour urinary creatinine, five formulas with serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan. Results: Of the 101 patients, glomerular renal diseases were present in 60 patients (59.4%) and non-glomerular diseases were present in 41 patients (40.6%). There was a significant correlation between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and Ccr (r=0.389, P <0.001). The correlation values between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and each formula of Schwartz, Counahan-Barratt, Cockcroft-Gault, Filler and Lepage, and Bokencamp were 0.265 (P=0.007), 0.128 (P=0.044), 0.230 (P=0.021), 0.356 (P<0.001), and 0.355 (P <0.001), respectively. $^{99m}Tc$-MAG3 renal scan was correlated with estimated-GFR by all formulas in decreased renal function. Conclusion: Estimated GFRs determined using serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan correlated well with estimated GFR determined using Ccr. $^{99m}Tc$-MAG3 renal scan may be replaced for evaluation of renal function with convenience in patients with renal disease and decreased renal function in childhood.

• YAKHAK HOEJI
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• v.56 no.1
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• pp.48-54
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• 2012

Enviromental differences in gentamicin pharmacokinetics by using population pharmacokinetic methods were compared with 20 Korean patients and 24 Korean-American appendicitis patients. Two to six blood specimens were collected from all patients at the following times : just before a regularly scheduled infusion and at 0.5 hour after the end of a 0.5 hour infusion. Nonparametric expected maximum (NPEM) algorithm for population modeling was used. The estimated parameters were the elimination rate constant (K), the slope (KS) of the relationship between K versus creatinine clearance ($C_{cr}$), the apparent volume of distribution (V), the slope (VS) of the relationship between V versus weight, gentamicin clearance (CL) and the slope (CS) of the relationship between CL versus $C_{cr}$ and the V. The output includes two marginal probability density function (PDF), means, medians, modes, variance and CV%. The mean K (KS) were $0.402{\pm}0.129\;h^{-1}(0.00486{\pm}0.00197\;[h{\cdot}ml/min/1.73\;m^2]^{-1})$ and $0.411{\pm}0.135\;h^{-1}(0.00475{\pm}0.00180\;[h{\cdot}ml/min/1.73\;m^2]^{-1})$ for Korean and Korean-American populations, respectively. The mean V (VS) were not different at $14.3{\pm}3.6l(0.241{\pm}0.0511l/kg)$ and $15.1{\pm}3.84l(0.239{\pm}0.0492l/kg)$ for Korean and Korean-American populations, respectively (p>0.2). The mean CL (CS) were $5.68{\pm}1.69l/h(0.0714{\pm}0.0222l/kg[h{\cdot}ml/min/1.73\;m^2])$ and $5.70{\pm}1.77l/h(0.0701{\pm}0.0215l/kg[h{\cdot}ml/min/1.73\;m^2])$ for Korean and Korean-American populations, respectively. There were no enviromental differences in gentamicin pharmacokinetics between Korean and Korean-American appendicitis patients.

• Clinical and Experimental Pediatrics
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• v.55 no.4
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• pp.136-142
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• 2012

Purpose: Urinary excretion of N acetyl-beta-D glucosaminidase (NAG) and ${\beta}_2$-microglobulin (${\beta}_2$-M) was increased in the presence of proximal tubular damage. Based on these urinary materials, we investigated the ability of expecting renal function in chronic glomerular diseases. In this study, we evaluated the relationship between glomerular filtration rate (GFR) urinary NAG, and urinary ${\beta}_2$-M. Methods: We evaluated 52 children with chronic kidney disease at the Chung-Ang University Hospital between January 2003 and August 2009. We investigated the 24-hour urinalysis and hematologic values in all 52 patients. Serum creatinine, creatinine clearance (Ccr), serum cystatin C, urinary ${\beta}_2$-M and urinary NAG were measured. Results: Out of 52 patients, there were 13 children with minimal change in disease, 3 children with focal segmental glomerulosclerosis, 17 children with immunoglobulin A nephropathy, 15 children with Henoch-Sch$\ddot{o}$nlein purpua nephritis, 3 children with poststreptococcal glomerulonephritis, and 1 child with thin glomerular basement membrane disease. In these patients, there were significant correlation between the Ccr and urinary NAG (r=-0.817; $P$ <0.01), and between the GFR (as determined by Schwartz method) and urinary NAG (r=-0.821; $P$ <0.01). In addition, there was a significant correlation between the GFR (as determined by Bokencamp method) and urinary NAG (r=-0.858; $P$ <0.01). Conclusion: In our study, there was a significant correlation between the GFR and urinary NAG, but there was no correlation between the GFR and urinary ${\beta}_2$-M, suggesting that the GFR can be predicted by urinary NAG in patients with chronic glomerular disease.

• Clinical and Experimental Pediatrics
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• v.50 no.11
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• pp.1104-1109
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• 2007

Purpose : Since 1998, school urinary screening tests have been performed on Korean school children. We could detect and treat so many asymptomatic chronic renal disease in early stage. We investigated the efficacy of school urinary screening tests from children with membranoproliferative glomerulonephritis (MPGN) type I. Methods : We analyzed the characteristics and prognosis of 18 patients with MPGN type I who admitted after 1996 and received steroid therapy with or without cyclosporine. These patients were divided into two groups. Group A (asymptomatic patients detected by school urinary screening tests) consisted of 7 patients; Group S (symptomatic patients) consisted 11 patients. Results : Mean follow-up duration was 6.3 years (from 2 to 11 years). Urinary protein excretion was 1.1 g/day in group A and 6.6 g/day in group S. 24 hour creatinine clearance (mL/min/$1.73m^2$) was 134.3 in group A and 82.3 in group S. No patients in group A had renal insufficiency, but three patients in group S had renal insufficiency and one patient required peritoneal dialysis. Conclusion : Early detection by school urinary screening tests improves prognosis of MPGN type I.

• Childhood Kidney Diseases
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• v.3 no.1
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• pp.48-56
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• 1999

Purpose : This multicenter collaboratory study was conducted to see the therapeutic efficacy and side effect of cyclosporine A (Cipol-$N^{(R)}$, Chong Kun Dang) on children with idiopathic nephrotic syndrome who experienced frequently relapsing (FR), steroid dependent (SD), or steroid resistant (SR) pattern. Patients and methods : Thirty-nine children with SD/FR NS and 3 children with SR NS were enrolled in the study. After induction of remission (SD/FR NS) with steroid or after 4 weeks of steroid therapy (SR NS), cyclosporine A was started in a dose of 4-5 mg/Kg/day in two divided dose and steroid (prednisolone or equivalent dose of deflazacort) was tapered slowly. During 16 weeks of study period, monthly check up of physical examination and various laboratory tests including BUN, creatinine, Ccr and cyclosporine blood level were done. Results : Out of 39 children with SD/FR NS, 35($89.7\%$) maintained sustained remission and at 4 weeks after therapy, values of serum protein, albumin, cholesterol, and 24 hours urinary protein excretion showed normal values. Two out of 3 children with SR NS showed and sustained remission with cyclosporine A therapy. Side reaction to cyclosporine A therapy showed hypertrichosis in 8 cases and hyperuricemia in 5 cases. However, other laboratory tests including CBC, liver profile, BUN, creatinine and GFR (creatinine clearance utilizing 24 hour urine) did not show any abnormalities during the 16 weeks of study period. Conclusion : Cyclosporine A (Cipoi-$N^{(R)}$ Chong Kun Dang) can be utilized quite effectively on children with SD/FR or SR NS and further trial of cyclosporine A on long-term basis (1-2 year period) is needed to determine it's efficacy and side effect (especially nephrotoxicity) of long-term administration of cyclosporine A.

• Journal of agricultural medicine and community health
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• v.16 no.1
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• pp.27-32
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• 1991

We measured volume of daily urinary excretion. daily excretion of $Na^+$ and $K^+$, creatinine clearance, blood $Na^+$ and $K^+$ concentration on 34 subjects(12 men. 21 wenen) who live in Hanlim sub-county. Kimhae county. Kyongnam, Korea in December 1990. The data were compared to the data in 9 urban residents(4 men, 5 wemen). Results were as follows. I) Daily mean urinary $Na^+$ excretion of rural residents was $255{\pm}95.6$mEq/day. It is much lower than that of in 1960 but higher than that of students living in urban area(1975) or that of occidentals. 2) Daily mean urinary $K^+$ excretion of rural residents was $45{\pm}15.1$mEq/day. 3) $K^+$ excretion of rural residents was similar to that of urban residents but because of the relatively high $Na^+$ excretion, $K^+/Na^+$ ratio was significantly lower than that of urban residents. In conclusion. salt intake and excretion of rural residents tends to have been decreased progressively and it is thought to be the result of the improvement in dietary life especially increased intake of animal protein.