• Title/Summary/Keyword: Acute Renal Failure

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A Case of Acute Renal Failure Caused by Rhabdomyolysis due to Hyperosmolar Nonketotic Coma in Children (소아의 고삼투압성 비케톤성 혼수에서 발생한 횡문근 융해증에 의한 급성 신부전 1례)

  • Kwak, Jeong Won;Oh, Jae Min;Kim, Su Yung
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.565-568
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    • 2005
  • Hyperosmolar nonketotic coma complicated in diabetes mellitus has been a rare cause of rhabdomyolysis, although increasingly reported recently. Acute renal failure can be complicated in 15 percent of rhabdomyolysis patients, but is rare in the case of rhabdomyolysis caused by diabetic hyperosomolar nonketotic coma. We report a 14 years-old boy with acute renal failure complicated by rhabdomyolysis caused by diabetic hyperosmolar coma.

Treatment of Acute Renal Failure in Neonate (신생아 급성 신부전의 치료)

  • Lee, Jin-A
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.168-180
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    • 2010
  • Acute renal failure (ARF) is common in the neonatal period, however, there are no uniform treatment strategies of ARF. The main treatment strategies are conservative management including medical treatment and the renal replacement therapy. Because ARF in the newborn is commonly acquired by hypoxic ischemic injury and toxic insults, removal of all the offending causes is important. Aminoglycoside, indomethacin, and amphotericin-B are the most common nephrotoxic drugs of ARF. To relieve the possible prerenal ARF, initial fluid challenge can be followed by diuretics. If there is no response, fluid restriction and correction of electrolyte imbalance should begin. Adequate nutritional support and drug dosing according to the pharmacokinetics of such drugs will be difficult problems. Renal replacement therapies may be provided by peritoneal dialysis, intermittent hemodialysis, or hemofiltration. New promising agents, bioartificial kidney, and stem cell will enable us to extend our therapeutic repertoire.

Renal replacement therapy in children with acute renal failure (소아 급성 신부전증의 신장 대체 요법)

  • Paik, Kyung Hoon
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.938-947
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    • 2007
  • Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

Definition and Diagnostic Criteria of Acute Kidney Injury (급성 신손상의 정의와 진단 기준)

  • NamGoong, Mee-Kyung
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.101-106
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    • 2011
  • Acute renal failure means that the word does not contain a mild kidney injury. In addition, the criteria for acute renal failure per researcher are different, and it is difficult in interpreting the results of research on acute renal failure. Therefore, rather than acute renal failure, a new term "acute kidney injury" meaning to include all the levels of injury is introduced. In 2002, to diagnose by means of serum creatinine, glomerular filtration rate and urine output, a detailed classification of acute kidney injury, the RIFLE criteria has been proposed. In 2007, the RIFLE criteria by transforming, AKIN criteria has been proposed. The pediatric RIFLE criteria for children has also been proposed. The author reviews here these criteria by comparing them.

Initial Diagnosis of Acute Renal Failure Induced by Ischemia in Miniature Pig (미니돼지에서 허혈성 신장 손상의 조기진단)

  • Kim, Se-Eun;Ko, A-Ra;Bae, Chun-Sik;Park, Soo-Hyun;Han, Ho-Jae;Shim, Kyung-Mi;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.52-56
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    • 2011
  • Acute renal injury induced by ischemia is a major cause of high morbidity and mortality in hospitalized patients and a common complication in hospitalized patients. Thus, the work with acute renal failure and renal ischemia has been studied for many years. Although serum creatinine concentration that is widely used as an index of renal function performs fairly well for estimating kidney function in patients with stable chronic kidney disease, it performs poorly in the setting of acute disease. Thus, an ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury in hospitalized patients, acute tubular necrosis, early and accurately, and may aid to risk-stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay and mortality. In this study, renal ischemia and reperfusion were performed by clapming and un-clamping right renal artery in miniature pigs. Plasma blood urea nitrogen (BUN) and creatinine were examined at pre- clamping, after-clamping at 0, 1 and 3 hours. And we searched initial indicators in these samples. Also, renal tissue was collected and searched the initial indicator by PCR and western blotting. As a result, hypoxia inducible factor $1{\alpha}$ ($HIF1{\alpha}$), nuclear factor kappa-B ($NF{\kappa}B$), $I{\kappa}B$, erythropoietin (EPO), erythropoietin receptor (EPOR), angiopoietin-1 and vascular endothelial growth factor (VEGF) were showed significant changes among the renal protein. $HIF1{\alpha}$, EPO, and EPOR were showed significant changes among the renal gene. Thus, these markers will be used as initial diagnosis of acute renal failure.

Effects of Moxibustion on Zusanli(SP6), Yinlingquan(SP9) and Pangguangshu(BL28) at Experimental Acute renal failure in rats. (삼음교(三陰交), 음릉천(陰陵泉), 방광유(膀胱兪) 단독(單獨) 및 배혈(配穴) 애구(艾灸) 시술(施術)이 Uranyl Acetate에 의하여 유발(誘發)된 백서(白鼠)의 급성신부전(急性腎不全)에 미치는 영향(影響))

  • Youn Dae-Hwan;Park Jong-Seung;Kim Young-Sung;Kim Jeong-Sang;Na Chang-Su
    • Korean Journal of Acupuncture
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    • v.20 no.2
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    • pp.55-66
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    • 2003
  • Objectives : The aim of this experiment is to investigate the effects of moxibustion on SP6, Sp9 and BL28 in uranyl acetate-induced acute renal failure in rats. Methods : To induce experimental acute renal failure, uranyl acetate was intraperitoneally injected to rats by 5mg/kg. 3 days later moxibustion treatment was done at SP6, Sp9 and BL28 bilaterally of the rats. And then 4 days later, we measured rats' body weight, kidney weight, serum BUN, creatinine and serum electrolytic levels(Na, K and Cl). Results : In the SP6 group, serum BUN were significantly decreased (p<0.01). In the BL28 group, serum Na level were significantly decreased (p<0.05). In the $SP6{\cdot}SP9$ group, serum creatinine level were significantly increased but serum Na level, serum Cl level were significantly decreased(p<0.05). In the $SP6{\cdot}BL28$ group, hypertrophy index of kidney and serum creatinine level were significantly decreased(p<0.01) and serum BUN were marginally significantly decreased (0.1

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The Effect of Paljeong-San Pharmacopuncture Treatment on Glycerol-Induced Acute Renal Failure in Rats (팔정산(八正散) 약침(藥鍼)이 글리세롤로 유발된 흰쥐의 급성 신부전에 미치는 영향)

  • Lee, So-Young;Kim, Min-Ho;Yun, Yeo-Choong;Cho, Su-In;Lim, Se-Hyun
    • Journal of Haehwa Medicine
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    • v.21 no.1
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    • pp.163-174
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    • 2012
  • Objective: The primary objective this study was to evaluate the effect of Paljeong-san (PJS) pharmacopuncture treatment on against the glycerol-induced acute renal failure in rats. Methods: Glycerol injection decreased GFR (glomerular filtration rate) and increased urine volume, serum creatinine, BUN level, urine albumine secretion and fractional excretion of Na+, K+. PJS was selected in the basis of invigorating kidney which can eliminate pathogens. Rats were treated with PJS pharmacopuncture on Shin-shu (BL23) and Chon-chu (ST25) point for 3 days, followed by 50% concentration of glycerol injection ($5m{\ell}/kg$ body weight). Results: After the 3 days treatment period, Paljeong-san (PJS) pharmacopuncture treatment improved renal function. In addition, Glycerol injection increased lipid peroxidation, and decreased Na-K-ATPase in renal cortex and which were prevented by PJS treatment. Conclusion: This study suggests that Paljeong-san (PJS) pharmacopuncture treatment show favorable effect on glycerol-induced acute renal failure in rats.

Clinical study on Renal Replacement Therapy for Acute Renal Failure following Cardiopulmonary Bypass (체외순환후 급성 심부전에 대한 신대체요법의 임삼적 검토)

  • 서경필
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.232-239
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    • 1992
  • Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

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Beneficial Effect of Scutellaria Balicalensis Georgi. Extract(SBGE) on Cisplatin-Induced Acute Renal Failure in Rabbits (황금약침액(黃芩藥鍼液)이 Cisplatin에 의해 유발된 급성신불전(急性腎不全)에 미치는 영향)

  • Ahn, Chang-Beohm;Kwon, Hae-Yon;Youn, Hyoun-Min;Jang, Kyung-Jeon;Song, Choon-Ho
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.156-167
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    • 2002
  • The present study was carried out to determine if Scutellaria balicalensis Georgi. extract (SBGE) exerts beneficial effect against the renal failure in rabbits. Rabbits were pretreated with SBGE orally for 7 days, followed by cisplatin injection (5 mg/kg, i.p.), cisplatin injection caused an increase in serum creatinine level, which was accompanied by a reduction in GFR. The fractional excretion of Na+, K+, glucose, and phosphate increased in cisplatin-treated animals, which was prevented by SBGE pretreatment. The uptake of p-aminohippurate, an organic anion, in renal cortical slices was inhibited by the administration of cisplatin, and the effect was prevented by SBGE. cisplatin injection increased lipid peroxidation, which was prevented by SBGE pretreatment. These results indicate that lipid peroxidation plays a critical role in cisplatin-induced acute renal failure. SBGE exerts the protective effect against acute renal failure induced by cisplatin, and its effect may be attributed to an antioxidant action.

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Clinicopathological Diagnosis of Gentamicin and Ethylene glycol Induced Acute Renal Failure in Dogs (개에서 Gentamicin과 Ethylene glycol에 임상병리학적 진단)

  • 김지현;이영재;이경갑
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.327-333
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    • 2000
  • The diagnostic method was, evaluated in experimentally induced acute renal failure in doges. Ten male dogs weighing from 5 to 10 kg were assigned to two groups(gentamicin & ethylene glycol treated group) al random. Gentamicin sulfate at 10 mg/kg of body weight, t.i.d., for 7 days and ethylene glycol at 3 ml/kg of body weight once used in a randomized complete block design with tee treatments in block. The samples(blood, urine) were collected before and 1,3,5,7,9 and l1th day after administration. The serum creatinine concentration and BUN(blood urea nitrogen) were sig- nificantly increased at the 7th day than before administration in gentamicin treated group (p<0.05), bolt there was significant increase at the 1st day than before administration in ethylene glycol treated group(p<0.05). The urine GGT(gramma glutamyl transpeptidase) and GGT/creatinine were significantly increased at the 1st (lay after administration in gentamicin treated group (p<0.05). But in ethylene glycol treated group, there was no significant changes. The value of FENa (fractional excretion of sodium) was significantly increased at the 3rd day after administration in gentamicin treated group and the 1 st day after administration in ethylene glycol treated group (p<0.05). These results suggest that FENa was a good parameter of renal function in dogs with acute renal failure.

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