• Korean Circulation Journal
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• v.54 no.3
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• pp.113-123
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• 2024

Background and Objectives: Previous studies have reported an association between impaired renal function and poor outcomes after radiofrequency catheter ablation in patients with atrial fibrillation (AF). However, outcomes of cryoballoon ablation (CBA) in patients with renal insufficiency are not fully elucidated. This study aimed to compare outcomes of CBA in AF patients with chronic kidney disease (CKD) versus those without CKD and to assess changes in renal function over 12 months following CBA. Methods: A total of 839 patients (65.1% with non-paroxysmal AF [PAF]) who underwent de novo CBA were prospectively enrolled. We divided patients into two groups based on creatinine clearance rate (CCr) and performed intracardiac echocardiography (ICE)-guided contrast agent-free CBA. Results: In comparison with patients without CKD (CCr >50, n=722), those with CKD (CCr ≤50, n=117) were older and predominantly female, had a lower body mass index, and showed a higher prevalence of heart failure and hypertension. Mean CHA₂DS₂-VAS score was significantly higher in CKD group than in non-CKD group. Procedure-related complications were not significantly different between two groups. During a mean follow-up period of 25.4±11.9 months, clinical recurrence occurred in 182 patients (21.7%) and not significantly different between two groups. In multivariate analysis, non-PAF and left atrial size were independent predictors of AF recurrence. CCr levels significantly improved over 12 months after CBA in CKD group. Conclusions: ICE-guided contrast-agent-free CBA showed comparable long-term clinical outcomes without increasing procedure-related complications and improvement of renal function over 12 months following CBA in AF patients with CKD.

• Korean Journal of Veterinary Research
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• v.22 no.2
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• pp.233-237
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• 1982

Pathological studies on 6 milk goats administrated with urea were carried out to determine the effects of acute and chronic poisonings on the animal. Clinical signs appeared about 10 minutes after ingestion of the urea and they consisted chiefly in dullness, staggering, uncontrolled urination, dyspnea, frothy salivation, bloating, muscular tremor, humping of back and tetanic spasms. Macroscopic lesions were failure of blood clot, frothy and bloody contents in the highly congested respiratory tract, pulmonary edema, rumenitis and abomatitis accompanying with petechiation of the upper small intestine. Microscopically, the liver showed vacuolar degeneration, fatty change and areas of necrosis and partial proliferation of the interlobular connective tissues in chronic crises. The renal epithelium displaced vacuolar degeneration, necrosis and hyaline casts in their lumens. In the lungs, there were hyperemia, edema, hemorrhages, and acute catarrhal bronchitis. Neuronal degeneration and necrosis in the central nervous system, catarrhal rumenitis, abomatitis, doudenitis and myocardial hemorrhage were also demonstrated.

• Nuclear Engineering and Technology
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• v.7 no.1
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• pp.3-8
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• 1975

The quantitative analysis of various kinds of free amino acids contained in blood serum of patients with chronic mandible ostities, epidermic hemorrhagic fever, chronic renal failure and liver cirrhosis were measured with the gas-liquid chromatography (G. L. C.). The results compared with the quantity of free amino acids of healthy persons. It was found that the quantity of free amino acids were differently contained in blood serum in accordance with kinds of patients.

• 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.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.144-153
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• 2000

Purpose : Effects to predict tile progression of chronic renal failure (CRF) in children, using mathematical models based on transformations of serum creatinine (Scr) concentration, have failed. Error may be introduced by age-related variations in creatinine production rate. Height (Ht) is a reliable reference for creatinine production in children. Thus, Scr, factored for Ht, could provide a more accurate predictive model. We examined this hypothesis. Methods : The progression of of was detected in 63 children who proceeded to end-stage renal disease. Derivatives of Scr, including 1/Scr, log Scr & Ht/Scr, were defined fir the period Scr was between 2 and 5 mg/dl. Regression equation were used to predict the time, in months, to Scr > 10 mg/dl. The prediction error (PE) was defined as the predicted time minus actual time for each Scr transformation. Result : The PE for Ht/Scr was lower than the PE for either 1/Scr or log Scr (median: -0.01, -2.0 & +10.6 mos respectively; P<0.0001). For children with congenital renal diseases, the PE for Ht/Scr was also lower than for the other two transformations (median: -1.2, -3.2 & +8.2 mos respectively; P<0.0001). However, the PEs for children with glomerular diseases was not as clearly different (median: +0.9, +0.5 & +9.9 respectively). In children < 13 yrs, PE for Ht/Scr was tile lowest, while in older children, 1/Scr provided the lowest PE but not significantly different from that for Ht/Scr. The logarithmic transformation tended to predict a slower progression of CRF than actually occurred. Conclusion : Scr, floored for Ht, appears to be a useful model to predict the rate of progression of CRF, particularly in the prepubertal child with congenital renal disease.

• Journal of Korean Critical Care Nursing
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• v.15 no.1
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• pp.24-34
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• 2022

Purpose : This descriptive survey aims to identify the prevalence of factors associated with sarcopenia among hemodialysis patients. Methods : The study subjects were 137 patients with chronic kidney failure undergoing hemodialysis in three artificial kidney centers in B and Y cities. Data were collected from August 1 to September 30, 2020, using the SARC-F (Strength, Assistant walking, Rising from a chair, Climbing stairs, Falls) questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF), International Physical Activity Questionnaire (IPAQ-SF), Bioelectrical Impedance Analysis (BIA), and a grip dynamometer. The collected data were analyzed using t-tests, crossover analysis, and logistic regression using the IBM SPSS 23 program. Results : The prevalence of sarcopenia among hemodialysis patients, determined using the SARC-F questionnaire, was 16.1%. The associated factors of sarcopenia among hemodialysis patients were found to be gender (OR=6.44, p =.002), age (OR=1.07, p =.015), nutritional status (OR=10.37, p =.027), and albumin level (OR=0.10, p =.014). These findings are supported by an explanatory power of 46.3% (p =.597). Conclusion : The identified risk factors for sarcopenia in hemodialysis patients were; sex, age, nutritional status, and albumin level. The findings of this study can serve as clinical evidence for the development of an intervention program for preventing and managing sarcopenia in patients undergoing hemodialysis.

• The Korean Journal of Nuclear Medicine
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• v.19 no.1
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• pp.127-136
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• 1985

To evaluate change of serum $beta_2-microglobulin$ concentration$(s\beta_2-MG)$ and the usefulness of $s\beta_2-MG$ and $s\beta_2-MG/serum$ creatinine concentration(sCr) ratio in various renal diseases, $s\beta_2-MG$ and sCr were measured in 25 normal controls and 90 patients of various renal diseases(16 cases of glomerulonephritis, 12 cases of acute renal failure, 8 cases of chronic renal failure, 24 cases of nephrotic syndrome, 15 cases of tubulointerstitial diseases and 15 cases of lupus nephritis) using $Phadebas^\circledR$ $Beta_2-Micro$ Test kits. The results were as follows; 1) In normal control, the mean value of $s\beta_2-MG$ was $1.65{\pm}0.41mg/l$ and the mean value of $s\beta_2-MG/sCr$ ratio was $0.14{\pm}0.05$. 2) In various renal diseases, the mean value of $s\beta_2-MG$ was $6.74{\pm}5.47mg/l$. The mean value of $s\beta_2-MG/sCr$ ratio was $0.24{\pm}0.11$ and significantly elevated than that of normal control. (p<0.05) 3) The correlation between $s\beta_2-MG$ and sCr in glomerular and tubulointerstitial disease was log $s\beta_2-MG-0.90$ log sCr-0.48 and its correlation coefficient was 0.78(p<0.05). 4) In glomerular disease, the correlation between $s\beta_2-MG$ and sCr was log $s\beta_2-MG-0.89$ log sCr-0.46(r - 0.76) and in tubulointerstitial disease, it was log, $s\beta2-MG-0.95$ log sCr-0.59 (r-0.87). There was no significant difference between the two groups(p<0.05). 5) Among 32 cases of glomerular and tubulointerstitial disease patients, whose sCr was within normal range, 17 cases showed elevated $s\beta_2-MG$. The mean values of $s\beta_2-MG/sCr$ ratio in these patients was $0.30{\pm}0.14$ and significantly elevated than that of normal control(p<0.05). 6) In 15 cases of lupus nephritis, 12 cases showed elevated $s\beta_2-MG$ with normal sCr and 12 cases showed elevated $s\beta_2-MG/sCr$ ratio. With above results, it was found that the $s\beta_2MG$ can be used as an index of glomerular filtration rate as in the case of sCr and that $s\beta_2-MG/sCr$ ratio can be used as a tool in early detection of slightly decreased glomerular filtration rate and in detection of the renal disease of increased $\beta_2-MG$ production.

• Journal of Acupuncture Research
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• v.25 no.4
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• pp.117-125
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• 2008

Objectives : Analyze according to types of event causing the adverse outcome due to acupotomy, and discuss problems and safety reqirements to using this therapy in Korea. Methods : Based upon the indication, contraindication, treatment procedures, clinical obsevations, acupotomy-related adverse outcome case reports, the factors of damaging event were classified. Results : The main factors of adverse outcome by acupotomy were anatomical ignorance, contamination of device or hospital staff, failure to notice preexisting disease(cardiovascular disease, hypertension, renal failure, hemophilia, chronic Liver Disease, etc.), unskilled treatment procedures(massive bleeding) and techniques(nerve injury, hepatic and splenic injury, Pneumothorax). Conclusions : It is mandatory to prepare adequate sterilie aseptic technique. The clinician should ensure understand genernal health state of patient and anatomical direction.

• Health Policy and Management
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• v.16 no.2
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• pp.96-116
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• 2006

To assess the economic value of pharmaceutical therapy with Kremezin, we investigated the maximum amount of willingness-to-pay (WTP) of patients with chronic renal failure (CRF) for a hypothetical effect of Kremezin in delaying the initiation of dialysis treatments. A face-to-face survey was carried out in a sample of 141 CRF patients from 2 dialysis centers, composed of 82 hemodialysis patients, 38 peritoneal dialysis patients, and 21 non-dialysis CRF patients. Using a bidding game method with a starting point of 320,000 Won, which is the average monthly out-of-pocket payment for dialysis treatment, we asked the study subjects how much they would pay per month to receive Kremezin therapy. The mean out-of-pocket monthly WTP for Kremezin was 310,000, 430,000, and 520,000 Won (p<0.05, repeated one-way ANOVA)) when Kremezin delays the initiation of dialysis treatments by 1, 2, and 4 years. Significant correlation between the respondent's WTP and income $(r=0.266{\sim}0.368,\;p<0.05)$ confirmed the construct validity of the WTP instrument. Regression results showed that patients with a higher education, with diabetes as a major causes of CRF, and undergoing hemodialysis treatments tended to express higher WTP for Kremezin. The economic value of WTP from the perspective of patients varied from 310,000 to 520,000 Won depending on the effect size of Kremezin. The mean WTP was higher than 32,000 Won, only when the hypothetical effect of Kremezin in delaying the initiation of dialysis is for 2 years. This implies that Kremezin might be the preferred choice of therapy by CRF patients if it delays the initiation of dialysis treatment for at least 2 years.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.18 no.1
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• pp.13-17
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• 2018

Methylmalonic acidemia is an autosomal recessive disorder caused by complete (mut0) or partial (mut-) deficiency of methylmalonyl-CoA mutase (MUT) or by defects in the synthesis of adenosylcobalamin (cblA, cblB, cblD variant 2). Long term complications of methylmalonic acidemia include tubulointerstitial nephritis with progressive renal failure, intellectual impairment, pancreatitis, and growth failure. We report a case of methylmalonic acidemia in a girl who diagnosed at 6 days after birth. She has developed recurrent metabolic crises with hyperammonemia and metabolic acidosis. In addition, she suffered from the chronic complications including tubulointerstitial nephritis, electrolyte imbalance associated with renal dysfunction, growth failure and fracture of femur shaft. At the age of 10 years, hypercalcemia and severe osteoporosis were noted, and pamidronate therapy was given for two years, which relieved hypercalcemia and osteoporosis.