• Title/Summary/Keyword: Chronic Renal failure

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Ultrasound-Guided Placement of Tunneled Hemodialysis Catheters (초음파 유도하 터널식 혈액투석용 도관 삽입술)

  • Lee Hee Bong;Jang Kuhn Jo
    • Journal of The Korean Radiological Technologist Association
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    • v.27 no.2
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    • pp.157-174
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    • 2001
  • Ⅰ. Purpose : To evaluate the usefulness of ultrasound-guided, radiologic placement of tunneled hemodialysis catheters via internal jugular vein(IJV). Ⅱ. Materials and Methods : In 32 patients(31 chronic renal failure, 1 acute renal failure), We performed

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A Clinical Study of Arteriovenous Shunts and Arteriovenous Fistula for Hemodialysis (혈액투석을 위한 동정맥연결술에 대한 임상적 고찰)

  • 김근호
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.227-231
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    • 1978
  • Since January 1973 we have performed 47 arteriovenous shunts and 22 arteriovenous fistulas for 57 patients with acute or chronic renal failure. Of these 57 cases, 50 cases had chronic renal failure and the other 7 cases had acute renal failure. The most frequent complications after operations were thrombosis, bleeding and infection. Less frequently dislodgement of shunt and aneurysmal change of the fistula were found. After 47 arteriovenous shunts, 21 those complications [44%] were found. On the other hand after 22 arteriovenous fistulas, 5 complications were found. Now we are using the arteriovenous shunt only for the patients who need emergency short term hemodialysis and temporary dialysis until arteriovenous fistula could be used.

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Obesity Related Glomerulopathy Progressed to Chronic Renal Failure (만성 신부전으로 진행된 비만 연관 사구체병증 1례)

  • Ahn, Jung-Hee;Yoon, Jung-Rim;Moon, Kyung-Chul;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.94-99
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    • 2010
  • Obesity-related glomerulopathy (ORG) is a secondary form of focal and segmental glomerulosclerosis (FSGS) manifesting as proteinuria and progressive renal dysfunction that results from maladaptive glomerular response to increasing adiposity. Reports of ORG progressing to end stage renal diseases in rare in the pediatric population. We report a 9-year-old boy with obesity (body mass index $35\;kg/m^2$) who was diagnosed with ORG presenting with proteinuria. He was diagnosed with obesity-related glomerulopathy based on the laboratory, urinary, and kidney biopsy finding. In spite of treatment with angiotensin- converting enzyme (ACE) inhibitor and/or, angiotensin-receptor blocking agent, the degree or amount of proteinuria increased and renal function declined continuously. His BMI did not decrease and eventually progressed to chronic renal failure. Consequently, obese patients should be monitored for proteinuria, which may be the first manifestation of FSGS, a lesion that may be associated with serious renal sequelae.

The Cases of Oriental diagnosis and treatment at the patients considering of the Chronic renal failure (만성신부전으로 의심되는 환자에서 주증에 따른 한의학적 변증치료의 예(例))

  • Lee Kyung-Hwan;Kim Yong-Seung;Kwark Jung-Jin;Ryu Hyung-Chun;Kim Haeng-Jin
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1046-1054
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    • 2003
  • Renal Failure is called a disorder of kidney excretion induced by glomerulus filtration rate(GFR) decrease. GFR is measured by Blood Urea Nitrogen(BUN) and Cretinine in blood. This study is about Oriental diagnosis and treatment of Chronic renal failure(CRF) patients. We treated five cases which were diagnosed as CRF by using methods used in oriental medicine, the application of Youkmijihwang-tang(六味地黃湯加減). In most such cases, we concluded that the results turns better as the symptoms like fatigue and digestive disorder decreases and the decrease of BUN and Creatinine in blood as well.

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Assessment of Nutritional Status and Survey of Dietary Habits in Predialysis Patients of Chronic Renal Failure (투석전 만성신부전 환자의 영양상태 평가 및 식습관 조사)

  • 노숙령;최윤정
    • Journal of the East Asian Society of Dietary Life
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    • v.13 no.5
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    • pp.408-424
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    • 2003
  • The purpose of this study was to analyze the nutritional status and dietary habits in predialysis patients of chronic renal failure(CRF). The patients group was composed of total 35 persons with chronic renal failure(diabetes exclusion), male 20, female 15 who were treated in the kidney internal department and the control group also composed of 35 persons, male 18, female 17 who were classified as normal by the medical examination. Their dietary habits, nutritional status and nutritional knowledge were investigated from two general hospitals in Inchon, middle of this year 2002. There were 31.4% of low weight patients (BMI below 20), 77.1% of anemia patients (serum hemoglobin below 12g/㎗), 6S.6% of hypertension patients with diastolic blood pressure over 90mmHg, 80% with systolic blood pressure over 140mmHg, 20% of hypercholesterolemia patients (serum cholesterol over 230mg/㎗), and 22.9% of hyperlipemia patients (serum triglyceride over 200mg/㎗). The cardiovascular disease seemed to be caused by the abnormality of lipid metabolism. The possibility of the bone disease was shown from patients of hyperphosphatemia (serum phosphorus over 4.7mg/㎗, 22.9%) and hypocalcemia (serum calcium below 8.4mg/㎗, 25.7%). Intake of insufficient calories which was caused by the lack of appetite affected on the nutritional status. The intake of most nutrients was not significantly different from the RDA for Koreans. Consequently, the patient groups took a lot of salt even after the diagnosis of CRF. But patients ate 6.lg of salt which were more than the recommended amount 2∼4g for patients with CRF. The patient groups, who had the experiences of nutritional counselling, had significantly higher nutritional knowledge related to CRF than control group. Unfortunately, patients could not have enough chances for nutritional counselling by the nutritionist even though they needed the nutritional informations and dietetic treatments. The continuous research is expected with regard to the detail plan for the improvement of nutritional support and the nutritional counselling because it is important to decide the requirements of nutrients for patients with kidney disease, considering the kidney function and status of nutrition.

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ORTHROGNATHIC SURGERY IN SEVERE CHRONIC RENAL FAILURE PATIENT (중증의 만성신부전 환자에서의 악교정 수술)

  • Shin, Sang-Hun;Kim, Ki-Hyun;Jeung, Suck-Young;Park, Sung-Hwan;Kim, Cheol-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.6
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    • pp.652-657
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    • 2000
  • The kidneys play a vital role in the maintenance of normal body fluid volumes and in the composition of the extracellular fluid compartments. There are normally more than 2 million functioning glomeruli that regulate total body water and solute concentrations. As renal failure progresses, there is a decrease in the number of functioning nephrons. Chronic renal failure(CRF) is the consequence of a multitude of diseases that cause permanent destruction of the nephron. Azotemia is an elevation in blood urea nitrogen(BUN) and serum creatinine levels subsequent to a decreased glomerular filtration rate(GFR), which results in uremia. This loss of renal function can cause functional and metabolic abnomalities of body. For this problem, oral & maxillofacial surgeons have demanded to routinely treat patients with CRF. However, there has not been a reported case of orthognathic surgery by bilateral sagittal split ramus osteotomy(BSSRO) in patients with CRF, which can cause multiple complications in healthy patients. We report developmental mechanism of complication associated with CRF and preop. and postop. care of orthognathic surgery by BSSRO in Cl III patient with severe chronic renal failure.

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Melittin induces autophagy to alleviate chronic renal failure in 5/6-nephrectomized rats and angiotensin II-induced damage in podocytes

  • Yufan Zhang;Huaping Xu;Hongwei Qiao;Ya Zhao;Minmin Jiang
    • Nutrition Research and Practice
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    • v.18 no.2
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    • pp.210-222
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    • 2024
  • BACKGROUND/OBJECTIVES: Chronic renal failure (CRF) is a complex pathological condition that lacks a cure. Certain Chinese medicines, such as melittin, a major component in bee venom, have shown efficacy in treating CRF patients. On the other hand, the mechanisms underlying the therapeutic effects of melittin are unclear. MATERIALS/METHODS: A 5/6 nephrectomy model (5/6 Nx) of renal failure was established on rats for in vivo assays, and mouse podocyte clone 5 (MPC5) mouse podocyte cells were treated with angiotensin II (AngII) to establish an in vitro podocyte damage model. The 24-h urine protein, serum creatinine, and blood urea nitrogen levels were evaluated after one, 2, and 4 weeks. Hematoxylin and eosin staining, Masson staining, and periodic acid-Schiff staining were used to examine the pathological changes in kidney tissues. A cell counting kit 8 assay was used to assess the cell viability. Reverse transcription polymerase chain reaction and Western blot were used to assess the mRNA and protein levels in the cells, respectively. RESULTS: In the rat 5/6 Nx, melittin reduced the 24-h urinary protein excretion and the serum creatinine and blood urea nitrogen levels. Furthermore, the renal pathology was improved in the melittin-treated 5/6 Nx rats. Melittin promoted podocin, nephrin, Beclin 1, and the LC3II/LC3I ratio and inhibited phosphorylated mammalian target of rapamycin (mTOR)/mTOR in 5/6 Nx-induced rats and AngII-induced MPC5 mouse podocyte cells. Moreover, inhibiting autophagy with 3-MA weakened the effects of melittin on podocin, nephrin, and the LC3II/LC3I ratio in podocytes. CONCLUSION: Melittin may offer protection against kidney injury, probably by regulating podocyte autophagy. These results provide the theoretical basis for applying melittin in CRF therapy.

A Case Report of Chronic Renal Failure(stage4) on Stroke Patient through Integrative Medicine Therapy. (만성 신부전 환자의 중풍치료에 대한 한·양방 협진효과 증례보고)

  • Hwang, Yunkyeong;Lee, Boram;Kim, Wonill
    • Herbal Formula Science
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    • v.24 no.3
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    • pp.233-242
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    • 2016
  • Objective : Chronic renal failure(CRF) is defined as a permanent reduction in glomerular filtration rate(GFR), resulting in Structural and functional abnormalities. The purpose of this thesis is to report the improvement of a CRF stage4 on stroke patient through integrative medicine therapy.Methods : We treated the patient with herbal medication(Sibjeondaebo-tang gagambang), acupuncture and moxibustion as well as Western medication. We measured the Creatinine, BUN, eGFR in the serum and observed clinical symptoms During 4monthsResult : After treatment, the level of BUN and Creatinine was decreased and eGFR was increased. And the symptoms of CRF(edema, anorexia, general weakness) were improved.Conclusion : This study suggests that Integrative Medicine Therapy is effective in the treatment of CRF symptoms. In the future, for the effective management of CRF, It is considered necessary to build a systematic integrative medicine therapy.

Related Factors and their Effects on Acute Renal Failure Resulting from Rhabdomyolysis after Pesticide Intoxication (횡문근 융해증이 발생한 농약중독 환자에서 급성 신부전 발생의 연관요인)

  • Kang, Chang-Woo;Lee, Kyung-Woo;Jung, Jin-Hee;Kang, Tae-Shin;Kim, Dong-Hoon;Kim, Sung-Choon;Park, In-Sung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.83-89
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    • 2009
  • Purpose: Rhabdomyolysis is one of the most important complications of pesticide intoxication. It affects a patient's clinical prognosis and can cause acute renal failure. It is important that patients diagnosed with pesticide intoxication receive an accurate initial diagnosis and proper treatment to prevent significant complications. This study's objective was to investigate and confirm related factors causing acute renal failure by verifying clinical observations and laboratory findings collected following pesticide intoxication. Methods: A retrospective analysis was made of 734 patients who presenting to our emergency medical center after ingesting pesticides between January 2006 and December 2008, Of these, 513 patients were selected for the study. Two hundred and twenty-one patients were excluded because of paraquat intoxication, age (if under 18), or chronic renal failure. Seventy-four patients were diagnosed with rhabdomyolysis, based on serum creatinine phosphokinase levels were > 1,000U/L. Acute renal failure was diagnosed when creatinine levels were > 2.0 mg/dL. Results: Among the 74 patients diagnosed with rhabdomyolysis, 26 (35.1%) experienced acute renal failure. The most meaningful related factor in the prediction of acute renal failure was initial arterial pH and creatinine level. Conclusion: Initial arterial pH and creatinine level are predictors of complications such as acute renal failure in patients with rhabdomyolysis.

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Hemorheology and clinical application : association of impairment of red blood cell deformability with diabetic nephropathy

  • Shin, Se-Hyun;Ku, Yun-Hee
    • Korea-Australia Rheology Journal
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    • v.17 no.3
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    • pp.117-123
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    • 2005
  • Background: Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day­to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. Methods: We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemo-dialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. Results: We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy: control (P = 0.0001). Conclusions: The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.