• Title/Summary/Keyword: Chronic kidney disease

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Peritoneal dialysis in children and adolescents (소아의 복막투석)

  • Ha, Il Soo
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1069-1074
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    • 2009
  • Peritoneal dialysis is a preferred modality of replacement therapy in children and adolescents with end-stage renal disease waiting for kidney transplantation. Recent development of pediatric swan-neck catheters with cuffs, novel dialysis solutions, and cyclers for automated peritoneal dialysis enabled more flexible prescriptions of dialysis with less complication, and improved patients' activities as well as the dialysis adequacy. Principles and practical issues of chronic peritoneal dialysis in children and adolescents are reviewed and utility of a web-based Korean Pediatric CRF Registry is explained.

Perceived Stress, Mood State, and Sympotms of Stress of the Patient with Chronic Illness (만성질환자의 스트레스 지각, 기분상태, 스트레스 증상에 관한 연구)

  • 한금선
    • Journal of Korean Academy of Nursing
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    • v.33 no.1
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    • pp.87-94
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    • 2003
  • Purpose: The purpose of this study was to identify the factors influencing Symptoms of Stress in patients with chronic illness. Method: Data were collected by questionnaires from 1,748 patients with chronic disease in General Hospital in Seoul. Chronic diseases of were cardiac disease including hypertension, peptic ulcer, pulmonary disease included COPD and asthma, DM, and chronic kidney disease. The data were analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. Result: 1. The level of symptoms of stress was moderate(M=2.17). 2. The score of symptoms of stress showed significantly positive correlation with the score of mood state(r=.58, p=.00), perceived stress(r=.57, p=.00), and ways of coping(r=.33, p=.00). The symptoms of stress showed significantly negative correlation with the score of social support(r=-.37, p=.00) and self-esteem(r=-.19, p=.00). 3. The most powerful predictor of symptoms of stress was mood state and the variance explained was 34%. A combination of mood state, ways of coping, perceived stress, social support, and duration of illness account for 45% of the variance in symptoms of stress of the patients with chronic illness. Conclusion: This study suggest that mood state, ways of coping, perceived stress, and social support are significantly influencing factors on symptoms of stress of the patients with chronic illness.

Development of Self-management Instrument for Pre-dialysis Patients with Chronic Kidney Disease (투석전 만성신장병 환자의 자가관리 도구 개발)

  • Lee, Suk Jeong;Kim, Sisook
    • The Journal of the Korea Contents Association
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    • v.14 no.7
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    • pp.367-375
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    • 2014
  • This study aimed to develop a valid and reliable self-management instrument for pre-dialysis patients with chronic kidney disease (CKD). A total of 143 patients with CKD recruited from a medical center completed the questionnaire. The dimension and items of self-management were composed by literature review. The items of self-management was evaluated using exploratory factor analysis and measures of reliability. Five factors were extracted and labelled adherence to treatment regimen and partnership, diet adherence, problem solving, health behavior, and pursuit of psycho-social health. The five factors accounted for 51.1% of total variance. Each factors showed acceptable internal reliability with Cronbach's alpha from 0.64-0.79. The developed self-management instrument can be useful in self control of their disease for patients with CKD, and both evaluating patients' self-management and developing intervention program for health care professionals.

Effect of Uric Acid on the Development of Chronic Kidney Disease: The Korean Multi-Rural Communities Cohort Study

  • Mun, Kwang Ho;Yu, Gyeong Im;Choi, Bo Youl;Kim, Mi Kyung;Shin, Min-Ho;Shin, Dong Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.248-256
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    • 2018
  • Objectives: Several studies have investigated the effects of serum uric acid (SUA) levels on chronic kidney disease (CKD), with discrepant results. The effect of SUA levels on CKD development was studied in the Korean rural population. Methods: A total of 9695 participants aged ${\geq}40years$ were recruited from 3 rural communities in Korea between 2005 and 2009. Of those participants, 5577 who participated in the follow-up and did not have cerebrovascular disease, myocardial infarction, cancer, or CKD at baseline were studied. The participants, of whom 2133 were men and 3444 were women, were grouped into 5 categories according to their quintile of SUA levels. An estimated glomerular filtration rate of < $60mL/min/1.73m^2$ at the time of follow-up was considered to indicate newly developed CKD. The effects of SUA levels on CKD development after adjusting for potential confounders were assessed using Cox proportional hazard models. Results: Among the 5577 participants, 9.4 and 11.0% of men and women developed CKD. The hazard ratio (HR) of CKD was higher in the highest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.60; 95% confidence interval [CI], 1.02 to 2.51) and women (adjusted HR, 1.56; 95% CI, 1.14 to 2.15). Furthermore, CKD development was also more common in the lowest quintile of SUA levels than in the third quintile in men (adjusted HR, 1.83; 95% CI, 1.15 to 2.90). The effect of SUA was consistent in younger, obese, and hypertensive men. Conclusions: Both high and low SUA levels were risk factors for CKD development in rural Korean men, while only high levels were a risk factor in their women counterparts.

Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

  • Kim, Jin Kyu;Shin, Jun Jae;Park, Sang Keun;Hwang, Yong Soon;Kim, Tae Hong;Shin, Hyung Shik
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.296-301
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    • 2013
  • Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

Construct a Structural Model for Health Promoting Behavior of Chronic Illness (만성 질환자의 건강 증진 행위 구조모형 구축)

  • 이숙자;김소인;이평숙;김순용;박은숙;박영주;유호신;장성옥;한금선
    • Journal of Korean Academy of Nursing
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    • v.32 no.1
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    • pp.62-76
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    • 2002
  • This study was designed to construct a structural model for health promoting behavior of patients with chronic disease. The hypothetical model was developed based on the literature review and Pender's health promotion model. Method: Data was collected by questionnaires from 1748 patients with chronic disease in General Hospital from December 1999 to July 2000 in Seoul. The disease of subject were cardiac disease included hypertension peptic ulcer, pulmonary disease included COPD and asthma, DM, and chronic kidney disease. Data analysis was done with SAS 6.12 for descriptive statistics and PC-LISREL 8.13 Program for Covariance structural analysis. Results: 1. The fit of the hypothetical model to the data was moderate, it was modified by excluding 4 path and including free parameters to it. The modified model with path showed a good fitness to the empirical data (χ2=591.83, p<.0001, GFI=0.97, AGFI= 0.94, NNFI=0.95, RMSR=0.01, RMSEA=0.05). 2. The perceived benefits, perceived barriers, self-efficacy, self- esteem, and the plan for action were found to have significant direct effect on health promoting behavior of chronic disease. 3. The health concept, health perception, emotional state, social support were found to have indirect effects on health promoting behavior of chronic disease. Conclusion: The derived model in this study is considered appropriate in explaining and predicting health promoting behavior of patients with chronic disease. Therefore, it can effectively be used as a reference model for further studies and suggested implication in nursing practice.

The Literature Study of Chronic rhinorrhea of children (만성(慢性) 비루(鼻漏)에 대(對)한 고찰(考察))

  • Kim, Jeong Sook;Han, Jae Kyung;Kim, Yun Hee
    • Journal of Haehwa Medicine
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    • v.13 no.1
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    • pp.197-210
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    • 2004
  • Objective : This study was designed to investigate causes, symptoms and treatments for the Chronic rhinorrhea of children with oriental medical literatures. Methods : We surveyed the oriental and western medical books from to recent published books that have articles on Chronic rhinorrhea. Results and Conclusions : The Chronic rhinorrhea are classified to Bigu and Biruan(鼻淵). Bigu is similar to Allergic Rhinitis and Biyan(鼻淵) is similar to Chronic Sinusitis. The external cause of disease is the invasion of Poong han(風寒) etc a wrong air and the internal causes of disease are the deficiency of the spleen, lung and kidney and inner heat caused by stress. Treatment in Oriental medicine consists of herbal-therapy, acupuncture and moxa. The methods of treatment are expelling of Poong han(風寒) in the early stage and helping the vital energy in the late stage.

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Atypical hemolytic uremic syndrome and eculizumab therapy in children

  • Kim, Seong Heon;Kim, Hye Young;Kim, Su Young
    • Clinical and Experimental Pediatrics
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    • v.61 no.2
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    • pp.37-42
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    • 2018
  • Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli-associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is mainly plasmapheresis or plasma infusion; however, many children with aHUS will progress to chronic kidney disease despite plasma therapy. Eculizumab is a newly developed biologic that blocks the terminal complement pathway and has been successfully used in the treatment of aHUS. Currently, several guidelines for aHUS, including the Korean guideline, recommend eculizumab as the first-line therapy in children with aHUS. Moreover, life-long eculizumab therapy is generally recommended. Further studies on discontinuation of eculizumab are needed.

Orofacial Manifestations of Hyperparathyroidism: A Dental Perspective

  • Jo-Eun Park
    • Journal of Oral Medicine and Pain
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    • v.49 no.2
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    • pp.40-42
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    • 2024
  • Hyperparathyroidism (HPT) is a significant condition marked by the overproduction of parathyroid hormones, affecting both systemic health and orofacial regions. Predominantly, secondary HPT associated with chronic kidney disease (CKD) is critical because of its link to widespread conditions such as diabetes and hypertension. This short article highlights the vital role of dental professionals in identifying HPT through panoramic radiography, which can reveal critical orofacial signs such as brown tumors, altered dental development, and specific bone changes. With the CKD prevalence expected to increase alongside an aging population, the importance of early detection of HPT and its manifestations in dental settings cannot be overstated. Dental practitioners play a crucial role in the early detection of HPT, emphasizing the importance of being knowledgeable about its orofacial manifestations.

Frequency of Inappropriate Metformin Use in Patients with Diabetes Mellitus (당뇨병환자에게 부적절하게 사용된 Metformin의 처방빈도 분석)

  • Sin, Hye-Yeon;Jung, Ki-Hwa
    • YAKHAK HOEJI
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    • v.54 no.6
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    • pp.455-460
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    • 2010
  • We evaluated the inappropriateness of metformin use in patients with type 2 diabetes and chronic medical conditions to identify the frequency of the prescription metformin in violation of the food and drug administration (FDA) black box warning. We reviewed medical records of 307 outpatients who received metformin at endocrinology department in a hospital setting between January 1, 2005 and August 30, 2009. Of the 307 outpatients, 25 discontinued treatment of metformin due to elevated serum creatinine level (Scr${\geq}$1.5 mg/dl in male, Scr${\geq}$1.4 mg/dl in female), cancers, and/or liver disease. 5 were lost to follow-up. 89 (29.0%) of the patients had cardiovascular disease, 54.1% for hypertension, 9.8% for liver disease, and 60 (20.8%) for chronic kidney disease. 12 patients (3.9%) with chronic kidney disease and/or elevated serum creatinine level, and 1 patient (0.3%) with lactic acidosis were contraindicated to metformin use. Metformin should be avoided in 7 outpatients (2.3%) with active hepatitis and 1 patient (2.6%) with liver cirrhosis. Of the 307 outpatients, 13 (4.2%) patients who received metformin at the first visit and 16 (8.7%) patients who received metformin at the last visit violated to black box warning. 8 (2.6%) of the patients were in precautionary conditions to metformin use. Adjusted mean difference of serum creatinine was -0.16 mg/dl [95% CI: -0.22 to -0.11 (p<0.05)] and adjusted mean difference of alanine aminotransferase was 4.46 IU/l [95% CI: 2.47 to 6.44 (p<0.05)] between the first visit and the last visit. Critical number of elderly patients who are at the high risks of drug-disease and drug-laboratory interaction is exposed to the inappropriate metformin use in violation of black box warning. The periodic evaluation of metformin use and monitoring prescription through drug utility review (DUR) system is needed to improve patients' safety and to reduce adverse drug events.