• Title/Summary/Keyword: Chronic kidney diseases

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A Case of Renal Osteodystrophy with Severe Bone Deformity (심각한 골격계 변형을 보인 신성 골이양증 1례)

  • Suh Hyun-Ah;Lee Joo-Hoon;Hahn Hye-Won;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.102-107
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    • 2005
  • With the advent of hemodialysis, the success of renal transplants in the 1960s and the wide use of continuous ambulatory peritoneal dialysis at the end of the 1970s, children with renal failure now enjoy an extended life span. As a result, several children experience renal osteodystrophy and growth retardation. Renal osteodystrophy is induced by phosphorus retention, hypocalcemia, low vitamin D levels and hyperparathyroidism. The pharmacologic interventions are used to prevent bone deformities and to normalize growth velocity. But surgical intervention is required sometimes whorl osteodystrophy is severe and poorly controlled. We report an eight-year-old boy with ctironic renal failure who developed severe bone deformities and needed osteotomy.

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A Case of Peritoneal Empyema in a Patient with Nephrotic Syndrome due to Medical Neglect (신증후군에서 의료방임으로 발생한 복부농양 1례)

  • Shin Yun-Hye;Hur Joon;Lee Kang-Gyoon;Yim Hyun-Ee;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.108-111
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    • 2005
  • Nephrotic syndrome is a common chronic disease in childhood. Patients with nephrotic syndrome are at an increased risk of bacterial Infections due to immunological changes secondary to proteinuria. Primary bacterial peritonitis is one of the most serious and common infectious complications. The rate of peritonitis is, 2-6% and overwhelming infection still carries a mortality rate of 1.5%. We experienced a rare case of nephrotic syndrome complicated with severe peritonitis and Peritoneal empyema in a 10-year old girl after 2 months of medical neglect by parents. Here we emphasize thf: importance of early detection and treatment of peritoneal infection in nephrotic syndrome.

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Biomarkers Predicting Treatment-Response in Nephrotic Syndrome of Children: A Systematic Review

  • Lee, Jiwon M.;Ahn, Yo Han;Lim, Seon Hee;Kang, Hee Gyung
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.92-111
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    • 2021
  • Purpose: Nephrotic syndrome (NS) is the most common form of glomerulopathy in children. Most pediatric patients respond to glucocorticosteroid treatment (steroid-sensitive NS, SSNS), while approximately 10-15% will remain unresponsive or later become steroid-resistant. There has been a long-standing effort to find biomarkers that may predict steroid responsiveness. Methods: We systematically reviewed current studies which investigated clinically relevant biomarkers for predicting steroid responsiveness in pediatric NS. We performed a PubMed and EMBASE search to identify eligible articles. We collected data on urinary markers, blood/serum markers (including cellular phenotypes and mRNA expression), genotypes and HLA allele frequency. Results: A total of 659 articles were identified following electronic and manual searches. After reviewing the titles, abstracts, and full texts, 72 eligible articles were finally included. Vitamin D-binding protein (VDBP) seemed to be significantly elevated in SRNS than in SSNS, in both serum and urine specimen, although further validation is required. Conclusions: The present paper narratively illustrates current understandings of potential biomarkers that may help predict steroid responsiveness. Further investigation and collaboration involving a larger number of patients are necessary.

Inhibitory Effect of Fermented Spanish Extract on Inorganic phosphate-induced Vascular Calcification in ex vivo Aortic Rings (발효 시금치 추출물의 무기인산염에 의해 유도된 혈관 석회화 저해 효과)

  • Lee, Sang Hee;Hong, Sun Mi;Sung, Mi Jeong
    • Journal of the Korean Society of Food Culture
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    • v.37 no.3
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    • pp.248-255
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    • 2022
  • Spinach (Spinacia oleracea L.), a green leafy vegetable, is well known as a functional food due to its biological activities. Vascular calcification is associated with several disease conditions including atherosclerosis, diabetes, and chronic kidney disease (CKD), and is known to raise the risk of cardiovascular diseases related morbidity and mortality. However, there are no previous studies that have investigated the effects of fermented spinach exract (FSE) against aortic and its underlying mechanisms. Therefore, this study investigated the effects and action of possible mechanisms of FSE on inorganic phosphate (PI)-induced vascular calcification in ex vivo mouse aortic rings. PI increased vascular calcification through calcium deposition in ex vivo aortic rings. FSE inhibited calcium accumulation and osteogenic key marker, runt-related transcription factor 2 (Runx2), and bone Morphogenetic Protein 2 (BMP-2) protein expression in ex vivo aortic rings. And, FSE inhibited PI-induced extracellular signal-regulated kinase (ERK) and p38 phosphorylation in ex vivo aortic rings. These results show that FSE can prevent vascular calcification which may be a crucial way for the prevention and treatment of vascular disease association with vascular calcification.

Inhibition of the Semaphorin 4D-Plexin-B1 axis prevents calcification in vascular smooth muscle cells

  • Hyun-Joo Park;Yeon Kim;Mi-Kyoung Kim;Hyung Joon Kim;Soo-Kyung Bae;Moon-Kyoung Bae
    • BMB Reports
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    • v.56 no.3
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    • pp.160-165
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    • 2023
  • Vascular calcification is common in cardiovascular diseases including atherosclerosis, and is associated with an increased risk of pathological events and mortality. Some semaphorin family members play an important role in atherosclerosis. In the present study, we show that Semaphorin 4D/Sema4D and its Plexin-B1 receptor were significantly upregulated in calcified aorta of a rat chronic kidney disease model. Significantly higher Sema4D and Plexin-B1 expression was also observed during inorganic phosphate-induced calcification of vascular smooth muscle cells. Knockdown of Sema4D or Plexin-B1 genes attenuated both the phosphate-induced osteogenic phenotype of vascular smooth muscle cells, through regulation of SMAD1/5 signaling, as well as apoptosis of vascular smooth muscle cells, through modulation of the Gas6/Axl/Akt survival pathway. Taken together, our results offer new insights on the role of Sema4D and Plexin-B1 as potential therapeutic targets against vascular calcification.

Acute dural venous sinus thrombosis in a child with idiopathic steroid-dependent nephrotic syndrome: a case report

  • Se Jin Park;Haing-Woon Baik;Myung Hyun Cho;Ju Hyung Kang
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.101-106
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    • 2022
  • Nephrotic syndrome (NS) is a hypercoagulable state in which children are at risk of venous thromboembolism. A higher risk has been reported in children with steroid-resistant NS than in those with steroid-sensitive NS. The mortality rate of cerebral venous sinus thrombosis (CVST) is approximately 10% and generally results from cerebral herniation in the acute phase and an underlying disorder in the chronic phase. Our patient initially manifested as a child with massive proteinuria and generalized edema. He was treated with albumin replacement and diuretics, angiotensin-converting enzyme inhibitor, and deflazacort. Non-contrast computed tomography showed areas of hyperattenuation in the superior sagittal sinus when he complained of severe headache and vomiting. Subsequent magnetic resonance imaging revealed empty delta signs in the superior sagittal, lateral transverse, and sigmoid sinuses, suggesting acute CVST. Immediate anticoagulation therapy was started with unfractionated heparin, antithrombin III replacement, and continuous antiproteinuric treatment. The current report describes a life-threatening CVST in a child with steroid-dependent NS, initially diagnosed by contrast non-enhanced computed tomography and subsequently confirmed by contrast-enhanced magnetic resonance imaging, followed by magnetic resonance venography for recanalization, addressing successful treatment.

Classification of Machine Learning Techniques for Diabetic Diseases Prediction

  • Sheetal Mahlan;Sukhvinder Singh Deora
    • International Journal of Computer Science & Network Security
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    • v.23 no.12
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    • pp.204-212
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    • 2023
  • Diabetes is a condition that can be brought on by a variety of different factors, some of which include, but are not limited to, the following: age, a lack of physical activity, a sedentary lifestyle, a family history of diabetes, high blood pressure, depression and stress, inappropriate eating habits, and so on. Diabetes is a disorder that can be brought on by a number of different factors. A chronic disorder that may lead to a wide range of complications. Diabetes mellitus is synonymous with diabetes. There is a correlation between diabetes and an increased chance of having a variety of various ailments, some of which include, but are not limited to, cardiovascular disease, nerve damage, and eye difficulties. There are a number of illnesses that are connected to kidney dysfunction, including stroke. According to the figures provided by the International Diabetes Federation, there are more than 382 million people all over the world who are afflicted with diabetes. This number will have risen during the years in order to reach 592 million by the year 2035. There are a substantial number of people who become victims on a regular basis, and a significant percentage of those people are uninformed of whether or not they have it. The individuals who are most adversely impacted by it are those who are between the ages of 25 and 74 years old. This paper reviews about various machine learning techniques used to detect diabetes mellitus.

$17{\beta}$-estradiol Attenuates Renal Fibrosis in Mice with Obstructive Uropathy (폐쇄성 요로병증에서 $17{\beta}$-estradiol에 의한 신섬유화 감소 효과에 대한 연구)

  • Cho, Min-Hyun;Jang, Hee-Seong;Jung, Kyung-Jin;Park, Kwon-Moo
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.125-137
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    • 2011
  • Purpose : Men are generally more prone to chronic renal disease and progression to end stage renal disease than women. The purpose of this study is to prove the effect of gender and sex hormone on renal fibrosis in mice with unilateral ureteral obstruction (UUO) and to elucidate the specific underlying mechanisms. Methods :We compared the expression of ${\alpha}$-smooth muscle actin (${\alpha}$-SMA) in female and male mice with complete UUO (day 7). After this, we estimated the changes of renal fibrosis in the female mice with oophorectomy and in the female mice with oophorectomy and replacement of $17{\beta}$-estradiol, respectively. Results : The level of ${\alpha}$-SMA in the female kidney with UUO was significantly lower than that in the male kidney with UUO. oophorectomy and replacement of $17{\beta}$-estradiol did not change the expression of angiotensin II type 1 (AT1) receptor in the female kidney with UUO, whereas the expression of angiotensin II type 2 (AT2) receptor was significantly more elevated in the intact female (IF) and the oophorectomized female with estrogen (OF+E) than that in the oophorectomized female (OF). The expressions of inducible nitric oxide synthase (iNOS) in the IF and OF+E mice were significantly more elevated than that in the OF mice, which was similar to the expression of AT2 receptor. Conclusion : The female gender is associated with resistance to renal fibrosis in obstructive uropathy and this gender difference may originate from the existence of $17{\beta}$-estradiol, which has an anti-fibrotic effect via upregulation of the AT2 receptor and iNOS.

Comparative Study of Gingival Changes in Cyclosporine-Induced Nephrotoxicity with Normal and Low Salt Diet (저염식으로 유도한 Cyclosporine 신독성 백서에서의 치은 변화)

  • Lim, Jae-Gye;Kim, Yong-Jin;Park, Yong-Hoon
    • Journal of Periodontal and Implant Science
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    • v.30 no.2
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    • pp.359-374
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    • 2000
  • Cyclosporine A(CsA) is a widely used immunosuppressant for transplant patients and is also used for the treatment of a wide variety of systemic diseases with immunologic disorders. However, its use is frequently limited because of complications such as nephrotoxicity or gingival hyperplasia. Although several hypotheses have been postulated for CsA-induced gingival hyperplasia, i.e. various cytokine effects of inflammatory cells, existence of plaque or CsA itself, but its pathogenesis is still unclear. For experimental chronic CsA toxicity, salt depletion has been shown to increased susceptibility of rodents to the effects of CsA, and this maneuver facilitates production of arteriolopathy and interstitial fibrosis in kidney that mimic the changes found in human. The purpose of this study was to evaluate pathogenesis of CsA-induced gingival hyperplasia by comparing changes between CsA administration groups of normal standard diet and those of low salt diet group. Specific pathogen-free, 20 to 25 days old(120 to 150 g), male Fisher-344 rats(KIST, Korea), 120 to 150g of body weight, were assigned to four groups of six animals each after one week of adaptation period for powder food. Group 1 received olive oil($300{\mu}l/g\;of\;diet$) with normal standard diet(0.4% of sodium)(NSD). Group 2 received CsA(Cypol-N, Jonggundang, Korea; $300{\mu}g/g\;of\;diet$) with normal standard diet(NSD+CsA). Group 3 received same amount of olive oil with low salt diet(0.05 % of sodium, Teklad Premier, U.S.A.)(LSD). Group 4 received same dose of CsA with low salt diet(LSD+CsA). Rats were pair fed and were sacrificed after six weeks. Renal histologic lesions associated with CsA, consisted of cortical interstitial fibrosis, tubular atrophy and hyalinization of arterioles and the impairment of renal function including increase of serum creatinine and decrease of glomerular filtration rate was more severe in low salt diet group. These were proved as the results of activated of renin-angiotensin system in the kidney by low salt condition. Meanwhile the degree of gingival hyperplasia at incisor and molar tooth was less severe in low salt diet group compared with normal sodium diet group. Hyperplastic gingiva showed mild epithelial hyperplasia and expanded underlyng stroma which consisted of matrix increasement, capillary proliferation and dilatation. While the number and the activation of fibroblasts were increased, inflammatory cells were rare in the stroma. The immunohistochemistry for TGF-${\beta}_1$ in the kidney and gingiva revealed stronger positive in LSD+CsA in kidney but in gingiva of NSD+CsA. These results suggested followings; Gingival hyperplasia can be developed without inflammatory cells infiltration and seemed not induced by CsA by itself. The major role for gingival hyperplasia by CsA would be the secondary effect of TGF-${\beta}$, which maybe upregulated by CsA administration. Low salt diet can attenuate this hyperplasia perhaps by decreasing the activation of $TGF-{\beta}$.

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Development of a Quality of Life Scale For Children on Chronic Peritoneal Dialysis (만성 복막투석 아동용 삶의 질 척도 개발)

  • Shin, Min-Sup;Cho, Soo-Churl;Jang, Jae-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.202-212
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    • 2008
  • Purpose : The aim of this study was to develop a quality of life scale for children on chronic peritoneal dialysis(QOL-CPD). Methods : Thirty children on chronic PD at Seoul National University Children's Hospital participated. A healthy control group included 47 elementary school children. Other patients groups are 32 children from the department of pediatric orthopedics and 28 children from the department of child psychiatry. The age range of all children was 7 to 16 years. Preliminary items of the QOL-CPD were developed and administered along with the Korean version of the Children's Depression Inventory(CDI) to all children. Results : The final QOL-CPD was constructed by excluding those items with a factor loading of less than .20, and the principal axis factor analysis was performed again. The QOLCPD demonstrated a good internal consistency with a value of .87. The dialysis and childpsychiatric groups showed significantly lower QOL scores compared to the healthy control group. In addition, the dialysis and child-psychiatric groups showed greater difficulties on physical and academic functions. For the CDI, the PD group showed a mild level of depression. Conclusion : The results of this study demonstrate the clinical utility of a newly developed self-report QOL scale specific for children on chronic PD.