• Korea-Australia Rheology Journal
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• 제17권3호
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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.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 1996년도 제4회 추계심포지움
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• pp.85-89
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• 1996

성장저해는 만성신부전 (chronic renal failure, CRF) 소아환자나 실험동물에게서 나타나는 합병증의 하나로, 그 발생기전이 잘 알려져 있지 않다. 성장저해를 일으키는 원인으로 비내분비적 요인 (metabolic acidosis, renal osteodystrophy, anemia)과 내분비적 요인의 복합적 결과로 생각하나, 비내분비적 요인들은 약물투여로 그 증세를 완화시켜도 성장저해에 대한 궁극적 치료효과는 나타나지 않는다. 따라서 성장 호르몬 (Growth Hormone, GH)이 관여하는 내분비적 요인의 변화에 그 병리기전이 있을 것으로 연구되어 왔다. GH는 직접적 성장 효과와 Insulin-like growth factor-1(IGF-I)을 간으로부터 유리시켜 나타나는 간접적 성장효과를 가지고 있다. 그런데 CRF환자의 GH 및 IGF-I 의 혈중 농도는 정상이거나, 흑은 오히려 증가상태에 있음에도 볼구하고 성장저해가 일어나는 것으로 보아, 환자의 말단기관 (end-organ)에 원인을 알 수 없는 저항성 (resistance)이 있다고 규정되어진다.

• International Journal of Internet, Broadcasting and Communication
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• 제12권4호
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• pp.188-195
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• 2020

Purpose: This study aimed to review the recent scientific literature regarding nursing care of arteriovenous fistula (AVF) for the patients with Chronic Renal Failure (CRF) undergoing hemodialysis. Methods: An integrative review was conducted and articles were searched from Cochrane library, Medline, PubMed, Science direct and CINAHL databases by using the terms "nursing", 'Chronic Renal Failure', 'Haemodialysis', renal failure', 'or 'AV Fistula' nursing care', 'self-care'. The inclusion criteria were articles published in English in the year of 2015-2020 with availability of free full text. Reviewed data were carefully analyzed and charted regard to the nursing care of the patient with AVF. Results: 12 articles papers met the inclusion criteria. Three themes were derived from the data: (a) Intervention (b). Patient and nurse education (c) KPA Assessment of (Knowledge, Practice and Attitude) Conclusions: This review indicates the challenges that nursing care of AVF patients undergoing hemodialysis. The identified themes can be used in the development of more effective educational- programs. Future studies should focus on the development and evaluation of educational programs that include these selected themes.

• 대한임상검사과학회지
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• 제38권3호
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• pp.218-223
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• 2006

Sensorineural hearing loss is frequently found in patients with chronic renal failure (CRF). There have been many efforts to elucidate the etiologic factors of hearing loss in patients with CRF. However, there was not any clear identified cause of hearing loss. This study was undertaken to evaluate the activity of mitochondrial respiratory chain (MRC) in CRF patients with hearing impairment. To determine MRC activity, peripheral blood cells were obtained from CRF patients with hearing impairment receiving dialysis and normal subjects without any hearing problems. MRC activity of complex I and complex III was measured by the Trounces method. In MRC activities between the normal subjects group and CRF patients with hearing problems, the complex I and III activities of CRF patients with hearing problems were 63% and 85% compared with normal subjects (p<0.01). These results suggest that the activity of MRC may be implicated in the underlying mechanism of the hearing impairment in CRF patients, through mitochondrial DNA mutations at MRC complex I region with a decrement of MRC activity.

• 대한본초학회지
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• 제27권4호
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• pp.45-51
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• 2012

Objectives : WHW is a polyherbal medicine for the treatment of chronic renal failure (CRF). WHW previously reported various biological property such as anti-inflammation, anti-oxidation and anti-renal fibrosis in CRF. This study aimed to investigate the anti-apoptotic effect of WHW on staurosporin(SSP)-induced apoptosis in canine kidney epithelial cells (MDCK). Methods : MDCK cells were treated with different concentrations of WHW (0.1, 0.2, 0.5 and $1mg/m{\ell}$) for 1 h, and then induced apoptosis by treatment of SSP ($1{\mu}M$) for 24 h. Cell viability was measured by WST-1 assay. The expression of apoptotic proteins such as caspase-3, Bax and Bcl-2 was determined by Western blot. Caspase-3 activity and ROS levels were also measured by their commercial available assay kits. Cell apoptosis was observed by Hoechst and DNA fragmentation. Results : WHW significantly increased the cell viability on SSP-treated MDCK cells. WHW inhibited SSP-induced expression of apoptotic proteins such as caspase-3 and Bax, and significantly decreased caspase-3 activity in MDCK cells. WHW significantly decreased SSP-induced production of ROS, and suppressed SSP-induced chromatin condensation and DNA fragmentation in MDCK cells. Conclusions : These results suggest that WHW has an anti-apoptotic effect in renal cells through suppressing the expression of apoptotic proteins, ROS production and DNA damages.

• 한국임상수의학회지
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• 제25권4호
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• pp.236-240
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• 2008

부갑상샘 호르몬 (PTH)은 칼슘과 무기인의 수송을 조절한다. 속발성 부갑상샘 기능항진증은 대개 만성신부전에서 발생하고, 이는 개와 고양이에 있어서 CRF의 일반적인 합병증이다. 신부전을 갖는 21마리의 개가 본 연구에 사용되었다. 공시동물로부터 채혈한 혈액 중 칼슘 (Ca),무기인 (iP), PTH의 농도를 측정하여 칼슘과 무기인의 비율에 따라 두 군으로 분류하였다 (Ca / iP $\leq$ I; 그룹 1, Ca/ip $\geq$ 1.5; 그룹 II). 성과 연령 사이에 부갑상샘 호르몬 수준은 유의성 있는 차이가 없었다. 두 군 사이에 부갑상샘 호르몬 수준과 Ca/P의 비율에는 유의성 (p<0.0001)있는 차이가 나타났다. 결론적으로, 칼슘과 무기인의 비율은 신부전을 갖는 개에서 부갑상샘 호르몬 수준을 예측하기 위한 지표로 이용될 수 있을 것으로 생각된다.

• 한국임상수의학회지
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• 제29권6호
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• pp.435-440
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• 2012

이번 연구는 만성신부전이 있는 개에서 대황 추출물($Rubenal^{(R)}$)의 치료적 효과와 부작용을 평가하기 위해서 실시되었다. 보호자가 있는 만성신부전 IRIS II-III 단계의 개 40마리가 이번 연구에서 사용되었다. 개들에게 동일한 모양의 대황 추출물과 위약을 투여한 후 0, 30, 90, 180일 동안 관찰, 평가하였다: BSC, 임상적 평가(식욕, 다음/다뇨, QOL), 혈액 검사(WBC, RBC, PCV), 혈청화학검사(ALT/AST, ALP, Creatinine /BUN, Total protein, albumin), 전해질검사(Na, K, Cl, Ca, iCa, P), 혈압, 요검사(UPC, 요비중) 그리고 IRIS 단계를 평가하였다. 이번 연구에서 개들에게 대황 추출물을 적용하였을 때 부작용 없이 잘 받아들이는 것을 확인하였다. 또한, 통계학적으로 임상적 평가(수의사와 보호자의 QOL)와 혈청 BUN, creatinine 수치, 혈청 인 농도, 단백뇨의 양, 그리고 만성신부전의 IRIS 점수가 루비날치료 6개월 후에 유의성 있게 개선되었다. 이러한 발견은 대황의 추출물은 만성신부적의 임상증상(i.e., azotemia, hypertension, proteinuria, hyperphosphoremia)과 삶의 질(i.e., body condition score, appetite and PD/PU)을 향상시키고, 개에서 만성신부전의 진행을 늦출 수 있다는 것을 보여준다. 그러므로 대황 추출물은 준임상적, 그리고 임상적으로 신장 질환을 치료하고 있는 개에게 좋은 보조제가 될 수 있다. 하지만 본 연구는 작은 규모의 파일럿 연구이므로 이중 맹검법의 대규모 실험을 통해 보다 정확한 실험결과의 재현이 요구된다.

• Journal of Preventive Medicine and Public Health
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• 제39권2호
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• pp.149-158
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• 2006

Objectives : We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. Methods : We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. Results : The present value of cumulative cost savings per patient with CRF from the societal perspective would be $18,555,000{\sim}29,410,000$ Won or $72,104,000{\sim}112,523,000$ Won if Kremezin delays the initiation of dialysis by 1 or 4 years. Conclusions : The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.

• 동의생리병리학회지
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• 제18권4호
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• pp.1207-1212
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• 2004

Twenty-one diabetic nephropathy patients with normal serum BUN(Blood Urea Nitrogen), creatinine levels and ten chronic renal failure patients with abnormal high BUN, creatinine levels were investigated to evaluate the renal function change after long term herb medicine administration. The hospitalized patients were administrated three times a day with herb medicine, which were prescribe frequently in practical oriental medicine such as many hospital and local clinics. Blood Urea Nitrogen, creatinine and glomerular filtration rate (GFR) were measured immediately after 7days medication. Serum BUN, creatinine levels in diabetic nephropathy patients changed from 17.63±4.38㎎/㎗, 1.09±0.26㎎/㎗(mean±SD) of pre-medication levels to 14.13±3.24 1,20±0.37, 14.75±2.21 1.23±0.55, 12.34±2.89 1.18±0.42 at 7th, 14th, 21th days after herb medicine administration respectively. Also 24hr urine total protein changed from 632.25±254.43㎎/㎗ of pre-medication levels to 623.18±231.56㎎/㎗ after herb medicine administration(P>0.05). Serum BUN, creatinine levels and GFR in chronic renal failure patients changed from 67.45±13.86㎎/㎗, 6.74±2.91㎎/㎗, 13.73±4.21㎖/min pre-medication levels to 61.23±17.75 6.43±2.29 15.49±3.56, 58.84±19.36 5.83±2.51 16.38±2.85, 56.39±20.33 5.64±2.52 16.73±3.40 at 7th, 14th, 21th days after herb medicine administration respectively. Therefore, there was not clinically remarkable difference in the serum BUN, creatinine, GFR levels between pre-medication and post-medication in both Group.

• Journal of Chest Surgery
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• 제27권8호
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• pp.669-676
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• 1994

Because the number of patients who require maintenance hemodialysis is increasing in number recently, angioaccess has become important to many vascular surgeons participating in the management of such patients.The authors created 269 arteriovenous fistulas[AVF] for angioaccess in 229 patients with chronic renal failure[CRF] at the Department of Thoracic and Cardiovascular Surgery in Chungnam National University Hospital during the period from August 1990 to March 1993. We analyzed the results of 260 operations for 220 patients except 9 patients who were lost during the follow up period. We performed snuffbox AVF in 171 cases, classic radiocephalic AVF in 46 cases, direct AVF at other site in 5 cases, forearm Gore-Tex AVF in 29 cases, and upper arm Gore-Tex AVF in 9 cases. We experienced 13 cases of operative failures, 11 cases of early complications, and 60 cases of late complications including obstructions during follow-up period. The 1 year, 2 year and 3 year patency rates of snuffbox AVF[Group 1], classic radiocephalic AVF[Group 2], and Gore-Tex AVF[Group 3] are like followings; 89, 84, 76% in group 1, 84, 75, 68% in group 2, and 79, 66, 55% in group 3. It showed a statistically significant difference between group 1, 2 and group 3.