• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.2
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• pp.580-584
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• 2003

Diabetic Nephropathy is one of the major causes of chronic renal failure. It is a common microvascular complication and clinically defined as the presence of persistent Proteinuria. We studied the effects and change of the renal function of Complex Herbal medication of the 20Diabetic Nephropathy patients. We measured the initial levels of Total Protein, Creatinine Clearance Rate(Ccr), Serum Creatinine(Serum-Cr), Urine Creatinine(Urine-Cr) and HbA1C on admission and followed up the level changes of Total Protein, Ccr, Serum-Cr and Urine-Cr on discharge. The results are following : Complex Herbal Medication does not cause the renal toxicity. The longer hypertension period is, the higher Serum-Cr level and Urine-Cr level. In an older age group, Urine-Cr is lower. 4.From the 'Deficiency in Origin and Excess in Superficiality(本虛表實)'points of view, Complex Herbal Medication improves the Serum-Cr in Diabetic Nephropathy patients. According to this results, it could be suggested that Complex Herbal Medication does not cause the renal toxicity in Diabetic Nephropathy patients and intensive controls of blood sugar, blood pressure and Complex Herbal Medication prevent the renal failure in Diabetic Nephropathy patients with early stage of Microalbumiuria.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.767-775
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• 2005

This study was carried out to investigate the preventive effect of Salviae Miltiorrhizae Radix, Rhei Rhizoma and Carthami Flos combined with Samgijiwhang-Tang(SJTSRC) on streptozotocin(STZ)-induced diabetic nephropathy. Rats were divided into a control group of rats with STZ-induced diabetic nephropathy, a sample group of those given SJTSRC, and a normal group. In the experiment diabetic nephropathy was induced by giving STZ(60mg/kg) to rats via the peritoneum, and effects were assessed with measures of serum creatinine, serum BUN, secretion content of albumin and glucose content of urine, malondialdehyde(MDA) and glutathione(GSH) content in cortex of kidney. When STZ was injected into sample rat, the value of creatinine and BUN increased validly and STZ did damage to the kidney. When applying SJTSRC to sample rats, the value of serum creatinine decreased validly but the value of serum BUN decreased invalidity. It was confirmed that SJTSRC had an effect on recovery after kidney damage and secretion content of albumin increasedafter administration of SJTSRC but there was no change in glucose content of urine compared with the control group. The decrease of secretion of albumin after injection of STZ was taken to mean progressive diabetic nephropathy, and that reversal of that trend after SJTSRC administration showed that kidney function had improved, not through decreasing blood sugar, but through other factors. Results suggest that diabetic nephropathy was induced by STZ, and SJTSRC was effective in restricting the extent of damage to the kidney and halting the progression of diabetic nephropathy with improvement in levels of serum creatinine and albumin secretion. More study is needed, particularity pertaining to anti-oxidative effects in the kidney cortex.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.1-13
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• 2009

Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.355-362
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• 2007

Diabetes mellitus can cause devastating complications, which often result in disability and death, and diabetic nephropathy is a leading cause of death in people with diabetes. In this study, we tried to predict the onset of diabetic nephropathy from an irregular and unbalanced diabetic dataset. We collected clinical data from 292 patients with type 2 diabetes and performed preprocessing to extract 184 features to resolve the irregularity of the dataset. We compared several feature selection methods, such as ReliefF and sensitivity analysis, to remove redundant features and improve the classification performance. We also compared learning methods with support vector machine, such as equal cost learning and cost-sensitive learning to tackle the unbalanced problem in the dataset. The best classifier with the 39 selected features gave 0.969 of the area under the curve by receiver operation characteristics analysis, which represents that our method can predict diabetic nephropathy with high generalization performance from an irregular and unbalanced dataset, and physicians can benefit from it for predicting diabetic nephropathy.

• Journal of Acupuncture Research
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• v.22 no.5
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• pp.1-10
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• 2005

Objectives : The Present study was carried out to investigate the preventive effect of Anti-diabetic prescription 1(AD-1) on streptozotocin(STZ)-induced diabetic nephropathy. Methods : AD-1 consists of eleven herbs that have an effect on diabetes mellitus. AD-1 was given to rats with the combination of oral administration and herbal-acupuncture stimulation. The experimental animals were divided into 3 groups : normal group of rats, control group of STZ-induced diabetic rats, sample group with AD-1 treatment. Experimental diabetes was induced by the injection of STZ(60mg/kg) to e rat via the peritoneum. The effect of AD-1 on STZ-induced diabetic nephropathy was observed by measuring the serum level of creatinine and BUN. Urine secretion of albumin for 24 hours and urine level of glucose measures too. Anti-oxidative stress of AD-1 administration in living body was estimated by measuring lipid peroxide and GSH content in cortex of kidneys. Results : STZ induced increase of serum creatinine, BUN and albumin secretion were lowered by AD-1 treatment. Conclusion : The AD-1 treatment showed protective effect on rat diabetic nephropathy model, and action mechanism of the effect was thought to be concerned with anti-oxidative stress.

• Annals of Clinical Neurophysiology
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• v.24 no.1
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• pp.7-16
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• 2022

Background: There is inadequate information on the validation of diabetic microvascular complications in the Korean National Health Insurance Service data set. We aimed to validate the diagnostic algorithms regarding the nephropathy, neuropathy, and retinopathy of diabetes. Methods: From various secondary and tertiary medical centers, we selected 6,493 patients aged ≥ 40 years who were diagnosed with diabetic microvascular complications more than once based on codes in the 10th version of the International Classification of Diseases (ICD-10). During 2019 and 2020, we randomly selected the diagnoses of 200 patients, 100 from each of two hospitals. The positive predictive value (PPV), negative predictive value, error rate, sensitivity, and specificity were determined for each diabetic microvascular complication according to the ICD-10 codes, laboratory findings, diagnostic studies, and treatment procedure codes. Results: Among the 200 patients who visited the hospital more than once and had the diagnostic codes of diabetic microvascular complications, 142, 110, and 154 patients were confirmed to have the gold standard of diabetic nephropathy (PPV, 71.0%), diabetic neuropathy (PPV, 55.0%), and diabetic retinopathy (PPV, 77.0%), respectively. The PPV and specificity of diabetic nephropathy (PPV, 71.0-81.4%; specificity, 10.3-53.4%), diabetic neuropathy (PPV, 55.0-81.3%; specificity, 66.7-76.7%) and diabetic retinopathy (PPV, 77.0-96.6%; specificity, 2.2-89.1%) increased after combining them with the laboratory findings, diagnostic studies, and treatment procedures codes. These change trends were observed similarly for both hospitals. Conclusions: Defining diabetic microvascular complications using ICD-10 codes and their related examination codes may be a feasible method for studying diabetic complications.

• Journal of Preventive Medicine and Public Health
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• v.49 no.2
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• pp.108-117
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• 2016

Objectives: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. Methods: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A "former smoker" was a patient who smoked only before receiving his diagnosis of diabetes. A "continuing smoker" was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ${\geq}30mg/g$) or low estimated glomerular filtration rate ($<60mL/min/1.73m^2$). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. Results: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). Conclusions: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1365-1380
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• 2007

Based on the theories and clinical data of oriental medicine, traditional medicinal prescriptions known to be effective to diabetic nephropathy were collected. The prescriptions were carefully examined and analyzed in order to be used as fundamental material for experiments and in clinicals. More than 40 publications related to diabetes were arranged and analyzed. Of the complications, diabetic nephropathy part of the publications were specifically focused during analysis. Data were analyzed and classified according to the quantity, prescription, differentiation of symptoms, signs and addition and subtraction of each medicine. Frequently used medicines were statistically analyzed. The most frequently used prescription was Yukmigihwang-tang(六味地黃湯) based medicine and prescriptions of its addition and subtraction, which was 15% of the total prescriptions cited. The most frequently used medicine was Astragali Radix, mentioned 192 times in the prescriptions. Hoelen was next with 180 citations, followed by Dioscoreae Rhizoma with 147 times, Rehmanniae Radix with 140, Corni Fructus with 131, Salviae Miltiorrhizae Radix with 106, Angelicae Gigantis Radix with 101, Alismatis Rhizoma with 95, Rhei Rhizoma with 90, Atractylodis Rhizoma Alba with 84, Rehmanniae Radix Preparata with 78, Leonuri Herba with 74, Moutan Cortex Radicis with 66, Aconiti Lateralis Preparata Radix with 66 Cnidii Rhizoma with 65, Pseudostellaria heterophylla with 62, Liriopis Tuber with 55, Lycii Fructus with 52, Rhei Rhizoma with 49, Codonopsis Pilosulae Radix with 44, Paeoniae Radix Rubra with 44, Schisandrae Fructus with 42, Polyporus with 42, Achyranthis Radix with 41 and Euryales Semen with 40. Medicines prescribed more than 30 grams a day included Astragali Radix, Imperatae Rhizoma, Benincasae Pericarpium, Leonuri Herba, Dioscoreae Rhizoma, Plantaginis Semen, Polyporus, Hoelen, Halloysitum Rubrum, Achyranthis Radix, Arecae Pericarpium, Phaseoli Angularis Semen, Coicis Semen, Rhei Rhizoma, Salviae Miltiorrhizae Radix, Sargassum, Ostreae Concha, Pseudostellaria heterophylla, Epimedii Herba, Rehmanniae Radix, Scrophulariae Radix and Polygonati Rhizoma. No scientific reports on the traditional medicinal aspects of diabetic nephropathy was searched. This analysis report would be able to provide the basis of developing new drug candidates for the treatment of diabetic nephropathy, as well as securing the EBM for the traditional medicines already being prescribed to the patients.

• Annals of Laboratory Medicine
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• v.38 no.6
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• pp.524-529
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• 2018

Background: An increase in neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular injury. Diabetic nephropathy causes typical changes in the kidney, characterized by glomerulosclerosis and eventual tubular damage. We validated the usefulness of plasma NGAL (pNGAL) as a biomarker of tubular damage in patients with diabetic nephropathy. Methods: We included 376 patients with diabetes mellitus (260 patients with chronic renal insufficiency who had not received hemodialysis and 116 hemodialyzed due to diabetic nephropathy) and 24 healthy controls. Patients with chronic renal insufficiency were divided into three groups according to urinary albumin excretion (UAE) levels. pNGAL levels were measured using the Triage NGAL test (Alere, San Diego, CA, USA) and were compared between groups. We also examined whether pNGAL level was related to the degree of albuminuria and cystatin C-based glomerular filtration rate (GFR). Results: Mean pNGAL levels of the healthy controls, chronic renal insufficiency patients with diabetes mellitus, and hemodialyzed patients were $61.9{\pm}5.3ng/mL$, $93.4{\pm}71.8ng/mL$, and $1,536.9{\pm}554.9ng/mL$, respectively. pNGAL level increased significantly in patients with severe albuminuria (P <0.001) and had a moderate correlation with the degree of albuminuria (r=0.467; P <0.001) and GFR (r=0.519; P <0.001). Multivariate regression analysis showed that the pNGAL level was associated with tubular damage independent of patient age, sex, and GFR. Conclusions: pNGAL level independently reflects the degree of tubular damage in patients with diabetic nephropathy. Measurement of pNGAL, combined with UAE, would enable simultaneous, highly reliable assessments of tubular damage for such patients.

• The Korea Journal of Herbology
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• v.21 no.3
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• pp.75-81
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• 2006

Objectives : The present study was carried out to investigate the beneficial effect of Coicis Semen extract(CSe) on streptozotocin(STZ)-induced diabetic nephropathy rats. CSe was given to rats with oral administration. Methods : The experimental animals were divided into 3 groups : normal group of rats, control group of STZ-induced diabetic rats, sample group with CSe treatment. Experimental diabetes was induced by the injection of STZ(60 mg/kg) to the rat via the peritoneum. The effects of CSe on STZ-induced diabetic nephropathy were observed by measuring the serum level of creatinine, BUN and uric level of glucose. Kidney level of lipid peroxidation and the activities of reduced glutathione(GSH) were also examined Results : STZ-induced increase of serum creatinine was lowered by CSe treatment, but BUN and uric level of glucose did not show significant changes. CSe oral administration showed statistical decrease of lipid peroxidation in renal cortical tissues, but it has no effect on the activities of GSH. Conclusion : CSe treatment showed protective effect on rat diabetic nephropathy model, but action mechanism of the effect was still not dear. We thought to be concerned with anti-oxidative stress.