• Biomolecules & Therapeutics
• /
• v.29 no.4
• /
• pp.365-372
• /
• 2021

Type 2 diabetes mellitus (T2DM) leads to many health problems like diabetic nephropathy (DN). One of the key factors for chronic kidney disease and end-stage renal disease (ESRD) is T2DM. Extensive work is being done to delineate the pathogenesis of DN and to extend possible remedies. This review is intended to understand the nature of DN risk factors, progression, effects of glycemic levels, and stages of DN. We also explored the novel diagnostic and therapeutic approaches for DN such as gene therapy and stem cell treatments.

• Proceedings of the PSK Conference
• /
• 2003.04a
• /
• pp.287.1-287.1
• /
• 2003

F$_2$-isoprostanes are derived in vivo principally from the formation of positional peroxyl radicals of arachidonic acid, endocyclization to prostaglandin G$_2$-like structures, and reduction to PGF$_2$-like compounds. F$_2$-isoprostanes have been proposed as biomarkers of lipid peroxidation, oxidative stress status, and oxidation of low density lipoprotein (LDL) in atherogenesis. Especially, elevated 8-iso-PGF$\sub$2a/ is known as a useful clinical biomarker of oxidative stress in-end stage renal disease (ESRD) patients receiving hemodialysis (HD). (omitted)

• Childhood Kidney Diseases
• /
• v.4 no.2
• /
• pp.92-101
• /
• 2000

Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

• Korean Journal of Clinical Pharmacy
• /
• v.23 no.4
• /
• pp.307-315
• /
• 2013

Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.

• 한국생물공학회:학술대회논문집
• /
• 2003.10a
• /
• pp.347-350
• /
• 2003

Dialysis and renal transplantation, the current therapies for end-stage renal disease (ESRD), have many limitations including severe complications, organ shortage, and graft failure. To overcome the limitations, the present study investigated the reconstruction of renal tissue in vivo by transplanting isolated fetal renal cells using fibrin gel to the kidney of renal failure rat model. After 4 weeks from the transplantation, blood urea nitrogen(BUN) and creatinine were examined from blood samples and histological examination of the implanted tissues revealed formation of renal-like structures and restoration of renal function.

• Journal of East-West Nursing Research
• /
• v.21 no.1
• /
• pp.1-9
• /
• 2015

Purpose: This study was attempted to provide the foundations for the nursing intervention program that could improve hemodialysis patient's quality of life by examining influences of family support, self-efficacy and fatigue on quality of life among hemodialysis patients. Methods: We have surveyed 200 patients that aged 18 or older being diagnosed with end-stage renal disease (ESRD) and are receiving hemodialysis treatment in three general hospitals equipped more than 400 beds, one specialized dialysis clinics located in city M. Using the SPSS 17.0 windows program, gathered data were analyzed by number, percentage, mean, standard deviation, t-test, ANOVA, Duncan, Pearson's correlation coefficients and multiple regression analysis. Results: We found the factors that had great influences on patient's quality of life were family support (${\beta}=.155$, t=2.18, p=.031), fatigue (${\beta}=-.487$, t=-7.73, p<.001), and monthly income (${\beta}=.147$, t=2.36, p=.019). Explanatory power of this model was 49.6%. Conclusion: The quality of life of the hemodialysis patients on hemodialysis is affected by family support, fatigue, and monthly income. The higher monthly income, family support and the less fatigue, the more likely they can improve their quality of life.

• Journal of Chest Surgery
• /
• v.26 no.10
• /
• pp.761-768
• /
• 1993

Angioaccess has become increasingly important to vascular surgeons as more patients with end stage renal disease[ESRD] are being supported by hemodialysis. Because of the rapid increase in the number of patients undergoing hemodialysis in recent years, it has become necessary to develope alternative vascular access procedures. During the period from December 1986 to December 1992, 290 cases of arteriovenous fistula and associated operations for hemodialysis were performed at Department of Thoracic & Cardiovascular Surgery, Seoul Paik Hospital, Inje University. They Consisited of 175 male and 115 female, ranging in age from 8 and 79 years. The procedure of first choice, the Brescia`s original radial artery-cephalic vein arteriovenous fistula was performed upon 219 patients. In many patients, the radial artery-cephalic vein fistula cannot be performed because of inadequate vein or failure of previous radial artery-cephalic vein fistula. The waiting time until initiation of venous puncture for the first hemodialysis session was 3 days. The second choice of angioaccess, using the brachiocephalic arteriovenous fistula and brachiobasilic arteriovenous fistula at antecubital fossa, ulnobasilic arteriovenous fistula, femorosaphenous arteriovenous fistula, and radiobasilic arteriovenous fistula with saphenous in situ routes, was obtained in 17, 7, 4, 2 and 1 patients. Interposition grafts, the third choice of angioaccess, were performed upon 2 patients. Twenty seven patients underwent revisions or thrombectomies. The purpose of this report is to review the technique of this procedure and discuss the longterm results.

• Biomedical Science Letters
• /
• v.25 no.1
• /
• pp.32-39
• /
• 2019

Conventional high-flux hemodialysis (HD) is not as good as normal kidney function. Morbidity and mortality rates of patients receiving HD are still very high. To increase mid-to-large molecule clearance by combining diffusion and convection, on-line hemodiafiltration (HDF) is required. The objective of this study was to compare long-term survival rate of patients treated with on-line HDF to those who received conventional high-flux HD by reviewing data from Chonnam National University Hospital (CNUH). We selected patients who attended the 'CUNH dialysis center' and agreed to participate in the study. Overall, 40 patients with ESRD switched from high flux HD to on-line HDF or started on-line HDF from August 2007 to December 2009. Additionally, a total of 42 patients receiving conventional high-flux HD during the same period were enrolled. We then reviewed long-term survival rate of patients receiving on-line HDF over the next seven years. When we compared survival rates for seven years, the survival rate of the group receiving on-line HDF was 65% (26/40) while that of the group receiving the conventional high-flux HD was 54.8% (23/42). Although the number of patients was small to see survival difference clearly by one specific dialysis modality, there was somewhat difference in survival rate between the two groups. Indicators such as anemia, calcium-phosphate metabolism, nutritional status, treatment adequacy, and hospitalization were also improved in the group receiving HDF. Overall, results of our study showed beneficial effects of on-line HDF on clinical outcomes and survival in chronic HD patients.

• Childhood Kidney Diseases
• /
• v.23 no.2
• /
• pp.67-76
• /
• 2019

Kidney disease is a major global health issue. Hemodialysis and kidney transplantation have been used in the clinic to treat renal failure. However, the dialysis is not an effective long-term option, as it is unable to replace complete renal functions. Kidney transplantation is the only permanent treatment for end-stage renal disease (ESRD), but a shortage of implantable kidney tissues limits the therapeutic availability. As such, there is a dire need to come up with a solution that provides renal functions as an alternative to the current standards. Recent advances in cell-based therapy have offered new therapeutic options for the treatment of damaged kidney tissues. Particularly, cell secretome therapy utilizing bioactive compounds released from therapeutic cells holds significant beneficial effects on the kidneys. This review will describe the reno-therapeutic effects of secretome components derived from various types of cells and discuss the development of efficient delivery methods to improve the therapeutic outcomes.

• Journal of Yeungnam Medical Science
• /
• v.30 no.2
• /
• pp.136-140
• /
• 2013

Diabetic nephropathy (DN) is a common complication and the leading cause of end-stage renal disease (ESRD) in diabetic patients. The occurrence of non-diabetic renal disease (NDRD) in diabetic patients has been increasingly recognized in recent years. Generally, renal injuries in DN are deemed difficult to reverse, whereas some NDRDs are often treatable and even remittable. Thus, the diagnosis of NDRD in patients with diabetes mellitus (DM) via a kidney biopsy would be significant for its prognosis and therapeutic strategy. According to recent studies, the most common NDRD is IgA nephropathy in type 2 diabetic patients, and some cases of minimal change disease and membranous glomerulonephritis have been reported in Korea. However, membranoproliferative glomerulonephritis (MPGN) is an uncommon condition in diabetic patients. To our knowledge, there has been no case yet of MPGN, except in a child with type 1 DM. We present an unusual case of a 27-year-old woman who had type 2 DM with MPGN, as confirmed via a kidney biopsy.