• Title/Summary/Keyword: End-Stage renal disease

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DENTAL TREATMENT OF A PATIENT WITH TUBEROUS SCLEROSIS ASSOCIATED WITH ESRD AND MENTAL RETARDATION UNDER GENERAL ANESTHESIA (정신지체와 만성신부전을 동반한 결절성경화증 환자의 전신마취 하 치과치료)

  • Seo, Kwang-Suk;Lee, So-Young;Baek, Kyung-Won;Kim, Hyun-Jeong;Yum, Kwang-Won
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.1 no.1
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    • pp.33-36
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    • 2005
  • Manifestations in tuberous sclerosis such as seizure, mental retardation, end-stage renal disease (ESRD), and heart problems present a number of challenges to the dentist and anesthesiologist. Lack of cooperation in addition to the severe medical condition makes dental treatment more difficult. General anesthesia is often required for mentally and physically handicapped patients undergoing extensive dental treatment. We experienced a case of dental treatment under general anesthesia in a 36-year-old male patient with tuberous sclerosis associated with ESRD and mental retardation. He was treated on an outpatient basis followed by hemodialysis without any complications.

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Validation of the Korean Version of the End-Stage Renal Disease Adherence Questionnaire (한국어판 말기신부전 환자의 치료순응도 측정 도구의 타당도와 신뢰도 검증)

  • Kim, Youngmee;Park, Young Mi
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.307-316
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    • 2012
  • Purpose: The purpose of this study was to develop and test psychometric properties the Korean version of the End-Stage Renal Disease Adherence Questionnaire (KESRD-AQ). The ESRD-AQ, a 46-item, multidimensional, self-administrated questionnaire which was developed to assess treatment adherence to hemodialysis (HD) attendance, medications, fluid restrictions, and diet prescription among patients on maintenance hemodialysis, has been validated. Methods: The KESRD-AQ was developed by performing both translation and backtranslation. The content validity and test- retest reliability of the KESRD-AQ were evaluated by establishing item-level content validity index (I-CVI) and intra-class correlation coefficients (ICC), respectively. Construct validity was assessed by adopting a known-group analysis comparing adheres and non-adherers using Mann-Whitney U Test. Results: 41 Korean-American patients with ESRD on HD from 3 outpatient dialysis centers in California participated in the study. The KESRD-AQ showed excellent content validity (average I-CVI=.96) and test-retest reliability (ICC=.917, p=.004). The construct validity indicated that the KESRD-AQ distinguished adheres and non-adheres (p=.02~.047). Conclusion: The KESRD-AQ is a valid and reliable instrument to measure treatment adherence.

Fetal 신장 세포 이식을 통한 신장 구조의 형성

  • Kim, Sang-Su;Park, Heung-Jae;Han, Jeong-Ho;Choe, Cha-Yong;Kim, Byeong-Su
    • 한국생물공학회:학술대회논문집
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    • 2003.04a
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    • pp.307-309
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    • 2003
  • To develop a new treatment for end stage renal disease, we examined the possibility of regenerating renal tissues by implanting renal cells on biodegradable polymer scaffolds. Histological examination of the implanted tissues revealed formation of renal-like structures including glomerulus and renal tubule.

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Perioperative management of facial reconstruction surgery in patients with end-stage renal disease undergoing dialysis

  • Chan Woo Jung;Yong Chan Bae
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.71-76
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    • 2024
  • Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.

Clinical Outcomes of Arteriovenous Graft in End-Stage Renal Disease Patients with an Unsuitable Cephalic Vein for Hemodialysis Access

  • Son, Joung Woo;Ryu, Jae-Wook;Seo, Pil Won;Ryu, Kyoung Min;Chang, Sung Wook
    • Journal of Chest Surgery
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    • v.53 no.2
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    • pp.73-78
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    • 2020
  • Background: As the population of patients with end-stage renal disease has grown older, the proportion of patients with poorly preserved vasculature has concomitantly increased. Thus, arteriovenous grafts (AVG) have been used more frequently to access blood vessels for hemodialysis. Despite this increasing demand, studies of AVG are limited. In this study, we examined the surgical outcomes of upper-limb AVG creation. Methods: Among the arteriovenous fistula formation procedures performed between January 2014 and March 2019 at Dankook University Hospital, 42 cases involved AVG creation. We compared patients in whom the axillary vein was used (group A; brachioaxillary AVG [B-Ax AVG]; n=20) with those in whom upper limb veins were used (group B; brachiobasilic AVG or brachioantecubital AVG; n=22). Results: The 1-year primary patency rate was higher in group A than in group B (57.9% vs. 41.7%; p=0.262). The incidence of postoperative complications was not significantly different between groups. Conclusion: AVG using the axillary vein showed no major differences in safety or functionality compared to AVG using other veins. Therefore, accounting for age, underlying disease, and expected patient lifespan, B-Ax AVG can be considered an acceptable surgical method.

Infarction of Renal Transplant with Extrarenal Excretion of Tc-99m $MAG_3$ Demonstrated by Renal Scintigraphy (Tc-99m $MAG_3$ 신장스캔에서 신외 배설과 함께 발견된 이식신 경색)

  • Lim, Seok-Tae;Kim, Min-Woo;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.199-201
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    • 2003
  • A 38-year-old woman with end stage renal disease received a living related donor-renal transplant to the right iliac fossa. She developed anuria a week later Tc-99m $MAG_3$ renal scintigraphy demonstrated no perfusion, uptake, or excretion of the radioactive tracer from the renal transplant. The expected area of the renal allograft appeared as a photopenic area with increased rim activity. The gallbladder and bowel activities were observed on delayed images at 24 hours. There was no blood flow within the renal artery on renal doppler examination. This case shows total absence of perfusion and function in the infarcted renal transplant with extrarenal excretion of Tc-99m $MAG_3$ caused by acute renal artery thrombosis.

Role of Reactive Oxygen Species in High Glucose-induced Tissue Injury

  • Hunjoo Ha;Lee, Hi-Bahl
    • Proceedings of the Korean Biophysical Society Conference
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    • 2001.06a
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    • pp.25-25
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    • 2001
  • Diabetes is the leading cause of end-stage renal disease worldwide. In Korea, diabetic kidney disease accounted for 39% of all new dialysis patients in 1998. Diabetic nephropathy is characterized by glomerular hyperfiltration, albuminuria, and expansion of glomerular mesangium. Since glomerular mesangial cells regulate glomerular filtration rates and are capable of producing extracellular matrix (ECM) proteins, the functional abnormalities of mesangial cells under diabetic milieu play an important role in the development and progression of diabetic nephropathy.(omitted)

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Intrathoracic Kaposi's Sarcoma in Renal Transplant Recipient proven by Open Lung Biospsy -A Case Report- (개흉폐생검으로 확진된 신장이식 후 발생한 흉강내 Kaposi육종 -1례 보고-)

  • 성기익;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.338-341
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    • 2000
  • Renal transplant recipients who received immunosuporessive agent are in high risk of development Kaposi's sarcoma. In Korea a few report of Kaposi's sarcoma has been pubilshed but any report of intrathoracic Kaposi's sarcoma provedn by open lung biopsy has not been pulbilshed until now. We report a case of intrathoracic Kaposi's sarcoma developed in a 25 year old Korean man, who had been operated renal transplantation due to end stage renal disease and received cyclosporine and prednisolone as immunosuppessive agent, without any other organ involvment and was proven by open lung biopsy. Although discontinuation of immunosuppressive agent, temporary symptomatic and radilolgic improvement were observed, he died 11 days later after open lung biopsy because of intractable resiratory failure.

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A case of regression of atypical dense deposit disease without C3 deposition in a child

  • Kim, Min-Sun;Hwang, Pyoung-Han;Kang, Mung-Jae;Lee, Dae-Yeol
    • Clinical and Experimental Pediatrics
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    • v.53 no.7
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    • pp.766-769
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    • 2010
  • Dense deposit disease (DDD) is a rare disorder characterized by the deposition of abnormal electron-dense material within the glomerular basement membrane of the kidneys. The diagnosis is made in most patients between 5 and 15 years of age, and within 10 years, approximately half of the affected patients progress to end-stage renal disease. We report a rare case of regressive DDD without C3 deposition after steroid therapy in an 11-year-old boy. The patient presented with edema, gross hematuria, and nephrotic-range proteinuria. Laboratory testing revealed a serum creatinine level of 1.17 mg/dL, albumin level of 2.3 g/dL, and serum C3 level of 125 mg/dL (range 90-180 mg/dL). The results of the renal biopsy were consistent with DDD without C3 deposition. After 6 weeks of steroid therapy, the nephrotic syndrome completely resolved. The follow-up renal biopsy showed a significant reduction in mesangial proliferation and disappearance of electron-dense deposits in the GBM.

Anesthetic Management of the Oral and Maxillofacial Surgery in a Patient with End-Stage Renal Disease -A case report - (말기신부전 환자의 구강외과 수술 마취관리 -증례보고-)

  • Park, Chang-Joo;Park, Jong-Chul;Kang, Young-Ho;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin;Kim, Hyun-Jeong;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.2 s.5
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    • pp.98-102
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    • 2003
  • Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically iii and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

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