• Childhood Kidney Diseases
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• 제27권2호
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• pp.97-104
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• 2023

Purpose: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria. Methods: This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks. Results: In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period. Conclusions: Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. ClinicalTrials.gov trial registration (NCT0223277)

• 대한한방내과학회지
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• 제29권4호
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• pp.1115-1122
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• 2008

Chronic renal failure (CRF) is defined as a permanent reduction in glomerular filtration rate (GFR) sufficient to produce detectable alterations in well-being and organ function. This usually occurs at GFR below 25 ml/min. In this report, is a 75-year-old woman who had back pain and diarrhea as chief complaints. She was diagnosed with CRF on March. 2008. is a 62-year-old man who had whole body weakness, anorexia and dyspepsia as chief complaints. He was diagnosed with CRF on 2008. We used herbal enteroclysis solution. which consists of Radix et Rhizoma Rhei. Concha Ostreae and Radix Glycyrrhizae or Radix Salviae Miltiorrhizae. Herbal enteroclysis was done for 15 min once a day. Enteroclysis solution was controlled at 37-39 $^{\circ}C$ and inserted 15-20cm depth for intubation. We found the patient's BUN, creatinine and GFR were improved through enteroclysis. In both and , the patient's BUN and creatinine decreased, and GFR increased favorably. This result suggests that herbal enteroclysis used for CRF is effective in clinical therapy.

• The Korean Journal of Physiology
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• 제19권1호
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• pp.25-33
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• 1985

Renal arterial infusion of renotropic agents has been a very useful technique in the renal function studies. This type of experiments have usually been conducted in the large animals such as dogs and sheep. In these animals a catheter can be placed in the site without much disturbances of renal blood flow. Rabbits as an experimental model, however, caused a disturbances of renal blood flow by a catheterization of renal artery by its properties. Therefore we have developed a new technique that allows a simple and selective access to one side of renal arteries and the other as a control, without any disturbances of renal function. The distance between the both bifurcations of renal arteries on abdominal aorta is about 7 mm. To locate the tip of catheter on one side renal artery, ascending cannulation performed via femoral artery was done. We did an experiment with the technique to clarify the effect of calmodulin inhibitor on the renal function. One of the phenothiazine derivatives, trifluoperazine known as a powerful calmodulin inhibitor. Trifluoperazine, actual dose ranges of $2.76-5.20\;ug\;{\cdot}\;kg^{-1}\;{\cdot}\;min^{-1}$, increased urine volume and glomerular filtration rate significantly. Significant increases in urinary excretion of sodium, chloride and potassium were found. Fractional excretion of sodium and free water clearance increased significantly. These data suggest that this new technique is very useful in field of renal physiology and that striking effect of trifluoperazine on the renal function may be caused by increasing the renal hemodynamics, and by the inhibition of sodium, chloride and potassium reabsorption in the renal tubules.

• Journal of Yeungnam Medical Science
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• 제37권4호
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• pp.314-320
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• 2020

Background: A diabetic foot is the most common cause of non-traumatic lower extremity amputations (LEA). The study seeks to assess the risk factors of amputation in patients with diabetic foot ulcers (DFU). Methods: The study was conducted on 351 patients with DFUs from January 2010 to December 2018. Their demographic characteristics, disease history, laboratory data, ankle-brachial index, Wagner classification, osteomyelitis, sarcopenia index, and ulcer sizes were considered as variables to predict outcome. A chi-square test and multivariate logistic regression analysis were performed to test the relationship of the data gathered. Additionally, the subjects were divided into two groups based on their amputation surgery. Results: Out of the 351 subjects, 170 required LEA. The mean age of the subjects was 61 years and the mean duration of diabetes was 15 years; there was no significant difference between the two groups in terms of these averages. Osteomyelitis (hazard ratio [HR], 6.164; 95% confidence interval [CI], 3.561-10.671), lesion on percutaneous transluminal angioplasty (HR, 2.494; 95% CI, 1.087-5.721), estimated glomerular filtration rate (eGFR; HR, 0.99; 95% CI, 0.981-0.999), ulcer size (HR, 1.247; 95% CI, 1.107-1.405), and forefoot ulcer location (HR, 2.475; 95% CI, 0.224-0.73) were associated with risk of amputation. Conclusion: Osteomyelitis, peripheral artery disease, chronic kidney disease, ulcer size, and forefoot ulcer location were risk factors for amputation in diabetic foot patients. Further investigation would contribute to the establishment of a diabetic foot risk stratification system for Koreans, allowing for optimal individualized treatment.

• 대한의생명과학회지
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• 제17권4호
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• pp.337-345
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• 2011

It is well recognized that conventional coronary artery bypass grafting (ONCAB) often leads to major organ dysfunction including renal injury. Diabetes mellitus is a major cause of nephropathy and poor clinical outcomes. The aim of this retrospective study was to evaluate the occurrence of adverse outcomes including renal impairment between diabetic (n=75, DM group) and non-diabetic patients (n=72, Non-DM group) underwent off-pump coronary artery bypass grafting surgery (OPCAB). Fasting glucose, hemoglobin A1c, fructosamine, fibrinogen and serum osmolality levels in the DM group were higher than those of the Non-DM group at pre-operative (Pre-OP) period ($P$ <0.05). History of hypertension and renal impairment in the DM group was higher than that of the Non-DM group ($P$ <0.05). Potassium ($K^+$), blood urea nitrogen and creatinine levels were higher, whereas sodium ($Na^+$) and glomerular filtration rate (GFR) levels were lower in the DM group than the Non-DM group at peri-operative period ($P$ <0.05). Fasting glucose levels at Pre-OP period had positive correlations with blood urea nitrogen and creatinine levels at peri-operative period, but negative correlations with GFR levels at peri-operative period in the DM group ($P$ <0.05). Incidences of renal impairment, diuretic therapy or continuous renal replacement therapy and fever in the DM group were higher than those of the Non-DM group at post-operative period ($P$ <0.05). These results suggest that blood glucose level should be tightly controlled at peri-operative period to avoid renal dysfunction in diabetic patients.

• Journal of Preventive Medicine and Public Health
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• 제49권2호
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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.

• 대한한의학회지
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• 제16권1호통권29호
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• pp.319-338
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• 1995

This article is to investigate the effects of Euphorbia Pekinensis RUPR. on rats with acute renal failure induced by gentamicin sulfate. So this experimental research was focused on measuring (1)the levels of creatinine, blood urea nitrogen, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, total protein, sodium, potassium, chloride in the serum and (2)the levels of protein, blood, sodium, potassium, chloride, pH, specific gravity and volume in the urine and (3)intake water. The results were summarized as follows. 1. While the levels of creatinine and glutamic oxaloacetic transaminase, glutamic pyruvic transaminase in the serum were significantly increased, the level of BUN in the serum were partially increased and the levels of sodium and potassium in the serum were partially decreased on the Euphorbia Pekinensis $R_{UPR}$. group. 2. While the urine volume was significantly increased, the levels of protein, blood, sodium and chloride in the urine were partially increased and the specific gravity, pH in the urine were partially decreased. According to the above results, it is shown that Euphorbia Pekinensis $R_{UPR}$. without refinning had a diuretic effect on rats with acute renal failure induced by gentamicin sulfate, but aggravated the glomerular filtration rate and tubular reabsorption. So, it is supposed that Euphorbia Pekinensis $R_{UPR}$. without refinning needs to be used carefully on renal disease and futhermore research about the kinds of extracts form is necessary.

• 한국임상약학회지
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• 제20권2호
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• pp.128-137
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• 2010

This review summarizes gender differences in pharmacokinetics, pharmacodynamics, and adverse drug reactions. Gender differences in pharmacokinetics are categorized by four major factors: absorption/bioavailability, distribution, metabolism, and elimination. There are sex-based differences in gastric emptying time, gastric alcohol dehydrogenase activity, apparent volume of distribution, ${\alpha}1$-acid glycoprotein level, phase I (CYP) and phase II metabolizing enzymes, glomerular filtration rate, and drug transporters. This review also reports gender differences in pharmacokinetics and pharmacodynamics of cardiovascular agents, central nervous system acting agents and antiviral agents. In addition, it has been reported that females experience more adverse reactions such as coughing, tachycardia, nausea, vomiting, rash, hypersensitivity, hepatotoxicity, and metabolic disorder after taking cardiovascular, central nervous system acting and antiviral agents. Therefore, in order to provide optimal drug dosage regimens both in male and female, gender differences in pharmacokinetics, pharmacodynamics, and adverse drug reactions must be considered.

• 대한약리학회지
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• 제12권2호
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• pp.43-49
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• 1976

The facts that $PGE_2$ produced diuresis in the rabbit when given into a lateral ventricle of the brain and that $PGF_{2{\alpha}}$ is abundantly found in the brain prompted us to investigate the effects of $PGF_{2{\alpha}}$ introduced directly into the ventricle on the renal function. $PGF_{2{\alpha}}$ given intraventriculary in doses of $10{\mu}g\;and\;100{\mu}g$ elicited prompt diuresis, 10-fold increase of sodium excretion and two-fold increment of potassium excretion. Free water reabsorption also increased along with the increased osmolar clearance. Neither renal plasma flow nor glomerular filtration rate did change significantly. This, along with the fact that the percentage of reabsorbed sodium filtered decreased from 99.5 to 93.9, indicates the tubular site of the diuretic and natriuretic action. Atropine pretreatment did not influence the renal effects of intraventricular $PGF_{2{\alpha}}$. Intravenously administered $PGF_{2{\alpha}}$ in doses of 30 to $100{\mu}g$ did not produce any significant change in renal function. Intraventricular $PGF_{2{\alpha}}$ had no effect on the systemic blood pressure, whereas intravenous administration brought about a transient hypotension. These observations suggest that $PGF_{2{\alpha}}$ induces diuresis and natriuresis via central mechanism, that the site of the action resides in renal tubules, and that the reabsorption of sodium is inhibited in the proximal tubule, possibly through mediation of certain humoral agent. Overall, it is suggested that $PGF_{2{\alpha}}$ might play a roll in regulating renal function through the center.

• Journal of Nutrition and Health
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• 제34권4호
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• pp.359-366
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• 2001

Studies were carried out to explore the influence of dietary protein level on bone metabolism in uninephrectomized rat (experimental renal failure model) when dietary Ca and P contents were equal. Male rats were uninephrectomized or sham operated and fed 8%, 15% and 40% casein diets for 24 weeks. Ca and P contents of the all diet were 0.4% and 0.6% respectively. The results are summarized as follows. We did not found any significant difference in PTH and Ca level of the serum, Ca intake and Ca excretion among the experimental groups. There was significant positive correlation between the PTH and phosphate level. There was significant inverse correlation between serum Ca and creatinine level. The effect of the dietary protein level and renal mass loss on density and Ca contents of the bone were small and different according to the kinds of the bone. Low protein diet was associated with a significant enhancement of scapular density. Femur and vertebra density, however, were not influenced by dietary protein level and uninephrectomy. Light microscopic examination showed several calcified foci in the kidney in all experimental groups. Low protein diets have been used for a long time in the conservative management of chronic renal failure as they have a beneficial effect in preventing the appearance of symptoms. This study elucidated that part of beneficial effects of the low protein diet related to the suppression of the hyperphosphatemia. And these results, even though uninephrectomized rats fed high protein diet, the secondary hyperparathyroidism is supressed by the regulation of the P level. Therefore this study emphasized the need to pay more attention to the regulation of dietary P level as well as dietary protein content in chronic renal failure. (Korean J Nutrition 34(4): 359∼366, 2001)