• 대한한방부인과학회지
• /
• 제32권3호
• /
• pp.142-161
• /
• 2019

Objectives: The purpose of this study is to report the effect and safety of traditional Korean medicine (TKM) for enhanced recovery after surgery (ERAS) after gynecological surgery. Methods: The study is conducted by analyzing the medical records of the hospitalized patients in TKM hospital. Eighty-six patients were enrolled who received TKM for ERAS after gynecological surgery from January 2015 to April 2018. We performed statistical analysis by using SPSS ver. 25.0. To prove the effect and safety of TKM for ERAS, we analyzed symptoms and Hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and serum creatinine (Cr) with glomerular filtration rate (GFR). In addition, we checked other adverse reactions that the patients complained to prove the safety of TKM for ERAS. Results: Among symptoms of pain, there was a statistically significant decrease in abdominal pain, lower back pain, and shoulder pain. Other symptoms showed statistically significant improvement in fatigue, abdominal tympanosis, operation-site discomfort, dizziness, urinary discomfort, throat discomfort, constipation, dyspepsia and colporrhagia. Anemia in both ferritin combination treatment group and herbal medicine only group showed significant improvement. There was no liver damage or renal damage by TKM. Conclusions: The result has shown that TKM for ERAS after gynecological surgery is effective and safe. The further study of TKM for ERAS with more patients is needed.

• Childhood Kidney Diseases
• /
• 제23권1호
• /
• pp.53-57
• /
• 2019

Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

• 비만대사연구학술지
• /
• 제1권2호
• /
• pp.78-82
• /
• 2022

Liraglutide (Saxenda^R) is prescribed to induce and sustain weight loss in obese patients. The starting dose of liraglutide is 0.6 mg/day for 1 week, which is increased by 0.6 mg/day every week until the full maintenance dose of 3 mg/day is achieved. Such dose titration is needed to prevent side effects, which primarily include gastrointestinal problems such as nausea, diarrhea, constipation, vomiting, dyspepsia, and abdominal pain. A 35-year-old, reportedly healthy obese man receiving liraglutide treatment for obesity visited the emergency room complaining of generalized weakness and dizziness accompanied by repeated diarrhea and vomiting. He reported over 20 episodes of diarrhea starting the day after liraglutide dose escalation from 1.2 mg/day to 1.8 mg/day. Laboratory findings suggested pre-renal acute kidney injury, including serum creatinine 4.77 mg/dl, blood urea nitrogen (BUN) 37 mg/dl, estimated glomerular filtration rate (eGFR) 15 ml/min/1.73 m², and Fractional excretion of sodium 0.08. After volume repletion therapy, his renal function recovered to a normal range with laboratory values of creatinine 1.08 mg/dl, BUN 14 mg/dl, and eGFR 88 ml/min/1.73 m². This case emphasizes the need for caution when prescribing glucagon-like peptide-1 receptor agonists, including liraglutide, given the risk of serious renal impairments induced by volume depletion and dehydration through severe-grade diarrhea and vomiting.

• 고신대학교 의과대학 학술지
• /
• 제33권2호
• /
• pp.191-199
• /
• 2018

Objectives: We designed the study to compare the oncologic and renal function outcomes of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional laparoscopic partial nephrectomy (HCLPN) for renal tumors. Methods: Between March 2008 and July 2015, 114 patients who underwent laparoscopic partial nephrectomy (LPN) of a renal neoplasm were studied. We performed LPN without hilar clamp on 40 patients (OCLPN, Group 1), and conventional LPN with hilar control and renorrhaphy on another 40 patients (HCLPN, Group 2). We retrospectively reviewed the medical records of each patient's age, sex, R.E.N.A.L. nephrometry score (RNS), operation time, complications, hospitalization period, tumor size, positive resection margin, histologic classification of tumor, pathologic stage, Fuhrman grade, estimated blood loss (EBL), warm ischemic time (WIT), and estimated glomerular filtration rate (eGFR) before and one year after surgery. Results: There were no significant differences in age, sex, preoperative eGFR, EBL, surgical (anesthesia) time, and tumor size between the two groups. The mean eGFR was not significantly different between the OCLPN and HCLPN groups 1 month (95 and $86.2mL/min/1.73m^2$, respectively; P = 0.106), 6 months (92.9 and $83.6mL/min/1.73m^2$, respectively; P = 0.151) and 12 months (93.8 and $84.7mL/min/1.73m^2$, respectively; P = 0.077) postoperatively. The change in eGFR after one year was 3.9% in the OCLPN group and -7.9% in the HCLPN group. Conclusions: OCLPN was superior to HCLPN in preserving renal function one year after surgery, and there was no statistically significant difference in tumor treatment results.

• 한국응용과학기술학회지
• /
• 제39권5호
• /
• pp.674-682
• /
• 2022

본 연구는 건강에 위협이 되는 고요산혈증과 대사증후군의 관련성을 살펴보고 고요산혈증이 신체에 미치는 영향을 분석하고자 한다. 분석 자료는 질병관리청에서 시행한 국민건강영양조사 제8기 2차(2020년도) 자료를 내려받아 사용하였으며 본 연구에서는 만 19세 이상 성인을 대상으로 요산의 검사를 시행한 대상자 중 남자 2,320명, 여자 2,893명을 최종 분석하였다. 자료의 분석은 수집된 일반적 특성과 고요산혈증에 따른 차이값은 Chi-square 검정과 t 검증을 사용하였으며 대사증후군의 하부요인과 eGFR 상승의 위험도는 회귀분석으로 분석하였고 각 변수와의 상관관계를 확인하기 위하여 Pearson correlation을 사용하였다. 본 연구를 통하여 고요산혈증이 대사증후군과 유의미한 관계가 있으며 이를 통하여 대사증후군이 콩팥질환을 포함한 혈관 질환으로 악화하지 않도록 선제 관리가 필요하다는 것을 알게 되었다. 따라서 본 연구를 통하여 환자의 연령에 맞는 건강프로그램을 개발할 것을 제안한다.

• 한국엔터테인먼트산업학회논문지
• /
• 제13권4호
• /
• pp.363-368
• /
• 2019

본 연구는 국민건강영양조사 자료를 이용하여 20세 이상 성인(n=9,409)에서 비만 및 복부비만과 CKD의 관련성을 평가하고자 실시하였다. 연구결과 CKD와 관련 있는 변수를 통제한 상태에서 남성의 경우 비만군[BMI ≥ 25.0kg/m², 1.83(95% CI, 1.20-2.80)]의 CKD의 OR값이 유의하게 높게 나타났으며, 여성에서는 복부비만군[WM ≥80cm, 1.52(95% CI, 1.52-2.28)]의 CKD의 OR값이 유의하게 높게 나타났다. 결론적으로, 여성에서는 복부비만 그리고 남성에서는 비만이 CKD의 발생률 증가와 관련이 있는 것으로 확인되었다.

• 운동영양학회지
• /
• 제16권1호
• /
• pp.27-33
• /
• 2012

This study was conducted to investigate the effect of a 24-week combined exercise training program in older women with hypertension. Women with hypertension who were 70 years and older were randomized into two groups: combined exercise group (CE; n = 15) and a control group (n = 15). The CE group performed a combined exercise training program four times per week for 24 weeks and the control group did not. Five factors, including body composition (percent body fat and skeletal muscle mass), health-related physical fitness, adipocytokines (interleukin-6 [IL-6] and tumor necrosis factor-alpha [TNF-α]), kidney risk factors (glomerular filtration rate [GFR] and cystatin C), and systolic and diastolic blood pressure were measured before and after the program. The findings showed that total muscle mass, health-related physical fitness factors, and GFR increased significantly in the CE group compared to those in the control. Additionally, systolic and diastolic blood pressure and IL-6, TNF-α, and cystatin C levels in the CE group decreased significantly after the intervention. In contrast, total muscle mass decreased significantly and blood pressure remained unchanged in the control group. These results suggest that CE training may positively impact circulating levels of adipocytokines and cystatin C and improve physical fitness levels in elderly women with hypertension. Therefore, CE training helps to prevent renal disease and improve health-related physical fitness, eventually leading to a better quality of life.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제49권5호
• /
• pp.243-251
• /
• 2023

Objectives: Although a few studies have investigated the relationship between kidney and oral function (number of remaining teeth), their results remain inconclusive. Therefore, this study aimed to investigate the relationship between kidney function and oral health in community-dwelling healthy elderlies and examine the factors associated with kidney function. Materials and Methods: We used cross-sectional data from the Shimane prefecture cohort recruited by the Center for Community-Based Health Research and Education in 2019. We collected clinical data on dental status, background factors and kidney function (estimated glomerular filtration rate [eGFR], mL/min/1.73 m² and creatinine levels, mg/dL). Results: The study enrolled 481 participants, whose mean age was 66.7±7.4 years, and 223 (46.4%) participants were men. Multivariate analysis revealed significant correlations between eGFR (B=0.17, P=0.04), creatinine (B=-0.54, P<0.01), and the number of remaining teeth. The number of remaining teeth was associated with creatinine and eGFR, which are indicators of kidney function. Conclusion: This study suggests that preserving the teeth may prevent decline in kidney function. Dental professionals should provide instructions and professional care to reduce the risk of systemic diseases such as kidney dysfunction.

• 중환자간호학회지
• /
• 제16권3호
• /
• pp.34-47
• /
• 2023

Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD. Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects meta-analysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0). Results : The systematic review included 11 RCTs (n = 591, average age 60.2-76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions. Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.

• Journal of Cardiovascular Imaging
• /
• 제31권4호
• /
• pp.169-177
• /
• 2023

BACKGROUND: Acute worsening of cardiac function frequently leads to kidney dysfunction. This study aimed to identify clinical and imaging parameters associated with impaired kidney function in patients with acute decompensated heart failure with reduced ejection fraction (HFrEF). METHODS: Data from 131 patients hospitalized with acute decompensated HFrEF (left ventricular ejection fraction, < 40%) were analyzed. Patients were divided into two groups according to the glomerular filtration rate (GFR) at admission (those with preserved kidney function [GFR ≥ 60 mL/min/1.73 m²] and those with reduced kidney function [GFR < 60 mL/min/1.73 m²]). Various echocardiographic parameters and perirenal fat thicknesses were assessed by computed tomography. RESULTS: There were 71 patients with preserved kidney function and 60 patients with reduced kidney function. Increased age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.04-1.12; p = 0.005), increased log N-terminal pro b-type natriuretic peptide (OR, 1.74; 95% CI, 1.14-2.66; p = 0.010), and increased perirenal fat thickness (OR, 1.19; 95% CI, 1.10-1.29; p < 0.001) were independently associated with reduced kidney function, even after adjusting for variable clinical and echocardiographic parameters. The optimal average perirenal fat thickness cut-off value of > 12 mm had a sensitivity of 55% and specificity of 83% for kidney dysfunction prediction. CONCLUSIONS: Thick perirenal fat was independently associated with impaired kidney function in patients hospitalized for acute decompensated HFrEF. Measurement of perirenal fat thickness may be a promising imaging marker for the detection of HFrEF patients who are more susceptible to kidney dysfunction.