• Title/Summary/Keyword: Glomerular filtration rate

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Glomerular Filtration Rate Determined in Conjunction with $^{99m}TC-DTPA$ Routine Renal Scintigraphy (통상적 $^{99m}TC-DTPA$ 신장스캔을 이용한 GFR 측정)

  • Yi, Gang-Wook;Han, Jin-Suk;Chung, June-Key;Lee, Myung-Chul;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.1
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    • pp.49-54
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    • 1989
  • Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintrgraphy. We measured $^{99m}Tc-DTPA$ renal clearance with Jackson's method during the routine $^{99m}Tc-DTPA$ renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of $Cl_{DPDA}$ was from 19.9 ml/min to 170 ml/min and the correlation of $Cl_{DPDA}$ and creatinine clearance was discribed by Y=16.2570+0.7852 X($X=Cl_{DTPA}$ Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that $^{99m}Tc-DTPA$ renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine $^{99m}Tc-DTPA$ renal scintigraphy simultaneously.

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Effects of Hwangryunhaedok-tang plus Yukmijihwang-tang add Chogudeung on Blood Pressure and Renal Function in Spontaneously Hypertensive Rats (황연해독탕 합 육미지황탕 가 조구등이 자발적 고혈압 백서의 혈압 및 현장 기능에 미치는 영향)

  • Sohn Eun Jin;Kang Dae Gill;Lee An Sook;Kim Bok Hae;Lee Ho Sub
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.359-364
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    • 2002
  • The present study examined the effects of water extract of Hwangruynhaedoktang plus Yukmijihwangtang add Chogudeung (HYC) on the blood pressure and renal function in spontaneously hypertensive rats (SHR). The HYC water extract blocked increase of systolic blood pressure (SBP) in SHR. The urinary volume (UV), sodium (UNaV), potassium (UkV), and chloride (UclV) excretions were significantly increased in SHR administered with high dose of water extract of HYC, but urinary osmolality was not changed. The creatinine clearance (Ccr), which is index of glomerular filtration rate (GFR), was increased by administration of HYC, while solute-free water reabsorption (TcH2O) was not changed. Taken together, these results suggest that the depressor effects of HYC, at least in part, caused by diuretic effect due to increase of glomerular filtration rate.

The Change of Renal Function in Diabetic Nephropathy and Chronic Renal Failure Patients with Long Term Herb Medication by Frequently Prescribed Formular (상용 한약복합 처방의 장기간 연용 투여가 당뇨병성 신증 및 만성 신부전 환자의 신기능에 미치는 영향)

  • Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.4
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    • pp.1207-1212
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    • 2004
  • Twenty-one diabetic nephropathy patients with normal serum BUN(Blood Urea Nitrogen), creatinine levels and ten chronic renal failure patients with abnormal high BUN, creatinine levels were investigated to evaluate the renal function change after long term herb medicine administration. The hospitalized patients were administrated three times a day with herb medicine, which were prescribe frequently in practical oriental medicine such as many hospital and local clinics. Blood Urea Nitrogen, creatinine and glomerular filtration rate (GFR) were measured immediately after 7days medication. Serum BUN, creatinine levels in diabetic nephropathy patients changed from 17.63±4.38㎎/㎗, 1.09±0.26㎎/㎗(mean±SD) of pre-medication levels to 14.13±3.24 1,20±0.37, 14.75±2.21 1.23±0.55, 12.34±2.89 1.18±0.42 at 7th, 14th, 21th days after herb medicine administration respectively. Also 24hr urine total protein changed from 632.25±254.43㎎/㎗ of pre-medication levels to 623.18±231.56㎎/㎗ after herb medicine administration(P>0.05). Serum BUN, creatinine levels and GFR in chronic renal failure patients changed from 67.45±13.86㎎/㎗, 6.74±2.91㎎/㎗, 13.73±4.21㎖/min pre-medication levels to 61.23±17.75 6.43±2.29 15.49±3.56, 58.84±19.36 5.83±2.51 16.38±2.85, 56.39±20.33 5.64±2.52 16.73±3.40 at 7th, 14th, 21th days after herb medicine administration respectively. Therefore, there was not clinically remarkable difference in the serum BUN, creatinine, GFR levels between pre-medication and post-medication in both Group.

Risk of Fracture Prevalence and Glycemic Control in Korean Older and Middle-aged Patients with Diabetes: A Retrospective Analysis of a Cohort Derived from the Korean National Health Insurance Sharing Service Database, 2009-2013 (노인과 중년 당뇨병 환자의 골절의 발생 빈도 위험과 혈당조절의 관계)

  • Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.194-203
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    • 2018
  • Background: Bone fractures are high in elderly patients with type 2 diabetes mellitus (T2DM). Hyperglycemia and chronic kidney disease may increase the risk of fracture prevalence via altered bone metabolism, but whether glycemic control and kidney function are associated with the risk of fracture prevalence remains unclear. This study evaluated the relationship between glycemic control and baseline estimated glomerular filtration rate (eGFR) and risk of fracture prevalence in older and middle-aged patients with T2DM. Methods: Patients who underwent a general medical check-up between 2009 and 2013 were selected from the Korean National Health Insurance Sharing Service records. Chi-square test and multiple logistic regression analysis were used to assess the relationship between glycemic control and eGFR and risk of fracture prevalence. Results: Cumulative fracture prevalence were higher in patients with T2DM, irrespective of whether they had tight or less stringent glycemic control (fasting blood glucose [FBG] ${\geq}110mg/dL$). After adjustment for baseline age and FBG, tight and less stringent glycemic control was significantly associated with increased adjusted risk of fracture prevalence in middle-aged patients with T2DM (OR=1.13, 95% CI, 1.05-1.21, p=0.0005 vs OR=1.13, 95% CI, 1.06-1.20, p=0.0001), but not in older patients. Baseline eGFR was not significantly related to fracture prevalence in either older or middle-aged patients. Conclusion: Less stringent glycemic control significantly increased the adjusted risk of fracture prevalence in middle-aged patients with T2DM. Further studies are needed to confirm the effect of tight glycemic control on fracture prevalence.

Nephropathy related to computed tomography in emergency department patients with serum creatinine <1.5 mg/dL (정상 혈청 크레아티닌을 가진 응급실 환자에서의 조영제 연관 신증)

  • kim, Jong Ha;Park, Sin-Youl;Kim, Chong Gun
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.90-97
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    • 2015
  • Background: Contrast-induced nephropathy (CIN) can cause serious adverse effects. To reduce the occurrence of CIN related computed tomography (CT) in emergency patients, we assessed the respective roles of serum creatinine (SCr) alone and estimated glomerular filtration rate (eGFR) as an early predictor for CIN related CT. Methods: For patients with SCr <1.5 mg/dL who underwent CT in emergency department (ED) between September 2012 and October 2013, we assessed the prevalence of CIN and its adverse effects. The Modification of Diet in Renal Disease Study (MDRD) and Cockcroft-Gault (CG) formula was used for the calculation of eGFR. Practical calculation was performed by electronic medical record (EMR) system for MDRD and internet calculating service for CG. And we investigated the prevalence of CIN in eGFR $<60mL/min/1.73m^2$ before CT. Results: A total of 1,555 patients were enrolled. The prevalence of CIN after CT was 4.6% and it showed correlation with renal deterioration, increased in-hospital mortality, and prolonged hospitalization. Despite baseline SCr <1.5 mg/dL, among enrolled patients, 11.3% as MDRD equation and 29.5% as CG formula were $<60mL/min/1.73m^2$ and in this condition, the prevalence of CIN was significantly high (odds ratio was 2.87 [1.64-5.02] as MDRD equation and 2.03 [1.26-3.29] as CG formula). Conclusion: Just SCr <1.5mg/dL was not appropriate to recognize preexisting renal insufficiency, but eGFR using MDRD equation was useful in predicting the risk of CIN related CT in ED. Using EMR, calculation of eGFR can be easier and more convenient.

Cancer Survivors Aged 40 Years or Elder are Associated with High Risk of Chronic Kidney Disease: The 2010-2012 Korean National Health and Nutrition Examination Survey

  • Shin, Hyun-Young;Linton, John A.;Shim, Jae-Yong;Kang, Hee-Taik
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1355-1360
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    • 2015
  • Background: The number of cancer survivors is increasing globally and recently, higher rates of comorbidities in cancer survivors have been reported. However, no studies have investigated whether cancer survivors have a higher risk of chronic kidney disease (CKD). Accordingly, our study evaluated the association between cancer survivors and the risk of CKD using the 2010-2012 Korean National Health and Nutrition Examination Survey. Materials and Methods: A total of 11,407 participants aged 40 years and over were categorized into two groups according to cancer experience. Multiple variables were compared and the odds ratios (ORs) for CKD prevalence were calculated using a weighted logistic regression analysis between the two groups. Results: Cancer survivors were older than were those in the non-cancer group, on average, the percentages of glomerular filtration rate(GFR) lower than $60mL/min/1.73m^2$, proteinuria, and CKD were significantly higher in cancer survivors when compared to controls. Weighted logistic regression analyses demonstrated that cancer survivors had a higher risk for CKD after adjusting for multiple variables (OR (95% confidence interval), 2.88 (1.48-5.59)). Conclusions: Our study demonstrated a possible association between CKD and cancer survival in Korean adults. Identifying and correcting risk factors for cancer survivors would positively affect prevention of CKD and result in a better cancer prognosis.

The Effect of Plantaginis Semen Herbal Acupuncture on Acute Renal Failure in Rat (차전자약침(車前子藥鍼)이 급성신부전(急性腎不全) 백서(白鼠)에 미치는 영향(影響))

  • Cho, Si-Yong;Kim, Cheol-Hong;Youn, Hyoun-Min;Jang, Kyung-Jeon;Ahn, Chang-Beohm;Song, Choon-Ho
    • Korean Journal of Acupuncture
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    • v.22 no.4
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    • pp.117-127
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    • 2005
  • Objective : This study was undertaken to determine if Plantaginis Semen herbal acupuncture(PSA) has a protective effect on glycerol-induced acute renal failure in rats. Methods : Rats were dehydrated for 24hr and then injected with 4 ml/kg of 50% glycerol in each hindlimb muscle. In experiments for PSA effect, rats were received 0.1 ml of PSA extraction in both sides of corresponding $Sh\grave{e}nsh\bar{u}(BL_{23})$ of human body for 3 days after injection of glycerol. The experimental group were divided into the normal group, the control group, the sample 1,2,3 group. Results : Glycerol injection decreased glomerular filtration rate and increased urine volume, serum creatinine, BUN level and fractional excretion of $Na^+,\;K^+\;and\;Cl^-$. These results show that glycerol injection bring about acute renal failure. PSA significantly increased glomerular filtration rate and significantly decreased serum creatinine, BUN level and fractional excretion of $Na^+,\;and\;Cl^-$ as compared with control group. Conclusion : These results suggest that PSA can be used in prevention and treatment for acute renal failure. However, the precise mechanisms of PSA protection remain to be determined.

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Beneficial Effect of Glycyrrhizae Radix Extract on Ischemia-Induced Acute Renal Failure in Rabbits (토끼의 허혈성 신부전 대한 감초(甘草) 추출물의 억제 효과)

  • Kim, Gyung-Ho;Kim, Min-Ho;Yun, Yeo-Chung;Kim, Young-Gyun;Cho, Su-In
    • The Korea Journal of Herbology
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    • v.20 no.3
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    • pp.43-49
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    • 2005
  • Objectives : The present study was carried out to determine if Glycyrrhizae Radix extract exerts beneficial effect against the ischemia-induced acute renal failure in rabbits. Glycyrrhizae Radix was known to reinforce the function of the spleen and replenish Qi, remove heat and counteract toxicity, dispel phlegm and relieve cough, alleviate spasmodic pain, and to moderate drug actions. It's indications are weakness of the spleen and the stomach marked by lassitude and weakness; cardiac palpitation and shortness of breath; cough with much phlegm: spasmodic pain in the epigastrium, abdomen and limbs: carbuncles and sores. It is often used for reducing the toxic or drastic actions of other drugs. Methods : Antioxidative effect of 3% concentration of Glycyrrhizae Radix extract was measured. Rabbits were treated with Glycyrrhizae Radix extract via i.v., followed by renal ischemia/reperfusion, and the changes of urine volume, serum creatinine levels, glomerular filtration rate(GFR), fractional Na+ excretion$(FE\;Na^+)\;and\;K^+\;excretion(FE\;K^+)$ in ischemia/reperfusion induced acute renal failure were measured. Results : Renal ischemia/reperfusion caused increase of serum creatinine level, which was accompanied by a reduction in glomerular filtration rate(GFR). The fractional excretion of $Na^+\;and\;K^+$ increased in ischemia-induced animals, which was partially prevented by Glycyrrhizae Radix extract treatment. Conclusions : These results indicate that lipid peroxidation plays a critical role in ischemia-induced acute renal failure. Glycyrrhizae Radix extract exerts the protective effect against acute renal failure induced by renal ischemia/reperfusion, and its effect may be attributed to an antioxidant action.

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Can distinction between the renal cortex and outer medulla on ultrasonography predict estimated glomerular filtration rate in canine chronic kidney diseases?

  • Lee, Siheon;Hong, Sungkyun;Kim, Seungji;Oh, Dayoung;Choen, Sangkyung;Choi, Mincheol;Yoon, Junghee
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.58.1-58.11
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    • 2020
  • Background: Quantitative evaluation of renal cortical echogenicity (RCE) has been tried and developed in human and veterinary medicine. Objectives: The objective of this study was to propose a method for evaluating RCE quantitatively and intuitively, and to determine associations between ultrasonographic renal structural distinction and estimated glomerular filtration rate (eGFR) in canine chronic kidney disease (CKD). Methods: Data were collected on 63 dogs, including 27 with normal kidney function and 36 CKD patients. Symmetric dimethylarginine and creatinine concentrations were measured for calculating eGFR. RCE was evaluated as 3 grades on ultrasonography images according to the distinction between the renal cortex and outer medulla. The RCE grade of each kidney was measured. Results: There was a significant difference in eGFR between the group normal and CKD (p < 0.001). As mean of RCE grades (the mean values of each right and left kidney's RCE grade) increases, the proportion of group CKD among the patients in each grade increases (p < 0.001). Also, severity of RCE (classified as "high" if any right or left kidney evaluated as RCE grade 3, "low" otherwise) and eGFR is good indicator for predicting group CKD (p < 0.001). Conclusions: The degree of distinction between the renal cortex and the outer medulla is closely related to renal function including eGFR and the RCE grade defined in this study can be used as a method of objectively evaluating RCE.

Comparison of Glomerular Filtration Rate Using Gates Method and Serum Creatinine (Gates 방법과 혈청 크레아티닌을 이용한 사구체 여과율의 비교)

  • Yun, Jong-Jun;Lee, Hyo-Yeong;Lee, Hwa-Jin;Lee, Mu-Seok;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.61-66
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    • 2009
  • Purpose: Glomerular filtration rate (GFR) is considered as the best overall index for the level of renal function, diagnosis of doubtful kidney disease, progress observation from chronic kidney disease and is measured with the various methods. In this study, We measured standard GFR by Gates method and attempted to compare the result with serum creatinin-based, Cockcroft-Gault(C-G) formula and Modification of Diet in Renal Disease (MDRD) formula. Materials and methods: 217 patients (127 men, 90 women, mean age $51.3{\pm}16.9$) with various renal function were examined. we compared the GFR using $^{99m}Tc$-DTPA (Gates), C-G formula and MDRD formula. Results: Significant correlations were noted between 2 different GFR estimates (from C-G formula: r=0.864, p<0.0001, MDRD formula: r=0.831, p<0.0001) and $^{99m}Tc$-DTPA (Gates) GFR. Average of serum creatinine (Scr) was measured with $3.0{\pm}3.1\;mg/dL$, In patients with normal renal function (Scr<1.5 mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula (p<0.0001) and MDRD formula (p<0.0001). In patients with mild to moderate renal insufficiency (1.5$^{99m}Tc$-DTPA (Gates) GFR was not statistically significant to C-G formula (p=0.181) and MDRD formula (p=0.127). In patients with severe renal insufficiency (Scr>4.0mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula and MDRD formula (p<0.0001). Conclusions: Glomerular filtration rate using Gates method was closly correlated to C-G formula and MDRD formula. In patients with normal renal function, $^{99m}Tc$-DTPA (Gates) GFR was significantly lower than C-G formula and MDRD formula. In patients with mild to moderate renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was simmilar with C-G formula and MDRD formula. In patients with severe renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was significantly higher than C-G formula and MDRD formula. None of the three different methods was clearly superior to the others.

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