• Kidney Research and Clinical Practice
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• v.36 no.2
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• pp.200-204
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• 2017

Administration of autologous mesenchymal stem cells (MSCs) has been shown to improve renal function and histological findings in acute kidney injury (AKI) models. However, its effects in chronic kidney disease (CKD) are unclear, particularly in the clinical setting. Here, we report our experience with a CKD patient who was treated by intravenous infusion of autologous MSCs derived from adipose tissue in an unknown clinic outside of Korea. The renal function of the patient had been stable for several years before MSC administration. One week after the autologous MSC infusion, the preexisting renal insufficiency was rapidly aggravated without any other evidence of AKI. Hemodialysis was started 3 months after MSC administration. Renal biopsy findings at dialysis showed severe interstitial fibrosis and inflammatory cell infiltration, with a few cells expressing CD34 and CD117, 2 surface markers of stem cells. This case highlights the potential nephrotoxicity of autologous MSC therapy in CKD patients.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.435-441
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• 2022

Background: This study aimed to evaluate the impact of the treatment modality on post-procedural acute kidney injury (AKI) and other clinical outcomes in patients with advanced chronic kidney disease who underwent surgical or transcatheter aortic valve replacement (AVR). Methods: A total of 147 patients with advanced chronic kidney disease (stage 3 to 5) who underwent isolated surgical AVR (SAVR group; n=70) or transcatheter AVR (TAVR group; n=77) were retrospectively studied. Postprocedural AKI was defined according to the RIFLE definition (an acronym corresponding to the risk of renal dysfunction, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage kidney disease). Factors associated with postoperative complications and mortality were analyzed using multivariable logistic regression models and Cox proportional hazard models. Results: Postprocedural AKI occurred in 17 (24.3%) and 6 (7.8%) patients in the SAVR and TAVR groups, respectively (p=0.006). Multivariable analyses demonstrated that the SAVR group had higher risks of AKI (odds ratio [OR], 5.63; 95% confidence interval [CI], 1.85-17.73; p=0.002) and atrial fibrillation (OR, 16.65; 95% CI, 4.44-62.50; p<0.001), whereas the TAVR group had a higher risk of permanent pacemaker insertion (OR, 5.67; 95% CI, 1.21-26.55; p=0.028). The Cox proportional hazard models showed that the occurrence of AKI, contrary to the treatment modality, was associated with overall survival. Conclusion: In patients with chronic kidney disease, the risk of postprocedural AKI might be higher after SAVR than after TAVR.

• Journal of Chest Surgery
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• v.49 no.6
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• pp.427-434
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• 2016

Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ${\times}3$ higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

• Korean Journal of Adult Nursing
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• v.12 no.3
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• pp.452-462
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• 2000

The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Program to prevent of obesity and cardiovascular diseases for the kidney transplant recipients. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study ws carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids therapy and did not take any physical exercise regularly. The subjects received the self efficacy promotion and exercise program for 12 weeks which contained self efficacy promotion education and exercise program. The weight, body fat rate, exercise time and cardiopulmonary function were evaluated before the experiment and after the experiment. The results were as follows: 1. After the experiment, the weight was significantly decreased than that of before the experiment(p=.0001). 2. After the experiment, the body fat rate was significantly decreased than that of before the experiment(p=.0010). 3. After the experiment, the exercise time was significantly increased than that of before the experiment(p=.0002). 4. After the experiment, the absolute VO2 was significantly increased than that of before the experiment(p=.0008). 5. After the experiment, the relative VO2 was significantly increased than that of before the experiment(p=.0002). This study showed that the self efficacy promotion and exercise program was effective. So it would be expected that this self efficacy promotion and exercise program could be applied as an effective independent nursing intervention widely in prevention of obesity and cardiovascular diseases for kidney transplant recipients.

• BMB Reports
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• v.36 no.4
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• pp.373-378
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• 2003

Effects of L-arginine and NG-nitro-L-arginine methyl ester (L-NAME) on the renal dysfunction that is induced by cisplatin (CDDP) were investigated. A single dose of CDDP (7.5 mg/kg i.p.) induced renotoxicity, which was manifested by increasing the sensitivity of isolated urinary bladder rings to acetylcholine (ACh), together with a significant elevation of serum urea and creatinine, and a severe decrease in serum albumin. Moreover, renal dysfunction was further confirmed by a significant decrease of enzyme activities, such as glutathione peroxidase, GSH-Px (E.C 1.11.1.9), catalase (E.C 1.11.1.6), as well as a significant increase in lipid peroxides that were measured as malondialdhyde (MDA) in kidney tissue homogenates. The administration of L-arginine (70 mg/kg/d p.o in drinking water 5 d before and 5 d after the CDDP injection) significantly ameliorated the renotoxic effects of CDDP, as judged by restoring the normal responses of isolated bladder rings to Ach, and also by an improvement in a range of renal function indices, which included serum urea and creatinine concentrations and kidney weight. In addition, L-arginine prevents the rise of MDA, as well as a reduction of GSH-Px and catalase activities in kidney tissues homogenates. On the other hand, the administration of L-NAME (4 mg/kg/d p.o) resulted in no protection against renal dysfunction that was induced by CDDP treatment. The findings of this study suggest that L-arginine can attenuate kidney injury that is produced by CDDP treatment. In addition, L-arginine may be a beneficial remedy for CDDP-induced renal toxicity, and could be used to improve the therapeutic index of CDDP.

• Journal of Korean Medical classics
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• v.26 no.1
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• pp.39-45
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• 2013

Objective : This article is based on a formula taken from Essential Prescriptions of the Golden Chamber(金匮要略). Shen Qi Pill(肾气丸) is generally used for such deficiency cases as: consumptive diseases, xiaoke(消渴) (waisting, thirst), beriberi, urinary problems during pregnancy, phlegm and so forth, and its main purpose is to treat Kidney Qi depletion, Qi transformation disorders, without obvious hot/cold appearance patterns. Method : Mainly through the literature study of related treatise on IInner Canon of the Yellow Emperor's internal classic(黃帝内经) and The Essential Prescriptions of the Golden Chamber. Result : According to the Yellow Emperor's internal classic, the Kidney has three main functions, storing essence, controlling the waters and holding Qi. Shen Qi Pill's(肾气丸) source formula is intended to supplement even though its constituent herbs aren't the warming type. To reinforce the Qi's transformation ability is considered to be a main function of the kidney organ, and in clinic, diagnosed kidney related problems and its treatment process are mainly associated with warming to help the Qi transforming. Conclusion : Thus recovering the kidneys Qi's transformation function is part of the process to eliminate diseases. Just cause the Kidney is deficient we shouldn't think immediately of using warming supplement herbs.

• Journal of Ginseng Research
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• v.41 no.3
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• pp.233-239
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• 2017

Background: Nephrotoxicity is the major side effect in cisplatin chemotherapy. Previously, we reported that the ginsenosides Rk3 and Rh4 reduced cisplatin toxicity on porcine renal proximal epithelial tubular cells (LLC-PK1). Here, we aimed to evaluate the protective effect of ginsenosides Rk3 and Rh4 on kidney function and elucidate their antioxidant effect using in vitro and in vivo models of cisplatin-induced acute renal failure. Methods: An enriched mixture of ginsenosides Rk3 and Rh4 (KG-KH; 49.3% and 43.1%, respectively) was purified from sun ginseng (heat processed Panax ginseng). Cytotoxicity was induced by treatment of $20{\mu}M$ cisplatin to LLC-PK1 cells and rat model of acute renal failure was generated by single intraperitoneal injection of 5 mg/kg cisplatin. Protective effects were assessed by determining cell viability, reactive oxygen species generation, blood urea nitrogen, serum creatinine, antioxidant enzyme activity, and histopathological examination. Results: The in vitro assay demonstrated that KG-KH ($50{\mu}g/mL$) significantly increased cell viability (4.6-fold), superoxide dismutase activity (2.8-fold), and glutathione reductase activity (1.5-fold), but reduced reactive oxygen species generation (56%) compared to cisplatin control cells. KG-KH (6 mg/kg, per os) also significantly inhibited renal edema (87% kidney index) and dysfunction (71.4% blood urea nitrogen, 67.4% creatinine) compared to cisplatin control rats. Of note, KG-KH significantly recovered the kidney levels of catalase (1.2-fold) and superoxide dismutase (1.5-fold). Conclusion: Considering the oxidative injury as an early trigger of cisplatin nephrotoxicity, our findings suggest that ginsenosides Rk3 and Rh4 protect the kidney from cisplatin-induced oxidative injury and help to recover renal function by restoring intrinsic antioxidant defenses.

• CELLMED
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• v.9 no.1
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• pp.2.1-2.6
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• 2019

Decoction of Cocos nucifera husk fibre is used indigenously in Nigeria for malaria treatment. Polyphenols have been identified as the phytochemicals responsible for the antimalarial activity of Cocos nucifera husk fibre, though their toxicity has not been evaluated. The polyphenols of Cocos nucifera husk fibre were therefore evaluated for their effects on selected kidney function indices in mice. Fifty mice were randomly divided into five groups (A-E) of ten mice each. Mice in group A were orally administered 5% DMSO solution while those in groups B, C, D and E were orally administered 31.25, 62.5, 125 and 250 mg/Kg body weight of the polyphenols respectively for seven days. Serum urea, creatinine and uric acid concentrations were determined. Serum levels of sodium, potassium, chloride and calcium ions and kidney alkaline phosphatase (ALP), glutamate dehydrogenase (GDH) and gamma-glutamyltransferase (GGT) activities were also determined. The results showed that the polyphenols significantly reduced (p<0.05) urea concentration at 250 mg/Kg body weight and creatinine concentration at all doses compared to controls. The polyphenols caused no significant alteration (p>0.05) in serum uric acid concentration and kidney ALP, GGT and GDH activities compared to controls. There was significant increase (p<0.05) in serum sodium ion concentration at 31.25, 125 and 250 mg/Kg body weight of polyphenols whereas significant increase (p<0.05) in serum potassium and chloride ions was observed at 62.5 and 250 mg/Kg body weight compared to controls. Thus, polyphenols of Cocos nucifera husk fibre may adversely affect some osmoregulatory functions of the kidney, especially at higher concentrations.

• YAKHAK HOEJI
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• v.36 no.1
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• pp.46-55
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• 1992

Methoxyverapamil, $Ca^{2+}$ channel blocker, when given intravenously by means of bolus, produced the transient increase of urine flow, and then methoxyverapamil was infused in this experiments. Methoxyverapamil, when infused into vein, elicited the increase of urine flow ancampanied with the increased glomeralar filtration rate(GFR), renal plasma flow(RPF), excretion amounts of sodium and potassium in urine($E_{Na},\;E_k$) and osmolar clearance(Cosm), wherease produced the no change of free water clearance($C_{H2O}$) and the reduction of reabsorption rates of sodium and potassium in reral tubules($R_{Na},\;R_k$). Methoxyverapamil, when infused into a renal artery, exhibited the diuretic action in only infused Kidney, at this time changes of renal function were the same aspect to that of intravenously infused methoxyverapamil. Methoxyverapamil, when infused into a carotid artery, exhibited the decreased urine flow along with the reduction of Cosm, $C_{H2O}\;and\;E_{Na}$. Above results suggest that methoxyverapamil possess both the diuretic action by direct action in kidney and antidiuretic action through the central function.

• Journal of Korean Medical classics
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• v.19 no.2 s.33
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• pp.97-107
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• 2006

From the study on the relation of voice and O-jang(五臟廳), the conclusion is as follows. The function of breathing out in larynx is involved with lung and kidney. Lung press out the air, at the same time, kidney supports that to maintenance the density of air constantly. So the person who has short breathing can not make strong voice, and also if having a weak kidney in upper Cho[下蕉], their voice will be changed so very softly to cannot make hard type of voice and lingering sounds. Opening and Closing of vocal cords are controled by liver and spleen. when vocal cords are contracted, liver makes tension, whereas spleen does in slackness. So liver is likely to make high-piched sounds in tension of vocal cords, and spleen is the same to do smoothy and husky sounds through relaxing the vocal cords. In the rising condition of liver function, the temp of speech become fast, and more the pronunciation is clearer, it means that the function of thinking by spleen is operated well. Otherwise, indistinct pronunciation means that in the body seup-sa(濕邪) spreads. Also depression of emotion in speech often makes Gi(氣) of heart weaker, whereas it means regular condition of heart including Simpo(心包) that expression of emotion looks happy.