• Childhood Kidney Diseases
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• v.15 no.2
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• pp.116-124
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• 2011

Acute kidney injury (AKI) can result in mortality or progress to chronic kidney disease in hospitalized patients. Although serum creatinine has long been used as the best biomarker for diagnosis of AKI, it has some clinical limitations, especially in children. New biomarkers are needed for early diagnosis, differential diagnosis, and reliable prediction of prognosis in AKI. Up to the present, candidate AKI biomarkers include neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), livertype fatty acid-binding protein (L-FABP), matrix metalloproteinase-9 (MMP-9), and Nacetyl-$\ss$-D-glucosaminidase (NAG). However, whether these are superior to serum creatinine in the confirmation of diagnosis and prediction of prognosis in AKI is unclear. Further studies are needed for clinical application of these new biomarkers in AKI.

• Childhood Kidney Diseases
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• v.12 no.1
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• pp.23-29
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• 2008

Kidney allograft transplantation is the most effective method of renal replacement for end stage renal disease patients. Still, it is another kind of 'disease', requiring immunosuppression to keep the allograft from rejection(allograft immune reaction). Immune system of the allograft recipient recognizes the graft as a 'pathogen (foreign or danger)', and the allograft-recognizing commanderin-chief of adaptive immune system, T cell, recruits all the components of immune system for attacking the graft. Proper activation and proliferation of T cell require signals from recognizing proper epitope(processed antigen by antigen presenting cell) via T cell receptor, costimulatory stimuli, and cytokines(IL-2). Thus, most of the immunosuppressive agents suppress the process of T cell activation and proliferation.

• Journal of Medicine and Life Science
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• v.19 no.2
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• pp.66-69
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• 2022

Patients with vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder to the kidney, are known to experience renal scarring; this results in the worsening of renal function. Reflux nephropathy is a cause of chronic kidney disease, and VUR has also been observed in dialysis patients. VUR is a major underlying precursor condition of urinary tract infection (UTI) and is sometimes accompanied by hydronephrosis. However, there are no guidelines for the management of UTI due to VUR-associated hydronephrosis in patients with end-stage kidney disease. Herein, we report a case of UTI caused by VUR-associated hydronephrosis in a dialysis patient treated with percutaneous nephrostomy.

• The Korean Journal of Medicine
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• v.99 no.2
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• pp.61-68
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• 2024

Chronic Kidney Disease (CKD) is a major global health burden. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated potential in slowing CKD progression. We evaluated the expanding role of SGLT2 inhibitors, emphasizing their renoprotective benefits in diabetic and non-diabetic CKD patients. We also investigated the underlying mechanisms, including the reduction of glomerular hypertension via modulation of tubuloglomerular feedback. Our study critically analyzed current indications for SGLT2 inhibitor therapy based on recent clinical trial data. To optimize patient outcomes, we present a comprehensive analysis of practical considerations for the prescription of SGLT2 inhibitors, including the potential initial decline in the estimated glomerular filtration rate and a review of adverse events.

• 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.

• The Journal of Korean Medicine
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• v.27 no.2 s.66
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• pp.23-35
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• 2006

Objectives : This study examined the reliability of disease mechanism diagnosis, to evaluate items of questionnaires and inquire about the relationships between disease mechanisms and 'diagnosis program' questionnaires used for the objective diagnosis of Oriental medicine in the department of Oriental OB&GYN, Oriental Medical Hospital of Dongeui University. Method : We analyzed the results of questionnaires from 3504 outpatients of OB&GYN disease at the Oriental Medical Hospital of Dongeui University from April 2000 to April 2005. Results & Conclusions : 1. The research questionnaire had 188 questions, the summary questionnaire 137, and the diagnosis questionnaire 80. 2. The reliability of all questionnaires shows above 90% in deficiency of qi, deficiency of Yin, insufficiency of Yang coldness heat syndrome liver and spleen kidney in all, 8 case disease mechanisms. These are higher in the diagnosis questionnaires than in the research questionnaires and the summary questionnaires, except for kidney disease mechanism. 3. Cronbach a of the questionnaires decreased, especially blood deficiency, phlegm, heat syndrome, and insufficiency of Yang; these 4 case disease mechanisms were lower than 0.6. 4. For degree of correspondence of meeting points, both. the diagnosis and the summary questionnaires were above 80% with the exception of the 2 case disease mechanisms heart and blood deficiency. The meeting points of both the diagnosis and research questionnaires were above 80% in the to case disease mechanisms deficiency of qi blood stasis deficiency of Yim insufficiency of Yang damp dryness liver spleen kidney phlegm. 5. The change in the result values of questionnaires was a decreased level of deficiency of qi heat syndrome phlegm damp kidney and raised level of coldness heart disorder of qi dryness 6. The computation degree of disease mechanism in DSOM(r) D.1.1 was much lower on phlegm deficiency of qi heat syndrome disorder of blood, somewhat lower on insufficiency of Yang and higher on coldness than in the two different questionnaires.

• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.2
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• pp.35-40
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• 2021

Purpose Glomerular filtration rate(GFR) is an important indicator for the diagnosis, treatment, and follow-up of kidney disease and is also used by healthy individuals for drug use and evaluating kidney function in donors. The gold standard method of the GFR test is to measure by continuously injecting the inulin which is extrinsic marker, but it takes a long time and the test method is complicated. so, the method of measuring the serum concentration of creatinine is used. Estimated glomerular filtration rate (eGFR) is used instead. However, creatinine is known to be affected by age, gender, muscle mass, etc. eGFR formulas that are currently used include the Cockroft-Gault formula, the modification of diet in renal disease (MDRD) formula, and the chronic kidney disease epidemilogy collaboration (CKD-EPI) formula for adults. For children, the Schwartz formula is used. Measurement of GFR using ⁵¹Cr-EDTA (diethylenetriamine tetraacetic acid), ^99mTc-DTPA (diethylenetriamine pentaacetic acid) can replace inulin and is currently in use. Therefore, We compared the GFR measured using ^99mTc-DTPA with the eGFR using CKD-EPI formula. Materials and Methods For 200 kidney transplant donors who visited Asan medical center.(96 males, 104 females, 47.3 years ± 12.7 years old) GFR was measured using plasma(Two-plasma-sample-method, TPSM) obtained by intravenous administration of ^99mTc-DTPA(0.5mCi, 18.5 MBq). eGFR was derived using CKD-EPI formula based on serum creatinine concentration. Results GFR average measured using ^99mTc-DTPA for 200 kidney transplant donors is 97.27±19.46(ml/min/1.73m²), and the eGFR average value using the CKD-EPI formula is 96.84±17.74(ml/min/1.73m²), The concentration of serum creatinine is 0.84±0.39(mg/dL). Regression formula of ^99mTc-DTPA GFR for serum creatinine-based eGFR was Y = 0.5073X + 48.186, and the correlation coefficient was 0.698 (P<0.01). Difference (%) was 1.52±18.28. Conclusion The correlation coefficient between the ^99mTc-DTPA and the eGFR derived on serum creatinine concentration was confirmed to be moderate. This is estimated that eGFR is affected by external factors such as age, gender, and muscle mass and use of formulas made for kidney disease patients. By using ^99mTc-DTPA, we can provide reliable GFR results, which is used for diagnosis, treatment and observation of kidney disease, and kidney evaluation of kidney transplant patients.

• Journal of Korean Medical classics
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• v.25 no.4
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• pp.123-147
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• 2012

Objective : By establishing the Five Viscera Source Point Acupuncture as the targeted acupuncture treatment for stadardization, as the first step, this study was conducted to sort the indications of each acupuncture remedies, which can be referred as one of the most important factors in acupuncture treatment, based on Yeoungchu. Method : This study selected only the contents related to indications of five viscera, by extracting the relevant sentences from Yeoungchu using the search words Liver(Liver Meridian, First Yin), Heart(Pericardium, Heart Meridian, Second Yin), Spleen(Spleen meridian, Third Yin), Lung(Lung Meridian, Third Yin), and Kidney(Kidney Meridian, Second Yin). Result & Conclusion : 1. We selected and extracted text related to liver disease from Chapter 16, heart (pericardium) disease from Chapter 16, spleen disease from Chapter 19, lung disease from Chapter 17, and finally kidney disease from Chapter 17 of Yeoungchu. 2. The basic theory of applying Five Viscera Source Point Acupuncture to five viscera diseases is first assorting the diseases according to its state (i.e. deficiency or excess), then draining the source point of the appropriate viscus in case of excess, or supplementing the source point of the appropriate viscus in case of deficiency. 3. For the correct application of Five Viscera Source Point Acupuncture, the classification of the disease, not only the judgement on its state, must be presented systematically and synthetically in combination with Four Examinations. Therefore the follow-up studies needs to be conducted.

• Parasites, Hosts and Diseases
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• v.54 no.3
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• pp.315-317
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• 2016

Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated.

• Journal of Korean Academy of Nursing
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• v.42 no.5
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• pp.699-708
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• 2012

Purpose: This study was designed to test structural equation modeling of the quality of life of pre-dialysis patients, in order to provide guidelines for the development of interventions and strategies to improve the quality of life of patients with Chronic Kidney Disease (CKD). Methods: Participants were patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic factors, social support, nutritional status, physical factors and biobehavioral factors and quality of life were collected between March 4 and March 31, 2011. Results: In the final analysis 208 patients were included. Of the patients 42% were in a malnourished state. Anxious or depressed patients accounted for 62.0%, 72.6%, respectively. Model fit indices for the hypothetical model were in good agreement with the recommended levels (GFI=.94 and CFI=.99). Quality of life in pre-dialysis patients with CKD was significantly affected by demographic factors, social support, nutritional status, physical factors and biobehavioral factors. Biobehavioral factors had the strongest and most direct influence on quality of life of patients with CKD. Conclusion: In order to improve the quality of life in pre-dialysis patients with CKD, comprehensive interventions are necessary to assess and manage biobehavioral factors, physical factors and nutritional status.