• 제목/요약/키워드: Kidney disease

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미세변화형 신증후군 환아에서 발생한 우측총장골동맥 혈전증 1례 (A Case of Thromboembolic Complication in Right Common Iliac Artery in a Child with Minimal Change Nephrotic Syndrome)

  • 남현주;김지홍;김병길;장병철
    • Childhood Kidney Diseases
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    • 제2권1호
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    • pp.69-72
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    • 1998
  • Thromboemolism is one of the severe complications of nephrotic syndrome. And arterial thromboembolism is rare than venous thromboembolism. Hypercoagulability is the main pathophysiologic factors of thromboembolism in nephrotic syndrome with severe hypoalbuminemia. We experienced one case of arterial thromboembolism which occured in right common iliac artery. It was seen in a 6 year-old male child that presented with generalized edema and rigth ankle joint pain. Emergency embolectomy and anticoagulant therapy (heparin and antithrombin III) was performed. He didn't have to be amputated and recovered to self ambulation. This is an uncommon case that successful recovery was possible by early diagnosis and invasive surgical management with proper anticoagulant therapy.

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Mouse models of polycystic kidney disease induced by defects of ciliary proteins

  • Ko, Je Yeong;Park, Jong Hoon
    • BMB Reports
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    • 제46권2호
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    • pp.73-79
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    • 2013
  • Polycystic kidney disease (PKD) is a common hereditary disorder which is characterized by fluid-filled cysts in the kidney. Mutation in either PKD1, encoding polycystin-1 (PC1), or PKD2, encoding polycystin-2 (PC2), are causative genes of PKD. Recent studies indicate that renal cilia, known as mechanosensors, detecting flow stimulation through renal tubules, have a critical function in maintaining homeostasis of renal epithelial cells. Because most proteins related to PKD are localized to renal cilia or have a function in ciliogenesis. PC1/PC2 heterodimer is localized to the cilia, playing a role in calcium channels. Also, disruptions of ciliary proteins, except for PC1 and PC2, could be involved in the induction of polycystic kidney disease. Based on these findings, various PKD mice models were produced to understand the roles of primary cilia defects in renal cyst formation. In this review, we will describe the general role of cilia in renal epithelial cells, and the relationship between ciliary defects and PKD. We also discuss mouse models of PKD related to ciliary defects based on recent studies.

원위 신세뇨관성 산증에 합병된 급성 주기성 저칼륨혈증 마비 1례 (Distal Renal Tubular Acidosis Complicated with Periodic Hypokalemic Paralysis)

  • 박지민;노병호;신재일;김명준;이재승
    • Childhood Kidney Diseases
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    • 제8권1호
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    • pp.63-67
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    • 2004
  • 저자들은 생후 2개월에 신석회화증, 원위 신세뇨관성 산증을 진단받고 지속적인 외래 추적 관찰을 하고 있는 여아에서 급성 저칼륨혈증 주기성 마비를 진단하였기에 문헌 고찰과 함께 보고하는 바이다.

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허혈성 대장염에 동반된 용혈성 요독 증후군 1례 (A Case of Hemolytic Uremic Syndrome in a Child with Ischemic Colitis)

  • 김양현;안선영;박지민;이재승
    • Childhood Kidney Diseases
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    • 제8권1호
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    • pp.86-90
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    • 2004
  • 저자들은 복통과 구토, 혈변을 주소로 내원한 환아의 바륨 대장 조영술에서 무지문양(thumb-printing)을 확인하여 허혈성 대장염 진단하에 치료 중 미세혈관성 용혈성 빈혈과 혈소판 감소, 전해질 불균형과 급격한 소변량 감소의 급성 신부전 소견을 확인하고 허혈성 대장염에 동반된 용혈성 요독 증후군을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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건강보험 자료를 이용한 만성신부전 환자의 신독성 약물사용 현황 (Retrospective Drugs Utilization Review Study for Chronic Kidney Disease Using National Health Insurance Database)

  • 김동숙;이현정;손인자;김귀숙;신주영;이건세
    • 약학회지
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    • 제53권3호
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    • pp.138-144
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    • 2009
  • The purpose was to implement drug utilization review (DUR) for whom were diagnosed with chronic kidney disease (CKD) population using health insurance claim data. This study constructed drug utilization database using Health Insurance Review and Assessment Service (HIRA) database and selected contraindicated drugs with kidney based on previously developed drug utilization guide and reviewing other countries' examples. Main outcome measures were the proportion of prescription for 1 or more drugs of concern. The cohort included 115,948 subjects, who were diagnosed with chronic kidney disease. Inappropriate drugs with CKD patients was some used, and the most commonly prescribed classes were aluminum drugs. However it is difficult to find problems with inappropriate drug because claims data doesn't have laboratory data. Based on the result of retrospective drug utilization review study, more studies should be analysed drug utilization patterns and monitoring system should be developed.

"동의보감(東醫寶鑑)" "내경편(內景篇)"의 포(胞), 소변(小便), 대편(大便)에 나타난 질병(疾病)의 변증화(辨證化) 연구 (Study on Mechanistic Pattern Identification of Disease for Uterine, Urine and Excrements Parts of DongEuiBoGam NaeGyungPyen)

  • 김영목
    • 동의생리병리학회지
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    • 제24권5호
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    • pp.727-736
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    • 2010
  • This study is about researching mechanistic pattern identification of disease for DongEuiBoGam NaeGyungPyen by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of uterine, urine and excrements parts of DongEuiBoGam NaeGyun gPyen in NaeGyungPyen of DongEuiBoGam are these. Menstrual irregularities in DongEuiBoGam can be classified flui d-humor depletion, blood deficiency, qi deficiency, qi stagnation, qi stagnation complicated by heat, blood stasis, blood deficiency complicated by heat, syndrome of heat entering blood chamber, syndrome of cold entering blood chamber. The disease pattern of abdominal pain after menstruation in DongEuiBoGam is blood deficiency complicated by heat, and a dysmenorrhea represents blood stasis with heat, fluid-humor deficiency. Advanced menstruation represent dual heat of the qi and blood, delayed menstruation is blood deficiency. The disease pattern of inhibited urination in DongEuiBoGam can be classified deficiency heat pattern of kidney yin deficiency(yin deficiency with effulgent fire), kidney qi deficiency, yin deficiency with yang hyperactivity, fluid-humor depletion, spleen-stomach dual deficiency, and excess he at pattern of bladder excess heat. The disease pattern of urinary incontinence in DongEuiBoGam can be classified deficiency pattern of kidney-bladder qi deficiency, consumptive disease, lung qi deficiency, kidney yin deficiency(yin deficiency with effulgent fire), kidney yang deficiency and excess pattern of lower energizer blood amassment, bladder excess heat. And most of them are deficiency from deficiency-excess Pattern Identification. The disease pattern of diarrhea in DongEuiBoGam can be classified deficiency pattern of qi deficiency, qi fall, spleen yang deficiency, kidney yang deficiency and so on and excess pattern of wind-cold-summerheat-dampness-fire, phlegm-fluid retention, dietary irregularities, qi movement stagnation. And most of them are deficiency from deficiency-excess Pattern Identification. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.

당뇨병성 신장질환 환자에서 적정 혈압 관리의 중요성 (Importance of Target Blood Pressure Management in Diabetic Kidney Disease)

  • 김희성
    • 한국콘텐츠학회논문지
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    • 제19권6호
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    • pp.461-470
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    • 2019
  • 신장질환은 당뇨병환자에서 흔한 합병증이며, 알부민뇨 배설의 증가, 사구체여과율의 감소가 특징적이다. KDIGO 분류에 따라 6기 국민건강영양조사 원시자료를 이용하여 알부민뇨와 사구체여과율에 따라 특성을 분석하였다. 당뇨환자를 KDIGO의 분류에 따라, Low risk 72.0%, Moderate risk 19.3%, High risk 5.6%, Very high risk 3.0%이었다. 당뇨병 유병기간이 길어질수록 Low risk는 74.7%에서 52.2%로 감소하였고, Moderate~Very high risk는 25.4%에서 47.8%로 상승하였다. 위험요인은 CKD stage 1 (HR 2.064) ~ stage 4 (HR 11.049)로 고혈압의 위험도가 가장 높았다. 고혈압 유병기간에 따라 신장질환의 발생빈도는 상승하였고, 적정 혈압을 유지하는 군에서 신장질환의 위험도 0.42가 감소하였다. 고혈압 환자에서 적정 혈압으로 관리하는 군이 그렇지 않은 군보다 42%의 신장질환의 감소효과가 있었다. 그러므로 고혈압을 적정혈압으로 조절 및 관리하는 것이 신장질환의 예방에 있어 중요하다.

The Impact of Surgical versus Transcatheter Aortic Valve Replacement on Postprocedural Acute Kidney Injury in Patients with Chronic Kidney Disease

  • Eun Chae, Kim;Sue Hyun, Kim;Yeiwon, Lee;Suk Ho, Sohn;Jae Woong, Choi;Jeehoon, Kang;Jung Kyu, Han;Kyung Hwan, Kim;Hyo-Soo, Kim;Ho Young, Hwang
    • Journal of Chest Surgery
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    • 제55권6호
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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.

Pneumocystis Pneumonia after Kidney Transplantation in Children

  • Hwang, Soojin;Jung, Jiwon;Lee, Joo Hoon;Park, Young Seo
    • Childhood Kidney Diseases
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    • 제24권1호
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    • pp.47-52
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    • 2020
  • Pneumocystis pneumonia (PCP) is a rare disease in healthy people but a potentially fatal opportunistic infection by Pneumocystis jirovecii in immunocompromised patients with organ transplantation. We present three cases of PCP after kidney transplantation in pediatric patients. First case was a 4-year-old boy diagnosed with Denys-Drash syndrome and received living-donor kidney transplantation from his mother at age of 1. Second case was a 19-year-old male, with polycystic kidney disease, who received kidney transplantation from his mother at the age of 18. Third case was a 19-year-old female with chronic kidney disease of unknown etiology, who received kidney transplantation from her father at age of 15. These three patients who were on immunosuppressive therapy and completed of routine PCP prophylaxis for 6 months had presented with cough and dyspnea more than 1 year after transplantation. Chest x-ray all showed diffuse haziness of both lung fields, and bronchoalveolar lavage from bronchoscopy revealed Pneumocystisjirovecii infection. All patients showed clinical resolution with intravenous trimethoprim-sulfamethoxazole (TMP-SMX) therapy for at least 3 weeks and had continued secondary prophylaxis for another 6-12 months. This report suggests that clinicians should have suspicion for the possibilities of opportunistic infection such as PCP after kidney transplantation in children.

포먼트 주파수 대역폭 추출 및 분석을 이용한 신장 질환 진단 방법의 설계 (A Design of Kidney Diseases Diagnosis Method Using Formant Frequency Bandwidth Extraction and Analysis)

  • 김봉현;조동욱
    • 한국통신학회논문지
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    • 제34권10B호
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    • pp.1062-1069
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    • 2009
  • 비만으로 인해 대사증후군을 많이 앓고 있는 상황에서 후유증으로 신장 질환이 커다란 사회문제가 되고 있는 실정이다. 따라서 자각증상이 없는 신장의 이상 유무를 조기에 판단하여 적절한 조치를 취하는 것이 무엇보다 중요하다. 이를 위해 본 논문에서는 음성 분석을 통해 신장 질환을 무자각, 무구속, 무통종의 방법으로 진단할 수 있는 방법을 제안하였다. 구성하고자 하는 전체 시스템은 크게 음성 분석과 얼굴색을 살피는 방법을 결합시키는 시스템이 개발되고 있으며 이 중 본 논문은 입술소리를 기반으로 신장 질환을 진단하는 방법에 설계하였다. 이를 위해 본 논문에서는 첫째, 신장 질환을 앓고 있는 환자와 정상인을 대상으로 피실험자 집단을 각각 구성하고 입술소리의 수치학적 분석을 실험으로 출력하고 그 결과값에 대한 비교 분석을 수행하였으며 둘째, 한의학적 청진 이론과 언어학, 음성학과의 상관성을 분석하고 이를 기반으로 음성에 대한 신장의 특징 요소를 추출하여 제1포먼트 주파수와의 연관성을 도출하였다. 실험 결과 신장 질환자 집단이 정상인 집단보다 제1포먼트 주파수 대역폭이 넓게 형성되는 결과를 추출하였으며 최종적으로 입술소리만으로 신장 질환을 진단할 때의 오진 확률에 대해 계산하였다.