• Title/Summary/Keyword: Kidney failure, Chronic

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The Mineral Contents in 42 Oriental Herbs (42종 한약재의 무기질 함량)

  • 두호경;안세영
    • The Journal of Korean Medicine
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    • v.21 no.2
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    • pp.43-51
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    • 2000
  • Objectives : It is well known that vegetables and fruits contain minerals, including potassium, sodium and phosphorus etc. Though most oriental herbal medications are made of natural plants, western scientists suppose that they also contain certain amounts of minerals and so are injurious to kidney disease such as chronic renal disease. However, by the reason of the limitation of western medical treatment on kidney disease, many patients depend on oriental medical treatment, which includes taking oriental herbal medicine. So, in order to find out the mineral contents in oriental herbal medicine, and to establish the oriental herbal medication's safety in kidney disease, studies were performed. Methods : In this study, we analyzed 42 oriental herbs commonly used in kidney disease by the Inductively Coupled Plasma(ICP) method. Results : 1. The potassium and sodium contents of oriental herbs were 3-10 times as much as of food. 2. The mineral contents of a daily dose of oriental herbal medicine satisfied the restriction of dietary mineral in CRF, though the amount of mineral intakes by food was considered. Conclusions : The mineral contents of oriental herbal medicine are less than the limits of mineral restriction in renal failure. The yielded results, we carefully suggest that oriental herbal medicine does not induce accumulation of minerals or damage in kidney disease patients.

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Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

  • Kim, Jin Kyu;Shin, Jun Jae;Park, Sang Keun;Hwang, Yong Soon;Kim, Tae Hong;Shin, Hyung Shik
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.296-301
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    • 2013
  • Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

Initial Diagnosis of Acute Renal Failure Induced by Ischemia in Miniature Pig (미니돼지에서 허혈성 신장 손상의 조기진단)

  • Kim, Se-Eun;Ko, A-Ra;Bae, Chun-Sik;Park, Soo-Hyun;Han, Ho-Jae;Shim, Kyung-Mi;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.52-56
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    • 2011
  • Acute renal injury induced by ischemia is a major cause of high morbidity and mortality in hospitalized patients and a common complication in hospitalized patients. Thus, the work with acute renal failure and renal ischemia has been studied for many years. Although serum creatinine concentration that is widely used as an index of renal function performs fairly well for estimating kidney function in patients with stable chronic kidney disease, it performs poorly in the setting of acute disease. Thus, an ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury in hospitalized patients, acute tubular necrosis, early and accurately, and may aid to risk-stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay and mortality. In this study, renal ischemia and reperfusion were performed by clapming and un-clamping right renal artery in miniature pigs. Plasma blood urea nitrogen (BUN) and creatinine were examined at pre- clamping, after-clamping at 0, 1 and 3 hours. And we searched initial indicators in these samples. Also, renal tissue was collected and searched the initial indicator by PCR and western blotting. As a result, hypoxia inducible factor $1{\alpha}$ ($HIF1{\alpha}$), nuclear factor kappa-B ($NF{\kappa}B$), $I{\kappa}B$, erythropoietin (EPO), erythropoietin receptor (EPOR), angiopoietin-1 and vascular endothelial growth factor (VEGF) were showed significant changes among the renal protein. $HIF1{\alpha}$, EPO, and EPOR were showed significant changes among the renal gene. Thus, these markers will be used as initial diagnosis of acute renal failure.

The Presence of Diabetes Mellitus and Anemia in Korean Adults-based on Data from 2005 Korean National Health and Nutrition Examination Survey(KNHANES III) (한국 성인에서 당뇨병이 빈혈의 발생에 미치는 영향 - 2005년 국민건강영양조사 자료를 중심으로)

  • Kim, Ji-Hye
    • Journal of Nutrition and Health
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    • v.41 no.6
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    • pp.502-509
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    • 2008
  • Anemia is common in Diabetes Mellitus(DM) with chronic kidney disease. Recent research suggests that DM itself also may be a risk factor of anemia even though kidney failure causes anemia. However, it has not been reported that the impact of DM on anemia in representative data of Korean population. A total of 5,417 Korean adults aged 20 years and older(2,328 men, 3,089 women) were selected from the participants of the 2005 Korean National Health and Nutrition Examination Survey(KNHANES) for this study. Anemia was defined as hemoglobin(Hb) < 13 g/dL and hematocrit(Hct) < 39% for men or Hb < 12 g/dL and Hct < 36% for women. DM was defined as a fasting blood glucose $\geq$ 126 mg/dL. Korean adults with anemia had a higher prevalence of DM than in normal adults(11.4 vs 7.5%; p<0.0001). The unadjusted odds ratio(OR) for anemia was greater in Korean men with DM than in normal men(OR=4.25; 95% CI: 2.48-7.29). This results did not differ after adjustment for the putative risk factors for anemia including chronic disease(OR=2.64; 95% CI: 1.45-4.83). However, the presence of DM was not related with anemia in Korean women. In conclusion, this study revealed that DM might be an independent risk factor for anemia in Korean men. Identification and management for anemia are needed in Korean population with DM as well.

A Case of the 1st Metatarsal Bone Fracture in a Patient with Chronic Kidney Disease Treated by Acupuncture with Complex Korean Medical Treatment (침 치료 중심의 한의 복합 치료로 호전된 만성 신부전 환자의 제 1지 중족골 골절 치험 1례)

  • Jae-Hoon Son;Min-Jeong Kim
    • Korean Journal of Acupuncture
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    • v.41 no.3
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    • pp.110-117
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    • 2024
  • Objectives : The objective of this study is to report a case of a patient with a fracture of the 1st metatarsal bone, whose symptoms improved after receiving Complex Korean Medical treatment mainly focused on acupuncture. Methods : During admission treatment, the patient received 2 sessions of acupuncture treatment, 1 session of pharmacopuncture treatment, and electromoxibustion daily. To assess the patient's condition regarding the 1st metatarsal bone fracture, X-rays were performed on the affected area of the patient on a weekly basis, along with a daily follow up on the Numerical Rating Scale (NRS), degree of swelling (measured in cm via measuring tape), and the temperature of the affected area. The Foot Function Index (FFI) and Health Assessment Questionnaire (HAQ) were also used to add credibility in assessing the patient's current condition. Results : After 4 weeks of hospital admission treatment, the NRS of the pain in the affected area decreased from 4 to 1, with the night pain NRS of the affected area also being reduced from 8 to 0. There was a general improvement in the swelling and temperature of the affected area, as well as the FFI and HAQ of the patient. Conclusions : The study shows that complex Korean medical treatment can be effective in treating patients with bone fractures even without interventions involving traditional Korean herbal medicine.

Fenugreek seeds reduce aluminum toxicity associated with renal failure in rats

  • Belaid-Nouira, Yosra;Bakhta, Hayfa;Haouas, Zohra;Flehi-Slim, Imen;Cheikh, Hassen Ben
    • Nutrition Research and Practice
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    • v.7 no.6
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    • pp.466-474
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    • 2013
  • Despite the reports on safety concerns regarding the relationship between aluminum salts and neurological and bone disease, many countries continue to use aluminum as phosphate binders among patients with renal failure. In search for a diet supplement that could reduce aluminum toxicity related to renal failure, we carried out this prospective animal study in which the fenugreek seeds were assessed for their effects on rats nephrotoxicity induced by aluminum chloride ($AlCl_3$). Oral $AlCl_3$ administration during 5 months (500 mg/kg bw i.g for one month then 1600 ppm via drinking water) led to plasma biochemical changes, an inhibition of alkaline phosphatase (ALP), a decrease of total antioxidant status (TAS), and an induction of lipid peroxidation (LPO) in the blood and brain, in addition to kidney atrophy and morphological alterations at the level of Bowman's capsule, the glomerulus and different sorts of tubules, reminiscent of some known kidney disease. The treatment with the whole fenugreek seed powder (FSP) (5% in the diet) during the last 2 months showed its effectiveness in restoring normal plasma values of urea, creatinine, ALP and glucose, as well as re-increasing the TAS, inhibiting LPO and alleviating histopathological changes in the injured kidneys. This study highlights the induced nephrotoxicicity, as well as the related toxicity in the brain and bone, by chronic oral ingestion of the aluminum salts. However, the maintenance of a diet supplemented with fenugreek seeds could offer protection for the kidney, bone and brain, at the same time.

The Leaf of Diospyros kaki Thumb Ameliorates Renal Oxidative Damage in Mice with Type 2 Diabetes

  • Choi, Myung-Sook;Jeong, Mi Ji;Park, Yong Bok;Kim, Sang Ryong;Jung, Un Ju
    • Preventive Nutrition and Food Science
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    • v.21 no.4
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    • pp.378-383
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    • 2016
  • Diabetic kidney disease is the most common and severe chronic complication of diabetes. The leaf of Diospyros kaki Thumb (persimmon) has been commonly used for herbal tea and medicinal purposes to treat a variety of conditions, including hypertension and atherosclerosis. However, the effect of persimmon leaf on kidney failure has not been investigated. This study aimed to examine the role of persimmon leaf in protecting the diabetes-associated kidney damage in a mouse model of type 2 diabetes. Mice were fed either a normal chow diet with or without powered persimmon leaf (5%, w/w) for 5 weeks. In addition to kidney morphology and blood markers of kidney function, we assessed levels of oxidative stress markers as well as antioxidant enzymes activities and mRNA expression in the kidney. Supplementation of the diet with powered persimmon leaf not only decreased the concentration of blood urea nitrogen in the plasma but also improved glomerular hypertrophy. Furthermore, the persimmon leaf significantly decreased the levels of hydrogen peroxide and lipid peroxide in the kidney. The activities of superoxide dismutase, catalase, and glutathione peroxidase and the mRNA expression of their respective genes were also increased in the kidney of persimmon leaf-supplemented db/db mice. Taken together, these results suggest that supplementation with the persimmon leaf may have protective effects against type 2 diabetes-induced kidney dysfunction and oxidative stress.

A Study on the Space Composition for Department of Kidney Dialysis in Regional Public Hospital(1) (지역거점 공공병원의 인공신장부 공간구성에 관한 연구(1))

  • Chai, Choul Gyun;Park, Kyeong Hyeon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.2
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    • pp.31-38
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    • 2022
  • Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

Effect of WHW, a polyherbal medicine for the treatment of chronic renal failure on staurosporin-induced apotosis in MDCK cells (만성신부전 한약제제 WHW의 신장세포에서의 Staurosporine 유도 세포사멸에 대한 억제 효과)

  • Bae, Hyo-Sang;Yoon, Cheol-Ho;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.27 no.4
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    • pp.45-51
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    • 2012
  • Objectives : WHW is a polyherbal medicine for the treatment of chronic renal failure (CRF). WHW previously reported various biological property such as anti-inflammation, anti-oxidation and anti-renal fibrosis in CRF. This study aimed to investigate the anti-apoptotic effect of WHW on staurosporin(SSP)-induced apoptosis in canine kidney epithelial cells (MDCK). Methods : MDCK cells were treated with different concentrations of WHW (0.1, 0.2, 0.5 and $1mg/m{\ell}$) for 1 h, and then induced apoptosis by treatment of SSP ($1{\mu}M$) for 24 h. Cell viability was measured by WST-1 assay. The expression of apoptotic proteins such as caspase-3, Bax and Bcl-2 was determined by Western blot. Caspase-3 activity and ROS levels were also measured by their commercial available assay kits. Cell apoptosis was observed by Hoechst and DNA fragmentation. Results : WHW significantly increased the cell viability on SSP-treated MDCK cells. WHW inhibited SSP-induced expression of apoptotic proteins such as caspase-3 and Bax, and significantly decreased caspase-3 activity in MDCK cells. WHW significantly decreased SSP-induced production of ROS, and suppressed SSP-induced chromatin condensation and DNA fragmentation in MDCK cells. Conclusions : These results suggest that WHW has an anti-apoptotic effect in renal cells through suppressing the expression of apoptotic proteins, ROS production and DNA damages.

Cardiovascular Outcomes of Sodium-Glucose Cotransporter-2 Inhibitors Therapy in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Systematic Review and Updated Meta-Analysis

  • Nicole Felix;Mateus M. Gauza;Larissa Teixeira;Maria Eduarda S. Guisso;Alleh Nogueira;Caroline S. Dagostin;Amanda Godoi;Sandro A. G. Ribeiro;Juan C. Duque;Jose A. Moura-Neto;Rhanderson Cardoso
    • Korean Circulation Journal
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    • v.54 no.9
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    • pp.549-561
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    • 2024
  • Background and Objectives: The efficacy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) may depend on renal function, and this raises theoretical concern over its effects on cardiovascular outcomes in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). Methods: This systematic review and updated meta-analysis of randomized controlled trials (RCTs) compared cardiovascular outcomes of patients with T2DM and CKD treated with SGLT2i to placebo. PubMed, Embase, and Cochrane were systematically searched. Prespecified subgroup analyses were performed in strata of estimated glomerular filtration rate (eGFR) of <45 mL/min/1.73 m2 and 45 to 59 mL/min/1.73 m2. Results: Nine RCTs comprising 29,146 patients were selected. Average follow-up ranged from 0.75 to 4.2 years. SGLT2i were shown to reduce the risk of all-cause mortality (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.79-0.97; p=0.01), the composite of cardiovascular mortality or hospitalizations for heart failure (HHF: HR, 0.71; 95% CI, 0.65-0.78; p<0.001), cardiovascular mortality (HR, 0.86; 95% CI, 0.76-0.98; p=0.02), HHF (HR, 0.62; 95% CI, 0.55-0.71; p<0.001), major adverse cardiovascular events (HR, 0.85; 95% CI, 0.77-0.94; p=0.002), stroke (HR, 0.76; 95% CI, 0.59-0.97; p=0.03), and myocardial infarction (HR, 0.78; 95% CI, 0.67-0.91; p=0.001). These findings were consistent over strata of eGFR, albeit with a lower incidence of stroke in patients treated with SGLT2i with eGFR <45 mL/min/1.73 m2 (p-value for interaction=0.04). Conclusions: Compared with a placebo, patients with T2DM and CKD treated with SGLT2i experience a reduction in all-cause mortality, cardiovascular mortality, and HHF.