• Childhood Kidney Diseases
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• v.10 no.2
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• pp.249-256
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• 2006

Diarrhea-associated hemolytic uremic syndrome(D+ HUS) is induced by enterohemorrhagic Escherichia coli(EHEC) and is characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. The disease is usually transmitted by meat and water contaminated by excreta of domestic animals. We report a son and his mother with diarrhea-associated hemolytic uremic syndrome that spread within the family.

• Clinical and Experimental Pediatrics
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• v.54 no.8
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• pp.322-328
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• 2011

Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.251-258
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• 2002

We report the experiences of pump-driven continuous venovenous hemofiltration therapy in three children with acute renal failure. The all three patients required mechanical ventilation and needed the support of vasopressors. Renal replacement therapy was needed to meet the metabolic and fluid balance, but intermittent hemodialysis and peritoneal dialysis were not feasible because of hemodynamic instability and concurrent infection. We instituted pump-driven continuous venovenous hemofiltratlon (CVVH), and immediate improvement of pulmonary edema and successful removal of retained fluid were observed. Urea clearance also was satisfactory. During the filter running time, significant thromboembolic event or rapid drop of systemic blood pressure were absent. We concluded that the CVVH is an effective and safe method of renal support for critically ill pediatric patient.

• The Journal of Korean Medicine
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• v.15 no.2 s.28
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• pp.132-142
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• 1994

Paraquat has been widely used as a herbicide in Korea since 1970. Human ingestion results in transient impairment of liver and kidney function and a characteristically respiratory failure with a high mortality rate. Clinical investigation and Oriental Medical Treatment were done on 3 cases of paraquat poisoning admitted to the department of 1st Internal Medicine. Kyung San University Oriental Medical Hospital from August 1991 to December 1992. and following results were obtained. The symptoms of paraquat poisoning can be regarded as Sim hua chi song(心火熾盛), Kan hua sang yom(肝火上炎). um hu hua wang(陰虛火旺), Kan tam sup yol(肝膽濕熱), Yang myong yol tok(陽明熱毒) in Oriental Medicine. and the principle of treatment for paraquat poisoning can be applicable to Chong yol Ii sop(淸熱利濕), Chong yol hae tok(淸熱解毒). Sa ha hae tok(瀉下解毒). Ja um kang hua(滋陰降火) and so on. Three cases were treated by HuangYonHaeTokTang(黃蓮解毒湯) and KamDuTang(甘豆湯): all of them have survived without complications. According to the result above, it suggests that determination of treatment based on the differentiation of symptoms and signs(Pyon jung si chi ;辨證施治) of Oriental Medicine may prove to be helpful in saving lives of patients with paraquat poisoning.

• Childhood Kidney Diseases
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• v.25 no.2
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• pp.112-116
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• 2021

Hyperammonemia is mainly caused by diseases related to liver failure. However, there are also non-hepatic causes of hyperammonemia, such as urinary tract infection (UTI) due to urease-producing organisms. Urease production by these bacteria induces a hydrolysis of urinary urea into ammonia that can cross the urothelial cell membrane and diffuse into blood vessels, leading to hyperammonemia. Delayed diagnosis and treatment of hyperammonemia can lead to lethal encephalopathy that can cause brain damage and life-threatening conditions. In the presence of obstructive uropathy, UTI by urease-producing bacteria can lead to more severe hyperammonemia due to enhanced resorption of ammonia into the systemic circulation. In this report, we present a case of acute severe hyperammonemic encephalopathy leading to brain death due to accumulation of ammonia in blood caused by Morganella morganii UTI in a 10-year-old girl with cloacal anomaly, causing obstructive uropathy even after multiple corrections.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.42-46
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• 2014

Kawasaki disease (KD) is a systemic vasculitis that can affect many organ systems. Renal manifestations include pyuria, hematuria, proteinuria, tubulointerstitial nephritis, acute renal failure, hemolytic uremic syndrome, or renal scarring. Although its precise pathogenesis remains unknown, it is considered an autoimmune disease. In the literature, it has been reported that KD may develop in conjunction with urinary tract infections. However, many of these previous studies did not use imaging methods such as renal sonograms, dimercaptosuccinic acid renal scans, and voiding urethrocystograms. We report a case of an 8-month old male infant with high grade vesicoureteral reflux, who developed incomplete KD after recurrent pyelonephritis. Acute pyelonephritis can be an early manifestation of KD. Such cases require the evaluation of urinary tract anomalies according to the guidelines for the management of urinary tract infections.

• Korean Journal of Plant Resources
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• v.26 no.5
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• pp.652-657
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• 2013

In the present study, anti-oxidative and the RMC proliferation inhibitory propeties of 80% ethanol extracts from 63 kinds of traditional medicines were investigated. Inhibitory effects of RMC proliferation were showed that Dalbergia odorifera T. Chen., Melia azedarach Linn$\acute{e}$ and Hydnocarpus anthelmintica Pierre. Among them Hydnocarpus anthelmintica Pierre had the highest anti-oxidative activity ($ORAC_{PE\;value}=1.6$, DPPH = 81.1), but Dalbergia odorifera T. Chen. and Melia azedarach Linn$\acute{e}$ had no effects. These results suggest that the Hydnocarpus anthelmintica Pierre could prevent or protect from kidney disease as antioxidant and anti-proliferative agent for RMC.

• Korean Journal of Clinical Pharmacy
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• v.32 no.3
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• pp.251-259
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• 2022

Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.

• Applied Microscopy
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• v.37 no.3
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• pp.167-174
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• 2007

Heat shock protein (HSP) 70 functions as a molecular chaperon and reduces stress-induced denaturation and aggregation of intracellular proteins. Erythropoietin (EPO) plays an important role during acute renal failure repair process by rapidly correcting anemia and enhancing renal tubular regeneration. The purpose of this study was to examine the effect of EPO treatment on renal HSP70 expression. Male Sprague-Dawley rats were injected rHUEPO. Kidney were preserved by in vivo perfusion with paraformaldehyde-lysine-periodate (PLP) and processed for immunohistochemistry and electron microscopy. In control kidney, HSP70 was expressed in the cortex, outer medulla and inner medulla. Especially, HSP immunoreactiviy was mainly founded in descending thin limb of outer medulla and inner medullary collecting duct. In EPO treated kidney, HSP70 expression markedly increased in the descending thin limb of outer medulla and newly detected in cortical collecting duct. Electron microscopy showed the presence of HSP immunoreactivity on the intracelluar vesicles and Golgi complex of descending thin limb and cortical collecting duct. These findings suggest that EPO treatment leads to new production of HSP70 in renal tubular cells, and induction of HSP70 by rHuEPO is causally related to protective function.

• Childhood Kidney Diseases
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• v.13 no.2
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• pp.130-137
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• 2009

Purpose : Stem cell transplantation (SCT) has gained worldwide acceptance as a treatment for hematologic disorders. This study was performed to evaluate the clinical characteristics and outcomes of the acute kidney injury after SCT in children. Methods : The records of 53 patients who were treated with SCT at the pediatric department of Yeungnam University Hospital between January, 1996 and April, 2009 were used as subjects. Their were divided into two groups ; 'Early renal insufficiency' (ERI, n=18) and 'Non-early renal insufficiency' (NERI, n=35). ERI had greater than 25% of drop in GFR after SCT. Results: Total 53 patients were analyzed. In cord blood SCT (n=11), ERI was 4 (36.4%) and NERI was 7 (63.6%). In bone marrow SCT (n=16), ERI was 8 (50.0%) and NERI was 8 (50.5%). In autologous peripheral blood SCT (n=26), ERI was 6 (23.1%) and NERI was 20 (76.9%). There is no difference in both groups according to kinds of SCT. GVHD was developed in 22 patients, and there is no difference in each group. Twenty two of 53 patients died. ERI was 12 (66.7%) and NERI was 10 (28.6%). Acute renal failure is most important cause of the deaths. Conclusion : Out of 53 pediatric patients who were treated with SCT, 18 patients had greater than 25% of drop in GFR. There is no difference in both groups according to kinds of SCT. GVHD was found in 22 patients and there is no relation between GVHD development and acute kideney injury.