• Title/Summary/Keyword: Kidney failure, acute

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Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis (양측성 신동맥 협착증에서 발생한 급성 비대상성 심부전과 급성 신손상)

  • Jung, Ho Jin;Choi, Won Suk;Kang, Hyun Jae;Jung, Byung Chun;Lee, Bong Ryeol;Lee, Jong Joo;Lee, Jun-Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.146-151
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    • 2015
  • Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

Severe Diarrhea-induced Acute Kidney Injury and Its Consequence in an Elderly

  • Chang-Gue Son
    • The Journal of Korean Medicine
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    • v.44 no.4
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    • pp.163-169
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    • 2023
  • Methods: This study presents a comprehensive case study of an elderly male diagnosed with acute kidney injury (AKI) resulting from severe dehydration, supported by an extended follow-up with laboratory findings. Results: An 83-year-old male patient experienced severe diarrhea overnight, leading to hospitalization due to symptoms of dehydration and hypotension. His laboratory results displayed a typical AKI pattern, including a significant increase in creatinine levels (5.19 mg/dL) and the presence of hyperkalemia and hyponatremia. Following general treatments, including the administration of an herbal drug (Bulhwangeumjeonggi-san), the estimated glomerular filtration rate (eGFR) improved from 10 ml/min (Stage 5) to 34 ml/min (Stage 3) within five days when he was discharged. Although subsequent eGFR tests, conducted one and two months later as an outpatient, revealed an improvement of 42 ml/min, the patient still experienced mild chronic dysfunction as a consequence. Conclusion: This study presents a noteworthy case of acute kidney injury attributed to severe dehydration, emphasizing the importance of medical awareness regarding diarrhea-induced kidney function impairment, especially in the elderly population.

A Case of Acetaminophen-induced Acute Interstitial Nephritis Presenting with Acute Renal Failure (급성 신부전을 보인 아세트아미노펜에 의한 급성 간질성 신염 1례)

  • Jeon, Hak-Su;Ha, Tae-Sun
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.228-232
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    • 2006
  • Acute interstital nephritis can occur by acetaminophen, but it is rarely presented as acute renal failure with azotemia. We report a case of acute interstitial nephritis induced by acetaminophen in a 14-year-old girl who developed non-oliguric acute renal failure. She has taken acetaminophen to control the persistent throat pain for the last two months. Renal biopsy revealed diffuse infiltration of mononuclear inflammatory cells admixed with eosinophils in the edematous interstitia. After the discontinuation of acetaminophen and the administration of corticosteroid, the serum creatinine level returned to normal.

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A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome (전신성 모세혈관 누출 증후군으로 인한 만성 신질환 1예)

  • Baek, Seon Ha;Shin, Nara;Kim, Hyo Jin;Han, Mi Yeun;Choi, Dong-Ju;Bang, Soo-Mee;Kim, Sejoong;Paik, Jin Ho
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.145-149
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    • 2012
  • Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyper-permeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

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Protective effect of ginsenosides Rk3 and Rh4 on cisplatin-induced acute kidney injury in vitro and in vivo

  • Baek, Seung-Hoon;Shin, Byong-kyu;Kim, Nam Jae;Chang, Sun-Young;Park, Jeong Hill
    • 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.

Effect of Processed Cyperi Rhizoma on Rat Kidney Function (수치(修治) 향부자 분획물의 흰쥐 신기능에 미치는 영향)

  • Kim, Tae-Hee;Yang, Ki-Sook;Park, Ji-Young
    • YAKHAK HOEJI
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    • v.42 no.1
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    • pp.70-74
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    • 1998
  • Cyperus rotundus L. (Cyperaceae) has been used as an analgesic, antiinflammatoty agent, diuretic and emmenagoga in folk remedies. Cyperi Rhizomata, processed and unproces sed, were extracted with MeOH and fractionated with petroleum ether (Pet. Ether), $CHCl_3$, BuOH, water. In order to investigate the effects of their fractions on kidney function of acute renal failure rats induced by $HgCl_2$ urinary volume, BUN, Creatinine, Uric acid were determined. The diuretic effect of processed Cyperi Rhizoma was significantly increased in renal failure rats, on serum chemical parameters, the significant inhibition of BUN (blood urea nitrogen) of processed Cyperi Rhizoma was revealed.

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Fyn Kinase: A Potential Therapeutic Target in Acute Kidney Injury

  • Uddin, Md Jamal;Dorotea, Debra;Pak, Eun Seon;Ha, Hunjoo
    • Biomolecules & Therapeutics
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    • v.28 no.3
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    • pp.213-221
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    • 2020
  • Acute kidney injury (AKI) is a common disease with a complex pathophysiology which significantly contributes to the development of chronic kidney disease and end stage kidney failure. Preventing AKI can consequently reduce mortality, morbidity, and healthcare burden. However, there are no effective drugs in use for either prevention or treatment of AKI. Developing therapeutic agents with pleiotropic effects covering multiple pathophysiological pathways are likely to be more effective in attenuating AKI. Fyn, a non-receptor tyrosine kinase, has been acknowledged to integrate multiple injurious stimuli in the kidney. Limited studies have shown increased Fyn transcription level and activation under experimental AKI. Activated Fyn kinase propagates various downstream signaling pathways associated to the progression of AKI, such as oxidative stress, inflammation, endoplasmic reticulum stress, as well as autophagy dysfunction. The versatility of Fyn kinase in mediating various pathophysiological pathways suggests that its inhibition can be a potential strategy in attenuating AKI.

Osteopontin and Developing Kidney (Osteopontin과 신장 발달)

  • Yim Hyung-Eun;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.10 no.1
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    • pp.1-7
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    • 2006
  • Osteopontin (OPN) is a glycosylated phosphoprotein which mediates cell adhesion and migration, and is produced by bone, macrophages, endothelial cells, and epithelial cells. The many regulatory functions of OPN include bone remodeling, tumor invasion, wound repair, and promotion of cell survival. It is produced by renal tubular epithelial cells, and expression is upregulated in glomerulonephritis, hypertension, ischemic acute renal failure, renal ablation, and UUO. In this review, we discuss about osteopontin in general aspect, expression, role on the development and pathologic condition of neonatal kidney.

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Medication Utilization Analysis of Basiliximab as a Maintenance Immunosuppressant in Renal Failure Patients Undergoing Lung Transplantation (폐 이식 후 신부전 발생 환자에서 유지 면역억제제로서 basiliximab의 사용 평가)

  • Seo, Yejin;Geum, Min Jung;Lee, Kyung Ah;Kim, Jae Song;Son, Eun Sun;Yu, Yun Mi
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.149-160
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    • 2020
  • Background: Basiliximab is used as an alternative to tacrolimus in patients with decreased renal function. However, studies on basiliximab as a maintenance immunosuppressant, particularly in patients with lung transplantation, are limited. Therefore, here, we investigated the efficacy and safety of basiliximab in patients with lung transplantation. Methods: Adult patients with acute kidney injury (AKI) who received lung transplantation at a single general hospital between July 1, 2014 and June 30, 2018, were selected and classified in tacrolimus and basiliximab groups. Both groups received a triple-drug regimen (tacrolimus, mycophenolate mofetil, and steroids). However, tacrolimus was discontinued in the basiliximab group when AKI occurred, and two or more repeat basiliximab doses were administered within 3 months after transplantation. The electronic medical records were analyzed retrospectively. Results: Of the 85 patients who met the selection criteria, 61 and 24 were assigned to the tacrolimus and basiliximab groups, respectively. Significant improvement in renal function was observed in the basiliximab group (p <0.001). However, there were no differences in acute and chronic rejection rates in both the groups. No difference was observed in the incidence rate of complications between the groups, except for chronic kidney disease, which showed higher incidence in the basiliximab group (25.0% vs. 4.9%; p =0.013). Conclusions: We suggest the use of basiliximab as an immunosuppressant alternative to tacrolimus in patients with acute renal failure after lung transplantation. Basiliximab demonstrated effectiveness as an immunosuppressant and improved renal function. Therefore, basiliximab can be used in patients with decreased renal function.