• 제목/요약/키워드: Kidney failure, acute

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

  • Chang-Gue Son
    • 대한한의학회지
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    • 제44권4호
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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.

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

  • 전학수;하태선
    • Childhood Kidney Diseases
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    • 제10권2호
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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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전신성 모세혈관 누출 증후군으로 인한 만성 신질환 1예 (A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome)

  • 백선하;신나라;김효진;한미연;최동주;방수미;김세중;백진호
    • Journal of Yeungnam Medical Science
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    • 제29권2호
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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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    • 제41권3호
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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.

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

  • 김태희;양기숙;박지영
    • 약학회지
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    • 제42권1호
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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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    • 제28권3호
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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.

Osteopontin과 신장 발달 (Osteopontin and Developing Kidney)

  • 임형은;유기환
    • Childhood Kidney Diseases
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    • 제10권1호
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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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폐 이식 후 신부전 발생 환자에서 유지 면역억제제로서 basiliximab의 사용 평가 (Medication Utilization Analysis of Basiliximab as a Maintenance Immunosuppressant in Renal Failure Patients Undergoing Lung Transplantation)

  • 서예진;금민정;이경아;김재송;손은선;유윤미
    • 한국임상약학회지
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    • 제30권3호
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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.

Bioactive Compounds for the Treatment of Renal Disease

  • Cho, Kang Su;Ko, In Kap;Yoo, James J.
    • Yonsei Medical Journal
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    • 제59권9호
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    • pp.1015-1025
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    • 2018
  • Kidney diseases including acute kidney injury and chronic kidney disease are among the largest health issues worldwide. Dialysis and kidney transplantation can replace a significant portion of renal function, however these treatments still have limitations. To overcome these shortcomings, a variety of innovative efforts have been introduced, including cell-based therapies. During the past decades, advances have been made in the stem cell and developmental biology, and tissue engineering. As part of such efforts, studies on renal cell therapy and artificial kidney developments have been conducted, and multiple therapeutic interventions have shown promise in the pre-clinical and clinical settings. More recently, therapeutic cell-secreting secretomes have emerged as a potential alternative to cell-based approaches. This approach involves the use of renotropic factors, such as growth factors and cytokines, that are produced by cells and these factors have shown effectiveness in facilitating kidney function recovery. This review focuses on the renotropic functions of bioactive compounds that provide protective and regenerative effects for kidney tissue repair, based on the available data in the literature.

Cisplatin 유도 급성신부전에서 Klotho 단백질의 발현 (Localization of Klotho in cisplatin induced acute kidney failure)

  • 박소라;김태원;김영중;김현태;류시윤;정주영
    • 대한수의학회지
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    • 제54권4호
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    • pp.225-231
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    • 2014
  • Klotho deficiency is an early event in acute kidney injury (AKI) that exacerbates acute kidney damage. The present study explored the expression of Klotho and inflammation related factors in cisplatin-induced AKI. Rats (n = 18) were treated with cisplatin intraperitoneal injection (5 mg/kg) or left untreated as controls (n = 6), then sacrificed at 5 (n = 6) and 10 days (n = 6) treatment. Five days after cisplatin injection, the serum kidney enzymes and kidney cell apoptosis were significantly increased. Moreover, the expression of Klotho was decreased when compared to the control group, especially in the cortex and outer medulla regions. In contrast, inflammation related signals including nuclear factor kappa B, tumor necrosis factor-${\alpha}$, and tumor necrosis factor-like weak inducer of apoptosis were enhanced. However, 10 days after cisplatin injection, Klotho expression was enhanced upon both IHC and Western blot analysis, with slightly recovered renal function and decreased apoptosis. Furthermore, inflammation related signals expression was decreased relative to the 5 days group. Overall, this study confirmed the opposite expression patterns between Klotho and inflammation related signals and their localization in cisplatin-induced AKI kidney.