• Title/Summary/Keyword: Kidney failure

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Treatment of Acute Renal Failure in Neonate (신생아 급성 신부전의 치료)

  • Lee, Jin-A
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.168-180
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    • 2010
  • Acute renal failure (ARF) is common in the neonatal period, however, there are no uniform treatment strategies of ARF. The main treatment strategies are conservative management including medical treatment and the renal replacement therapy. Because ARF in the newborn is commonly acquired by hypoxic ischemic injury and toxic insults, removal of all the offending causes is important. Aminoglycoside, indomethacin, and amphotericin-B are the most common nephrotoxic drugs of ARF. To relieve the possible prerenal ARF, initial fluid challenge can be followed by diuretics. If there is no response, fluid restriction and correction of electrolyte imbalance should begin. Adequate nutritional support and drug dosing according to the pharmacokinetics of such drugs will be difficult problems. Renal replacement therapies may be provided by peritoneal dialysis, intermittent hemodialysis, or hemofiltration. New promising agents, bioartificial kidney, and stem cell will enable us to extend our therapeutic repertoire.

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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Effect of Scutellaria Baicalensis Georgi. Extract on Cisplatin-Induced Acute Renal Failure in Rabbits (토끼에서 cisplatin에 의해 유도된 급성 신부전시 황금(黃芩; Scutellaria Baicalensis Georgi.) 추출물의 효과)

  • Kim, Soo-Chang;Song, Yeong-Min;Lee, Sung-Dae;Song, Seung-Hee;Koh, Phil-Ok;Kim, Jong-Su;Kim, Chung-Hui;Kang, Chung-Boo
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.392-399
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    • 2007
  • Scutellaria baicalensis Georgi. (SBGE) is known to be antioxidant effect. In addition of the effects, we further investigated the SBGE on the antioxidant effect on a renal cortical slices cell and kidney protecting effects. The results were as follows. 1 When renal cortical slices separated from a rabbit's kidney were treated with 1mM tert-Butylhydroperoxide (t-BHP) in the presence of SBGE. SBGE significant prevented t-BHP induced increase in lactate dehydrogenase (LDH) release and lipid peroxidation. 2. When renal cortical slices separated from a rabbit's kidney were treated with oxidant $300{\mu}M$ cisplatin in the presence of SBGE. SBGE significant prevented cisplatin-induced increase in LDH release and lipid peroxidation. 3. Pretreatment with 0.1g/kg SBGE for seven day and treatment with 5 mg/kg cisplatin by the intraperitoneal injection The results were that the pretreatment group with SBGE showed a significant decrease in lipid peroxidation, increase in clearance rate of blood urea nitrogen (BUN) and creatinine in the kidney than the administering single agent group of cisplatin. and pretreatment group with SBGE showed intact microvillus of proximal tubule and no contraction of rumen, it was a similar result with normal group. With the results SBGE showed to be highly effective on antioxidant effect and cellular protection activity against cisplatin that was a toxic agent on a kidney. Therefore, SBGE is considered to have protective effective on a disordered kidney or kidney diseases such as nephritis or renal failure that cause tissue damages in a kidney.

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.

A Report on Clinical Application of Chenxiang about Chronic Renal Failure (만성(慢性) 신부전(腎不全)에 대한 침향(沈香)의 임상적용(臨床適用) 보고(報告))

  • Hwang, Won-Duk
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.368-378
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    • 2004
  • In Oriental Medical theory, origin of kidney's weakness or atrophy is shen qi(腎氣) and function of san jiao(三焦) deteriorate, it result in a passage of evacuation is blocked. - In Oriental Medicine, Shen(腎) take charge of storing and evacuating function, by taking qi(氣) of the five viscera and the six bowels. - The cause of reducing of shen qi and san jiao's evacuative function is xu han(Emptiness and Coldness) of the five viscera and the six bowels' activity. So we do not treat only kidney, but we also must focus the five viscera and the six bowels' organic function and ying wei's function. A Renal Failure is similar in symptom to Kwan-kyuk(關格), oliguria or anuria, edema, Hu-son(虛損), Sin-pung(腎風) and Yuk-kuk(六極) in chenxiang(沈香). We grasp symptom of 7 cases of chronic renal failure, and diagnose its pathology based on Sa-jin(四診), and prescribed herbal medicines. And in the point of the chenxiang, we separate two group, Ater one is taken herbal medicine with chenxiang and the other is only taken herbal medicine with no using chenxiang, we compared the rate of treating with only herbal and herbal compounded chenxiang. We repeat medical examination for continuation of effective result, report clinical progress and result which based on this examination.

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Effect of Acupuncture and Moxibustion at SP6(Sanyinjiao) and BL28(Pangguangshu) on Experimental Acute renal failure in rats (삼음교(三陰交)(SP6), 방광유(膀胱兪)(BL28)의 침자 및 애구자극이 흰쥐의 실험적 급성신부전에 미치는 영향)

  • Kim, Min-ho;Park, Chun-ha;Kim, Hyo-ean;Yun, Yeo-chung
    • Journal of Acupuncture Research
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    • v.19 no.6
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    • pp.49-60
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    • 2002
  • Objective : The aim of this experiment is to investigate the effect of acupuncture and moxibustion at SP6(Sanyinjiao) and BL28(Pangguanshu) on uranyl acetate-induced acute renal failure in rats. Methods : To induce experimental acute renal failure, uranyl acetate was intraperitoneally injected to rats by 5mg/kg. 3 days later acupuncture and moxibustion treatment was done at SP6(Sanyinjiao) and BL28(Pangguanshu) bilaterally of the rats. And then 4 days later, we measured rats' body weight, kidney weight, serum BUN, creatinine and serum eletrolyte levels(Na, K and Cl). Results : In the moxibustion group, hypertrophy index of kidney and serum BUN level were decreased marginally significantly, and serum creatinine, K levels were decreased significantly. But in the acupuncture group, there was no significance at this experiment. Conclusions : SP6(Sanyinjiao) and BL28(Pangguanshu) moxibustion can decrease serum BUN, creatinine, and serum eletrolyte levels on uranyl acetate-induced acute renal failure in rats. And the study will be done continuously about non-effect in the acupuncture group at this experiment.

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Bioactive Compounds for the Treatment of Renal Disease

  • Cho, Kang Su;Ko, In Kap;Yoo, James J.
    • Yonsei Medical Journal
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    • v.59 no.9
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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.

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.

Melatonin Rescues Mesenchymal Stem Cells from Senescence Induced by the Uremic Toxin p-Cresol via Inhibiting mTOR-Dependent Autophagy

  • Yun, Seung Pil;Han, Yong-Seok;Lee, Jun Hee;Kim, Sang Min;Lee, Sang Hun
    • Biomolecules & Therapeutics
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    • v.26 no.4
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    • pp.389-398
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    • 2018
  • p-Cresol, found at high concentrations in the serum of chronic kidney failure patients, is known to cause cell senescence and other complications in different parts of the body. p-Cresol is thought to mediate cytotoxic effects through the induction of autophagy response. However, toxic effects of p-cresol on mesenchymal stem cells have not been elucidated. Thus, we aimed to investigate whether p-cresol induces senescence of mesenchymal stem cells, and whether melatonin can ameliorate abnormal autophagy response caused by p-cresol. We found that p-cresol concentration-dependently reduced proliferation of mesenchymal stem cells. Pretreatment with melatonin prevented pro-senescence effects of p-cresol on mesenchymal stem cells. We found that by inducing phosphorylation of Akt and activating the Akt signaling pathway, melatonin enhanced catalase activity and thereby inhibited the accumulation of reactive oxygen species induced by p-cresol in mesenchymal stem cells, ultimately preventing abnormal activation of autophagy. Furthermore, preincubation with melatonin counteracted other pro-senescence changes caused by p-cresol, such as the increase in total 5'-AMP-activated protein kinase expression and decrease in the level of phosphorylated mechanistic target of rapamycin. Ultimately, we discovered that melatonin restored the expression of senescence marker protein 30, which is normally suppressed because of the induction of the autophagy pathway in chronic kidney failure patients by p-cresol. Our findings suggest that stem cell senescence in patients with chronic kidney failure could be potentially rescued by the administration of melatonin, which grants this hormone a novel therapeutic role.

Growth Hormone Treatment in Children with Chronic Kidney Disease (만성 소아 신질환 환자에서의 성장호르몬 치료 인제의대 부산백병원 소아청소년과)

  • Chung, Woo-Yeong
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.14-20
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    • 2009
  • Growth retardation is a common consequenc of chronic kidney disease (CKD) in childhood. Many recent clinical and experimental data indicate that growth failure in CKD is mainly due to a relative GH insensitivity and functional IGF-I deficiency. Glucocorticoids also glucocorticoids interfere with the integrity of the somatotropic hormone axis at various levels. Over the past 10 years, recombinant growth hormone (rhGH) has been used to help short children with chronic kidney disease. A GH dosage of 0.35 mg/kg/week (28 IU/$m^2$/week) appears efficient and safe. Some clinical trial data show that final height will be within the normal target height range when GH treatment is continued for many years without remarkable adverse events.