• Childhood Kidney Diseases
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• v.28 no.1
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• pp.1-7
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• 2024

Antenatally diagnosed urinary tract dilatation (UTD), previously referred to as antenatal hydronephrosis, is the most commonly detected abnormality by prenatal ultrasonography. Several grading systems have been developed for the classification of antenatal UTD using prenatal and postnatal ultrasonography. UTD comprises a wide variety of congenital abnormalities of the kidney and urinary tract ranging from transient UTD to more significant abnormalities such as vesicoureteral reflux, ureteropelvic junction obstruction, ureterocele, ureterovesical junction obstruction, posterior urethral valves, and non-refluxing megaureter. Optimizing the evaluation of antenatally detected UTD is essential to recognize children with important disorders while avoiding excessive investigations. Conservative approach with close follow-up is increasingly accepted as an appropriate treatment option for patients with asymptomatic vesicoureteral reflux and ureteropelvic junction obstruction in recent years. However, predicting permanent kidney damage in an unselected group of children with antenatal UTD is still challenging. The management and follow-up of children with UTD should be individualized based on recommendations from a pediatric nephrologist, a pediatric urologist, or both. Future research directed at predicting long-term outcomes of children diagnosed with UTD from mild findings to severe disease is needed to refine management for those at higher risk of kidney disease progression.

• 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.

• Journal of Cardiovascular Imaging
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• v.31 no.4
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• pp.178-179
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• 2023

• The Journal of Internal Korean Medicine
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• v.29 no.4
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• pp.1100-1114
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• 2008

The aim of the study was to investigate recovery effects of Rehmannia, which has been used clinically for chronic renal failure therapy. Mice had 5/6 nephrectomy to induce chronic renal failure. The results were as follows: 1. The protein amount in urine per 24hrs of the Rehmannia-treated group was significantly reduced compared to the control. 2. The albumin amount in the blood of the Rehmannia-treated group significantly increased compared to the control. The creatinine. total-cholesterol, LDL-cholesterol and triglyceride levels in serum of the Rehmannia-treated group as compared to the control were significantly inhibited. 3. The structural change in kidney of the Rehrnannia-treated group was significantly inhibited compared to the control. 4. The factor (macrophage/monocyte antigen (ED-1), type IV collagen and angiotensin II type 1 ($AT_1$) receptor) of the Rehmanala-treated group was significantly inhibited compared to the control, which induced the structural change in kidneys. The above results suggest that Rehmannia partially improved kidney function.

• The Journal of Internal Korean Medicine
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• v.32 no.2
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• pp.278-287
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• 2011

Objectives : The object of this study was to observe the nephroprotective effects of Sojongchobisunki-tang (SCST), which has traditionally been used as Korean medicine for treating various renal diseases, on cisplatin-induced rat acute renal failure. Methods : Three different dosages of SCST were orally administered once a day for 23 days before cisplatin treatment (5 mg/kg, single intraperitoneally administered) and 5 days after cisplatin treatment (once a day for 28 days). 6 groups, of 8 rats per group were used in the present study after 7 days of acclimatization. Changes of the body weight, kidney weight, serum BUN and creatinine levels were observed, as well as changes of the kidney MDA and GSH contents. The results were compared with captopril 100 mg/kg of which the effects on cisplatin-induced acute renal failures are already confirmed. Results : Acute renal failure induced by cisplatin were induced by oxidative stress and related lipid peroxidation in the present study. However, these acute renal failures and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment at all three different dosages of SCST extracts. Conclusions : This study suggests that SCST extracts showed favorable effects on the cisplatin-induced rat ARF.

• Journal of the East Asian Society of Dietary Life
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• v.13 no.5
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• pp.408-424
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• 2003

The purpose of this study was to analyze the nutritional status and dietary habits in predialysis patients of chronic renal failure(CRF). The patients group was composed of total 35 persons with chronic renal failure(diabetes exclusion), male 20, female 15 who were treated in the kidney internal department and the control group also composed of 35 persons, male 18, female 17 who were classified as normal by the medical examination. Their dietary habits, nutritional status and nutritional knowledge were investigated from two general hospitals in Inchon, middle of this year 2002. There were 31.4% of low weight patients (BMI below 20), 77.1% of anemia patients (serum hemoglobin below 12g/㎗), 6S.6% of hypertension patients with diastolic blood pressure over 90mmHg, 80% with systolic blood pressure over 140mmHg, 20% of hypercholesterolemia patients (serum cholesterol over 230mg/㎗), and 22.9% of hyperlipemia patients (serum triglyceride over 200mg/㎗). The cardiovascular disease seemed to be caused by the abnormality of lipid metabolism. The possibility of the bone disease was shown from patients of hyperphosphatemia (serum phosphorus over 4.7mg/㎗, 22.9%) and hypocalcemia (serum calcium below 8.4mg/㎗, 25.7%). Intake of insufficient calories which was caused by the lack of appetite affected on the nutritional status. The intake of most nutrients was not significantly different from the RDA for Koreans. Consequently, the patient groups took a lot of salt even after the diagnosis of CRF. But patients ate 6.lg of salt which were more than the recommended amount 2∼4g for patients with CRF. The patient groups, who had the experiences of nutritional counselling, had significantly higher nutritional knowledge related to CRF than control group. Unfortunately, patients could not have enough chances for nutritional counselling by the nutritionist even though they needed the nutritional informations and dietetic treatments. The continuous research is expected with regard to the detail plan for the improvement of nutritional support and the nutritional counselling because it is important to decide the requirements of nutrients for patients with kidney disease, considering the kidney function and status of nutrition.

• 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.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.247-254
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• 2007

Purpose : Continuous renal replacement therapy(CRRT) has been the first choice for the treatment of acute renal failure in critically ill children not only in western countries but also in Korea. However, there are very few studies that have analyzed the outcome and prognosis of this modality in Korean children. We performed this study to evaluate the factors associated with the outcome and prognosis of patients treated with CRRT. Methods : We retrospectively reviewed the medical records of 32 children who had received CRRT at Severance hospital from 2003 to 2006. The mean age was 7.5 years(range 4 days-16 years) and the mean body weight was 25.8 kg (range 3.2-63 kg). Results : Eleven(34.4%) of the 32 patients survived. Bone marrow transplantation and malignancy were the most common causes of death and underlying disease leading to the need for CRRT Mean patient weight, age, duration of CRRT, number of organ failures, urine output, estimated glomerular filtration rate(eGFR), C-reactive protein, and blood urea level did not differ significantly between survivors and nonsurvivors. (1) Pediatric risk of mortality(PRISM) III score at CRRT initiation($9.8{\pm}5.3$ vs. $26.7{\pm}7.6$, P<0.0001), (2) maximum pressor number ($2.1{\pm}1.2$ vs. $3.0{\pm}1.0$, P=0.038), and (3) the degree of fluid overload($5.2{\pm}6.0$ vs. $15.0{\pm}8.9$, P=0.002) were significantly lower in survivers than in nonsurvivors. Multivariate analysis revealed that fluid overload was the only independent factor reducing survival rate. Conclusion : CRRT was successfully applied to the treatment of acute renal failure in a wide range of critically ill children. To improve survival, we suggest the early initiation of CRRT to prevent the systemic worsening and progression of fluid overload in critically ill children with acute renal failure. (J Korean Soc Pediatr Nephrol 2007;11:247-254)

• Korean Journal of Oriental Medicine
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• v.5 no.1
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• pp.17-25
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• 1999

To investigate recovery effects of Insambackhotang, which have been used clinically in diabetes therapny, on kidney failure of a diabetes-induced mouse by Alloxan administration, body and kidney weight changes of mice, BUN, creatinine, glucose and MDA level in serum, MDA level in kidney tissue. 1. A hyperglycemia(250-400mg/dl) mouse induced by Alloxan(75mg/kg) showed significant decline of kidney function: increase of BUN and creatinine in serum, excretion of glucose, protein, ketone in urine were observed at 4 days after the treatment. 2. Increase of the mouse body and kidney weight and a ratio of the kidney/body weight of Insambackhotang treated group as compared to the control group was significantly inhibited. 3. The BUN, creatinine level in serum of Insambackhotang treated group as compared to the control group were significantly inhibited. 4. The MDA level in serum and kidney tissue of Insambackhotang treated group as compared to the control group were significantly inhibited.

• The Journal of Internal Korean Medicine
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• v.30 no.4
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• pp.832-844
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• 2009

Objectives : This study was to observe the nephroprotective effects of the traditional prescription, Taeksa-san(TSS). TSS has generally been used for treating various renal diseases, including renal failure. Methods : Three different dosages of TSS extract were orally administered once a day for 28 days, At the 23rd day after TSS extract treatment, cisplatin was also treated. Then, 5 days after cisplatin treatment, all the rats (6 groups of 8 rats each) were sacrificed. Changes in the body weight, kidney weight, serum BUN and creatinine levels were observed with changes on the kidney MDA and GSH contents. The results were compared with captopril 100mg/kg, of which the effects on cisplatin-induced acute renal failures are already confirmed. Results : Dramatic decrease of body weight, increase of kidney weight, increase of serum BUN and creatinine levels were detected in the cisplatin control as compared with the intact control. In addition, marked increase of kidney MDA contents and decrease of kidney GSH contents were also detected in the cisplatin control as compared with the intact control. This means that cisplatin-induced ARF is induced by oxidative stress and related lipid peroxidation in the present study. However, these ARFs and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment with all three different dosages of TSS extracts. Conclusion : This study suggests that TSS extracts show favorable effects on cisplatin-induced rat ARF.