• Advances in pediatric surgery
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• v.3 no.1
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• pp.71-76
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• 1997

A 3-year-old boy with a Wilms' tumor had unusually severe hypertension, polydipsia, polyuria and hypokalemia. Physical examination on admission was unremarkable except for the presence of a smooth, firm mass in the right abdomen. Computerized tomography showed a tumor occupying the upper two thirds of the right kidney. Plasma renin activity and aldosterone concentration were markedly elevated, 37.7 mg/ml/hour(normal in supine position 0.15-2.33 mg/ml/hour) and 120.1 ng/dL(normal in supine position 1 to 16 ng/dL), respectively. Hypertension varied from 150/90 mmHg to 240/180 mmHg, and was not effectively controlled by antihypertensive drugs. Right nephrectomy was performed on the sixth hospital day. At laparatomy, there was no evidence of mechenical compression of the renal artery by the tumor. The tumor, about 8 cm in diameter, was confined to the renal capsule without involvement of the renal blood vessels at the hilum. Histopathology was Wilms' tumor of favorable histology. On electron microscopy, tumor cells contained intracytoplasmic electron dense secreting graules, suggesting the possibility of renin secreting tumor cells. Shortly after nephrectomy, signs and symptoms were relieved dramatically, and plasma renin activity and aldosterone concentration were also decreased to normal.

• Journal of Acupuncture Research
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• v.15 no.2
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• pp.255-277
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• 1998

The aim of this experiment was to investigate the effects of Aqua-Acupuncture of Yukmijiwangtang(六味地黃湯) and Palmijihwang-tang(八味地黃湯) water extracts applied at the meridian points BL 23(賢兪) and GV 4(命門) to test the renal function in normal rats. The results obtained were as follows; 1. Among the effects of Aqua-Acupuncture of Yukmijihwangtang water extract at the merdian point BL 23 group, there were significant changes in water balance and urine volume over a 1 week period; Both decreasing and decreasing trends were exihibited. Urinary excretion of sodium and free water clearance changed significantly over a 2 week period; Both decreasing and increasing trends were exihibited, Urinary excretion of potassium, chloride and creatinine, plasma renin activity, plasma levels of aldosterone and atrial natriuretic peptide showed no significant differences compared to the contral group. 2. Among the effects of Aqua-Acupuncture of Palmljihwangtang water extract at the merdian point BL 23 group, there were significant changes in water balance and free water clearance over a 2 week period; a decreasing trend. Urinary excretion of creatinine changed significantly over a 2 week period; an increasing trend. Urinary excretion of chloride changed significantly over 1 week period; an increasing trend. The plasma levels of atrial natriuretic peptide changed significantly over 1 and 2 week period; an increasing trend. Urine volume, urinary excretion of sodium and pottasium, plasma renin activity and plasma level of aldosterone showed no significant differences compared to the control group. 3. Among the effects of Aqua-Acupuncture of Yukmijihwangtang water extract at the meridian point GV 4 group, there was significant decrease in water balance over a 2 week period; there was significant decrease in urine volwne and urinary excretion of sodium and creatinine over a 1 week period, followed by an increasing trend after 2 weeks. Urinary excretion of free water clearance demonstrated significant changes over both 1 and 2 week period; both increasing and decreasing trends were exihibited. Urinary excretion of chloride and plasma levels of aldosterone increased significantly over 1 and 2 week period. Plasma levels of atrial natriuretic peptide also decreased significantly. Plasma renin activity showed no significant differences compared to the control group. 4. Among the effects of Aqua-Acupuncture of Palmijihwangtang water extract at the meridian point GV 4 group, water balance and urinary excretion of chloride, plasma levels of aldosterone decreased significantly over both 1 and 2 week period. Urine volume and urinary excretion of pottasium decreased significantly. Urinary excretion of creatinine and urinary excretion of sodium changed significantly over both 1 and 2 week period. Urinary excretion of free water clearance, plasma renin activity and plasma level of atrial natriuretic peptide showed no significant differences compared to the control group. Seeing these results, I come to know that the effects Aqua-Acupuncture of Yukmijihwangtang and Palmijihwangtang water extracts at the meridian point BL 23 and GV 4 have affected the renal function differently. Seeing the results that BL 23 is a meridian point for Aqua-Acupuncture directly related to the kidney, I think, we can use Aqua-Acupuncture of Yuk-mijihwangtang and Palmijihwangtang water extracts to prevent and to treat the diseases related to kidney.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.71-78
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• 2015

The incidence of acute kidney injury (AKI) in critically ill pediatric patients has been reported as increasing to 25 %, depending on population characteristics. The etiology of AKI has changed over the last 10-20 years from primary renal disease to the renal conditions associated with systemic illness. The AKI in pediatric population is associated with increased mortality and morbidity, and prevention is needed to reduce the consequence of AKI. It is known that the most important risk factors for AKI in critically ill pediatric patients are clinical conditions to be associated with decreased renal blood flow, direct renal injury, and illness severity. Renal hypoperfusion leads to neurohormonal activation including renin-angiotensin-aldosterone system, sympathetic nervous system, antidiuretic hormone, and prostaglandins. Prolonged renal hypoperfusion can result in acute tubular necrosis. The direct renal injury can be predisposed under the condition of renal hypoperfusion, and appropriate treatment of volume depletion is important to prevent AKI. The preventable causes of AKI include contrast-induced nephropathy, hemodynamic instability, inappropriate mediation use, and multiple nephrotoxic insults. Given the evidence of preventable factors for AKI, several actions such as the use of protocol for prevention of contrast-induced nephropathy, appropriate treatment of volume depletion, vigorous treatment of sepsis, avoidance of combinations of nephrotoxic medications, and monitoring of levels of drugs should be recommended.

• The Korean Journal of Physiology
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• v.23 no.1
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• pp.67-78
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• 1989

Since the atrial receptor was suggested to be involved in the control of extracellular fluid volume, it has been shown that the granularity of atrial cardiocytes can be changed by water and salt depletion, and that an extract of atrial tissue, when injected intravenously into anesthetized rats, causes a large and rapid increase in renal excretions of sodium and water. The immunoreactive atrial natriuretic peptide (ANP) has been found in the plasma of patients suffering from various cardiovascular diseases. A high level of ANP in the plasma has been reported in essential hypertension. Several studies on the effects of ANP on renal function and arterial blood pressure have presented contradictory results showing attenuated or accentuated responses. Thus, involvement of the ANP in the development of hypertension remains unresolved. Present study was undertaken to investigate whether the ANP is involved in the development of hypertension in two-kidney one-clip Goldblatt hypertensive rats. The plasma concentration of immunoreactive ANP appeared to be significantly elevated in hypertensive rats as compared with normotensive Goldblatt operated and sham-operated rats. Plasma renin concentration was higher in hypertensive rats than in normotensive rats, as observed in earlier experiments. Intravenous infusions of ANP resulted in increases of urine flow and urinary excretions of sodium and potassium in both hypertensive and normotensive rats. The renal response to ANP was markedly accentuated in Goldblatt hypertensive rats. The plasma concentration of ANP showed a linear relationship with the arterial blood pressure. Infusions of ANP reduced blood pressure both in hypertensive and normotensive rats. These results suggest that in Goldblatt hypertensive rats an elevation of ANP level in the plasma may not be a cause, but instead a consequence of hypertension, and that the renal responsiveness to the ANP is accentuated by some unknown mechanisms.

• Journal of Acupuncture Research
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• v.23 no.3
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• pp.165-175
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• 2006

Objectives: The purpose of this study was to compare Taebaek(SP3) Sinmun(HT7), Daedon(LR 1) Yongcheon(KI1) on the Blood Pressure in Hypertensive RAT induced by 2K1C. Methods : This experiments was to investigate the effects of Herbal-Acupuncture at Taebaek(SP3) Sinmun(HT7), Daedon(LR1) Yongcheon(KIl) on the Blood Pressure, Cardiomegalic index, plasma levels of renin, plasma levels of atrial natriuretic peptide(ANP), serum levels of potassium, and serum levels of aldosterone in Hypertensive RAT induced by 2KlC. Results : The results were as follows. I. Blood Pressure was decreased significantly after Herbal-Acupuncture of Taebaek(SP3) Sinmun(HT7), Daedon(LR1) Yongcheon(KI1). II. Cardiomegalic index was decreased significantly after Herbal-Acupuncture of Daedon(LRl) Yongcheon(KI1). III. Plasma levels of atrial natriuretic peptide(ANP) was increased significantly after Herbal-Acupuncture of Taebaek(SP3) Sinmun(HT7), Daedon(LRl) Yongcheon(KIl). IV. Plasma levels of renin was decreased significantly after Herbal-Acupuncture of Taebaek(SP3) Sinmun(HT7), Daedon(LRl) Yongcheon(KI1). Conclusion : These results suggest that Blood pressure was decreased significantly after Herbal-Acupuncture of Daedon(LRl) Yongcheon(KI1) in Hypertensive RAT induced by 2K1C.

• The Korean Journal of Pharmacology
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• v.20 no.2
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• pp.1-6
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• 1984

It has been generally recognized that the secretion of aldosterone is mainly regulated by angiotensin II in animals and humans, however, potassium and ACTH are also proposed as other humoral factors involved in the aldosterone secretory process. Recently, stress, anesthesia, adrenergic stimulation, low sodium intake or water deprivation stimulate plasma renin activity, while high sodium intake and deoxycorticosteroid have been reported to cause suppression of renin activity in animals. It seems that overall response of aldosterone secretory mechanisms reflects complex interactions both intrarenal and extrarenal components. Furosemide has been widely used to investigate the control of renin secretion by the kidney, and the relationship between diuretics and the disposition of endogenous aldosterone were reported (Oh, 1984). The sequential with 10 min interval samples of plasma were collected following administration of furosemide(1 mg/kg), aspirin(10 mg/kg), respectively. And also similar experiment was performed in the propranolol (10 mg/kg) pretreated rabbits. The results were as follows : 1) The concentration of plasma aldosterone was average of $426.I{\sim}485.5pg/ml$ in normal rabbits. Plasma concentrations of aldosterone rised significantly after injection of furosemide during 50 min, and the rise of plasma aldosterone was blocked by the propranolol pretreatment 2) Significant fall in the plasma level of aldosterone after injection of aspirin was noted. This result indicates that the increased secretion of aldosterone induced by furosemide administration is mediated through ${\beta}-receptors$, and the possible role of prostaglandin is substantiated.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.2
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• pp.95-100
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• 2016

The aim of the present study is to investigate the hypotensive effect of Mantidis ootheca (WMO), Rosa laevigata (WIC), and Imperata cylindrica (WRL) in renovascular hypertension rats. Experimental hypertension model is 2-kidney and 1-clip (2K1C) induced rats. 2K1C rats were treated with WMO, WIC, and WRL at dose of 100 mg/kg/day orally for 3 weeks, respectively. Treatment groups with WMO, WIC, and WRL significantly lowered blood pressure. Interestingly, WMO, WIC, and WRL ameliorated endothelium-dependent and independent vascular relaxation in the phenylephrine-precontracted thoracic aorta in hypertension models. In addition, 2K1C-induced hypertension model increased plasma renin activity, however, WMO, WIC, and WRL attenuated those activities. These results suggest that WMO, WIC, and WRL ameliorates vascular dysfunction in 2K1C-induced hypertension models via the regulation of nitric oxide and renin-angiotensin-aldosterone system.

• Korean Journal of Acupuncture
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• v.24 no.3
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• pp.165-177
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• 2007

Objectives : The purpose of this study was to examine effects of acupuncture by needle manipulation at $LR1{\cdot}Kl1$ on the blood pressure, plasma levels of ANP(atrial natriuretic peptide), renin and cardiomegalic index in hypertensive rat Induced by two kidney one clip(2K1C). Material and methods : The groups divided into 7 groups; Control, no treatment. Acu-1,acupuncture at $LR1{\cdot}Kl1$ bilaterally and the needle was twirled and rotated forward with the thumb of the right hand 6 times. Acu-2, acupuncture at $LR1{\cdot}Kl1$ bilaterally and the needle was twirled and rotated forward with the forefinger of the right hand 6 times. Acu-3, acupuncture at $LR1{\cdot}Kl1$ bilaterally and the needle was inserted in the opposite direction(body direction) as the channel runs, Acu-4, acupuncture at $LR1{\cdot}Kl1$ bilaterally, the needle was inserted in the opposite direction(body direction) as the channel runs and the needle was twirled and rotated forward with the forefinger of the right hand 6 times. The acupuncture executed 5times for 2 weeks. Results : Systolic blood pressure was decreased significantly in Acu-2, Acu-3 and Acu-4. Plasma renin was decreased significantly in Acu-2 and Acu-4. Plasma ANP was increased significantly in Acu-2, however was decreased significantly in Acu-4. Cardiac hypertrophy index was decreased significantly in Acu-1, Acu-2, Acu-3 and Acu-4. Conclusions : These results suggest that acupuncture by needle manipulation at $LR1{\cdot}Kl1$ is effective in hypertension by renal blood problem.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.347-355
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• 2018

Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.2
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• pp.135-143
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• 2018

Tumor necrosis $factor-{\alpha}$ ($TNF{\alpha}$) and the angiotensin system are involved in inflammatory diseases and may contribute to acute kidney injury. We investigated the mechanisms by which $TNF{\alpha}$-converting enzyme (TACE) contributes to lipopolysaccharide (LPS)-induced renal inflammation and the effect of TACE inhibitor treatment on LPS-induced cellular injury in human renal proximal tubule epithelial (HK-2) cells. Mice were treated with LPS (10 mg/kg, i.p.) and HK-2 cells were cultured with or without LPS ($10{\mu}g/ml$) in the presence or absence of a type 1 TACE inhibitor ($1{\mu}M$) or type 2 TACE inhibitor ($10{\mu}M$). LPS treatment induced increased serum creatinine, $TNF{\alpha}$, and urinary neutrophil gelatinase-associated lipocalin. Angiotensin II type 1 receptor, mitogen activated protein kinase (MAPK), and TACE increased, while angiotensin-converting enzyme-2 (ACE2) expression decreased in LPS-induced acute kidney injury and LPS-treated HK-2 cells. LPS induced reactive oxygen species and the down-regulation of ACE2, and these responses were prevented by TACE inhibitors in HK-2 cells. TACE inhibitors increased cell viability in LPS-treated HK-2 cells and attenuated oxidative stress and inflammatory cytokines. Our findings indicate that LPS activates renin angiotensin system components via the activation of TACE. Furthermore, inhibitors of TACE are potential therapeutic agents for kidney injury.