• Childhood Kidney Diseases
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• v.27 no.1
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• pp.26-33
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• 2023

Purpose: Hematuria and proteinuria have various causes and consequential outcomes in children. Immunosuppressants are needed in some children with biopsy-proven glomerulonephropathy but have many adverse effects. Since the clinical practice patterns of Korean pediatric nephrologists are diverse, we surveyed their opinions. Methods: Using a clinical vignette, the survey was emailed to all Korean Society of Pediatric Nephrology members. The questionnaires included diagnosis, examination, medications, and dietary recommendations for patients with hematuria and proteinuria. Results: A total of 32 clinicians (5.48%, 22 pediatric certificated nephrologists) responded to the survey. Most responders (87.5%) suspected immunoglobulin A nephropathy, and 68.8% replied that kidney biopsies were a diagnostic tool. Renin-angiotensin system inhibition (62.5%) or steroids (18.8%) were selected as the treatment. Salt and protein intakes were usually encouraged as dietary reference intakes (34.4% and 65.6%, respectively). Conclusions: Children with abnormal urinalysis have various causes, treatments, and prognoses. As treatments such as immunosuppressants can have many adverse effects, it is necessary to confirm an accurate diagnosis and indications of treatments before starting the treatment. Recommendations for a diet should not hinder growth.

• Childhood Kidney Diseases
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• v.27 no.2
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• pp.117-120
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• 2023

Here, we present the case of a 2-month-old male infant with hyponatremic hypertensive syndrome resulting from stenosis of the right proximal and mid-renal arteries. The patient exhibited nephrotic-range proteinuria, low serum albumin, increased serum creatinine, and elevated renin and aldosterone levels. Doppler ultrasonography and computed tomography angiography revealed decreased vascular flow in the small right renal artery. Following a successful percutaneous balloon angioplasty, the patient experienced a decrease in blood pressure and normalization of serum electrolyte levels within a few days. However, it took 3 months for the proteinuria to resolve completely. This case is significant as it represents the first reported instance of a neonate presenting with clinical features resembling congenital nephrotic syndrome caused by renal artery stenosis that was successfully treated with percutaneous renal angioplasty.

• The Korean Journal of Physiology
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• v.24 no.1
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• pp.145-159
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• 1990

Recently, it has been suggested that the endogenous adenosine may be the mediator for the intercellular communication in the regulation of tubuloglomerular feedback control and renin release. Even though two subclasses of adenosine receptors, A1 and A2, have been described, their functional roles are controversial. The present study was undertaken to clarify the role of adenosine receptors in hypertensive rabbit caused by clamping of renal artery. Experiments were done in two-kidney one clip Goldblatt hypertensive rabbits (2K1GHR) and sham-operated normotensive rabbits. Adenosine, N6-cyclohexyladenosine (CHA) and 5'-N-ethylcarboxamidoadenosine (NECA) were infused into a renal artery. The decreases in urine volume, renal blood flow, glomerular filtration rate and excreted amounts of electrolytes caused by adenosine and CHA were significantly attenuated in 2K1CHR. However, changes in renal function caused by A2 adenosine receptor agonist, NECA, tend to be accentuated in 2K1CHR. These results suggest that the attenuation of renal effect caused by adenosine and A1 adenosine receptor agonist may be due to the modification of adenosine receptor in the kidney in Goldblatt hypertensive rabbits.

• Journal of Biomedical and Translational Research
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• v.19 no.4
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• pp.86-91
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• 2018

Angiotensin receptor blockers, such as telmisartan, are considered effective in the treatment of hypertension and proteinuria due to chronic kidney disease (CKD) in cats. It selectively blocks the $AT_1$ receptor and does not affect the $AT_2$ receptor, thus effectively blocking the activity of the renin angiotensin aldosterone system. This study aims to compare over time the changes in various indicators, including systemic hypertension and proteinuria, before and after the administration of telmisartan in cats with CKD. Decrease in blood pressure (BP) (p<0.001) and urine protein to creatinine (UP/C) ratio (p<0.001) were found to be statistically significant over time after the administration of telmisartan. BP and the UP/C ratio were $160{\pm} 22.2$ and $0.50{\pm}0.647$ before telmisartan administration (Day 0), $150{\pm}21.0$ and $0.27{\pm}0.487$ on the 30th day (Day 30), $150{\pm}17.0$ and $0.25{\pm}0.376$ on the 60th day (Day 60), and $140{\pm}17.8$ and $0.15{\pm}0.233$ on the 90th day (Day 90) after administration, respectively. BP and UP/C were statistically significantly lower in cats with CKD over time at each time point from Day 0 to Day 90 at 30 day intervals. Especially after 90 days of telmisartan administration, the improvement of BP and UP/C were estimated to be about 20 mmHg and 0.35, respectively. In conclusion, the oral administration of telmisartan to cats with CKD is effective in improving BP and proteinuria, which has a positive effect on long-term survival in cats with CKD.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.91-96
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• 2018

Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.91-95
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• 2004

We report a 2-month-old boy who presented with severe hyponatremia and hyperkalemia secondary to ureteropelvic junction(VPJ) obstruction. By prenatal ultrasonography at 19 weeks of gestation, severe hydronephrosis was found which was confirmed postnatally Pyeloplasty was done on the 45th day of life, and fifteen days after pyeloplasty, non-bilious vomiting, decreased activity and dehydration developed. Severe hyponatremia and hyperkalemia were observed, as a result of elevated serum aldosterone and plasma renin activity. The anterior posterior pelvic diameter(APPD) and Society for Fetal Urology(SFU) grade measured showed no interval change before and after pyeloplasty. Pseudohypoaldosteronism was diagnosed, and 2M NaCl was administrated orally for 7 days. The electrolyte imbalance was corrected, and 8 weeks later, the elevated levels of aldosterone and plasma renin activity were normalized. The left hydronephrosis was improved at 5 months of age. We hereby report a transient pseudohypoaldosteronism secondary to UPJ obstruction with a review of the literature.

• The Korean Journal of Food And Nutrition
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• v.24 no.1
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• pp.28-36
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• 2011

To investigate the protective effect of omija(Schizandra chinensis Baillon) tea extracts against the aluminum toxicity, Sprague-Dawley rats($100{\pm}10\;g$) were divided into 6 groups consisting of a control group, a 3% Schizandra chinensis Baillon tea plus extract group, a 1,000 and 2,000 ppm aluminum group, and a 1,000 and 2,000 ppm aluminum plus 3% Schizandra chinensis Baillon tea plus extract group. The rats administered aluminum were given 1,000 and 2,000 ppm of $Al_2(SO_4)_3$ dissolved in distilled water. The aluminum content in tissues from rats administered aluminum was lower than in the tissues of rats of administered aluminum plus 3% Schizandra chinensis Baillon tea in the water extract. Aspartate aminotransferase (AST) and alanine aminotransferase(ALT) levels were increased in the aluminum group and lower in the group receiving a 3% extract of Schizandra chinensis Baillon tea. Lactate dehydrogenase(LDHase) was lower in the group receiving a 3% extract of Schizandra chinensis Baillon tea plus aluminum than in the aluminum group. Cholinesterase(ChEase) was higher in the 3% Schizandra chinensis Baillon tea-aluminum group than in the aluminum group. Plasma levels of renin were increased in the aluminum group, compared to the group receiving 3% Schizandra chinensis Baillon tea plus aluminum. Plasma levels of aldosterone were increased in the aluminum group compared with the 3% Schizandra chinensis Baillon tea plus aluminum group. These results suggest that the group receiving Schizandra chinensis Baillon tea in water extract had a lowered level of aluminum accumulation, and it is believed that the Schizandra chinensis Baillon tea plus water had some protective effects against aluminum toxicity when administered in rats, but the mechanism of these effects remains obscure.

• The Journal of Internal Korean Medicine
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• v.19 no.2
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• pp.159-184
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• 1998

The aim of the study was the experiment of the effect that Kami-Daesihotang had on the essential hypertension and hyperlipidemia. Rats were orally administered with Kami-Daesihotang for 30days and the constituent of the plasma and serum were analysed at the 10th, 20th and 30th day from the first day of experiment, respectively. The heart rate, blood pressure, plasma renin activity, plasma level of aldosterone, catecholamine, sodium and angiotensin II were measured after an oral administration of Kami-Daesihotang in SHR. In addition, serum levels of total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol and total lipid were measured with cholesterol-fed rats. The results were summarized as following ; 1. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang remarkably decreased the blood pressure in SHR. 2. Double-dosage Kami-Daesihotang were recognized as having the effect on the decreased of the pulse rate in SHR. 3. Plasma renin activity was significantly decreasd in SHR after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 4. Double-dosage Kami-Daesihotang considerably reduced the plasma angiotensin level in SHR. 5. Noticeable decreased of plasma norepinephrine level was showed in SHR, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 6. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang noticeable reduced body weight in hyperlipidemia rats which had fed with 1% cholesterol. 7. Single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang had a significantly decreasing effect on serum total cholesterol in hyperlipidemia rats which had fed with 1% cholesterol. 8. Serum triglyceride level was importantly decreased in hyperlipidemia rats which had fed with 1% cholesterol, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 9. Remarkable decreased of serum low density lipoprotein cholesterol level was found in hyperlipidemia rats which had fed with 1% cholesterol, after single-dosage Kami-Daesihotang & double-dosage Kami-Daesihotang treatment. 10. Double-dosage Kami-Daesihotang was showed a significantly decreasing effect on serum total lipid level in hyperlipidemia rats which had fed with 1% cholesterol. 11. Single-dosage Kami-Daesihotang noticeably reduced organ weight of liver, kidney, spleen and testis in hyperlipidemia rats which had fed with 1% cholesterol. Double-dosage Kami-Daesihotang significantly decreased organ weight of liver, kidney and spleen in hyperlipidemia rats. These Findings suggest a possible anti-hypertensive and hyperlipidemic effect of Kami-Daesihotang.

• The Korean Journal of Physiology and Pharmacology
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• v.1 no.3
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• pp.325-335
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• 1997

Evidence for the existance of at least two subclasses of renal adenosine receptors has been presented. N-6-cyclohexyladenosine (CHA) is a relatively selective $A_1$ adenosine agonists, whereas 5'-N-ethylcarboxamidoadenosine (NECA) acts as a preferential agonist of $A_2$ adenoisne receptor. N6-(L-2-phenylisoproryl)-adenosine (PIA) almost unselectively activates both $A_1\;and\;A_2$ adenosine receptors at micromolar concentrations. During the characterization of adenosine receptor in the kidney, we have discovered a novel phenomenon, that is, an intramuscular administration of CHA for 3 days caused a diuresis and a suppression of urinary concentrating ability. To further characterize this novel phenomenon, an intramuscular administration of adenosine and other adenosine angonists, PIA and NECA, and prior treatment of adenosine antagonists, caffeine, theophylline and 1,3-diethyl-8-phenyl-xanthine (DPX) were performed. Systemic administration of CHA, PIA, and NECA for 3 days caused a suppression in heart rate, blood pressure and general motor activity without change in rectal temperature. Systemic administration of CHA, 0.5, 1 and 2 mg/kg/day, for 3 days caused a dose-dependent increase in urine volume and decrease in urinary osmolarity and free water reabsorption. This phenomenon was reversible and repeatable. Administration of adenosine (40 mg/kg/day) produced no apparent effect on the renal function, whereas PIA (2 mg/kg/day) produced an similar effect to CHA on the renal function. Systemic adminstration of NECA, 0.025, 0.05 and 0.25 mg/kg/day, for 3 days caused a dose-dependent increase in urine volume and dose-dependent increases in excreted amount of creatinine, urinary osmolarity and free water reabsorption. These renal effects of adenosine agonist were maximum at second day during the drug administration. In terms of increase in urine volume and the suppression of urinary concentrating ability, NECA was potent than CHA. Prior treatment of caffeine (50 mg/kg/day) or theophylline (50 mg/kg/day) abolished the diuretic effect of CHA, whereas DPX (50 mg/kg/day) did not affect the CHA effect. CHA, 0.5 mg/kg/day, produced no change in plasma renin activity and plasma levels of aldosterone, epinephrine, and norepinephrine. These results suggest that this novel phenomenon produced by an activation of renal adenosine receptors plays an important role in urinary concentrating mechanism.

• Korean Journal of Acupuncture
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• v.28 no.2
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• pp.1-11
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• 2011

Objectives : The aim of this study was to examine the effect acupuncture by needle manipulation at acupoints, SP3 HT7, on the blood pressure and renin and atrial natriuretic peptide(ANP) in plasma, cardiac hypertrophy in hypertensive rats induced by two kidney one clip (2K1C). Materials and Methods : The experiments were performed on twenty-five Sprague Dawley rats, 2K1C hypertension model was prepared by constricting the left renal artery with a sliver clip. Animals were divided into five groups, control, AC-1a and AC-2a(acupuncture at SP3 HT7 bilaterally and the needle was twirled and rotated forward with the thumb and forefinger of the right hand 6 times), AC-3a(acupuncture at SP3 HT7 bilaterally and the needle was inserted in the opposite direction(body direction) as the channel runs), AC-4a(acupuncture at SP3 HT7 bilaterally and 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 treatments were started on the 4 week after inducing 2K1C, and they were performed two times a week for 3 weeks in rats. Results : The results are that The blood pressure was significantly decreased at 4 times in Acu-1a, The cardiac hypertrophy was significantly decrease in Acu-2a and Acu-3a. The activity of plasma renin was decreased in all groups without control and Acu-1a, and that of plasma ANP was decrease in Acu-2a and Acu-3a than control group. Conclusions : These results suggest that acupuncture on SP3 HT7 mostly cause significant changes on controlling renal hypertension induced by 2K1C in the rats.