• Title/Summary/Keyword: Renal Failure

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Plasmaphresis therapy for pulmonary hemorrhage in a pediatric patient with IgA nephropathy

  • Yim, Dae-Kyoon;Lee, Sang-Taek;Cho, Heeyeon
    • Clinical and Experimental Pediatrics
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    • v.58 no.10
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    • pp.402-405
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    • 2015
  • IgA nephropathy usually presents as asymptomatic microscopic hematuria or proteinuria or episodic gross hematuria after upper respiratory infection. It is an uncommon cause of end-stage renal failure in childhood. Pulmonary hemorrhage associated with IgA nephropathy is an unusual life-threatening manifestation in pediatric patients and is usually treated with aggressive immunosuppression. Pulmonary hemorrhage and renal failure usually occur concurrently, and the pulmonary manifestation is believed to be caused by the same immune process. We present the case of a 14-year-old patient with IgA nephropathy who had already progressed to end-stage renal failure in spite of immunosuppression and presented with pulmonary hemorrhage during oral prednisone treatment. His lung disease was comparable to diffuse alveolar hemorrhage and was successfully treated with plasmapheresis followed by oral prednisone. This case suggests that pulmonary hemorrhage may develop independently of renal manifestation, and that plasmapheresis should be considered as adjunctive therapy to immunosuppressive medication for treating IgA nephropathy with pulmonary hemorrhage.

Pharmacokinetics of Furosemide in Rabbits with Renal Failure (신장장해 가토에서 Furosemide의 약물동태)

  • Choi, Jun-Shik;Choi, Tou-Ma;Lee, Jin-Hwan;Burm, Jin-Pil
    • YAKHAK HOEJI
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    • v.34 no.6
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    • pp.401-406
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    • 1990
  • The Pharmacokinetics of furosemide (5 mg/kg iv) was investigated in rabbits with folate (75 mg/kg, 150 mg/kg 300 mg/ug, iv) induced renal failure. The plasma concentration was increased and urinary excretion was decreased significantly compared with those of normal rabbits. ${\alpha},\;{\beta}\;and\;K_{12},\;K_{21},\;K_{10}$ were decreased, $t_{1/2}$ and AUC were increased significantly. Correlation of serum creatinine concentration and AUC, renal clearance have linear relationship respectively. In short, dosage regimen of furosemide is considered to be adjusted in the dose size and the dosing interval by degree of serum creatinine concentration.

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Antibiotic therapy in renal failure (신부전 환자에 있어서 항생제 요법)

  • Cho, Byoung-Soo
    • Pediatric Infection and Vaccine
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    • v.3 no.1
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    • pp.66-74
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    • 1996
  • There continues to be increasing the number of patients being treated for renal failure day by day due to lot of causes. It is prerequsite for the physician to have a proper understanding of drug use in patients with renal failure since kidney is the major route of elimination for many kinds of drugs and their metabolites. In order to provide practical guidelines for prescribing antibiotics, the literature has been reviewed, and summarized. The tables presented here are made by Dr. William M Bennett et al. and listed the specific pharmacokinetic information such as drug half life, serum levels, and drug removal during dialysis, plasma protein binding, volume of distribution.

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Pharmacokinetics of Theophylline in Experimental Acute Renal Failure Rats(I) (실험적 급성 신장장해 쥐에서 Theophylline의 체내동태(I))

  • 김옥남
    • YAKHAK HOEJI
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    • v.35 no.1
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    • pp.38-44
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    • 1991
  • It has been reported that the pharmacokinetic behaviors of drugs which are mostly metabolized in the liver are significantly different in patients with renal failure. Theophylline(TP) is mainly metabolized in the liver (approximately 90%) and renal clearance of the drug is negligible (less than 10%). Therefore, we have investigated the changes in pharmacokinetics of theophylline in normal, G-ARF and U-ARF rats after an intravenous administration. The total body clearance of TP decreased approximately 40% in U-ARF rats. The reduced CL$_{T}$, value in U-ARF rats could be due to reduced hepatic intrinsic clearance by up to 40% since it has been published that plasma protein binding of TP and liver blood flow does not change in U-ARF rats.

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Pharmacokinetics of Lithium Carbonate in Rabbits with Experimental Renal Failure (실험적(實驗的) 신장장애(腎臟障害) 가토(家兎)에서 탄산리튬의 약물동태학적(藥物動態學的) 연구(硏究))

  • Burm, Jin-Pil;Kim, Yong-Hyun
    • Journal of Pharmaceutical Investigation
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    • v.15 no.3
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    • pp.113-120
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    • 1985
  • The pharmacokinetics of lithium carbonate were investigated in rabbits with folate-induced renal failure. The blood level, the area under the blood concentration curve (AUC) and the biological half·life were increased significantly, and the urinary excretion was decreased significantly compared with those of normal rabbits. Correlation of serum creatinine concentration and AUC, biological half-life, and correlation of creatinine clearance and renal clearance of lithium carbonate have linear relationship respectively. In short, dosage regimen of lithium carbonate is considered to be adjusted in the dose size and the dosing interval by degree of experimental renal failure.

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Effects of Squalene on The Epidermal Growth Factor (EGF) Expression and Histological Changes by Glycerol-Induced Acute Renal Failure in Mice (Glycerol-유도 급성신부전에서 표피성장인자 발현 및 조직학적 변화에 관한 스쿠알렌의 효과)

  • Choi, Young-Bok;Kim, Young-Ho;Lee, Jun-Heung;Kim, Jong-Se
    • Applied Microscopy
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    • v.34 no.4
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    • pp.241-254
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    • 2004
  • Kidney had recovery functions against toxicants, ischemia, reperfusion-induced damage, acute-renal failure (ARF). Urinary epidermal growth factor (EGF) is produced by the juxtaglomerular apparatus. Kidney accumulates or excretes the EGF. In case of renal diseases, excreted EGF was decreased. The aim of this study is to evaluate the effects squalene (SQ) on the prevention of experimental acute renal failure induced by glycerol. In case of in vitro study, we investigated the expression of EGF by RT-PCR. After the proximal tubular cells was isolated, glycerol (1, 2, 4 mM) or glycerol plus squalene (0.1, 0.05 or 0.1%) was added. In case of in vivo study, we investigated the changes of BUN, creatine, and ultrastructure. Experimental groups were divided into four groups. Group 1 was normal mouse. Group 2 was injected with SQ only (180 mg/kg). Group 3 was not treated with squalene after intraperitoneal contamination of glycerol (50%, 8 ml/kg). And, Group 4 was treated with squalene (180 mg/kg) after intraperitoneal contamination of glycerol (50%, 8 ml/kg). All groups were used to 7 mice. In the results, we investigated the glycerol induced renal failure. The expression of EGF mRNA was decreased in renal proximal tubules when treated with only glycerol. SQ increased the mRNA expression of EGF in renal proximal tubules. SQ also quickly recovered the levels of BUN and creatine compared with those of mice treated with only glycerol (P<0.01). In case of ultrastructure, group 3 had heavily damaged mitochondria, but, mitochondria in group 4 had evidences of the recovery. It was concluded that SQ had the recovery effects for the glycerol-induced acute renal failure.

Clinical Study of Gamdutang Complex Formula on Patients of Acute Renal Failure due to Paraquat Intoxication

  • Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.588-593
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    • 2002
  • Paraquat, one of the potent herbicides, causes fatal damage to many vital organs, when orally ingested, resulting in circulatory failure, respiratory distress syndrome, and a few other serious problems, but there is no known specific antidote against it. Of the possible problems related to paraquat intoxication, oliguric acute renal failure, which has been known to develop within 24 or 48 hours after intoxication, are notoriously life-threatening. So we attempted to investigate the clinical characteristics and progress of paraquat-induced acute renal failure and the therapeutic possibilities of herbal medicines. All of the fifteen subjects were treated with intravenous fluid injection of 5% dextrose saline or 10% dextrose water in conjunction with herbal medicines which were used for oral administration or gargling. Gamdutang, a decoction of Semen Glycin(黑豆 200g) and Radix Glycyrrhizae(甘草 100g) with addition of other herbs when necessary, was administered orally. At the same time, gargling fluid, consisted of Chinese ink(墨汁), char-frying powder of Rhei Rhizoma(大黃炒炭末), Succus phyllostachyos(竹瀝), was used to detoxify the oral cavity. Serum levels of Blood Urea Nitrogen(BUN) and Creatinine reached its peak on the third day of hospitalization, but then decreased and fell within the normal range on the 7th day and remained there. Serum levels of Na+ and K+ decreased down below the lower limits of normal range on the 7th day and on the 3rd day, respectively. Then they returned back within normal limits. Mean urine output on the 1st day of hospitalization was 1,050ml and it continuously increased to reach more than 2,000ml on the 14th day. From that day on, it stayed over 2,000ml. Fifteen cases of acute renal failure caused by paraquat intoxication were treated with combined treatments of oriental and western medicine in our hospital. However, we think that it is necessary to study further about the way to combine oriental and western medicine, to find out a more effective treatment method.

Ultrasound-Guided Placement of Tunneled Hemodialysis Catheters (초음파 유도하 터널식 혈액투석용 도관 삽입술)

  • Lee Hee Bong;Jang Kuhn Jo
    • Journal of The Korean Radiological Technologist Association
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    • v.27 no.2
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    • pp.157-174
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    • 2001
  • Ⅰ. Purpose : To evaluate the usefulness of ultrasound-guided, radiologic placement of tunneled hemodialysis catheters via internal jugular vein(IJV). Ⅱ. Materials and Methods : In 32 patients(31 chronic renal failure, 1 acute renal failure), We performed

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Two cases of Familial Juvenile Hyperuricemic Nephropathy (Familial Juvenile Hyperuricemic Nephropathy 2례)

  • Park Jin-Ho;Choi Bo-Hwa;Lee So-Young;Yoo Eun-Sil;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.183-188
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    • 1997
  • Familial juvenile hyperuricemic nephropathy is an autosomal dominant disease characterized by progressive renal disease and hyperuricemia or gout, affecting young people of either sex equally. There are two biochemical markers of this disorder. The first is hyperuricemia disproportionate to the degree of renal dysfunction; the second is a grossly reduced clearance of uric acid relative to creatinine, dispropotionate to age, sex and degree of renal failure. We experienced 2 family members with hyperuricemia. One family member, a 13-year-old girl who had suffered from tophaceous gout and chronic renal failure. Her younger brother also had hyperuricemia and moderately reduced renal function. Their urinary excretion fractions of uric acid($FE_{uric\;acid}$) were reduced and renal biopsy specimens showed interstitial fibrosis with tubular atrophy and interstitial urate crystal deposition. We have treated these two patients with allopurinol but we have done renal transplantation because she progressed to end stage renal disease at 16 year old age.

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Development of An Evaluation Tool for the Quality of Patient Care Chonic Renal Failure (만성 신부전 환자간호의 질평가 도구개발)

  • Yang, Young-Ock;Kim, Moon-Sil
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.57-72
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    • 1996
  • Provision of better nursing care to patients is a difficult but important task. The first problem for nursing quality improvement is development of evaluation tool for the quality of nursing care. This study tries to develop a patient care tool for patients with chronic renal failure. This study as a procedural evaluation of patient care, tries to show what, how, at what order to provide care to patients with chronic renal failure. This study is divided into process of development of tool, its reliability and validity. Among process of development of tool is focal group, small expert group and expert evaluation group. To develop approprieteness of tool, nurses working is four major hospitals is Seoul were selected. To evaluate the credibility of subjects, 19 patient who were hospitalized and discharged within 3 months were selected. The period for collecting data for reliability and valiability evaluation was between Sept. 20 to Oct. 18, 1995. The development process of this study is as follows ; 1. Make preliminary list of the tool by focal group consisting of 8 clinical nurses. 2. Modify and add preliminary list by 4 expert nursing panel. 3. Calculate content validity of the tool by 23 nursing expert panel of judge. 4. Verity relability and validity of the tool. 5. Finalize an evaluation tool for the quality of nursing care in chronic renal failure patient. The result of this study were as follows ; 1. Development of evaluation tool for the quality of nursing care in chronic renal failure. 1) The evaluation of this study was developed 5 standards, 28 criteria. and 130 indicators 2) Nursing care evaluation scores for chronic renal failure patients were average 68.8. 2. Verity reliability and validity of the tool. 1) 5 standards were divided into 4 point scale and according to 28 creteria, indicators of standard were 3.72 and of criteria were 3.77 2) Inter - rater reliability (consentaneity score) of the tool by pearson correlation coefficient betwwen rates were r= .72, r= .75 and interreliabilities by single - facet crossed design were r= .96. 3) The alpha coeffecient relating to internal consistency was .7259 over 27 items of 28 criterias of developed tool. Through this study, I'm sure that the developed tool for the quality of patient care in chronic-renal failure patient will show the way of more improvement of the quality of nursing care and effective nursing intervention.

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