• Title/Summary/Keyword: Renal damage

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A Case Report of Improvement of Glomerular Filtration Rate and Anemia in Chronic Renal Failure through Herbal Medication (만성신부전 환자에게 한약투여 후 사구체여과율 및 빈혈 호전 1례)

  • Kim, Dong-Hyun;Bae, Eun-Joo;Park, Seong-Uk;Yoon, Seong-Woo;Ko, Chang-Nam;Rheu, Kyoung-Hwan
    • The Journal of Internal Korean Medicine
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    • v.26 no.2
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    • pp.498-505
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    • 2005
  • Renal failure means irreversible damage and depression of renal function, represented by glomerular filtration rate(GFR). A renal failure patient with uremia and anemia is presented. Anemia, in this patient, appeared before uremia did. A 55 year-old male patient was treated for renal failure with Weilingtang. Improvement was observed in, not only GFR, blood urea nitrogen(BUN), and creatinine, but also in such symptoms as difficulty in urine excretion, dyspepsia and abdominal swelling. But anemia appeared during treatment, so a mixture of Dangguibuxuetang(當歸補血湯) and Xiongguitang(芎歸湯) was prescribed. After this treatment, improvement in hemoglobin, and hematocrit was observed.

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Clinical study on Renal Replacement Therapy for Acute Renal Failure following Cardiopulmonary Bypass (체외순환후 급성 심부전에 대한 신대체요법의 임삼적 검토)

  • 서경필
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.232-239
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    • 1992
  • Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

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Curcumin attenuates renal ischemia reperfusion injury via JNK pathway with the involvement of p300/CBP-mediated histone acetylation

  • Yang, Lu;Chen, Xiaoxiang;Bi, Zirong;Liao, Jun;Zhao, Weian;Huang, Wenqi
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.5
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    • pp.413-423
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    • 2021
  • Apoptosis is proved responsible for renal damage during ischemia/reperfusion. The regulation for renal apoptosis induced by ischemia/reperfusion injury (IRI) has still been unclearly characterized to date. In the present study, we investigated the regulation of histone acetylation on IRI-induced renal apoptosis and the molecular mechanisms in rats with the application of curcumin possessing a variety of biological activities involving inhibition of apoptosis. Sprague-Dawley rats were randomized into four experimental groups (SHAM, IRI, curcumin, SP600125). Results showed that curcumin significantly decreased renal apoptosis and caspase-3/-9 expression and enhanced renal function in IRI rats. Treatment with curcumin in IRI rats also led to the decrease in expression of p300/cyclic AMP response element-binding protein (CBP) and activity of histone acetyltransferases (HATs). Reduced histone H3 lysine 9 (H3K9) acetylation was found near the promoter region of caspase-3/-9 after curcumin treatment. In a similar way, SP600125, an inhibitor of c-Jun N-terminal kinase (JNK), also attenuated renal apoptosis and enhanced renal function in IRI rats. In addition, SP600125 suppressed the binding level of p300/CBP and H3K9 acetylation near the promoter region of caspase-3/-9, and curcumin could inhibit JNK phosphorylation like SP600125. These results indicate that curcumin could attenuate renal IRI via JNK/p300/CBP-mediated anti-apoptosis signaling.

Vesicoureteral Reflux and Renal Scar (방광요관역류와 신반흔)

  • Nam, Hee-Young;Shin, Joon-Heon;Lee, Jun-Ho;Choi, Eun-Na;Park, Hye-Won
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.201-212
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    • 2006
  • Purpose : Vesicoureteral reflux(VUR) is the major risk factor of urinary tract infection(UTI) in children and may result in serious complications such as renal scarring and chronic renal failure. The purpose of this study was to evaluate the relationship between VUR and renal scar formation, the usefulness and correlation of various imaging studies in reflux nephropathy, and the spontaneous resolution of VUR. Methods : We retrospectively reviewed 106 patients with VUR with no accompanying urogenital anomalies in the Department of Pediatrics, Bundang CHA Hospital during the period from Jan. 1996 to Mar. 2005. Ultrasonography and $^{99m}Tc$-dimercaptosuccinic acid(DMSA) scan were performed in the acute period of UTI. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. Follow-up DMSA scan was performed 4 to 6 months after treatment and a follow-up VCUG was performed every 12 months. Results : The mean age at detection of VUR was $13.8{\pm}22.2$ months and the male to female ratio was 2:1. The incidence of renal scarring showed a tendency of direct correlation between severity of VUR(P<0.001) and abnormal findings of renal ultrasonography(P<0.01). 63.2%(24 of 38 renal units) of renal parenchymal defects present in the first DMSA scan disappeared on follow-up DMSA scans. Follow-up DMSA scans detected renal scars in 7(14%) of 50 renal units with ultrasonographically normal kidneys. Meanwhile, ultrasonography did not show parenchymal defects in 7(36.8%) of 19 renal units where renal scarring was demonstrated on a follow-up DMSA scan. The spontaneous resolution rate of VUR was higher(75%) in cases with low grade(I to III) VUR(P<0.01). Conclusions : The presence and severity of VUR and abnormal findings of renal ultrasonography significantly correlated with renal scar formation. DMSA scan was useful in the diagnosis of renal defects. Meanwhile renal ultrasonography was an inadequate method for evaluating renal parenchymal damage. Therefore, follow-up DMSA scans should be performed to detect renal scars even in children with low-grade VUR and normal renal ultrasonography.

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Hot Water Extract of Triticum aestivum L. (Common Wheat) Ameliorates Renal Injury by Inhibiting Apoptosis in a Rat Model of Ischemia/Reperfusion

  • Baek, Hae Sook;Lim, Sun Ha;Ahn, Ki Sung;Lee, Jong Won
    • The Korea Journal of Herbology
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    • v.28 no.3
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    • pp.7-15
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    • 2013
  • Objectives : Interruption and subsequent restoration of blood flow into the kidney result in renal injury. As an approach to preventing the renal injury, we determined the optimal conditions and the underlying mechanisms by which supernatant of hot water extract of ground Triticum aestivum L. (extract) attenuated ischemia/reperfusion (I/R) injury. Methods : One hour after administration of the extract (400 mg/kg) by intraperitoneal injection, renal I/R injury was generated by clamping the left renal artery in rats after surgical removal of the right kidney, followed by reperfusion. The maximal difference between the vehicle-treated and the extract-treated group under ketamine/xylazine or enflurane anesthetization was assessed at varying periods of ischemia (30-45 min) and reperfusion (3-48 hr), based on the renal function assessed with serum creatinine levels, tissue injury with hematoxylin/eosin staining, and apoptosis with terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling staining. Results : Enflurane anesthetization with 40 min of ischemia and 24 hr of reperfusion was identified to be the optimal condition, under which condition serum creatinine levels and tubular damage in the extract-treated group were significantly reduced compared with those in the vehicle-treated group ($1.3{\pm}0.2$ versus $2.7{\pm}0.3$ mg/dL, P < 0.01, and average score $1.8{\pm}0.1$ versus $3.5{\pm}0.3$, P < 0.01, respectively). These beneficial effects were mediated by inhibition of apoptotic cascades through attenuation of renal tissue malondialdehyde levels, Bax/Bcl-2 ratio and caspase-3 levels. Conclusions : The extract conferred renal protection against ischemia/reperfusion injury in rats by scavenging reactive oxygen species and consequently blocking apoptotic cascades, plausibly augmented by enflurane protection.

Influences of Prolonged Extracorporeal Circulation on Organ Function in Dogs (장시간의 체외순환이 생체에 미치는 영향)

  • 김의윤
    • Journal of Chest Surgery
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    • v.7 no.1
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    • pp.73-78
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    • 1974
  • Influences on organ function were studied in animals during prolonged extracorporeal circulation with a bubble type of oxygenator. More than six hours of total cardiopulmonary bypass was performed under mild hypothermia by means of an extracorporeal circulation system in five dogs. Obtained results were summarized as follows. 1. The renal function was not so impaired seriously until four hours of extracorporeal circulation. However, there was more serious impairment of renal function in this study when extracorporeal circulation was carried out for a period of five hours or more. 2. There was gradual hepatic damage during extracorporeal circulation and the damage was more significant after bypass for a period of five to six hours. 3. There was a significant decrease in serum K during bypass, irrespective of the pump oxygenator prime with a high K solution. The reason for this is complex and due to many factors, however, it was evidently related to serum glucose levels during extracorporal circulation.

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Renal Manifestations and Imaging Studies of Kawasaki Disease (가와사키 질환에서의 신증상과 영상 검사 소견)

  • Oh, Ji Young;Park, Se Jin;Kim, Sun Jung;Jang, Gwang-Cheon;Kim, Uria;Shin, Jae Il;Kim, Kee Hyuck
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.86-91
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    • 2013
  • Purpose: The aim of this study was to verify renal inflammation following Kawasaki disease (KD) using single photon emission computed tomography along with Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT). Methods: From March 2011 to October 2011, 15 patients diagnosed with KD at the National Health Insurance System Ilsan Hospital were enrolled in the study. All patients underwent DMSA renal SPECT to evaluate renal involvement during the acute phase of KD. Urine ${\beta}2$-microglobulin (${\beta}2$-MG), a marker of renal proximal tubular dysfunction, was also measured to assess renal damage. Results: All 15 patients had normal renal function test results. However, microscopic hematuria and pyuria were observed in 13% and 33% of the patients, respectively. Moreover, urine ${\beta}2$-MG was elevated in 46% of the patients. In addition, patients were divided into two groups based on ${\beta}2$-MG level: those with an increased ${\beta}2$-MG level, and those with a normal ${\beta}2$-MG level. No significant differences were found between these two groups in clinical characteristics, laboratory, sonography, and echocardiography findings. All patients' DMSA renal SPECT scans were normal. Conclusion: Our study showed that mild abnormalities in the urinalysis and elevated urine ${\beta}2$-MG were the only findings of renal involvement in KD. However, no aggressive renal manifestations were detected on DMSA renal SPECT.

Effect of Baicalein on t-Butylhydroperoxide-Induced Cell Injury in Renal Tubular Epithelial Cells

  • Soon-Bee Jung
    • Biomedical Science Letters
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    • v.9 no.4
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    • pp.189-193
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    • 2003
  • This study was undertaken to investigate the effect of baicalein, a major flavone component of Scutellaria balicalensis Georgi, on oxidant-induced cell injury in renal epithelial cells. Opossum kidney cells, an established proximal tubular epithelial cells, were used as a cell model of renal epithelial cells and t-butylhydroperoxide (tBHP) as an oxidant drug model. Cell viability was measured by MTT assay and lipid peroxidation was estimated by measuring the content of malondialdehyde, a product of lipid peroxidation. Exposure of cells to tBHP caused cell death and its effect was dose-dependent over concentration range of 0.1~1.0 mM. When cells were exposed to tBHP in the presence of various concentrations (0.1~10 $\mu$M) of baicalein, tBHP-induced cell death was prevented with a manner dependent of baicalein concentration. tBHP induced A TP depletion, which was significantly prevented by baicalein. Similarly, tBHP-induced DNA damage was prevented by baicalein. tBHP produced a marked increase in lipid peroxidation and its effect was completely inhibited by baicalein. These results indue ate that tBHP induces cell injury through a lipid peroxidation-dependent mechanism in renal epithelial cells, and baicalein prevented oxidant-induced cell injury via antioxidant action inhibiting lipid peroxidation. In addition, these results suggest that baicalein may be a candidate for development of drugs which are effective in preventing and treating renal diseases.

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Recent Findings on the Mechanism of Cisplatin-Induced Renal Cytotoxicity and Therapeutic Potential of Natural Compounds

  • Lee, Dahae;Choi, Sungyoul;Yamabe, Noriko;Kim, Ki Hyun;Kang, Ki Sung
    • Natural Product Sciences
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    • v.26 no.1
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    • pp.28-49
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    • 2020
  • The efficacy and side effects associated with anticancer drugs have attracted an extensive research focus. Onconephrology is an evolving field of nephrology that deals with the study of kidney diseases in cancer patients. Most renal diseases in cancer patients are unique, and management of renal disease can be challenging especially in the presence of continuing use of the nephrotoxic drugs. Cisplatin is one of the most important chemotherapeutic agents used in the treatment of various malignancies, such as head, neck, ovarian, and cervical cancers. The major limitation in the clinical use of cisplatin is its tendency to induce adverse effects, such as nephrotoxicity. Recently, plant-derived phytochemicals have emerged as novel agents providing protection against cisplatin-induced renal cytotoxicity. Owing to the diversity of phytochemicals, they cover a wide spectrum of therapeutic indications in cancer and inflammation and have been a productive source of lead compounds for the development of novel medications. Of these agents, the effectiveness of triterpenoids, isolated from various medicinal plants, against cisplatin-induced renal cytotoxicity has been reported most frequently compared to other phytochemicals. Triterpenes are one of the most numerous and diverse groups of plant natural products. Triterpenes ameliorate cisplatin-induced renal damage through multiple pathways by inhibiting reactive oxygen species, inflammation, down-regulation of the MAPK, apoptosis, and NF-κB signaling pathways and upregulation of Nrf2-mediated antioxidant defense mechanisms. Here, we reviewed recent findings on the natural compounds with protective potential in cisplatin-induced renal cytotoxicity, provided an overview of the protective effects and mechanisms that have been identified to date, and discussed strategies to reduce renal cytotoxicity induced by anticancer drugs.

Effect of Pollen Load on Chloroform-induced Hepatic and Renal Damage in Rats -Concerning Pathohibtological Aspects- (Chloroform에 의한 Rat 간(肝) 및 위장(胃臟) 장해(障害)에 미치는 화분립(花粉粒)의 영향(影響) -병리조직학적 소견-)

  • Kwon, Chong-Suk;Yoon, Soo-Hong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.3
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    • pp.229-234
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    • 1986
  • The present experiment was intended to determine the effect of pollen load on chloroform-induced hepatic and renal damage in albino rats. The subjects were administered with the graded concentration of chloroform and an additional amount of pollen load to some groups, and the result of which was: 1. Fatty changes and necrosis in liver and kidneys of the experimental group became more severe according to the chloroform concentration. 2. The tissue damage decreased in the pollen-treated groups. But the higher the concentration of chloroform administered with pollen is, the less the damaged tissue is rehabilitated.

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