• Title/Summary/Keyword: Renal diseases

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Treatment of severe sepsis and septic shock associated with urogenital tract infection (요로감염과 관련된 중증 패혈증 및 패혈성 쇼크의 치료)

  • Hwang, Kyu Bin;Huh, Jung-Sik;Kim, Young-Joo;Park, Kyung Kgi;Kim, Sung Dae;You, Hyun Wook
    • Journal of Medicine and Life Science
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    • v.17 no.3
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    • pp.80-85
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    • 2020
  • Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.

Spontaneous Tumor Lysis Syndrome Presenting Acute Kidney Injury with Extreme Hyperuricemia and Urinary Stone: A Rare Case of Spontaneous Tumor Lysis Syndrome

  • Kim, Seong Heon;Yang, Eu Jeen;Lim, Young Tak;Kim, Su Young
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.31-34
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    • 2017
  • Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin's lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.

A Case of Primary Fanconi Syndrome (일차성 Fanconi 증후군 1례)

  • Kang Hyeon-Ho;Cha Seong-Ho;Cho Byung-Soo
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.82-85
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    • 1998
  • Fanconi syndrome is a renal disorder characterized by a generalized dysfuntion of the proximal tubule leading to excessive urinary losses of amino acids, glucose, phosphate, and bicarbonate. It is often associated with hypokalemia, hypophosphatemia, rickets, and osteomalacia. We have experienced one case of primary Fanconi syndrome. The patient was a 10 year old boy and his chief complaints were short stature, glycosuria, and genu valgum. There were aminoaciduria, hypokalemia, glycosuria, decreased TRP, and hypophosphaturia. We report a case of primary Fanconi syndrome with brief review of the literature.

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A Case of Nephrotic Syndrome in Behcet Syndrome (신 증후군을 동반한 베체트 증후군(Behcet syndrome) 1례)

  • Juhng Woo-Suk;Kim Hye-Young;Lee Dae-Yeol
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.73-76
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    • 1998
  • Behcet syndrome is a multisystem disease complex of unknown cause. It is usually manifested by aphthous oral and genital ulcers, uveitis and skin eruption. Less frequently, CNS involvement, colitis, large vessel vasculitis, and myocarditis occur. Recently, several studies have reported renal manifestations of amyloidosis and focal necrotizing glomerulonephritis in Behcet syndrome. We describe a patient with Behcet syndrome who experienced nephrotic syndrome with focal effacement of epithelial foot process in glomeruli. A brief review of literature ensues.

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Chronopharmacology in Clinical Medicine (임상에서 시간약물학)

  • Lee, Heon-Jeong;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.11 no.2
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    • pp.67-72
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    • 2004
  • Circadian rhythm is a global phenomenon, the control mechanisms of which are manifested at every level of biological organization, from genes and intracellular mechanisms to networks of cell populations, and to all central neuronal systems at the organismic level. In pharmacotherapy, the pharmacokinetic parameters such as drug absorption and distribution, drug metabolism, and renal elimination show diurnal variations. The symptoms and signs in diseases like asthma, myocardiac infarction, angina pectoris, hypertension and stroke also show diurnal fluctuations. These observations require drug treatment considering the circadian rhythm of body function and disease. Circadian time has to be taken into account as an important variable influencing a drug's pharmacokinetics and/or its effects or side effects in clinical practice.

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Mutagenic Assessment of Olmesartan Cilexetil by Bacterial Mutation Assay

  • Kim, Ji Won;Ahn, Ilyoung;Ryu, Sung Ha;Jeon, Hong Ryeol;Lee, Bong Sang;Kim, Kyu-Bong
    • Toxicological Research
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    • v.29 no.3
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    • pp.217-219
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    • 2013
  • Hypertension is a serious health problem due to high frequency and concomitant other diseases including cardiovascular and renal dysfunction. Olmesartan cilexetil is a new antihypertensive drug associated with angiotensin II receptor antagonist. This study was conducted to evaluate the mutagenicity of olmesartan cilexetil by bacterial reverse mutation test using Salmonella typhimurium (TA100, TA1535, TA98, and TA1537) and Escherichia coli (WP2 uvrA). At the concentrations of 0, 62, 185, 556, 1667, and 5000 ${\mu}g$/plate, olmesartan cilexetil was negative in both Salmonella typhimurium and Escherichia coli regardless of presence or absence of metabolic activation system (S9 mix). These results demonstrate that olmesartan cilexetil does not induce bacterial reverse mutation.

Extra-anatomic bypass for Treatment of Leg Ischemia (하지동맥폐쇄환자에서의 비해부학적 우회술의 임상적 고찰)

  • 조재호
    • Journal of Chest Surgery
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    • v.27 no.10
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    • pp.846-849
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    • 1994
  • Extra-anatomic bypass is indicated for the limb salvage of patients with threatened limb loss especially those who have high risk of infection and death after general anesthesia. We did extra-anatomic bypass procedure nineteen times over a seven year, two month period on sixteen patients. Their mean follow up period was 41.3 months. Male to female ratio was 7:1. Major complaints were resting pain[36.8%], claudication[31.6%], cyanosis[15.8%] and ulcerative change[15.8%]. Associated diseases were hypertension, tuberculosis, chronic renal failure, atrial fibrillation, complete heart block and laryngeal cancer. Postoperative patency rates were 76.9% at 1 year, 72.7% at 2 years and 70% at 3 years. Limb salvage rate was 78.9%. Postoperative mortality rate was 10.5%.

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Poststreptococcal Glomerulonephritis Mimicking Henoch-$Sch{\ddot{o}}nlein$ Purpura (신생검에서 급성 사구체신염 양상을 보인 Henoch-$Sch{\ddot{o}}nlein$ 자반증 2례)

  • Lee Sang Heun;Namgoong Mee Kyung;Cha Byung Ho;Kim Jong Soo
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.192-195
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    • 1998
  • [ $\beta$ ]-streptococci have been reported as an etiology of Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the role of $\beta$-streptococci in HSP is not yet confirmed. Our report of two HSP patients is as follows : Although the two patients' clinical symptoms resembled those symptoms of HSP, whereas serum $C_3$ decreased in one case, ASO titer increased in both cases and a histological examination of renal biopsy specimens revealed the fetures commonly described in poststreptococcal glomerulonephritis.

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A case of Crescentic Glomerulonephritis Superimposed on Membranous Glomerulonephropathy (급속진행성 사구체 신염이 동반된 막성신증 1례)

  • Kim, Baek-Nam;Yook, Jin-Won;Kim, Ji-Hong;Kim, Pyung-Kil;Jung, Hyeun-Joo
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.95-99
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    • 1999
  • Idiopathic membranous nephropathy is one of the most common causes of nephrotic syndromes in adults but rare in childhood. The occurrence of crescentic glomerulonephritis and membranous nephropathy in a patient is rare. This report describes a patient who initially was diagnosed as a membranous glomerulonephropathy at age 12 years and subsequently developed a crescentic, rapidly progressive glomerulonephritis at age 19 years. The patient responded to methylprednisolone pulse therapy and he maintained with partial remission and normal renal function with residual proteinuria.

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A Case of Rapidly Progressive Glomerulonephritis in $Henoch-Sch\"{o}nlein$ Purpura (급속 진행성 사구체신염형의 $Henoch-Sch\"{o}nlein$ 신염 1 례)

  • Chang Soo-Hee;Jo Dae-Sun;Lee Dae-Yeol
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.82-85
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    • 1997
  • The incidence of nephritis associated with Henoch-Sch nlein purpura varies, but glomerulonephritis consistently accounts for most of the associated morbidity and mortality. A very small number of Henoch-Sch nlein purpura develop rapidly progressive glomerulonephritis. A three-year old male patient who showed acute nephritic nephrotic syndrome developed abdominal pain, arthralgia and multiple purpurae on lower extremities later. Peritoneal dialysis was done at the 6th hospital day and continued for 7 months. Renal biopsy disclosed crescentic glomerulonephritis (with 81% crescent formation) and methylprednisolone pulse therapy was done. These days, his general condition is good, but serum creatinine levels are 1.2-1.3 mg/dL. This case was reviewed briefly with the literatures.

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