• Childhood Kidney Diseases
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• 제21권1호
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• pp.8-14
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• 2017

Purpose: To classify the results of renal biopsy in pediatric patients and to compare pathological findings with clinical features. Methods: This study included data of 318 children who underwent renal biopsy at our hospital between December 1987 and November 2014. Biopsy specimens were examined histopathologically using light, immunofluorescence, and electron microscopy. Results: Asymptomatic urinary abnormalities was the most common clinical diagnosis (35.9%), followed by nephrotic syndrome (29.3%), and acute glomerulonephritis (18.0%). Glomerular disease was identified in 98.1% of the renal biopsy specimens. The most common primary cause of glomerulonephritis was IgA nephropathy, with gross hematuria in 61.9% of the patients, hypertension in 14.2%, proteinuria >1.0 gm/24-hr in 33.3%, and impaired renal function in 3.6% patients. Conclusion: The most common clinical diagnosis was asymptomatic urinary abnormalities, with primary glomerular disease being the most common renal biopsy finding, and IgA nephropathy the most common histopathological lesion. This study provides a 27-year overview of pediatric renal disease at our center and underlines the importance of renal biopsy for accurate diagnosis and proper management.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.125-130
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• 2015

Introduction: This study investigated whether renal and bladder ultrasonography (RBUS) findings performed in children with the first incidence of febrile urinary tract infection (UTI) can predict UTI recurrence, high-grade vesicoureteral reflux (high-grade VUR), or acquired renal scarring (aRS). Methods: In all, 917 children who were admitted to our hospital from January 2001 to October 2010, owing to the first incidence of febrile UTI were enrolled in this study. All children underwent RBUS during admission. The mean follow-up was 7.9 months (standard deviation $[SD]{\pm}13.3$). UTI recurrence rates were calculated according to various clinical parameters. By using bivariate and multiple logistic regression analyses, we determined whether age, sex, abnormal RBUS findings, abnormal dimercaptosuccinic acid renal scan findings, or RBUS findings parameters were predictive of UTI recurrence, high-grade VUR, or aRS. Results: On RBUS, hydronephrosis and congenital anomaly of the kidney and urinary tract significantly predicted UTI recurrence. A small kidney, hydroureter, hydronephrosis, cortical thinning, and increased parenchymal echogenicity significantly predicted high-grade VUR. However, their odds ratios (OR) are low compared to normal RBUS findings (recurrent UTI: OR 0.432 and 0.354 vs. 0.934, respectively, high-grade VUR: .019, 0.329, 0.126, 0.058, and 0.188 vs. 2.082, respectively). No RBUS findings significantly predicted aRS. Recurrent UTI, high-grade VUR, and abnormal RBUS findings significantly predicted aRS (OR of 4.80, 4.61, and 2.58, respectively). Conclusion: RBUS is necessary to exclude severe congenital renal scarring, obstructive uropathy, and renal abscess at the first incidence of febrile UTI and is helpful in determining the need for subsequent clinical imaging.

• Childhood Kidney Diseases
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• 제15권2호
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• pp.179-183
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• 2011

영아때 방광요관역류 환아로 진단된 남아중 2세가 넘어 후천적으로 신반흔이 급격히 악화되는 경우는 드물다. 본 증례는 생후 4개월 때 첫 열성 요로감염으로 입원하여, 왼쪽 5등급 방광요관역류로 진단되었고, 부모가 수술을 원치 않아 2년간 예방적 항생제 요법만 시행받았다. 생후 29개월 때 열성 요로감염이 한 차례 재발하였고, 이후 3년간 추적관찰되지 않았다. 이 후, 5세 때 본원을 방문하여 신장초음파, DMSA 신스캔, 배뇨성 방광요도조영술을 재시행받았다. 추적 DMSA 신스캔에서 왼쪽 신상대섭취율이 생후 2세경 38%였으나, 8%까지 떨어졌으며, 왼쪽 방광요관역류는 4등급으로 남아있었다. 현재 방광요관역류의 수술적 요법이 신기능의 예후와 관련이 없다고 알려져 있으나, 이런 증례를 볼 때, 아직은 신반흔을 동반한 고등급의 방광요관역류 환자들에게 수술적 요법을 권유하는 것이 임상의들에겐 타당하다고 볼 수 있으며, 어떤 치료요법이 선택되어지든 상관없이 첫 요로감염 이후 환자를 장기적인 추적 관찰하는 것이 중요하다고 사려된다.

• Childhood Kidney Diseases
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• 제24권2호
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• pp.63-68
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• 2020

Despite the many advantages of peritoneal dialysis (PD) in children with end-stage renal disease, there exist redoubtable complications of PD that should be overcome. To prevent and manage these complications, a multidisciplinary team should provide support highly tailored for each child and family, based on the standardized practice guidelines for the management of pediatric PD. In this review, we summarize the clinical manifestations and management of several complications of PD.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.189-194
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• 1997

Oligomeganephronia is a rare congenital form of bilateral renal hypoplasia histologically characterized by reduction in number and hypertrophy of nephrons. Clinically, this condition is presented in early infancy with vomiting, polyuria, polydipsia and dehydration. The problems are readily corrected, but slowly progressive renal failure follows accompanied by failure to thrive, short stature, and renal osteodystrophy. We experienced three cases of oligomeganephronia. Case 1. : A 3 2/12 years old female child was incidentally diagnosed as renal failure at age of 2 months when she was hospitalized due to pneumonia. She had open renal biopsy and was diagnosed as bilateral dysplastic kidney. On OPD follow-up, she progressed to end-stage renal failure (BUN/Cr 114/4.6 mg/dl) and had renal transplantation. The specimen was shrunk remarkably and light microscopy showed oligomeganephronia. Case 2. : A 14 8/12 years old female child with proteinuria was detected in an annual urine screening program for school children, she was diagnosed as renal failure (BUN/Cr 33.9/4.1 mg/dl), and had $5{\times}4{\times}3\;cm$ sized mass on abdominal CT scan. She had renal biopsy, and the specimen showed oligomeganephronia. She had hemodialysis for six months, and renal transplantation along with bilateral nephrectomy was performed. Case 3. : A 14 8/12 years old male child was diagnosed having chronic nephritis and chronic renal failure at 3 years old, progressed to end-stage renal failure (BUN/Cr 87/9.6 mg/dl) on OPD follow-up, and had a rephrectomy and renal transplantation. The biopsy specimen showed oligomeganephronic hypoplasia, secondary focal segmental glomerolosclerosis, and chronic interstitial nephritis. We report 3 cases of oligomeganephronia that progressed to end-stage renal failure and had successful renal transplantation with a brief review of related literatures.

• Childhood Kidney Diseases
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• 제17권2호
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• pp.86-91
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• 2013

목적: 본 연구는 가와사키 질환의 신장 침범에 대하여 비교적 덜 침습적이며, 특이도와 민감도가 높은 검사인 Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT)을 통하여 밝혀보고자 한다. 방법: 2011년 3월부터 10월까지 국민건강보험 일산병원에서 가와사키로 진단된 15명의 환아들을 대상으로 진행하였다. 15명의 환아 모두 가와사키의 급성기에 DMSA renal SPECT를 시행하였다. 또한 신장 세뇨관 손상 지표인 요중 ${\beta}2$-microglobulin (${\beta}2$-MG)을 측정하여 이를 통한 가와사키 환아에서 신장 손상의 조기 진단 가능 여부를 연구해보았다. 결과: 환아 15명 모두의 신기능 검사는 정상이었다. 소변 검사상 현미경적 혈뇨와 농뇨가 각각 13%, 33%에서 관찰되었다. 요중 ${\beta}2$-MG는 46%에서 증가된 소견을 보였다. 또한 환아들을 요중 ${\beta}2$MG를 기준으로 증가되어 있는 군과 증가되지 않은 군으로 나누어 비교, 분석해 보았으며, 두군간에 임상 증상, 임상 검사, 초음파 검사 및 심초음파 검사에서 유의한 차이를 보이지 않았다. 모든 환아에서 DMSA renal SPECT는 정상 소견을 보였다. 결론: 본 연구에서 가와사키 질환의 신장 침범은 경한 소변 검사 이상 및 일부 환아에서의 요중 ${\beta}2$-MG의 상승 소견을 보였으며, DMSA renal SPECT에서 관찰될 정도의 신장 침범은 보이지 않았다.

• Childhood Kidney Diseases
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• 제27권1호
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• pp.54-54
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• 2023

• Childhood Kidney Diseases
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• 제8권2호
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• pp.244-249
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• 2004

비만성 사구체경화증(obesity-associated focal segmental glomerulosclerosis)은 비만과 부종이 없는 신증후군 범위의 단백뇨, 사구체 비대 및 경화 등의 임상상을 보이는 질환으로, 다수의 환자에서 신부전으로 진행되는 것으로 알려져 있다. 연구자들은 부종 없이 심한 단백뇨와 저알부민혈증을 보인 14세의 Prader-Willi 증후군 여아에서 신생검을 통하여 사구체비후와 메산지움 증식이 동반된 국소성 분절성 사구체경화 소견을 관찰하였다 이로써 소아의 Prader-Willi 증후군에서도 비만성 사구체경화증에 의한 신부전으로의 진행 위험이 있음을 알리는 바이다.

• 대한의생명과학회지
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• 제9권4호
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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.

• Childhood Kidney Diseases
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• 제13권2호
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• pp.256-260
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• 2009

Russell-Silver 증후군은 자궁내 성장 지연, 특징적인 얼굴 기형, 저신장을 특징으로 하는 질환이다. Russell-Silver 증후군에서 동반되는 신질환은 말굽 신장, 신세뇨관 산증, 물콩팥증, 요관 깔때기막힘, 방광 요관 역류 등이 있다. 저자들은 Russell-Silver 증후군 환자에서 말기 신부전이 발생한 예를 경험하였으며 문헌 고찰에서 유사한 증례를 찾을 수 없었기에 보고하는 바이다.