• Childhood Kidney Diseases
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• 제11권1호
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• pp.100-105
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• 2007

Cockayne 증후군은 지능저하와 발육부전을 특징으로 하며 피부의 광과민성, 색소성의 망막증, 백내장, 신경전도성 귀머거리 외에 다기관 이상을 동반하는 드문 질환이다. 신장학적 이상 소견 또한 드물지 않게 동반되는 합병증 중 하나이며 병리학적으로 사구체의 유리질화, 세뇨관의 위축 및 간질 내 섬유화가 관찰될 수 있다. 저자들은 7세된 남아에서 Cockayne 증후군의 특징적인 외모와 임상양상을 확인하고 동반된 국소 분절성 사구체 경화증을 진단하였기에 문헌 고찰과 함께 보고하는 바이다.

• Childhood Kidney Diseases
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• 제22권2호
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• pp.37-41
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• 2018

Purpose: Familial renal glucosuria (FRG, OMIM #233100) is a rare but relatively benign genetic condition characterized by persistent isolated glucosuria with a normal blood glucose level. We report three additional SLC5A2 mutations and examine their phenotypic and genetic characteristics in a Korean FRG cohort. We also reviewed the literature and summarized the genotypes of all Korean patients with FRG. Methods: A genetic analysis was conducted by directly sequencing all 14 exons of the SLC5A2 gene and their flanking regions in six unrelated Korean children with FRG and their family members. Novel non-synonymous single-nucleotide polymorphisms were identified and compared with known mutations that are repeatedly detected in the Korean population. Results: We found two novel mutations [c.274G>A (G92S) and c.1168C>T (L390F)] and one known [c.1382G>A (S461N)] mutation in each family and one recurrent mutation [c.1346G>A (G449D) (rs768392222)] in two pedigrees. The recurrent G449D was predicted to be "possibly damaging," with a score of 0.883 in Polyphen-2, while G92S, L390F, and S461N were predicted to be "probably damaging," with scores of 1.000, 0.999, and 0.996, respectively. Conclusions: Two novel, one previously reported, and one recurrent mutation were identified in six Korean FRG pedigrees as causative mutations of renal glucosuria. Sequence variations in the SLC5A2 gene were frequently detected in children with persistent isolated glucosuria. A long-term follow-up of this FRG cohort is needed to understand how these specific SGLT2 mutations impair kidney function and energy homeostasis.

• Childhood Kidney Diseases
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• 제12권2호
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• pp.221-226
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• 2008

PNH는 혈관내 용혈, 야간 혈색소뇨, 혈전증, 골수부전을 특징으로 하는 후천적 질환이며 소아에서는 매우 드물게 발생한다. 급성 신부전은 PNH의 합병증으로 알려져 있지만 우리나라 소아에서의 보고는 아직 없었다. 저자들은 소아에서 PNH로 인한 급성 신부전을 경험하였기에 이를 보고하며 용혈을 동반한 소아의 급성 신부전의 감별 진단에서 PNH가 포함되어야 한다고 생각한다.

• Childhood Kidney Diseases
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• 제17권2호
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• pp.132-136
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• 2013

Parainfluenza virus 감염은 횡문근융해증의 하나의 원인이 될 수 있다. 횡문근융해증은 지속된 금식기간동안 미토콘드리아 지방산 ${\beta}$-oxidation 장애에 의해 악화될 수 있다. 또한 후기 발생 isovaleric 산증을 가진 환아들에게서 고암모니아혈증이 이화작용을 일으키는 상태 후 발생할 수 있다. 본 케이스는 parainfluenza virus 감염과 후기 발생 isovaleric 산증을 가진 4세 남아가 혼수, 경련 및 심호흡 부전으로 빠르게 진행했던 경우이다. 초기 암모니아와 creatinine kinase는 각각 $385{\mu}Mol/L$과 23,707 IU/L 이었으나 지속적 신대체요법 시행 후 암모니아와 creatinine kinase 수치는 정상으로 돌아왔다. 그러므로 생명을 위협하는 횡문근융해증과 고암모니아혈증을 가진 환아들의 치료에 있어서 즉각적인 지속적 신대체요법의 사용을 권하는 바이다.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.105-110
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• 2019

Purpose: We sought to determine associations of urinary neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP), known markers of renal injury, with hematuria in children and adolescents. Methods: A total of 112 urine samples from 72 patients aged 2 to 18 years with hematuria were enrolled in this study. Urinary concentrations of NGAL and L-FABP were measured by ELISA and compared between subjects with and without proteinuria and between subjects with and without glomerulonephritis diagnosed by renal biopsy. Results: Urinary concentrations of NGAL and L-FABP/creatinine (Cr) in subjects with proteinuria were not significantly different from those in subjects without proteinuria. They were not significant different between subjects with and without glomerulonephritis either. However, both concentrations of urinary NGAL and L-FABP/Cr were positively associated with urinary protein to creatinine ratio. Their levels had a tendency to be increased when proteinuria developed at later visits in subjects with hematuria only at initial visits. Conclusion: Monitoring urinary NGAL and L-FABP levels in addition to conventional risk factors such as proteinuria and serum creatinine might improve the prediction of renal injury in pediatric patients with hematuria.

• Pediatric Infection and Vaccine
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• 제26권1호
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• pp.71-79
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• 2019

8세 남아가 호흡곤란과 기면증을 보이며 응급실에 내원하였다. 극도의 호흡부전을 보이고 있었고 고유량의 산소 공급을 함에도 불구하고 88-90%로 밖에 유지되지 않았고 단순 흉부 방사선 검사에서 전 폐야에 불투과도가 증가하였고 중등도의 흉수를 보였다. 마이코플라스마 폐렴 진단 하에 정맥 macrolide 를 포함한 항생제 치료를 시작하였으나 2병일 째 간, 신장에 다기관 부전 및 급성 호흡부전 증상을 보였다. 정맥-정맥 체외순환막성산소화기를 삽입하였고 지속적 신대체요법도 병행하였다. 18병일 째 성공적으로 체외순환막성산소화기에서 이탈하였고 저산소성 뇌 손상 없이 성공적으로 치료되었기에 본 사례를 보고한다.

• Childhood Kidney Diseases
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• 제25권1호
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• pp.29-34
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• 2021

C3 glomerulonephritis (C3GN), a rare condition associated with dysregulation of the alternative pathway of the complement system, is histopathologically characterized by isolated or dominant C3 deposition in the renal glomeruli. We report a case of C3GN associated with anti-complement factor H (CFH) autoantibodies and CHF-related protein deficiency in an adolescent male. A 16-year-old adolescent male was admitted to a hospital with a 1-month history of generalized edema prior to presentation. Persistent microscopic hematuria and low serum C3 levels were incidentally detected at 7 and 10 years of age, respectively. Laboratory test results revealed hypoalbuminemia, nephrotic-range proteinuria, microscopic hematuria, and normal serum creatinine levels. The serum C3 and C4 levels were 17 mg/dL (normal 80-150 mg/dL) and 22 mg/mL (17-40 mg/mL), respectively. Renal biopsy showed typical features of C3GN. Further investigations revealed positive results on plasma anti-CFH autoantibody testing and a homozygous deletion of CFHR1 and CFHR3, which encode CFH-related proteins 1 and 3, respectively. Proteinuria persisted despite treatment with intravenous methylprednisolone, mycophenolate mofetil, and angiotensin-receptor blocker; however, his renal function remained stable. In conclusion, anti-CFH autoantibodies serve as important contributors to C3GN. This is the first case report that describes C3GN in an adolescent Korean male with anti-CFH autoantibodies and homozygous CFHR1 and CFHR3 deletion.

• Journal of Ginseng Research
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• 제47권3호
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• pp.400-407
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• 2023

Background: Rb3 is a ginsenoside with anti-inflammatory properties in many cell types and has been reported to attenuate inflammation-related metabolic diseases such as insulin resistance, nonalcoholic fatty liver disease, and cardiovascular disease. However, the effect of Rb3 on podocyte apoptosis under hyperlipidemic conditions, which contributes to the development of obesity-mediated renal disease, remains unclear. In the current study, we aimed to investigate the effect of Rb3 on podocyte apoptosis in the presence of palmitate and explore its underlying molecular mechanisms. Methods: Human podocytes (CIHP-1 cells) were exposed to Rb3 in the presence of palmitate as a model of hyperlipidemia. Cell viability was assessed by MTT assay. The effects of Rb3 on the expression of various proteins were analyzed by Western blotting. Apoptosis levels were determined by MTT assay, caspase 3 activity assay, and cleaved caspase 3 expression. Results: We found that Rb3 treatment alleviated the impairment of cell viability and increased caspase 3 activity as well as inflammatory markers in palmitate-treated podocytes. Treatment with Rb3 dosedependently increased PPARδ and SIRT6 expression. Knockdown of PPARδ or SIRT6 reduced the effects of Rb3 on apoptosis as well as inflammation and oxidative stress in cultured podocytes. Conclusions: The current results suggest that Rb3 alleviates inflammation and oxidative stress via PPARδ-or SIRT6-mediated signaling, thereby attenuating apoptosis in podocytes in the presence of palmitate. The present study provides Rb3 as an effective strategy for treating obesity-mediated renal injury.

• Childhood Kidney Diseases
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• 제3권2호
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• pp.109-116
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• 1999

목적 : Insuln-like growth factor(IGF)-I및 -II는 성장인자로 일군의 IGF-binding protein(IGFBP)에 의하여 그 작용이 조절된다. IGF-I은 백서 신장에서 발견되고 대사효과와 성장효과를 갖고 있다. 이번 연구는 백서에서 신장발육과 허혈성 신손상 후 재생과정 동안에 IGFBP의 발현이 변화하는지를 보고자 한다. 방법 : 태생 15주부터 성숙 할때까지 백서 신장에서 IGFBP 발현의 변화를 알아보기 위해 Northern blotting을 시행하였고, 급성신부전 백서의 신장에서 IGF-IGBP axis의 변화를 보기 위해 Northern blotting과 Immunohisto-chemistry를 이용하였다. 결과 : IGFBP-1과 -3는 태생기에는 거의 발현되지 않다가 출생 후 7일째부터 성숙이 끝날 때까지 점진적으로 증가하였다. 반면에 IGFBP-2와 -5는 태생기에 많이 발현되고, IGFBP-2는 출생 후 7일째까지 IGFBP-5는 30일째까지 높은 농도를 유지하다가 급격히 감소하였다. 한편 IGFBP-4는 태생기에 중등도로 발현되는데 출생 후 증가하기 시작하여 7일째 가장 많이 발현되다가 급격히 감소하였다. 신손상 후 IGFBP의 변화를 보면 IGFBP-1과 -4는 재생기간 동안 3-5배 증가되다가 정상으로 회복된 반면 IGFBP-3와 IGFBP Related Protein-1(IGFBPrP-1) 은 신손상 1일째에는 약간 감소하다가 그후 증가하여 정상보다 약간 높은 수준을 유지하였다. 결론 : 백서 신장에서 신장구조나 기능의 발달, 분화 및 재생에 대한 IGF의 작용을 조절할 수 있는 IGFBP 발현에 현저한 변화가 있었다.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.98-104
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• 2015

Objective: To find out clinical features and long-term outcomes of idiopathic childhood nephrotic syndrome(NS) patients with late steroid resistance(LSR)/late steroid sensitiveness(LSS). Patients and Methods: A retrospective chart review was performed on 480 patients diagnosed with idiopathic childhood NS at Asan Medical Center Children's Hospital from 1990 to 2013. Twenty-four patients whose responsiveness to steroids changed over a minimum 2 year follow-up period (2-17.5 years) were investigated. All patients had undergone a renal biopsy. Results: Among 480 nephrotic children, 428 (89%) were sensitive to the first steroid course. Of those who initially responded, 11 (2.5%) developed resistance to steroid therapy after relapses. LSR mostly developed between 1 month and 1 year after the initial episode. Six patients showed a minimal change and five showed focal segmental glomerulosclerosis (FSGS). Nine (82%) responded to cyclosporine or methylprednisolone pulse therapy. Of these, two had no further relapse, whereas the other seven experienced several relapses that ranged in length from 1.1 to 13.9 years. Three of the nine who initially responded to immunosuppression went on to experience several changes in steroid responsiveness. Two (18%) with resistance to immunosuppressants, including steroids, eventually progressed to end stage renal disease. Among the 52 patients (11%) who were initially steroid resistant, 13 (23%) were converted to steroid sensitive at relapses. Among these, 9 showed minimal change and 4 showed FSGS. Two had no further relapse and the other 11 responded to steroids on subsequent relapses ranging in length from 1.3 to 9.4 years. All these patients have had no further changes in steroid responsiveness with normal renal function. Conclusions: In this study, 2.5% of initial steroid responders and 25% of initial steroid non-responders changed their responsiveness to steroids at subsequent relapses. Eighteen percent of LSR patients developed end stage renal disease. All of the LSS patients showed preserved normal renal function. Responsiveness to immunosuppressants seemed to be the most important factor determining longterm outcomes in LSR/LSS patients.