• Title/Summary/Keyword: Renal excretion

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NAG Activity and Urinary Excretion of Hippuric Acid Among Workers Exposed to Aromatic Organic Solvents (방향족 유기용제 폭로근로자들의 요중 N-Acetyl-β-Glucosaminidase Activity와 마뇨산농도)

  • Kim, Jung Chul;Kim, Kwang Jong;Lee, Kwang Mook
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.3 no.2
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    • pp.166-176
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    • 1993
  • In order to investingate the renal dysfunction in workers exposed to aromatic organic solvents, 105 male exposed workers and 109 controls were participated in this study. This study was conducted to examine the correlation among the concentration of aromatic organic solvents in air, worker's urinary NAG activity and urinary hippuric acid. The results were as follows : 1. The exposure level of aromatic organic solvent mixture caculated by the equation proposed by ACGIH was ranged from 0.27 to 0.54 and toluene concentration was ranged from 18.3ppm to 48.3ppm. 2. NAG activity in the urine of control and exposed group were $36.1{\pm}14.2nmolMU/mg$ creatinine and $52.4{\pm}26.1nmolMU/mg$ creatinine, respectively. Hippuric acid concentration in the urine of control and exposed group were $191.1{\pm}194.2mg/g$ creatinine and $789.3{\pm}784.1mg/g$ creatinine, respectively. 3. Correlation coefficent between the exposure level of aromatic organic solvent mixture was significantly related to urinary NAG activity(r=0.542) and urinary hippuric acid(r=0.752). 4. Correlation coefficient between NAG activity and hippuric acid concentration was 0.357. This study suggested that urinary NAG activity was a good renal function index for aromatic organic solvents exposure and urinary hippuric acid was an index for the biological monitoring of toluene exposure.

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Effect of Ethacrynic Acid on Renal Tubular Secretion of PAH in Anesthetized Cat (고양이의 신장에서 Ethacrynic Acid가 PAH 분비에 미치는 영향)

  • Kim, Y.K.;Jung, J.S.;Kim, J.H.;Suh, D.J.;Lee, S.H.
    • The Korean Journal of Physiology
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    • v.16 no.2
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    • pp.177-186
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    • 1982
  • The effect of ethacrynic acid (EA) on the renal secretion of PAH was examined in cat kidney. $C_{PAH}$ and $T_{PAH}$ were measured before and after infusion of EA $(0.5{\sim}50mg/kg)$ through the femoral vein. The following results were obtained: 1) In the dosage range of 0.5 to 25 mg/kg, EA increased the urine flow, and sodium and potassium excretion in dose-dependent manner, but the glomelular filtration rate was decreased as the dosage of EA was increased. 2) $C_{PAH}$ and $T_{PAH}$ were decreased by EA in the dosage range of 3 to 25 mg/kg and 1 to 50 mg/kg, respectively, in dose·dependent manner with the dosage to cause 50% inhibition of about 5 mg/kg. 3) With dosage of 0.5mg/kg, EA appeared to exert a great effect on diuretic response without the influence on $T_{PAH}$. At 10min after infusion of EA, a potent diuretic effect appeared, while $T_{PAH}$ did not show a significant change. These results suggest that the action mechanism of EA on tubular secretion of PAH may be different from that on natriuresis. 4) With dosage of 5 mg/kg, EA did not inhibit the Na-K-ATPase activity in microsomal fractions from both cortex and medulla. 5) The double reciprocal plot ($l/T_{PAH}$ versus $l/P_{PAH}$) suggested that EA inhibited the P AH secretion by a competitive pattern. However, probenecid, a prototypic inhibitor of the organic acid pump, had no influence on both the inhibitory effect of $T_{PAH}$ and the natriuretic effect by EA. These results suggest that in vivo EA altered tubular secretion of P AH through interactions with receptors that are not identical with the Na-K-ATPase.

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General Pharmacological Properties of the New +/K+ ATPase Inhibitor DBM-819

  • Park, Woo-Kyu;Kong, Jae-Yang;Kim, Hyun-Jung;Lee, Dong-Ha;Lim, Hong;Cheon, Hyae-Gyeong
    • Biomolecules & Therapeutics
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    • v.10 no.1
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    • pp.19-24
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    • 2002
  • The effects of a newly synthesized $H^+/K^+$ ATPase inhibitor,1-(2-methyl-4-methoxypheny)-4-[(3-hy-droxypropyl)amino] -6-methyl-2,3-dihydropyrrolo (3,2-c) quinoline (DBM-819) , on the central nervous system, isolated smooth muscle, cardiovascular and digestive systems and renal function were investigated in various experimental animals. Oral administration of DBM-819 had no effect on the central nervous system except body temperature of mice slightly decreased at doses of 15 and 50 mg/kg. DBM-819 produced a moderate analgesic effect in acetic acid-induced writhing test in mice at 50 mg/kg (p.o.). In conscious rats, DBM-819 (15 and 50 mg/kg, p.o.) showed a slight increase in blood pressure and a small decrease in heart rate. DBM-819 had an significant effect on agonist-induced contraction of guinea pig ileum at $1.5{\times}10^{-5}g/ml.$ No significant effect of DBM-819 (5 and 15 mg/kg, i.p) on urinary volume or urinary excretion of $Na^+,\;K^+$ and Cl- was observed in rats. DBM-819 had no significant effect on intestinal transport of a semisolid meal in mice at 15 and 50 mg/kg (p.o.). These findings suggest that DBM-819 exerts no significant pharmacological effects on the central nervous system and renal function at 15 mg/kg (p.o.), but produces some effects on the smooth muscle and circulatory system.

Management of a 25-day-old Male Presenting with a First Episode of Acute Pyelonephritis, and Persistent Hyperkalemia with Normal Serum Aldosterone (급성신우신염으로 입원 후 지속적인 고칼륨혈증과 정상 혈중 알도스테론 수치를 보인 25일 영아 1례)

  • Kang, Yu Sun;Choi, Ji Yeon;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.111-115
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    • 2014
  • Hyperkalemia is often detected in young infants, particularly in association with acute pyelonephritis or a urinary tract anomaly. Cases of hyperkalemia in this population may also be due to transient pseudohypoaldosteronism, or immaturity of renal tubules in handling potassium excretion. Symptoms of hyperkalemia are non-specific, but are predominantly related to skeletal or cardiac muscle dysfunction, and can be fatal. Therefore, treatment has to be initiated immediately. Administration of fludrocortisone for hyperkalemia is appropriate in cases with hypoaldosteronism, but is challenging in young infants with hyperkalemia due to renal tubular immaturity, without pseudohypoaldosteronism. We report the case of a 25-day-old male presenting with persistent hyperkalemia with normal serum aldosterone, who was admitted with a first episode of pyelonephritis and unilateral high-grade vesicoureteral reflux. The patient was treated successfully with fludrocortisone.

Microalbuminuria in children with urinary tract infection

  • Kwak, Byung-Ok;Chung, So-Chung;Kim, Kyo-Sun
    • Clinical and Experimental Pediatrics
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    • v.53 no.9
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    • pp.840-844
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    • 2010
  • Purpose: Microalbuminuria is defined as increased urinary albumin excretion (30-300 mg/day) or microalbumin/creatinine ratio (30-300 mg/g) in a spot urine sample. Although microalbuminuria is a predictor of clinical nephropathy and cardiomyopathy, few studies have investigated microalbuminuria in children with urinary tract infection (UTI). Therefore, we compared the spot urine microalbumin/creatinine ratio in pediatric UTI patients with that of control subjects. Methods: We investigated the correlation between the ratio in children with UTI and age, height, weight, blood pressure, glomerular filtration rate (GFR), hematuria, vesicoureteral reflux, renal parenchymal defect, and renal scar, and its predictability for UTI complications. Results: We studied 66 patients (42 boys, 24 girls) and 52 healthy children (24 boys, 28 girls). The mean microalbumin/creatinine ratio in UTI patients was statistically significantly increased compared to the control group ($340.04{\pm}321.36mg/g$ vs. $225.68{\pm}154.61mg/g$, $P$=0.0141). The mean value of spot urine microalbumin/creatinine ratio ($384.70{\pm}342.22mg/g$ vs. $264.92{\pm}158.13mg/g$, $P$=0.0341) in 1-23 months age patient group showed statistically significant increase compared to control group. Microalbumin/creatinine ratio showed negative correlation to age (r=-0.29, $P$=0.0167), body surface area (BSA) (r=-0.29, $P$=0.0173) and GFR (r=-0.26, $P$=0.0343). The presence of hematuria ($P$=0.0169) was found to be correlated. Conclusion: The spot urine microalbumin/creatinine ratio in children with UTI was significantly greater than that in normal children, and it was positively correlated with GFR. This ratio is a potential prescreening and prognostic marker in UTI patients. Further studies are required to validate the predictability of microalbuminuria in pediatric UTI patients.

Importance of Target Blood Pressure Management in Diabetic Kidney Disease (당뇨병성 신장질환 환자에서 적정 혈압 관리의 중요성)

  • Kim, Hee Sung
    • The Journal of the Korea Contents Association
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    • v.19 no.6
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    • pp.461-470
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    • 2019
  • In diabetes mellitus, renal disease is a common complication, characterized by increased urinary albumin excretion and reduced eGFR. According to KDIGO CKD stage classification, Korean characteristics were analyzed according to urinary albumin and eGFR using the National Health and Nutrition Examination Survey VI raw data. According to KDIGO classification, diabetic patients were classified as Low risk 72.0%, Moderate risk 19.3%, High risk 5.6% and Very high risk 3.0%. Low risk decreased from 74.7% to 52.2%, and moderate to very high risk increased from 25.4% to 47.8% as the duration of diabetes mellitus was prolonged. The risk factors were CKD stage 1 (HR 2.064) to stage 4 (HR 11.049), the highest risk of hypertension. The incidence of renal disease was elevated according to duration of hypertension and HR 0.42 of kidney disease was decreased in the group maintaining proper blood pressure. In the hypertensive patients, the group administered with target blood pressure had a reduction of the kidney disease by 42% than the group with the hypertension. Therefore, controlling and managing hypertension to target blood pressure is important for the prevention of kidney disease.

Prognostic Factors in Childhood IgA Nephropathy (소아 IgA 신병증의 예후에 관한 고찰)

  • Park Jae-Hyun;Kim Pyung-Kil;Jeong Hyeon-Joo;Choi In-Joon
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.17-23
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    • 1997
  • After the first description of IgA nephropathy by Berger in 1968, the prognosis of this disease was considered favourable. However recent studies have revealed that IgA nephropathy result in end stage renal desease in 25-30% by 20 years. Heavy proteinuria, hypertension, histological high class are regarded as poor prognostic factors. In 1996, Yagame et al reported the new histopathologic grading with a strong correlation between the grading, heavy proteinuria, high s-Cr level and renal survival. The aims of this study are to determine whether the pathological grading and other clinical parameters could contribute to predicting the outcome of this disease eventhough pediatric patients. Seventy nine patients (59 males, 20 females) with IgA nephropathy were examined. Patients were 2.08-15.17 years of age ($9.85{\pm}2.83$). The mean follow-up duration were $27{\pm}28$ months. Six of seventy nine patients progressed to chronic renal failure during the follow-up periods. High 24h urinary protein excretion at diagnosis were significantly higher in chronic renal failure patients (p<0.05). Hypertension at diagnosis were the significant associated factors in progression of chronic renal failure (p<0.05). Histological changes of IgA nephropathy in light microscopy were classified into five classes by WHO classification, four grades in Yagame's gradings. Among the seventy nine patients, 24 were as class 1, 30 as class 2, 23 as class 3; 4 as class 4, 0 as class 5 by WHO classification. 23 were classified grade 1, 31 as grade 2, 24 as grade 3, 1 as grade 4 by Yagame's grading. Among six patients who progressed to chronic renal failure, 1 clssified as class 1, 1 as class 2, 3 as class 3, 1 as class 4, 0 as class 5 by WHO Classification. 1 patients were classified as grade 1, 1 as grade 2, 3 as grade 3, 1 as grade 4 by Yagame's grading. (p>0.05) In conclusion, hypertension and heavy proteinuria at initial presentation were significantly associated with progression of chronic renal failure. The classification of WHO & Yagame's grading has no significant association with the progression of chronic renal failure in pediatric patients.

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Significance of Random Urine ${\beta}_2$-Microglobulin as a Marker for Vesico-ureteral Reflux in Children with Urinary Tract Infection (요로감염 환자에서 방광요관역류의 지표로서 무작위 추출뇨중 ${\beta}_2$-microglobulin의 의의)

  • Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.72-79
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    • 1999
  • Renal scarring associated with vesico-ureteral reflux(VUR) is one of the major causes of end stage renal failure and renal hypertension in children. Urinary ${\beta}_2$-microglobulin(MG) has been suggested as a potential marker for presence of renal tubular damage. This study was designed to evaluate the significance of random urine ${\beta}_2$-MG as a predictor of presence of vesico-ureteral reflux in children with urinary tract infection(UTI). 57 children with urinary tract infection were studied. Patients were devided into two groups; 35($78.9\%$) children have UTI without VUR and 12($21.1\%$) children have UTI and VUR. Beta2-MG and creatinine in random urine sample was measured to decide the excretion ratio(${\beta}_2$-MG/creatinine). Among the 57 children with UTI, 44 children were confirmed by urine culture study and 13 children suspected by compatible clinical feature. Random urine ${\beta}_2$-MG of VUR group ($2.2{\pm}5.91$ mg/L) were significantly higher than that of simple UTI group($0.19{\pm}0.16mg/L$)(P=0.03). The ${\beta}_2$-MG/creatinine ratio of VUR group($32.41{\pm}25.7$) were significantly higher than that of simple UTI group($3.93{\pm}3.44$)(P=0.007). In conclusion, random urine ${\beta}_2$-MG and excretion ratio deserved early predictor of presence of VUR in children with UTI. And this method was more simple and inexpensive than the method of measuring ${\beta}_2$-MG with 24 hour urine collection, so might be a useful screening test for VUR in children with UTI.

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Effects of Jinmootang on the Gentamicin-induced Nephrotoxicity in Rats (진무탕(眞武湯)이 Gentamicin-유도 신독성에 미치는 영향)

  • Lee, Kyu-Hyun;Kim, Gil-Whon
    • Journal of Oriental Physiology
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    • v.14 no.2 s.20
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    • pp.189-198
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    • 1999
  • Aminoglycosides, including gentamicin, have been used as antibiotics for the various infections by gram-negative bacteria. However, there are some restrictions for using these drugs. Gentamicin, a typical aminoglycoside, has the side effect of nephrotoxicity, including polyuria, glycosuria, proteinuria, glomerulonephritis, and uremia. The aims of this study were to examine the prevention or reduction effects of Jinmootang on the gentamicin-induced nephrotoxicity and to investigate the possible mechanisms on the effect of Jinmootang. The subcutaneous injections of 60mg of gentamicin per kg of boby weight to Sprague-Dawley rats for 8 days induced typical symptoms of nephrotoxicity by aminoglycosides. 0.6ml of water extract Jinmootang (100ml/chup) was orally treated in the experimental animal. 24-hour urine was collected with the metabolic cage and plasma was sampled from the abdominal aorta. The plasma concentration of sodium was significantly decreased by the treatment of gentamicin but it was not-significantly changed by the treatment of Jinmootang to the animal. The concentration of potassium was greatly decreased in the gentamicin-treated animals. However. it was returned to the normal level in the Jinmootang-treated animals. The concentrations of creatinine and urea were increased by gentamicin treatment. But, Jinmootang reduced these concentrations. Nevertheless, the osmolalities of plasma in both group were not different from each other. Even though the plasma concentration of aldosterone was not significantly changed, the mean value was increased by the gentamicin intoxication. The concentration of aldosterone was decreased by the treatment of Jinmootang. The reduction of aldosterone level in plasma could be a factor to improve the hypokalemia. The fractional excretion of potassium was much higher than normal by the treatment of gentamicin and it was decreased by 50% in the Jinmootang-treated rats. Therefore, the reabsorption of potassium was significantly increased by the treatment of Jinmootang, even though the filtered load of potassium in the experimental group was much highter than control. Even though the concentration of plasma aldosterone was decreased by the treatment of Jinmootang, the fractional excretion of sodium was not increased, slightly lower. These data suggested that Na reabsorption was increased in the proximal tubule by Jinmootang. The filtered load of glucose in the Jinmootang-treated group was greater than in control. Nevertheless, the fractional excretion of glucose in the experimental group was not different from that in control. These results indicate that glucose reabsorption was increase in the proximal tubule by Jinmootang treatment. The results of this study suggest that Jinmootang could improve the some nephrotoxic symptoms induced by gentramicin treatment. Hypokalemia, the reduced glomerular filtration rate, and dysfunctions of renal proximal tubule and distal nephron were significantly recovered to normal level. The increase of glomerular filtration rate by Jinmootang might contribute to eliminate the waste product, including creatinine and urea, and/or gentamicin through the kidney.

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SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE (악안면(顎顔面) 외상환자에서 나타난 항이뇨(抗利尿)호르몬 분비장애증후군(分泌障碍症候群))

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Baek-Soo;Choi, Jae-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.15 no.1
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    • pp.7-10
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    • 1993
  • The final purpose of oral & maxillofacial trauma is functional & esthetic repair. Nowadays, severe trauma involving with the head & neck trauma is increasing. After these trauma occurs, the patients develop similar signs & symptoms with the postoperative healing period, as like thurst, hypertention, excitability, disorientation, convulsion, et al. Because SIADH which is one of important complications after head trauma, shows similar clinical features after operation, we should pay attention to detect it. SIADH shows characteristic laboratory findings, as like hyponatremia, urine hyperosmolality, increased plasma ADH level, continued renal excretion of sodium, so we can easily distinguish it from postoperative conditions. This paper reports two cases, one was the case of the mandibular fracture and cerebral contusion, which included permanent SIADH. The other was the case of the multiple teeth injury and cerebral contusion, which was transient SIADH. We treated them with water restriction, hypertonic saline, and diuretics.

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