• Title/Summary/Keyword: Renal failure, chronic

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Evaluation of Serum Symmetric Dimethylarginine Concentrations in Dogs with Chronic Mitral Valve Insufficiency

  • Kim, Nam-Kyun;Song, Joong-Hyun;Yu, Do-Hyeon;Hwang, Tae-Sung;Lee, Hee-Chun;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.313-317
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    • 2017
  • Symmetric dimethylarginine (SDMA) is a new renal biomarker for kidney function. It is almost exclusively eliminated by renal filtration. The purpose of this retrospective study was to evaluate the changes in serum ceatinine (CREA), blood urea nitrogen (BUN) and SDMA concentrations in dogs with chronic mitral valve insufficiency (CMVI), according to the severity of CMVI. The evaluation of the severity of CMVI was performed according to the American College of Veterinary Internal Medicine (ACVIM) classification of heart failure. The dogs were classified into two groups: group 1 (ACVIM B; n = 11) and group 2 (ACVIM C; n = 15). In dogs with advanced CMVI, the serum SDMA concentrations were significantly increased above the normal reference range and were independent of body weight (BW), systolic blood pressure (SBP), or sex. No dog in either group had higher serum CREA concentrations than the upper limit. The serum SDMA concentration may be a better renal marker than serum CREA concentrations for the early diagnoses of renal dysfunction in dogs with CMVI.

Case reports of amniotic membrane derived-cell treatment for feline chronic renal failure

  • Noh, Seul Ah;Kim, Taeho;Ju, Junguk
    • Journal of Animal Reproduction and Biotechnology
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    • v.36 no.2
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    • pp.116-120
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    • 2021
  • Three different cats who had chronic kidney disease (CKD) were treated for more than one month with fluid therapy in an animal clinic. Although this long-term treatment and hospitalization, there was no clinical improvement in clinical signs as well as serum biochemical indexes including blood urea nitrogen (BUN), creatinine (CREA), and phosphate (PHOS). All cases were then injected three times with allogeneic stem cells through an intravenous route for treatment on Day 0, 7, and 14 or 30. On the same day, clinical observation and blood tests for serum biochemistry were conducted together. Upon administrating stem cells to the CKD cats, clinical conditions and the indexes of BUN and CREA were clinically improved within normal ranges. Additionally, one of the cats who had the renal cysts presented clinical improvement with showing decreased cysts size than before.

Prognostic Factors of Renal Scarring on Follow-up DMSA Scan in Children with Acute Pyelonephritis

  • Lee, Juyeen;Woo, Byung Woo;Kim, Hae Sook
    • Childhood Kidney Diseases
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    • v.20 no.2
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    • pp.74-78
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    • 2016
  • Purpose: Early diagnosis and treatment of urinary tract infection have been emphasized to prevent renal scarring. If untreated, acute pyelonephritis could cause renal injury, which leads to renal scarring, hypertension, proteinuria, and chronic renal failure. The purpose of this study was to assess risk factors of renal scarring after treatment of acute pyelonephritis (APN). Methods: The medical records of 59 patients admitted at Daegu Fatima Hospital because of APN between March 2008 and April 2015 whose renal cortical defects were confirmed by using initial technetium-99m dimercaptosuccinic acid (DMSA) scans were reviewed retrospectively. We divided 59 patients into 2 groups according to the presence of renal scar and assessed risk factors of renal scar, including sex, age at diagnosis, feeding method, hydronephrosis, bacterial species, vesicoureteral reflux, and vesicoureteral reflux grade. Results: Of 59 patients (41%), 24 showed renal scar on follow-up DMSA scan. No significant differences in sex, hydronephrosis, bacterial species, and fever duration were found between the renal-scarred and non-scarred groups. As for age at diagnosis, age of >12 months had 5.8 times higher incidence rate of renal scarring. Vesicoureteral reflux (VUR) affected renal scar formation. VUR grade III or IV had 14.7 times greater influence on renal scar formation than VUR grade I or II. Conclusion: Our data suggest that the presence of VUR and its grade and age at diagnosis are risk factors of renal scar on follow-up DMSA scan after APN.

Relationship between Calcium/Inorganic Phosphorus and Parathyroid Hormone Concentrations in Dogs with Renal Failure (신부전증의 개에서 혈중 칼슘/무기인과 부갑상샘 호르몬의 관계)

  • Kang, Dong-Joon;Lee, Soo-Han;Park, Hee-Myung;Chung, Byung-Hyun
    • Journal of Veterinary Clinics
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    • v.25 no.4
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    • pp.236-240
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    • 2008
  • Parathyroid hormone (PTH) regulates calcium (Ca) and phosphate transport. Secondary hyperparathyroidism usually occur in chronic renal failure (CRF), and it is a common complication of CRF in dogs and cats. Twenty one dogs with renal failure were enrolled in this study. Plasma Ca, inorganic phosphorus (iP) and PTH concentrations were measured. Dogs were divided into two groups by the ratio of Ca to iP (Ca/iP$\leq$1; Group I, Ca/iP$\leq$1.5; Group II). The PTH level between sexes ages were not significantly different. The PTH level and Ca/iP between two groups were significantly different (p < 0.0001). In conclusion, The ratio of Ca to iP may be considered as useful surrogator to predict PTH level of dogs with renal failure.

Hypokalemic Muscular Paralysis Causing Acute Respiratory Failure in a Chronic Glue Sniffer (만성 본드 흡입 환자에게 발생한 호흡부전 1례)

  • Choi, Yoon-Hee;Lee, Dong-Hoon;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.63-66
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    • 2005
  • Toluene is an aromatic hydrocarbon found in glues, cements, and solvents. It is known to be toxic to the nervous system, hematopoietic system, and causes acid-base and electrolyte disorders. Acute respiratory failure with hypokalemia and rhabdomyolysis with acute renal failure should be considered as potential events in protracted glue sniffing. We reported the case of 26-year-old woman was admitted to the emergency department with the development of respiratory failure and altered mentality due to hypokalemia after chronic glue sniffing. She was weaned from the ventilator 3 days later after potassium and sodium bicarbonate replacement and was discharged without respiratory symptoms and other complications.

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Prognostic Factors and Clinical Outcomes of Acute Intracerebral Hemorrhage in Patients with Chronic Kidney Disease

  • Kim, Jin Kyu;Shin, Jun Jae;Park, Sang Keun;Hwang, Yong Soon;Kim, Tae Hong;Shin, Hyung Shik
    • Journal of Korean Neurosurgical Society
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    • v.54 no.4
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    • pp.296-301
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    • 2013
  • Objective : We conducted a retrospective study examining the outcomes of intracerebral hemorrhage (ICH) in patients with chronic kidney disease (CKD) to identify parameters associated with prognosis. Methods : From January 2001 to June 2008, we treated 32 ICH patients (21 men, 11 women; mean age, 62 years) with CKD. We surveyed patients age, sex, underlying disease, neurological status using Glasgow Coma Scale (GCS), ICH volume, hematoma location, accompanying intraventricular hemorrhage, anti-platelet agents, initial and 3rd day systolic blood pressure (SBP), clinical outcome using the modified Rankin Scale (mRS) and complications. The severity of renal functions was categorized using a modified glomerular filtration rate (mGFR). Multifactorial effects were identified by regression analysis. Results : The mean GCS score on admission was $9.4{\pm}4.4$ and the mean mRS was $4.3{\pm}1.8$. The overall clinical outcomes showed a significant relationship on initial neurological status, hematoma volume, and mGFR. Also, the outcomes of patients with a severe renal dysfunction were significantly different from those with mild/moderate renal dysfunction (p<0.05). Particularly, initial hematoma volume and sBP on the 3rd day after ICH onset were related with mortality (p<0.05). However, the other factors showed no correlation with clinical outcome. Conclusion : Neurological outcome was based on initial neurological status, renal function and the volume of the hematoma. In addition, hematoma volume and uncontrolled blood pressure were significantly related to mortality. Hence, the severity of renal function, initial neurological status, hematoma volume, and uncontrolled blood pressure emerged as significant prognostic factors in ICH patients with CKD.

Initial Diagnosis of Acute Renal Failure Induced by Ischemia in Miniature Pig (미니돼지에서 허혈성 신장 손상의 조기진단)

  • Kim, Se-Eun;Ko, A-Ra;Bae, Chun-Sik;Park, Soo-Hyun;Han, Ho-Jae;Shim, Kyung-Mi;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.52-56
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    • 2011
  • Acute renal injury induced by ischemia is a major cause of high morbidity and mortality in hospitalized patients and a common complication in hospitalized patients. Thus, the work with acute renal failure and renal ischemia has been studied for many years. Although serum creatinine concentration that is widely used as an index of renal function performs fairly well for estimating kidney function in patients with stable chronic kidney disease, it performs poorly in the setting of acute disease. Thus, an ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury in hospitalized patients, acute tubular necrosis, early and accurately, and may aid to risk-stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay and mortality. In this study, renal ischemia and reperfusion were performed by clapming and un-clamping right renal artery in miniature pigs. Plasma blood urea nitrogen (BUN) and creatinine were examined at pre- clamping, after-clamping at 0, 1 and 3 hours. And we searched initial indicators in these samples. Also, renal tissue was collected and searched the initial indicator by PCR and western blotting. As a result, hypoxia inducible factor $1{\alpha}$ ($HIF1{\alpha}$), nuclear factor kappa-B ($NF{\kappa}B$), $I{\kappa}B$, erythropoietin (EPO), erythropoietin receptor (EPOR), angiopoietin-1 and vascular endothelial growth factor (VEGF) were showed significant changes among the renal protein. $HIF1{\alpha}$, EPO, and EPOR were showed significant changes among the renal gene. Thus, these markers will be used as initial diagnosis of acute renal failure.

The Influences of Maintenance Hemodialysis on Sleep Architecture and Sleep Apnea in the Patients with Chronic Renal Failure (만성신부전 환자에서 혈액투석 유지요법이 수면구조 및 수면 무호흡에 미치는 영향)

  • Park, Yong-Geun;Lee, Sang-Haak;Choi, Young-Mee;Ahn, Seok-Joo;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.824-835
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    • 1999
  • Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

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Anesthetic Management of the Oral and Maxillofacial Surgery in a Patient with End-Stage Renal Disease -A case report - (말기신부전 환자의 구강외과 수술 마취관리 -증례보고-)

  • Park, Chang-Joo;Park, Jong-Chul;Kang, Young-Ho;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin;Kim, Hyun-Jeong;Yum, Kwang-Won
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.3 no.2 s.5
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    • pp.98-102
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    • 2003
  • Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically iii and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

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A Study on the Relationship of Perceived Social Support on Self-esteem and Hopelessness in Patients with Chronic Renal Failur (만성 신부전 환자가 지각한 사회적지지, 자아존중감 및 절망감의 관계 연구)

  • 최연희
    • Journal of Korean Academy of Nursing
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    • v.25 no.3
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    • pp.549-561
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    • 1995
  • This study was designed to identify the relation-ship of perceived social support on self-esteem and hopelessness in patients with chronic renal failure who are hemodialysis. The subjects of this study were the 50 patients who were registered in the hemodialysis department of the two hospitals. The data were collected using a questionnaire and The period of the data collection was from August 9 to 16, 1993. The instruments for this study were the perceived social support scale designed by Park Ji-Won, the self -esteem scale designed by Rosenberg and the hopelessness scale designed by Beck et al. The data were analyzed using frequencies, percentages, t-test, ANOVA, and .Pearson correlation coefficient. The results are summarized as follows ; 1. The degree of support according to the type of perceived social support ranged down in the fol-lowing order from high to low the mean emotion-al support 21.12, the mean informational support 19.58, the mean appraisal support 17.00, the mean material support 15.22, the man self-esteem was 32.00 and the mean hopelessness was 60.48. 2. Test for hypothesis ; Hypothesis 1, "The higher the level of perceived social support in patients on hemodialysis, the higher their level of self-esteem will be. " was not supported(r=.05, p=0.74). Hypothesis 2, "The higher the level of perceived social support in patients on hemodialysis, the lower their level of hopelessness will be. " was supported(r=-0.53, p=0.00). 3. The relations between general characteristics and the level of perceived social support, self-esteem, and hopelessness ; (1) The 'Gender'(P=0.04), 'Occupation'(P=0.04), 'Education'(P=0.00), 'Married state'(P=0.00) 'Duration of Hemodialysis'(P=0.00) and 'In-come'(P=0.00) of the subjects were related to perceived social support and showed a statistically significant difference. (2) No general characteristics of the subjects were related self-esteem in a statistically significant way. (3) The 'Education'(P=0.00) , 'Income'(P=0.00) of the subjects were related to hopelessness and showed a statistically significant difference. Thus, it is concluded that social support must be included in nursing interventions for patients with chronic renal failure on hemodialysis.

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