• The Journal of Internal Korean Medicine
• /
• v.31 no.1
• /
• pp.66-78
• /
• 2010

Objective : This study was designed to investigate the possibility of AR for chronic renal injury. Methods : The author first investigated the expression levels of DNA by inducing of chronic renal injury. Then, the author investigated the effects of AR on chronic renal injury induced by combination treatment with Adriamycin and cisplatin in terms of changes in body weights and renal tissues, urine volume, BUN and creatinine levels, creatinine clearance and histopathological changes in renal tissues. Total expression levels of 546 genes were elevated or lowered by induction of chronic renal injury. Genes of which whose expression levels were elevated by induction of chronic renal injury were related to the PPAR signaling pathway and fatty acid mechanism, etc. Genes of which expression levels were lowered by induction of chronic renal injury were related to the neuroactive ligand-receptor signaling pathway. Results : Oral administration of AR restored renal mass which was reduced by induction of chronic renal injury. AR also restored creatinine clearance and lowered serum BUN level. In histopathological observation, the AR group has a tendency to prevent tissue damages as shown in the chronic renal injury group. Conclusions : AR can be used to treat patients with chronic renal injury although further study will be needed to elucidate the exact mechanisms in the efficacy of AR on chronic renal injury.

• Journal of Trauma and Injury
• /
• v.30 no.4
• /
• pp.192-196
• /
• 2017

Purpose: Blunt injury accounts for 80-95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80-85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury. Methods: We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high-grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III-V) renal injury patients were included in the analysis. Results: During the eight-year study period, there were 62 AAST grade III-V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade. Conclusions: Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

• Advances in Traditional Medicine
• /
• v.9 no.4
• /
• pp.292-302
• /
• 2009

Ischemia/reperfusion injury, which is commonly seen in the field of renal surgery or transplantation, is a major cause of acute renal failure. Previous studies showed that antioxidant treatments attenuated renal ischemia/reperfusion injury. The objective of this study was to examine the role of hesperidin in modulating reactive oxygen species induced inflammation and apoptosis after renal ischemia/reperfusion injury. Rats were subjected to right nephrectomy, 15 days later 45 min of renal ischemia and 24 h reperfusion with or without treatment with hesperidin. Renal function, inflammation and apoptosis were compared at 24 h after reperfusion injury. Hesperidin improved the renal dysfunction and reduced inflammation and apoptosis after ischemia/reperfusion injury. In conclusion, hesperidin shows potent anti-apoptotic and antiinflammatory properties due to antioxidant property. These findings may have major implications in the treatment of human ischemic acute renal failure.

• Journal of Ginseng Research
• /
• v.21 no.1
• /
• pp.49-52
• /
• 1997

There are many mechanisms that mediate progression of renal injury, such as abnormalities of nitric oxide (NO) regulation, increased Platelet aggregatlon, and oxygen free radical injury. Ginseng has been known to have NO dependent vasorelaxant effect and antioxidant effect, also inhibit thrombin stimulated platelet aggregation. And these effects of ginseng may have some roles in prevention of renal injury. So we studied 24 patients with mild pathologic proteinuria and hypertension to evaluate the effect of ginseng on progression of renal injury. After 1 month treatment, creatinine clearance was significantly increased especially in the patient group with normal serum creatinine level without specific side effect. The result of this study suggest that ginseng may pre vent or retard the progression of renal injury especially in early stage.

• Journal of Trauma and Injury
• /
• v.23 no.1
• /
• pp.29-37
• /
• 2010

Purpose: Controversy exists regarding whether pediatric blunt abdominal trauma patients with microscopic hematuria should undergo radiographic evaluation. Adult patients have indications such as shock and deceleration injury. This study was conducted to suggest indications for the use of CT to detect significant renal injury in pediatric blunt abdominal trauma patients with microscopic hematuria. Methods: From January 2005 to December 2009, patients less than 18 years of age with blunt abdominal trauma and microscopic hematuria who had undergone CT were included in this retrospective study. We analyzed the correlation between microscopic hematuria, shock, deceleration injury, and American Association for the Surgery of Trauma (AAST) renal injury grade. Patients were divided into two groups: the insignificant renal injury group (AAST grade 1) and the significant renal injury group (AAST grades 2-5). We compared age, gender, mechanism of injury, degree of microscopic hematuria, evidence of shock, presence of deceleration injury, and associated injuries between the two groups. We analyzed the effect of each of the above each factors on renal injury by using a logistic regression analysis. Results: Forty-three children were included, and the median age was 15 years. Five children had a significant renal injury. No significant differences, except age and microscopic hematuria (more than 30 red blood cells per high power field (RBC/HPF), p = 0.005) existed between the insignificant and the significant injury groups. A positive correlation existed between renal injury and microscopic hematuria (rho = 0.406, p = 0.007), but renal injury was not correlated with shock and deceleration injury. In the multivariate regression analysis, microscopic hematuria was the only factor correlated with renal injury (p = 0.042). Conclusion: If a microscopic hematuria of more than 30 RBC/HPF exists, the use of CT should be considerd, regardless of shock and deceleration injury to detect significant renal injury in pediatric blunt abdominal trauma patients.

• Journal of Trauma and Injury
• /
• v.23 no.1
• /
• pp.16-20
• /
• 2010

Purpose: High-grade (III, IV, V) renal injury may need interventional management. We investigated whether the selective embolization of the renal artery is effective for the treatment of major renal injury in comparison with emergency renal exploration. Methods: We retrospectively reviewed the medical and radiologic records of patients who underwent surgery or embolization for renal injury (Grade III, IV, V) between January 1990 and December 2007. We analyzed the change in treatment method before and after 2000, the blood pressure, the hemoglobin at the time of visit, the hospital days and the complications in patients who received surgery or embolization. Preserved renal functions of the embolized kidneys were identified by using enhanced CT. Results: Cases of surgery and embolization were 37 and 13, respectively: 5 and 4 in renal injury grade III, 17 and 6 in grade IV and 13 and 3 in grade V. Cases of surgery and embolization were 33 and 1 before 2000 and 2 and 12 after 2000, repectively: embolizations increased after 2000. No significant differences in mean diastolic pressure, hemoglobin, hospital days and complications existed between the surgery and the embolization groups (p>0.05). However, the transfusion volume was significantly smaller in the embolization group (p<0.05). One postoperative complication occurred in the surgery group. We identified the preserved renal functions of the embolized kidney by using enhanced CT. Conclusion: Embolization could be one treatment method for high-grade renal injury. Thus, we might suggest selective embolization a useful method for preserving the renal function in cases of high-grade renal injury.

• Korean Journal of Oriental Medicine
• /
• v.7 no.1
• /
• pp.135-144
• /
• 2001

Objectives : This study was carried out to research the protective effects of Sagunja-Tang(SA) through in vivo experiments, and tried to investigate the relation between oxidation of renal tissues and deficiency of Qi. Methods : Acute renal injury which initiated from free radical induced by $HgCl_2$, were applied to mice and metabolic data were obtained. In order to measure the degree of renal injury, serum level of creatinine, blood urea nitrogen(BUN), total protein(TP) and glucose were measured. Besides, serum level of alanine aminotransferase(AST), aspartate aminotransferase(ALT) were measure too. Lipid peroxidation of renal cortex was examined by measuring malondialdehyde(MDA), a product of lipid peroxidation. Results : SA had protective effects on acute renal injury caused by decrease of glomerular filtration which was initiated by subcutaneous injection of $HgCl_2$. SA protected acute liver injury too. Conclusions : Through this study, we found that SA have healing effects on renal injury of $HgCl_2$ induced oxidative stress that is similar to deficiency of Qi. And further studies have to be followed to certify the mechanisms.

• Biomedical Science Letters
• /
• v.8 no.4
• /
• pp.251-256
• /
• 2002

This study was undertaken to determine the underlying mechanisms of reactive oxygen species-induced cell injury in renal epithelial cells and whether there is a difference in the role of lipid peroxidation between freshly isolated renal cells and cultured renal cells. Rabbit renal cortical slices were used as a model of freshly isolated cells and opossum kidney (OK) cells as a model of cultured cells. Cell injury was estimated by measuring lactate dehydrogenase (LDH) release in renal cortical slices and frypan blue exclusion in OK cells. $H_2O$$_2$ was used as a drug model of reactive oxygen species. $H_2O$$_2$ induced cell injury in a dose-dependent manner in both cell types. However, renal cortical slices were resistant to $H_2O$$_2$ approximately 50-fold than OK cells. $H_2O$$_2$-induced cell injury was prevented by thiols (glutathione and dithiothreitol) and iron chelators (deferoxamine and phenanthroline) in both cell types. $H_2O$$_2$-induced cell injury in renal cortical slices was completely prevented by antioxidants N,N-diphenyl-p -phenylenediamine and Trolox, but the cell injury was not affected by these antioxidants in OK cells. $H_2O$$_2$ increased lipid peroxidation in both cell types, which was completely inhibited by the antioxidants. These results suggest that $H_2O$$_2$ induces cell injury through a lipid peroxidation-dependent mechanism in freshly isolated renal cells, but via a mechanism independent of lipid peronidation in cultured cells.

• The Korea Journal of Herbology
• /
• v.28 no.3
• /
• pp.7-15
• /
• 2013

Objectives : Interruption and subsequent restoration of blood flow into the kidney result in renal injury. As an approach to preventing the renal injury, we determined the optimal conditions and the underlying mechanisms by which supernatant of hot water extract of ground Triticum aestivum L. (extract) attenuated ischemia/reperfusion (I/R) injury. Methods : One hour after administration of the extract (400 mg/kg) by intraperitoneal injection, renal I/R injury was generated by clamping the left renal artery in rats after surgical removal of the right kidney, followed by reperfusion. The maximal difference between the vehicle-treated and the extract-treated group under ketamine/xylazine or enflurane anesthetization was assessed at varying periods of ischemia (30-45 min) and reperfusion (3-48 hr), based on the renal function assessed with serum creatinine levels, tissue injury with hematoxylin/eosin staining, and apoptosis with terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling staining. Results : Enflurane anesthetization with 40 min of ischemia and 24 hr of reperfusion was identified to be the optimal condition, under which condition serum creatinine levels and tubular damage in the extract-treated group were significantly reduced compared with those in the vehicle-treated group ($1.3{\pm}0.2$ versus $2.7{\pm}0.3$ mg/dL, P < 0.01, and average score $1.8{\pm}0.1$ versus $3.5{\pm}0.3$, P < 0.01, respectively). These beneficial effects were mediated by inhibition of apoptotic cascades through attenuation of renal tissue malondialdehyde levels, Bax/Bcl-2 ratio and caspase-3 levels. Conclusions : The extract conferred renal protection against ischemia/reperfusion injury in rats by scavenging reactive oxygen species and consequently blocking apoptotic cascades, plausibly augmented by enflurane protection.

• Journal of Trauma and Injury
• /
• v.34 no.3
• /
• pp.198-202
• /
• 2021

Super-selective renal artery embolization is an increasingly popular technique for the management of traumatic, low-grade renal trauma. When performed in distal arterial branches, this intervention enables tissue preservation and arrest of hemorrhage, but it may not be practical in cases of multifocal, high-grade renal injuries. In such cases, surgical nephrectomy remains the more common treatment modality to ensure hemodynamic control. We present the unique case of a patient who presented in hemorrhagic shock following a major trauma that resulted in a grade 5 renal injury treated with complete renal artery embolization using Gelfoam, resulting in hemodynamic stabilization. Interestingly, imaging 1 month after embolization revealed residual enhancement of the inferior pole of the kidney, suggesting reconstitution of flow and partial renal salvage. Ultimately, transcatheter "nephrectomy" with careful selection of a temporary embolic agent may serve as a safe and efficient alternative to surgical nephrectomy with the added possibility of preserving partial renal perfusion and function in the emergent setting.