• Title/Summary/Keyword: Renal involvement

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Effects of Atrial Natriuretic Peptide on Renal and Endocrine Functions in Spontaneously Hypertensive Rats (Spontaneously Hypertensive Rat에 있어서 Atrial Natriuretic Peptide의 신장기능과 몇가지 호르몬 분비에 미치는 영향)

  • Kim, San-Ho;Kim, Suhn-Hee;Seul, Kyung-Hwan;Cho, Kyung-Woo
    • The Korean Journal of Physiology
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    • v.22 no.1
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    • pp.41-53
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    • 1988
  • The present study was undertaken to clarify the involvement of atrial natriuretic peptide in the development of hypertension in spontaneously hypertensive rats. Plasma concentration of immunoreactive atrial natriuretic peptide was higher in spontaneously hypertensive rats than in normotensive Sprague-Dawley and Wistar rats. Plasma renin concentration was lower in SHR than in normotensive rats, as observed in earlier experiments. Hydration-induced increase in urine flow and urinary excretions of sodium and potassium were smaller in SHR than in normotensive control rats. Intraarterial infusion of atrial natriuretic peptide resulted in increases in urine flow, urinary excretions of sodium and potassium in both hypertensive and normotensive rats. Renal response to atrial natriuretic peptide was markedly suppressed in SHR. Plasma renin and aldosterone concentration were suppressed by atrial natriuretic peptide in both SHR and normotensive rats. The responses were not significantly different in both groups. These results suggest that the renal responsiveness to atrial natriuretic peptide may be suppressed in SHR by some mechanisms still remaining obscure.

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A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure (급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예)

  • Kim, Seok-Min;Chang, Kyung-Ae;Jung, Sun-Young;Park, Chan-Soh;Park, Jong-Won;Do, Jun-Young;Kim, Yong-Jin;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.58-63
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    • 2008
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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A Case of Moyamoya Disease Associated with Neurofibromatosis Type 1 in Patients with Renal Artery Stenosis and Hypertension (제 1형 신경섬유종증에 합병된 모야모야병에서 신장동맥 협착을 동반한 고혈압)

  • Seo, Young Ho;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.143-148
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    • 2013
  • Neurofibromatosis type 1 (NF-1) is an autosomal dominant neurocutaneous disorder, which can affect different organs or systems of the body, including the cardiovascular system. One of the more serious aspects of the disease relates to arterial involvement. In particular, renal artery stenosis is one of the most common vascular abnormalities in patients with NF-1, and the manifestations vary, ranging from no symptoms to end-stage renal failure. Treatment usually consists of antihypertensive drugs, percutaneous transluminal angioplasty, or surgery. Other causes of hypertension should be ruled out and the patient followed up for close monitoring and proper management. We report a case of bilateral renal artery stenosis and hypertension in a patient with moyamoya disease associated with neurofibromatosis type 1. This report discusses the literature available on the current subject, its clinical features, diagnosis, and treatment.

Reciprocal regulation of SIRT1 and AMPK by Ginsenoside compound K impedes the conversion from plasma cells to mitigate for podocyte injury in MRL/lpr mice in a B cell-specific manner

  • Ziyu Song;Meng Jin;Shenglong Wang;Yanzuo Wu;Qi Huang;Wangda Xu;Yongsheng Fan;Fengyuan Tian
    • Journal of Ginseng Research
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    • v.48 no.2
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    • pp.190-201
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    • 2024
  • Background: Deposition of immune complexes drives podocyte injury acting in the initial phase of lupus nephritis (LN), a process mediated by B cell involvement. Accordingly, targeting B cell subsets represents a potential therapeutic approach for LN. Ginsenoside compound K (CK), a bioavailable component of ginseng, possesses nephritis benefits in lupus-prone mice; however, the underlying mechanisms involving B cell subpopulations remain elusive. Methods: Female MRL/lpr mice were administered CK (40 mg/kg) intragastrically for 10 weeks, followed by measurements of anti-dsDNA antibodies, inflammatory chemokines, and metabolite profiles on renal samples. Podocyte function and ultrastructure were detected. Publicly available single-cell RNA sequencing data and flow cytometry analysis were employed to investigate B cell subpopulations. Metabolomics analysis was adopted. SIRT1 and AMPK expression were analyzed by immunoblotting and immunofluorescence assays. Results: CK reduced proteinuria and protected podocyte ultrastructure in MRL/lpr mice by suppressing circulating anti-dsDNA antibodies and mitigating systemic inflammation. It activated B cell-specific SIRT1 and AMPK with Rhamnose accumulation, hindering the conversion of renal B cells into plasma cells. This cascade facilitated the resolution of local renal inflammation. CK facilitated the clearance of deposited immune complexes, thus reinstating podocyte morphology and mobility by normalizing the expression of nephrin and SYNPO. Conclusions: Our study reveals the synergistic interplay between SIRT1 and AMPK, orchestrating the restoration of renal B cell subsets. This process effectively mitigates immune complex deposition and preserves podocyte function. Accordingly, CK emerges as a promising therapeutic agent, potentially alleviating the hyperactivity of renal B cell subsets during LN.

Influence of Yohimbine on the Central Dopaminergic Regulation of Renal Function (신장기능의 중추 Dopamine성 조절에 미치는 Yohimbine의 영향)

  • Kook, Young-Johng;Kim, Kyung-Keun;Cho, Kang-Seon;Min, Byung-Kap
    • The Korean Journal of Pharmacology
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    • v.22 no.2
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    • pp.79-87
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    • 1986
  • Recently it has been shown that central dopaminergic system regulates the renal function and that intracerebroventricularly (icv) administered dopamine (DA) produces antidiuresis and antinaturiuresis, resembling icv norepinephrine, and evidence has been accumulated which would suggest the involvement of adrenergic system in the DA effects. It was attempted therefore in this study to see whether the DA effect is influenced by pretreatment of yohimbine which is known as a specific ${\alpha}_2-adrenoceptor$ antagonist. Yohimbine produced, when given icv in doses of $100\;{\mu}g/kg$, marked antidiuresis and antinatriuresis along with decreases in renal perfusion and glomerular filtration. DA, in doses of $15\;{\mu}g/kg$, also produced antidiuresis and antinaturiuresis. However, after yohimbine-pretreatment DA $15\;{\mu}g/kg$ improved renal hemodynamics, and electrolyte excretion and urine flow rate transiently increased. With $150\;{\mu}g/kg$ DA, the antidiuresis was more marked in the control group. But the yohimbine-pretreated animals responded with marked diuresis and natriuresis, sodium excretion increasing more than three-fold, which lasted for 20 minutes. $K^+-excretion$, osmolar clearance as well as free-water reabsorption increased. Renal hemodynamics improved partly. Apomorphine, a DA agonist, when given icv in doses of $150\;{\mu}g/kg$, produced diuresis and naturiuresis, concomitant with increased renal hemodynamics. Yohimbine-pretreatment however did not abolish the apomorphine-induced diuresis and naturiuresis. Antidiuresis and antinatriuresis elicited by norepinephrine, $10\;{\mu}g/kg$, was not affected by yohimbine-pretreatment. These results indicate that the renal effects of icv DA is not so simple as those of norepinephrine, and the diuretic natriuretic cffect which had been masked by the hemodynamic effect becomes manifest only when the decreases in hemodynamics were removed by the pretreatment of yohimbine. It was further suggested that those DA receptors which mediate the natriuretic response to icv DA is not affected by yohimbine, whereas those receptors involved in the decrease in renal hemodvnamics are blocked by yohimbine. And the possibility of involvement of adrcnergic system in the DA action is not substantiated.

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A case report of Henoch-Schonlein purpura (아나필락시스양(樣) 자반증(紫班症) 치험례 보고)

  • Kim, Hyun-Hee;Park, Young-Ju;So, Ki-Suk;Cho, Young-Kee;Park, Eun-Jung;Na, Won-Kyung
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.2
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    • pp.75-83
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    • 2003
  • Background : Henoch-Schonlein purpura is a small-vessel vasculitis characterized by palpable purpura, abdominal pain, hematuria, and arthalgia. The exact etiology remain unknown despite a long and intensive research, but the findings showes immune mechanism is involved in the pathogenesis of this disease. The main clinical manifestations are skin rash, abdominal symptoms, joint symptoms, and renal involvement. And the existence of renal involvement influences on the course and prognosis of the Henoch-Schonlein purpura Objective : To demonstrate the therapeutic effect of herbal medicine(Kamiguibiondamtang) on parents with Henoch-Schonlein purpura Method : We treated two cases of Henoch-Schonlein purpura in a nine-year old male and a twenty-year old female, who showed multiple petechiae and ecchymoses on both extrimities with Kamiguibiondamtang. Result : A nine-year old male recovered completely and a twenty-year old female improved. Conclusion : We repert that we had good effects of herbal medicine treatment on two cases of Henoch-Schonlein purpura.

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The Serum Level of Insulin Growth Factor-1 and Insulin Growth Factor Binding Protein-3 in Children with Henoch-Schönlein Purpura

  • Kim, Hee Jin;Jung, Su Jin;Lee, Jun Ho
    • Childhood Kidney Diseases
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    • v.20 no.1
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    • pp.23-28
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    • 2016
  • Purpose: We investigated whether serum levels of insulin growth factor-1 (IGF-1) and insulin growth factor binding protein-3 (IGFBP-3) are valuable in predicting clinical outcomes or are correlated with other laboratory findings in children with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: We examined 27 children who were consecutively admitted to our hospital with HSP between January 2011 and February 2012. Blood tests (C-reactive protein, white blood cell count, platelet count, erythrocyte sedimentation rate, albumin, immunoglobulin A, complement C3, antineutrophil cytoplasmic antibody, IGF-1, IGFBP-3) and urine tests were performed upon admission. IGF-1 and IGFBP-3 were resampled in the recovery phase. Controls included 473 children whose IGF-1 and IGFBP-3 were sampled for evaluating their growth, at the outpatient department of pediatric endocrinology in our hospital. IGF-1 and IGFBP-3 were compared between the HSP children and controls, and between the acute and recovery phases in HSP children. The ability of these values to predict clinical outcomes including renal involvement was analyzed using bivariate logistic regression analysis (BLRA). Results: IGF-1 and IGFBP-3 were not different between the HSP children and controls ($148.7{\pm}117.6$ vs. $69.2{\pm}96.9$, P=0.290: $3465.9{\pm}1290.9$ vs. $3597.2{\pm}1,127.6$, P=0.560, respectively). There was no significant difference in IGF-1 or IGFBP-3 between acute and recovery phases. Based on the BLRA, no variable, including IGF-1 and IGFBP-3, could predict clinical outcomes including the presence of nephritis Conclusion: We concluded that IGF-1 and IGFBP-3 do not predict clinical outcomes of HSP, including renal involvement, in this study.

Autoimmune thyroiditis with minimal change disease presenting acute kidney injury (급성 신손상으로 발현된 미세 변화 신증에 동반된 자가면역 갑상선염)

  • Kim, Ji-Su;Park, Chi Young;Shin, Suk Pyo;Lim, Yeong Min;Ko, Eun Jung;Kim, Hyung-Jong
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.127-130
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    • 2014
  • Autoimmune thyroiditis is the most common cause of hypothyroidism in the world. It is characterized clinically by gradual thyroid failure, goiter formation, or both, because of the autoimmune-mediated destruction of the thyroid gland. Renal involvement presenting proteinuria in autoimmune thyroiditis is not uncommon, occurring in 10% to 30% of the cases. Glomerulonephropathy associated with autoimmune thyroiditis, however, is a rare disease. Most reports of autoimmune thyroiditis with glomerulonephropathy have demonstrated a mixed pathological morphology and have been predominantly associated with membranous glomerulopathy. The case of minimal-change disease associated with thyroiditis presenting acute kidney injury is a rare disease that has not been reported in South Korea. Reported herein is the case of a 16-year-old man diagnosed with Hashimoto's thyroiditis, with minimal-change disease presenting acute kidney injury. He revealed hypothyroidism, proteinuria, and impaired renal function. Renal biopsy showed minimal-change disease and minimal tubular atrophy. The patient was treated with thyroid hormone, and his renal function and proteinuria improved. Therefore, for patients with autoimmune thyroiditis presenting unexplained proteinuria, glomer-ulonephropathy should be ruled out. Conversely, for patients with glomerulonephropathy and persistent proteinuria despite proper treatment, thyroid function and antibody tests should be performed.

Autophagy localization and cytoprotective role in cisplatin-induced acute kidney injury

  • Karunasagara, Shanika;Hong, Geum-Lan;Jung, Da-Young;Ryu, Si-Yun;Jung, Ju-Young
    • Korean Journal of Veterinary Research
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    • v.59 no.3
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    • pp.133-139
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    • 2019
  • Autophagy is a fundamental cellular process that maintains homeostasis and cell integrity, under stress conditions. Although the involvement of autophagy in various conditions has been elucidated, the role of autophagy in renal structure is not completely clarified. Our aim was to investigate the cytoprotective effect of autophagy against acute kidney injury (AKI) through cisplatin deteriorative pathway, which leads to AKI via renal cell degradation. For in vivo experiments, male Sprague Dawley rats were divided in to 2 groups (n = 6/group) as control, Cis-5D. Following a single intraperitoneal injection of cisplatin, rats were sacrificed after 5 days. Blood urea nitrogen (BUN), creatinine (Cr) and histological alterations were examined. Further, expression of key regulators of autophagy, light-clain 3 (LC3), p62, and Beclin1, was evaluated by immunohistochemistry (IHC). The rats exhibited severe renal dysfunction, indicated by elevated BUN, Cr. Hematoxylin and eosin staining revealed histological damages in cisplatin-treated rats. Furthermore, IHC analysis revealed increased expression of LC3, Beclin1 and decreased expression of p62. Furthermore, expression of aforementioned autophagy markers was restricted to proximal tubule. Taken together, our study demonstrated that cisplatin can cause nephrotoxicity and lead to AKI. This phenomenon accelerated autophagy in renal proximal tubules and guards against AKI.