• Title/Summary/Keyword: chronic kidney disease

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Comparison of Glomerular Filtration Rate Using Gates Method and Serum Creatinine (Gates 방법과 혈청 크레아티닌을 이용한 사구체 여과율의 비교)

  • Yun, Jong-Jun;Lee, Hyo-Yeong;Lee, Hwa-Jin;Lee, Mu-Seok;Song, Hyeon-Seok;Park, Se-Yun;Jeong, Ji-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.61-66
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    • 2009
  • Purpose: Glomerular filtration rate (GFR) is considered as the best overall index for the level of renal function, diagnosis of doubtful kidney disease, progress observation from chronic kidney disease and is measured with the various methods. In this study, We measured standard GFR by Gates method and attempted to compare the result with serum creatinin-based, Cockcroft-Gault(C-G) formula and Modification of Diet in Renal Disease (MDRD) formula. Materials and methods: 217 patients (127 men, 90 women, mean age $51.3{\pm}16.9$) with various renal function were examined. we compared the GFR using $^{99m}Tc$-DTPA (Gates), C-G formula and MDRD formula. Results: Significant correlations were noted between 2 different GFR estimates (from C-G formula: r=0.864, p<0.0001, MDRD formula: r=0.831, p<0.0001) and $^{99m}Tc$-DTPA (Gates) GFR. Average of serum creatinine (Scr) was measured with $3.0{\pm}3.1\;mg/dL$, In patients with normal renal function (Scr<1.5 mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula (p<0.0001) and MDRD formula (p<0.0001). In patients with mild to moderate renal insufficiency (1.5$^{99m}Tc$-DTPA (Gates) GFR was not statistically significant to C-G formula (p=0.181) and MDRD formula (p=0.127). In patients with severe renal insufficiency (Scr>4.0mg/dL), $^{99m}Tc$-DTPA (Gates) GFR was statistically significant to C-G formula and MDRD formula (p<0.0001). Conclusions: Glomerular filtration rate using Gates method was closly correlated to C-G formula and MDRD formula. In patients with normal renal function, $^{99m}Tc$-DTPA (Gates) GFR was significantly lower than C-G formula and MDRD formula. In patients with mild to moderate renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was simmilar with C-G formula and MDRD formula. In patients with severe renal insufficiency, $^{99m}Tc$-DTPA (Gates) GFR was significantly higher than C-G formula and MDRD formula. None of the three different methods was clearly superior to the others.

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Evaluation of Renal Function Determined by Relative Renal Uptake of $^{99m}Tc-DMSA$ and Relative Glomerular Filteration Rate of $^{99m}Tc-DTPA$ ($^{99m}Tc-DMSA$$^{99m}Tc-DTPA$의 상대적 신섭취율을 이용한 신기능의 평가)

  • Chung, Byung-Chun;Choi, Chung-Il;Kim, Kwang-Weon;Lee, Jae-Tae;Lee, Kyu-Bo;Kwon, Tae-Hwan;Cho, Dong-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.227-236
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    • 1991
  • Background: The evaluation of individual renal function is important to diagnosis and follow-up of various diseases. Ureteral catheterization of each kidney has been widely used for this purpose, but this method had some technical difficulty, frequent complications and much restriction in reapplication. Therefore we tried to applicate radiopharmaceuticals for the evaluation of individual renal function. Methods: We measured 2 hour, 4 hour and 24 hour relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ with 59 patients with various renal diseases to determine their usefulness for assessment of individual renal function and to compare correlations between every renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate. Results: The correlations between 2 hour-, 4 hour- and 24 hour- relative renal uptake of $^{99m}Tc-DMSA$ and relative glomerular filteration rate of $^{99m}Tc-DTPA$ were R=0.9190 (p < 0.001), R: 0.9229 (p<0.001) and R=0.9917 (p<0.001). In acute obstructive uropathy, the correlations at 2 hour and 4 houre were poor as R=0.1812 (p<0.05) and R=0.4923 (p < 0.05), but the correlation at 24 hour was good as R=0.9942 (p<0.001). Conclusions: We concluded that relative renal uptake at 2 hour and 4 hour had good correlation with relative DTPA uptake ratio in the cases without chronic renal failure and obstructive uropathy. Delayed image with 24 hour relative renal uptake $^{99m}Tc-DTPA$ had the best correlation with relative glomerular filteration rate of $^{99m}Tc-DTPA$ and that might be useful in evaluation of chronic renal disease in which showed increased beckground activity or acute obstructive uropathy.

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Production of the Novel Disease Animal Model by Used Tet-off System

  • Park, Jun-Hong;Kim, Kil-Soo;Lee, Eun-Ju;Kim, Myoung-Ok;Kim, Sung-Hyun;Kyoungin-Cho;Jung, Boo-Kyung;Kim, Hee-Chul;Sol ha Hwang
    • Proceedings of the KSAR Conference
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    • 2003.06a
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    • pp.54-54
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    • 2003
  • The activation of protooncogenes or the inactivation of their gene products may be a specific and effective functional study for human neoplasia. To examine this possibility, we have used the tetracycline regulatory system to generate transgenic mice that conditionally express the HccR-2 protooncogene in vivo. The new human cervical cancer protooncogene (HccR-2) was detected from cervical cancer cell line. To elucidate its biological functions, we generated transgenic mice that expressed the HccR-2 gene. The sustained expression of the HccR-2 transgene culminated chronic neutrophilic leukemia (CNL). CNL is a rare chronic myeloproliferative disorder that presents as a sustained, mature neutrophilic leukocytosis with few or no circulating immature granulocytes, the absence of peripheral blood monocytosis, basophilia, or eosinophilia, and infiltration of neutrophils at the liver, spleen and kidney. Mice expressing the HccR-2 and tetracycline-transactivating protein (tTa) transgene were found to have altered myeloid development that was characterized by increased percentages of mature neutrophil and band form neutrophil in the peripheral blood, liver and spleen. Activation of the transgene causes CNL. In our model, expression of HccR-2 transgene mice was similar in many respects to the human CNL. This model will be valuable not only for investigating the biological properties of the HccR-2 and other protooncogenes in vivo but also for analyzing the mechanism involved in the progression of CNL.

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Group A Streptococcal Bacteremia in Pediatric Patients: A Single-Center Study (소아환자에서의 A군 사슬알균 혈류감염: 단일기관 연구)

  • Kim, Dongsub
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.83-89
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    • 2020
  • Purpose: Group A streptococcus (GAS) is a common pathogen in pediatric patients and often causes acute pharyngotonsillitis and skin and soft tissue infections. In addition, bacteremia with significant morbidity and mortality can also occur. This study was conducted to describe the clinical manifestations and treatment outcomes of pediatric GAS bacteremia patients in Korea. Methods: This was a single-center, retrospective study. From January 2000 to December 2016, pediatric patients aged ≤18 years with GAS bacteremia were studied. Clinical manifestations, underlying diseases, intensive care unit stay, and antibiotic susceptibility were evaluated. Results: During the study period, 19 patients had GAS bacteremia. Ten (53%) were male, and the median age was 7.4 years (range, 0.3-17.4 years). Fourteen (74%) had chronic underlying diseases. Five (26%) were immunocompromised (leukemia and chronic kidney disease). Eight (42%) had lymphatic or vascular malformations, of which seven had lesions with signs of inflammation. Three (16%) developed pneumonia, and two of them received ventilator care. The 30-day mortality rate was 6% (1/19), and the cause of death was bacteremic pneumonia. All GAS isolates were sensitive to penicillin. Fifteen (79%) were sensitive to both erythromycin and clindamycin. Conclusions: This study identified various clinical manifestations of GAS bacteremia. GAS should be considered as a potential pathogen that can cause bacteremia and result in a serious clinical course.

Evaluation of Factors Affecting Glomerular Filtration Rate by Contrast Media in Patients with Coronary Angiography (심혈관 조영술 시행 환자의 조영제 사용 시 사구체여과율 변화에 영향을 미치는 인자들 평가)

  • Kim, Eun-Young;Lee, Ok-Sang;Lim, Sung-Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.2
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    • pp.103-112
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    • 2012
  • Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

Applications of Prescriptions Including Anemarrhenae Rhizoma and Phellodendri Cortex in Dongeuibogam (동의보감(東醫寶鑑) 중(中) 지모(知母)와 황백(黃柏)이 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察))

  • Sung, See-Yeol;Kook, Yoon-Bum
    • Herbal Formula Science
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    • v.19 no.1
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    • pp.1-22
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    • 2011
  • Objectives : This study was performed to investigate applications of 122 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex in Dongeuibogam. Methods : 122 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex which have been used separately or concurrently in Oriental Medicine for a long time as a treatment for various disease in Dongeuibogam were studied through order of frequency, symptoms, dosages, and etc. Results : 1. 19(15.57%) prescriptions are recorded in fatigue chapter, 11(9.02%) in mental or emotional disorder as a result of repressed anger or stress chapter, 9(7.38%) in urine and cough chapters respectively and 8(6.56%) in eyes, ears and glycosuria chapters respectively, which are arranged in order of frequency. 2. Burning stress resulted from Yin deficiency treat herbs are ranked top, Yin deficiency treat herbs, dim eyes, Yin-yang deficiency treat herbs, kidney function deficiency treat herbs are ranked in order of frequency among 78 symptoms in prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 3. The dosages of Anemarrhenae Rhizoma which is more used than Phellodendri Cortex are ranged from 5 puns:4 puns ~ 2 nyangs:1 nyang. 1 jeon:5 puns is recorded 3(30.00%), 1 jeon:7 puns is 2 times(20.00%), the others are 1 (10.00%) used among 10 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 4. The dosages of Anemarrhenae Rhizoma which is used same amount Phellodendri Cortex are ranged from 3 puns each ~ 4 nyangs each, same amount each or unidentified dosages. Same amount each or unidentified dosages each is recorded 36 times(38.71%), 5 puns each is 15 times(16.85%), 1 nyang each is recorded 12 times(13.48%), 0.7 jeon each is recorded 7 times (7.87%) and 1 jeon each is recorded 6 times(6.74%) used among 89 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 5. The dosages of Anemarrhenae Rhizoma which is less used than Phellodendri Cortex are ranged from 3 puns:1 jeon ~ 4 nyangs:8 nyangs. 1 nyang:2 nyangs is recorded 4(17.39%), 0.5 jeon:1 jeon is 3(13.40%) each, the others are 1 time(4.35%) used among 23 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex. 6. The less using dosage of Anemarrhenae Rhizoma and Phellodendri Cortex has a more percentage of decoctions groups, The more using dosage of Anemarrhenae Rhizoma and Phellodendri Cortex has a more percentage of the other groups except decoctions. The less using prescriptions have an effects of controlling yin and blood deficiency, enhancing Qi, etc, as a whole. The more using prescriptions as a form of compound powder have an effects in incurableness disease, chronic diseases, and etc. Conclusions : The 122 prescriptions including Anemarrhenae Rhizoma and Phellodendri Cortex in Dongeuibogam are mainly composed of Gamree-hwan, Samool-tang, Naebo-hwan, Sagoonja-tang and Gobangpoong-tang, and etc.

A Study of the Effects of Health Contracting on Compliance with Health Behaviors in Clients with Hypertension (자가간호증진을 위한 건강계약이 고혈압자의 건강행위 이행에 미치는 영향)

  • 이향련
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.204-217
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    • 1987
  • It is generally accepted that the delivery of health care is undergoing many changes specially those related to acute, contagious disease care and to the increase of chronic illnesses which can not be cured but are controlable. The health care practitioner can not be soley responsible for the control of their clients' care. Because the clients will play a vital role in controlling their illnesses, long term participation by both the health care provider and the client is necessary. Since most individuals with hypertension do not experience signs or symptoms, the disease is difficult to detect and even when diagnosed, clients do not comply well with their hypertension regimens. The noncompliant client is at increased risk for compliants involving the heart, brain, kidney and other organs. In an effort to explore methods of increasing patient participation in and adherence to treatment programs for hypertension, the researcher used health contracting to promote self care. The research questions are; 1) Will the health contracting increase compliance in health behavior and reduce the blood pressure\ulcorner 2) If clients comply with their regimens will this reduce their blood pressure\ulcorner The research design utilized in this study was a quasi-experimental design. A purposive sample, was abtained from two churches in the 1. area, consisting of 64 clients with hypertension. The data was collected from the middle of January to the 1st of September 1985. Randomization was only of the two church groups into experimental and control groups. Compliance with health behavior related to the hypertensive regimen, blood pressure and body weight were measured, compared and analyzed. In the experimental group measurements were made 6 times; one month before the education program after education program when health contracting was done and 4 more times once a month for 4 months. In the control group measurements were made 3 times; one month before the education program after the education program, and once 4 months later. There was no health contracting. The data were analyzed by t-test, Pearson correlation and ANOVA according to purpose of the study. The result of this study may be summarized as follows: The result related to the hypothesis on the effect of health contracting are as follows: H$_1$; “The hypothesis that the experimental group, with a health contractual agreement will demonstrate increased compliance levels for health behavior than the control group” was supported(t=-5.29, df=62, p=.000). H$_2$; “The hypothesis that the experimental group, with a health contractual agreement, will demonstrate a greater reduction in blood pressure than the control group” was supported (for systolic blood pressure t=2.72, df=62, p=.009, for diastolic blood pressure t=1.95, df=62, p=.050). H$_3$; The hypothesis that the greater the compliance of the client with health behavior the lower the client's blood pressure will be was partially supported (for systolic pressure r=-.2981, p=.008, for diastolic pressure r=-.1720, p=.087). From the examination of the results of this study it can be concluded that the interaction between the nurse and the client, contracting to define goals and reinforcing compliant behavior, leads to improved compliance with health care behaviors and thus to an increase in the effectiveness of nursing care. Further consideration need to be given to the inclusion of the concept of health contracting in primary nursing and to further research in this area.

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Comparison of Frequency and Stay Time between Normal and Abnormal Elimination Behavior of Cats Using a Litter Box with Automatic Sensor

  • Ji-Woo Shin;Sun-Woo Han;Soon-Hak Kweon;Myungseok Kang;Jong-Hyuk Kim;Chung-Gwang Choi;Joon-Seok Chae
    • Journal of Veterinary Clinics
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    • v.41 no.2
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    • pp.71-78
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    • 2024
  • Changes in elimination behavior, including urination and defecation, are common clinical signs of numerous disorders in cats. Therefore, this study attempted to automatically measure the elimination behavior of cats using the litter box and develop an early warning system for the guardian in case of abnormalities. To construct an early warning system for abnormal changes through cat elimination behavior, it consisted of a litter box, an automatic sensor for data collection and data wifi transmission, a server for data analysis, and a mobile phone app for result transmission and early warning. To establish the reference interval (RI), the elimination behavior was monitored for more than 2 weeks using a motion sensor within a litter box in 37 healthy cats and 19 diseased cats. The data were expressed as daily total visits, daily total stay duration, average stay duration per elimination, weekly total visits, and weekly total stay duration. Healthy cats showed median daily total visits of 3 times/day (RI 1.0-7.0) and daily total stay duration of 192 s/day (RI 8.0-452.0). For weekly data, the median total visits were 20 times/week (RI 3.0-35.25) and the median total stay duration was 1,147 s/week (RI 80.0-2,249.5). The average stay duration per elimination was 59 s/elimination (RI 4.67-132.0). Diseased cats showed more frequent elimination behavior than healthy cats (p < 0.001). Otherwise, for each elimination, diseased cats had shorter stay durations than healthy cats (p < 0.001). This study established the RIs of elimination behavior parameters (frequency and duration) in healthy cats. The present study might help guardians and veterinarians detect changes in elimination behaviors in diseased cats at an early stage.

Predicting the Progression of Chronic Renal Failure using Serum Creatinine factored for Height (소아 만성신부전의 진행 예측에 관한 연구)

  • Kim, Kyo-Sun;We, Harmon
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.144-153
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    • 2000
  • Purpose : Effects to predict tile progression of chronic renal failure (CRF) in children, using mathematical models based on transformations of serum creatinine (Scr) concentration, have failed. Error may be introduced by age-related variations in creatinine production rate. Height (Ht) is a reliable reference for creatinine production in children. Thus, Scr, factored for Ht, could provide a more accurate predictive model. We examined this hypothesis. Methods : The progression of of was detected in 63 children who proceeded to end-stage renal disease. Derivatives of Scr, including 1/Scr, log Scr & Ht/Scr, were defined fir the period Scr was between 2 and 5 mg/dl. Regression equation were used to predict the time, in months, to Scr > 10 mg/dl. The prediction error (PE) was defined as the predicted time minus actual time for each Scr transformation. Result : The PE for Ht/Scr was lower than the PE for either 1/Scr or log Scr (median: -0.01, -2.0 & +10.6 mos respectively; P<0.0001). For children with congenital renal diseases, the PE for Ht/Scr was also lower than for the other two transformations (median: -1.2, -3.2 & +8.2 mos respectively; P<0.0001). However, the PEs for children with glomerular diseases was not as clearly different (median: +0.9, +0.5 & +9.9 respectively). In children < 13 yrs, PE for Ht/Scr was tile lowest, while in older children, 1/Scr provided the lowest PE but not significantly different from that for Ht/Scr. The logarithmic transformation tended to predict a slower progression of CRF than actually occurred. Conclusion : Scr, floored for Ht, appears to be a useful model to predict the rate of progression of CRF, particularly in the prepubertal child with congenital renal disease.

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Current Status of Children on Peritoneal Dialysis in Korea : A Cross-Sectional Multicenter Study (소아복막투석의 현황: 다기관 공동연구 결과보고)

  • Youn, Ji-Seok;Lee, Joo-Hoon;Park, Young-Seo;Yim, Hyung-Eun;Paik, Kyung-Hoon;Yoo, Kee-Hwan;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.176-188
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    • 2009
  • Purpose : Peritoneal dialysis (PD) is the major form of dialysis in use for infants and children with end-stage renal disease (ESRD). The aim of this study was to gain insight into the current status of children on PD in Korea. Methods : In May 2008, questionnaires were sent to the pediatric nephrologists via e-mail. Four centers replied and those data were reviewed. Results : A total of 103 patients were included in this study. Male to female ratio was 1.6:1. Mean age was $11.5{\pm}4.9$ years (0-19 years). Primary renal diseases diagnosed were as follows: primary glomerular disease (34%), chronic pyelonephritis-reflux nephropathy (14.6%), systemic disease (9.7%), renal hypoplasia/dysplasia (8.7%), heredofamilial disease (6.8%), vascular disease (3.9%), drug-induced nephropathy (1.0%), and unknown (12.6%). PD modalities were as follows: CAPD (42.7%), CCPD (27.2%), NIPD (11.7%), and Hybrid (18.4%). Weekly total Kt/V was $2.1{\pm}0.7$ (0.3-4.1). Results of peritoneal equilibrium test were as follows: low 36.8%, low average 31.6%, high average 19.7%, and high 11.8%. Z-score for weight was $-1.00{\pm}1.20$ (-4.54~+2.50). Z-score for height was $-1.55{\pm}1.65$ (-9.42~+1.87). Growth hormone was administered in 24.3% of patients. Anti-hypertensive drugs were administered in 64.0% of patients. Laboratory findings were as follows: hemoglobin $10.5{\pm}1.4$ g/dL, calcium $9.7{\pm}0.7$ mg/dL, phosphorus $5.4{\pm}1.4$ mg/dL, and parathyroid hormone $324.2{\pm}342.8$ pg/mL. Conclusion : Primary glomerular disease was the most common cause of ESRD. CAPD was the most prevalent PD modality. Low and low average peritoneal transport type were common. Growth disturbance were noted in many patients. Some patients had hypertension even with anti- hypertensive drugs. Calcium-phosphorus levels were maintained adequately, but many patients had secondary hyperparathyroidism.