• 제목/요약/키워드: chronic kidney failure

검색결과 147건 처리시간 0.026초

Chitosan Increases the Release of Renal Dipeptidase from Porcine Renal Proximal Tubule Cells

  • Hyun Joong, Yoon;Kim, Young-Ho;Park, Sung-Wook;Lee, Hwanghee-Blaise;Park, Haeng-Soon
    • Animal cells and systems
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    • 제7권4호
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    • pp.309-315
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    • 2003
  • Renal dipeptidase (RDPase, membrane dipeptidase, dehydropeptidase 1, EC 3.4.13.19) has been widely studied since it was first purified from porcine kidney brush border membrane. It was reported that RDPase activity in urine samples of acute and chronic renal failure patients decreases. Nitric oxide (NO) is a highly reactive free radical involved in a number of physiological and pathological processes. NO is able to act in a dual mode, leading either to induction of apoptosis or to blunted execution of programmed cell death. NO inhibited the RDPase release from porcine renal proximal tubules, which could be blocked by L-NAME. Chitosan, the linear polymer of D-glucosamine in $\beta$(1\longrightarrow4) linkage, not only reversed the decreased RDPase release by NO but also increased NO production in the proximal tubule cells. The stimulatory effect of NO on RDPase release from proximal tubules in the presence of chitosan must be different from the previously proposed mechanism of RDPase release via NO signaling pathway. Chitosan stimulated the RDPase release in the proximal tubules and increased RDPase activity to 220% and 250% at 0.1% and 1%, respectively. RDPase release was decreased to about 40% in the injured proximal tubules and was recovered in proportion to the increase of chitosan. Chitosan may be useful in recovery of renal function from $HgCl_2$injury.

보중치습탕이 3T3-L1 성숙지방세포의 염증성 아디포카인의 생산 및 MAPK 신호전달에 미치는 영향 (Effects of Bojungchiseub-tang on the Production of Inflammatory Adipokine and MAPK Signaling in 3T3-L1 Mature Adipocytes)

  • 이수정;김원일;강경화
    • 동의생리병리학회지
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    • 제28권5호
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    • pp.486-493
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    • 2014
  • Adipocytes are endocrine cells that release bioactive mediators called adipokines. In condition of obesity characterized by low-grade chronic inflammation, adipocytes release inflammatory adipokines, which is related to insulin resistance. Bojungchiseub-tang (BJCST) has been used in symptoms and signs of edema, dampness-phlegm, kidney failure, and so on in Korean medicine. BJCST is also expected to have anti-obesity activities. In the present study, we examined whether BJCST modulate the production of inflammatory adipokines and the activations of the mitogen-activated protein kinases (MAPK) signaling pathway related to induce adipocyte inflammation to elucidate the effects and its mechanism of BJCST on lowering the content of inflammatory adipokines in 3T3-L1 adipocytes. As a result, BJCST suppressed the production of proinflammatory cytokines, tumor necrosis factor (TNF) $-{\alpha}$, interleukin (IL) $-1{\beta}$, IL-6, interferon (IFN) -${\gamma}$, granulocyte-macrophage colony-stimulating factor (GM-CSF), monocyte chemoattractant protein-1 (MCP-1), and the production of other inflammatory mediators, prostaglandin $E_2(PGE_2)$ and nitric oxide(NO)viadownregulationofcyclooxygenase-2(COX-2)andinducible NO synthase (iNOS) gene expressions. In addition, BJCST decreased the phosphorylation of MAPK that promotes the production of inflammatory adipokines in 3T3-L1 mature adipocytes. In conclusion, BJCST could regulate the production of inflammatory adipokines and MAPK signaling pathway related to induction of adipose inflammation.

The Relevance between Renal Ultrasonographic Findings and Disease Course in Two Poststreptococcal Glomerulonephritis (PSGN) Patients

  • Lee, Jin Hee;An, Yu Kyung;Yoo, Ha Yeong;Kwak, Byung Ok;Park, Hye Won;Lim, So Dug;Son, Jae Sung;Chung, So Chung;Kim, Kyo Sun
    • Childhood Kidney Diseases
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    • 제19권2호
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    • pp.184-189
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    • 2015
  • Poststreptococcal glomerulonephritis (PSGN) is one of the most well-known and important infectious renal diseases resulting from a prior infection with group A ${\beta}$-hemolytic streptococcus. The typical clinical characteristics of the disease reflect acute onset with gross hematuria, edema, hypertension and moderate proteinuria after the antecedent streptococcal infection. In children, usually PSGN is healed spontaneously but if it combines with fast progressing glomerulonephritis, it would be developed to chronic renal failure. Therefore, it is important to make a fast diagnosis and treatment by simple tools to predict the course and the prognosis of disease. Sonography is a simple tool for diagnosis but there is no typical renal sonographic finding in PSGN, so it is difficult to predict the course and the prognosis of disease by sonographic findings. In comparison between two cases of renal sonographic findings in PSGN, a patient who showed more increased echogenicity in more extended area of renal sonography had the severe results of renal pathology, prolonged treatment period and low serum C3 level. Here, we report the different findings of renal sonography and pathology depending on the degree of severity between two patients. Thus, it is necessary to gather more information from further studies to make a consensus about the relationship between the renal sonography and the prognosis of disease in PSGN.

Discordant findings of dimercaptosuccinic acid scintigraphy in children with multi-detector row computed tomography-proven acute pyelonephritis

  • Lee, Jeong-Min;Kwon, Duck-Geun;Park, Se-Jin;Pai, Ki-Soo
    • Clinical and Experimental Pediatrics
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    • 제54권5호
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    • pp.212-218
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    • 2011
  • Purpose: The diagnosis of acute pyelonephritis (APN) is often difficult, as its clinical and biological manifestations are non-specific in children. If not treated quickly and adequately, however, APN may cause irreversible renal damage, possibly leading to hypertension and chronic renal failure. We were suspecting the diagnostic value of $^{99m}Tc$-dimercaptosuccinic acid (DMSA) scan by experiences and so compared the results of DMSA scan to those of multi-detector row computed tomography (MDCT). Methods: We retrospectively selected and analyzed 81 patients who were diagnosed as APN by MDCT during evaluation of their acute abdomen in emergency room and then received DMSA scan also for the diagnostic work-up of APN after admission. We evaluated the results of imaging studies and compared the diagnostic value of each method by age groups, <2 years (n=45) and ${\geq}$2 years (n=36). Results: Among total 81 patients with MDCT-proven APN, DMSA scan was diagnostic only in 55 children (68%), while the remaining 26 children (32%) showed false negative normal findings. These 26 patients were predominantly male and most of them, 19 (73.1%) were <2 years of age. Conclusion: DMSA scan holds obvious limitation compared to MDCT in depicting acute inflammatory lesions of kidney in children with APN, especially in early childhood less than 2 years of age. MDCT showed hidden lesions of APN, those were undetectable through DMSA scan in children.

신석회화와 소뇌 충부의 무형성을 동반한 Joubert 증후군 1례 (A Case of Joubert Syndrome Associated with Nephrocalcinosis and Agenesis of Cerebellar Vermis)

  • 김지희;신혜경;홍영숙;이주원;김순겸;유기환
    • Childhood Kidney Diseases
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    • 제6권2호
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    • pp.266-271
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    • 2002
  • Joubert 증후군은 소뇌 충부 무형성을 특징으로 하며 근 긴장 저하, 불규칙적인 호흡, 발달 지연, 안진, 망막 이형성, 낭종성 신질환, 간 섬유증, 다지증 등이 동반되는 증후군이다. 이 질환에서는 소뇌 충부의 병변과 신장의 병변이 무작위적으로 함께 나타나기도 하는데, 저자들은 소뇌 충부 무형성, 근 긴장저하, 안진, 무호흡 등이 있어 Joubert 증후군으로 진단받은 환아가 신장 수질 석회화 병변과 만성 신부전으로 진행한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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방광요관역류를 동반한 재발성 요로감염 환자 1례 (A Case of Recurrent Urinary Tract Infection with Vesicoureteral Reflux)

  • 이진신;이병철;장원만;안영민;안세영;두호경;최기림
    • 대한한방내과학회지
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    • 제21권4호
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    • pp.683-686
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    • 2000
  • Vesicoureteral reflux(VUR) is a state that urine regurge from bladder to ureter and kidney because of congenital, structural, functional abnormality of ureterovesical junction and lower urinary tract than bladder. It may be the primary cause of recurrent urinary tract infection(UTI) in chindhood, If urine regurge with UTI, it can cause renal damage, leading to scar formation, hypertension, chronic renal failure, But upper complications can be prevented by early diagnosis and proper treatment of VUR and UTI, so clinician must focus on them in treatment of VUR. We had experienced a case of recurrent UTI with VUR regardless of consistent antibiotics therapy in 7 years old boy, Chief complain was urinary frequency, The symptom of urinary frequency was successfully treated by herb medicine(Gamijihwag-tang), So, we report this case with a brief review of related literatures.

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Clinical Value of Intraoperative Flow Measurements of Brachiocephalic Arteriovenous Fistulas for Hemodialysis

  • Lee, Jonggeun;Lee, Seogjae;Chang, Jee Won;Kim, Su Wan;Song, Jung-Kook
    • Journal of Chest Surgery
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    • 제53권3호
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    • pp.121-126
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    • 2020
  • Background: The aim of this study was to analyze the clinical outcomes of autogenous brachiocephalic arteriovenous fistulas and to investigate the factors associated with 1-year patency after initiation of hemodialysis. Methods: We retrospectively reviewed the medical records of 41 patients who underwent surgery to create an autogenous brachiocephalic arteriovenous fistula between January 2015 and December 2017, received hemodialysis at the same hospital for longer than 1 year, and were monitored for their vascular access status. Intraoperative flow was measured using transit-time ultrasonography. Results: The 1-year primary and secondary patency rates were 61% (n=25) and 87.8% (n=36), respectively. The functional group (subjects who required no intervention to maintain patency within the first year after hemodialysis initiation) displayed a significantly higher median intraoperative flow rate (450 mL/min) than the non-functional group (subjects who required intervention at least once regardless of 1-year patency) (275 mL/min) (p=0.038). Based on a receiver operating characteristic curve analysis, all patients were additionally subdivided into a high-flow group (>240 mL/min) and a low-flow group (≤240 mL/min). The high-flow group included a significantly greater number of functional brachiocephalic arteriovenous fistulas than the low-flow group (74.2% vs. 20%, respectively; p=0.007). Conclusion: Transit-time flow, as measured with intraoperative transit-time ultrasonography, was associated with patency without the need for intervention at 1 year after initiation of hemodialysis.

투석치료 중인 만성신부전 환자의 영양지식 수준과 식사요법 실천 정도 및 교육요구도 (Level of Nutrition Knowledge, Diet Practice and Education Demands in Dialysis Patients with Chronic Renal Failure)

  • 김수민;임현숙
    • 대한영양사협회학술지
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    • 제24권2호
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    • pp.117-140
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    • 2018
  • The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.

Comparable Outcomes of Bicuspid Aortic Valves for Rapid-Deployment Aortic Valve Replacement

  • Somin Im;Kyung Hwan Kim;Suk Ho Sohn;Yoonjin Kang;Ji Seong Kim;Jae Woong Choi
    • Journal of Chest Surgery
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    • 제56권6호
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    • pp.435-444
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    • 2023
  • Background: Edwards Intuity is recognized as a relatively contraindicated bioprosthesis for bicuspid aortic valve disease. This study compared the early echocardiographic and clinical outcomes of rapid-deployment aortic valve replacement for bicuspid versus tricuspid aortic valves. Methods: Of 278 patients who underwent rapid-deployment aortic valve replacement using Intuity at Seoul National University Hospital, 252 patients were enrolled after excluding those with pure aortic regurgitation, prosthetic valve failure, endocarditis, and quadricuspid valves. The bicuspid and tricuspid groups included 147 and 105 patients, respectively. Early outcomes and the incidence of paravalvular leak were compared between the groups. A subgroup analysis compared the outcomes for type 0 versus type 1 or 2 bicuspid valves. Results: The bicuspid group had more male and younger patients. Comorbidities, including diabetes mellitus, hypertension, chronic kidney disease, and coronary artery disease, were less prevalent in the bicuspid group. Early echocardiographic evaluations demonstrated that the incidence of ≥mild paravalvular leak did not differ significantly between the groups (5.5% vs. 1.0% in the bicuspid vs. tricuspid groups, p=0.09), and the early clinical outcomes were also comparable between the groups. In the subgroup analysis between type 0 and type 1 or 2 bicuspid valves, the incidence of mild or greater paravalvular leak (2.4% vs. 6.7% in type 0 vs. type 1 or 2, p=0.34) and clinical outcomes were comparable. Conclusion: Rapid-deployment aortic valve replacement for bicuspid aortic valves demonstrated comparable early echocardiographic and clinical outcomes to those for tricuspid aortic valves, and the outcomes were also satisfactory for type 0 bicuspid aortic valves.

Cortical thickness of the rostral anterior cingulate gyrus is associated with frailty in patients with end-stage renal disease undergoing hemodialysis in Korea: a cross-sectional study

  • Sang Hyun Jung;Jong Soo Oh;So-Young Lee;Hye Yun Jeong
    • Journal of Yeungnam Medical Science
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    • 제40권4호
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    • pp.381-387
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    • 2023
  • Background: Frailty is defined as a condition of being weak and delicate, and it represents a state of high vulnerability to adverse health outcomes. Recent studies have suggested that the cingulate gyrus is associated with frailty in the elderly population. However, few imaging studies have explored the relationship between frailty and the cingulate gyrus in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Methods: Eighteen right-handed patients with ESRD undergoing hemodialysis were enrolled in the study. We used the FreeSurfer software package to estimate the cortical thickness of the regions of interest, including the rostral anterior, caudal anterior, isthmus, and posterior cingulate gyri. The Beck Depression Inventory, Beck Anxiety Inventory, and laboratory tests were also conducted. Results: The cortical thickness of the right rostral anterior cingulate gyrus (ACG) was significantly correlated with the Fried frailty index, age, and creatinine level. Multiple regression analysis indicated that the cortical thickness of the right rostral ACG was associated with frailty after controlling for age and creatinine level. Conclusion: Our results indicate that the cortical thickness of the rostral ACG may be associated with frailty in patients with ESRD on hemodialysis and that the rostral ACG may play a role in the frailty mechanism of this population.