• Title/Summary/Keyword: chronic renal disease

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A Study on the Naturopathic Utilization Among Chronic Renal Disease Patients (만성 콩팥병환자의 자연치유요법 이용 연구)

  • Lee, Seong-Ran
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.4
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    • pp.1781-1785
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    • 2011
  • This study was attempted a study on the naturopathic uitilization among chronic renal disease patients. Data was surveyed using interview and questionnaires by 165 patients of naturopathic utilization who visited the renal medical department of a general hospital which was located in Seoul from April 13 to May 13, 2010. The results were as follows ; First, the period of naturopathic utilization is the most in early disease(52.1%). Secondly, there was a significant positive correlation between the number of naturopathic utilization and expenditure a month(r=.251. p<.01). Thirdly, naturopathic utilization increased as the longer period of naturopathic utilization, the higher expenditure a month, the more age. In conclusion, factors influencing naturopathic utilization were the period of naturopathic utilization. expenditure a month, and age.

Clinical approach to quality of life in children with end-stage renal disease

  • Cho, Min Hyun
    • Clinical and Experimental Pediatrics
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    • v.56 no.8
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    • pp.323-326
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    • 2013
  • Quality of life in addition to various medical problems in children with end-stage renal disease (ESRD) should be objectively assessed to accomplish normal growth and development during childhood. However, unfortunately, studies of quality of life (QoL) in children with ESRD have been not popular yet and there are only fewer suitable assessment tools compared with adults. Recently, disease-specific modules to evaluate QoL in children with chronic disease such as ESRD have been developed. This review was made to introduce these QoL instruments for children and help the clinical application of them.

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.

Lower Leg Amputation by Calciphylaxis in Diabetic Nephropathy Patient (A Case Report) (당뇨병성 신부전증 환자의 선단 궤양에 의한 하지절단(1예 보고))

  • Lee, Jun-Young;Yu, Jae-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.109-112
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    • 2009
  • Calciphylaxis is a rare disease that appear in patients with secondary hyper-parathyroidism or chronic renal failure or that show defect in calcium phosphate metabolism which is characterized by fibrin deposit or calcification of medial wall of vessels causing gradual ischemic skin necrosis. Calciphylaxis is a disease with poor prognosis as skin necrosis can progress rapidly. If left untreated, calciphylaxis will progress to sepsis with high mortality. The treatment is controversial but kidney transplantation or parathyroidectomy is suggested to recover calcium-phosphate metabolism. The authors have experienced calciphylaxis in a patient with chronic renal failure caused by DM nephropathy with characteristic skin lesion and rapid skin necrosis. We describe this case with documentary reviews.

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Renal fibrosis

  • Cho, Min-Hyun
    • Clinical and Experimental Pediatrics
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    • v.53 no.7
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    • pp.735-740
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    • 2010
  • Renal fibrosis, characterized by tubulointerstitial fibrosis and glomerulosclerosis, is the final manifestation of chronic kidney disease. Renal fibrosis is characterized by an excessive accumulation and deposition of extracellular matrix components. This pathologic result usually originates from both underlying complicated cellular activities such as epithelial-to-mesenchymal transition, fibroblast activation, monocyte/macrophage infiltration, and cellular apoptosis and the activation of signaling molecules such as transforming growth factor beta and angiotensin II. However, because the pathogenesis of renal fibrosis is extremely complicated and our knowledge regarding this condition is still limited, further studies are needed.

Effects of long-term tubular HIF-2α overexpression on progressive renal fibrosis in a chronic kidney disease model

  • Dal-Ah Kim;Mi-Ran Lee;Hyung Jung Oh;Myong Kim;Kyoung Hye Kong
    • BMB Reports
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    • v.56 no.3
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    • pp.196-201
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    • 2023
  • Renal fibrosis is the final manifestation of chronic kidney disease (CKD) regardless of etiology. Hypoxia-inducible factor-2 alpha (HIF-2α) is an important regulator of chronic hypoxia, and the late-stage renal tubular HIF-2α activation exerts protective effects against renal fibrosis. However, its specific role in progressive renal fibrosis remains unclear. Here, we investigated the effects of the long-term tubular activation of HIF-2α on renal function and fibrosis, using in vivo and in vitro models of renal fibrosis. Progressive renal fibrosis was induced in renal tubular epithelial cells (TECs) of tetracycline-controlled HIF-2α transgenic (Tg) mice and wild-type (WT) controls through a 6-week adenine diet. Tg mice were maintained on doxycycline (DOX) for the diet period to induce Tg HIF-2α expression. Primary TECs isolated from Tg mice were treated with DOX (5 ㎍/ml), transforming growth factor-β1 (TGF-β1) (10 ng/ml), and a combination of both for 24, 48, and 72 hr. Blood was collected to analyze creatinine (Cr) and blood urea nitrogen (BUN) levels. Pathological changes in the kidney tissues were observed using hematoxylin and eosin, Masson's trichrome, and Sirius Red staining. Meanwhile, the expression of fibronectin, E-cadherin and α-smooth muscle actin (α-SMA) and the phosphorylation of p38 mitogen-activated protein kinase (MAPK) was observed using western blotting. Our data showed that serum Cr and BUN levels were significantly lower in Tg mice than in WT mice following the adenine diet. Moreover, the protein levels of fibronectin and E-cadherin and the phosphorylation of p38 MAPK were markedly reduced in the kidneys of adenine-fed Tg mice. These results were accompanied by attenuated fibrosis in Tg mice following adenine administration. Consistent with these findings, HIF-2α overexpression significantly decreased the expression of fibronectin in TECs, whereas an increase in α-SMA protein levels was observed after TGF-β1 stimulation for 72 hr. Taken together, these results indicate that long-term HIF-2α activation in CKD may inhibit the progression of renal fibrosis and improve renal function, suggesting that long-term renal HIF-2α activation may be used as a novel therapeutic strategy for the treatment of CKD.

Chewing difficulty and multiple chronic conditions in Korean elders: KNHANES IV (임상가를 위한 특집 3 - 한국 노인에서 저작불편감과 복합만성질 환의 연관성: 제4기 국민건강영양조사)

  • Han, Dong-Hun
    • The Journal of the Korean dental association
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    • v.51 no.9
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    • pp.511-517
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    • 2013
  • To assess the association between oral health and general health, this study examined the relationship between chewing difficulty and twelve chronic health conditions such as hypertension, hyperlipidemia, diabetes, cerebro- and cardiovascular disease, musculoskeletal disease, respiratory disease, eye/nose/throat disease, stomach/intestinal ulcer, renal dysfunction, thyroid disease, depression, and cancer in Korea. The study population was 3,066 elders aged 65 years old and more from the fourth Korean National Health and Nutrition Examination Survey. Chewing difficulty was measured on a 5-point Likert scale. Chronic conditions were assessed by self-reported questionnaire. Confounders were age, gender, education, income, smoking, drinking, and obesity. Chi-square test, general linear model, and multiple logistic regression model were done with complex sampling design. Musculoskeletal disease (adjusted odds ratio=1.33), respiratory disease (adjusted odds ratio=1.52), and cancer (adjusted odds ratio=1.58) were independently associated with chewing difficulty. Multiple chronic conditions with more than 4 chronic disease showed significant association with chewing difficulty (adjusted odds ratio=1.37).

Management of hepatitis C viral infection in chronic kidney disease patients on hemodialysis in the era of direct-acting antivirals

  • Ko, Soon Young;Choe, Won Hyeok
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.351-357
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    • 2018
  • The advent of novel, direct-acting antiviral (DAA) regimens for hepatitis C virus (HCV) infection has revolutionized its treatment by producing a sustained virologic response of more than 95% with few side effects and no comorbidities in the general population. Until recently, ideal DAA regimens have not been available to patients with severe renal impairment and end-stage renal disease because there are limited data on the pharmacokinetics, safety, and efficacy of treatment in this unique population. In a hemodialysis context, identifying patients in need of treatment and preventing HCV transmission may also be a matter of concern. Recently published studies suggest that a combination of paritaprevir/ritonavir/ombitasvir and dasabuvir, elbasvir/grazoprevir, or glecaprevir/pibrentasvir successfully treats HCV infection in chronic kidney disease stage 4 or 5 patients with or without hemodialysis.

A Pediatric Case of Inflammatory Bowel Disease with Renal Amyloidosis

  • Hyun, Hyesun;Park, Eujin;Kim, Ji Hyun;Cho, Myung Hyun;Kang, Hee Gyung;Moon, Jin Soo;Moon, Kyung Chul;Ha, Il-Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.81-85
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    • 2018
  • Amyloidosis is a rare disease that results from the deposition of extracellular protein in various body tissues, causing progressive organ dysfunction. Secondary renal amyloidosis is a rare but serious complication of chronic inflammatory bowel disease, particularly in patients with Crohn's disease or ulcerative colitis. We report a case of secondary renal amyloidosis in a pediatric patient who reported a 16-year history of "very early onset inflammatory bowel disease". Intensive treatment including repeated infliximab infusions improved clinical parameters of inflammatory bowel disease, although renal dysfunction showed progression. Amyloidosis should be considered in patients with IBD, particularly if they suffered disease progression.