• Title/Summary/Keyword: chronic renal disease

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Rapid deterioration of preexisting renal insufficiency after autologous mesenchymal stem cell therapy

  • Kim, Jun-Seop;Lee, Jong-Hak;Kwon, Owen;Cho, Jang-Hee;Choi, Ji-Young;Park, Sun-Hee;Kim, Chan-Duck;Kim, Yong-Jin;Kim, Yong-Lim
    • Kidney Research and Clinical Practice
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    • v.36 no.2
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    • pp.200-204
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    • 2017
  • Administration of autologous mesenchymal stem cells (MSCs) has been shown to improve renal function and histological findings in acute kidney injury (AKI) models. However, its effects in chronic kidney disease (CKD) are unclear, particularly in the clinical setting. Here, we report our experience with a CKD patient who was treated by intravenous infusion of autologous MSCs derived from adipose tissue in an unknown clinic outside of Korea. The renal function of the patient had been stable for several years before MSC administration. One week after the autologous MSC infusion, the preexisting renal insufficiency was rapidly aggravated without any other evidence of AKI. Hemodialysis was started 3 months after MSC administration. Renal biopsy findings at dialysis showed severe interstitial fibrosis and inflammatory cell infiltration, with a few cells expressing CD34 and CD117, 2 surface markers of stem cells. This case highlights the potential nephrotoxicity of autologous MSC therapy in CKD patients.

Valve Replacement in an Anuric Patient with Chronic Renal Failure - 1 Case Report - (만성 신부전으로 인한 무뇨증 환자에서의 판막치환술 - 1례 보고 -)

  • Kim, Si-Hoon;Kwack, Moon-Sub;Lee, Sun-Hee;Park, Jae-Kil;Jin, Ung
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.588-590
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    • 1999
  • It is now generalized to perform cardiac surgery in the patients with end-stage renal disease. The growing number of patients with chronic renal failure wake us up to the need to prepare for proper management. There are not only the prevalence of coronary artery disease, but also a great amount of valve dysfunction exist in this group. Peritoneal dialysis may be one of the obstacles for cardiopulmonary bypass but it is not a great hindrance in cardiac surgery with careful preparation and well organized perioperative care. The author has performed mitral valve replacement in a 33-year-old anuric female patient with chronic renal failure and severe mitral insufficiency. Preoperatively, the patient was kept in adequate fluid and electrolyte balance using peritoneal dialysis. Peritoneal dialysis continued and regulated according to the laboratory data in this patient during and after the surgery. She recovered well showing an uneventful course and was discharged on postoperative 1 th day.

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Metastatic Bilateral Renal T-Cell Lymphoma in a Persian Cat

  • Kim, Mi-Ryung;Son, Jung-Min;Lee, Seoung-Jin;Jang, Seong-Hwan;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.36 no.6
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    • pp.353-357
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    • 2019
  • A two-year-old spayed female Persian cat demonstrated weight loss, anorexia, and vomiting for one week. Hematologic findings suggested chronic renal failure. Radiography and ultrasonography revealed severe bilateral renomegaly with hypoechoic nodules and subcapsular hypoechoic rim. Fine needle aspiration of the kidney revealed malignant lymphoma. The cat received in-hospital treatment for chronic renal failure for seven days, followed by chemotherapy (cyclophosphamide, vincristine, and prednisolone). The cat tolerated chemotherapy well and chronic kidney disease was alleviated. However, complete remission was not achieved. After 93 days of treatment, the cat exhibited anisocoria and mental dullness. Brain magnetic resonance imaging revealed hypertrophy and enhancement of cranial nerves. Chemotherapy was replaced with lomustine (10 mg orally), and two weeks later, cytosine arabinoside (50 mg/㎡ subcutaneously), twice daily for consecutive days. Five days after substitution chemotherapy, the patient showed anemia due to severe intestinal bleeding and died. Post-mortem examination and histopathologic analysis confirmed renal T-cell lymphoma with metastasis to the central nervous system, colon, and nasal cavity. Survival time was 117 days after the diagnosis of renal lymphoma.

Case reports of amniotic membrane derived-cell treatment for feline chronic renal failure

  • Noh, Seul Ah;Kim, Taeho;Ju, Junguk
    • Journal of Animal Reproduction and Biotechnology
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    • v.36 no.2
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    • pp.116-120
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    • 2021
  • Three different cats who had chronic kidney disease (CKD) were treated for more than one month with fluid therapy in an animal clinic. Although this long-term treatment and hospitalization, there was no clinical improvement in clinical signs as well as serum biochemical indexes including blood urea nitrogen (BUN), creatinine (CREA), and phosphate (PHOS). All cases were then injected three times with allogeneic stem cells through an intravenous route for treatment on Day 0, 7, and 14 or 30. On the same day, clinical observation and blood tests for serum biochemistry were conducted together. Upon administrating stem cells to the CKD cats, clinical conditions and the indexes of BUN and CREA were clinically improved within normal ranges. Additionally, one of the cats who had the renal cysts presented clinical improvement with showing decreased cysts size than before.

Surgical Treatment of Takayasu`s Arteritis with Renovascular Hypertension (신성고혈압을 동반한 Takayasu 동맥염의 수술치험 1)

  • 권우석
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.171-176
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    • 1987
  • Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and its major branches. Symptoms and signs of the disease are various depending on the involved area. We experienced a surgical case of Takayasu`s arteritis mainly involving both renal arteries with renovascular hypertension in a 13 year old girl. Hypertension was not controlled by medical treatment including diuretics and captopril [160/140 mmHg]. Aortogram showed severely stenosed right renal artery, nearly obstructed left renal artery and not visulalized superior mesenteric artery. Angioplasty was performed for the right renal artery but aorta-renal bypass graft with greater saphenous vein was inevitable for the left renal artery. Blood pressure was controlled sufficiently with some adjunct of captopril postoperatively [130/90 mmHg]. While the patient was discharged with much improvement, she was lost follow up and died of not identified definitive cause 3 months later.

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Two cases of Familial Juvenile Hyperuricemic Nephropathy (Familial Juvenile Hyperuricemic Nephropathy 2례)

  • Park Jin-Ho;Choi Bo-Hwa;Lee So-Young;Yoo Eun-Sil;Park Young-Seo
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.183-188
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    • 1997
  • Familial juvenile hyperuricemic nephropathy is an autosomal dominant disease characterized by progressive renal disease and hyperuricemia or gout, affecting young people of either sex equally. There are two biochemical markers of this disorder. The first is hyperuricemia disproportionate to the degree of renal dysfunction; the second is a grossly reduced clearance of uric acid relative to creatinine, dispropotionate to age, sex and degree of renal failure. We experienced 2 family members with hyperuricemia. One family member, a 13-year-old girl who had suffered from tophaceous gout and chronic renal failure. Her younger brother also had hyperuricemia and moderately reduced renal function. Their urinary excretion fractions of uric acid($FE_{uric\;acid}$) were reduced and renal biopsy specimens showed interstitial fibrosis with tubular atrophy and interstitial urate crystal deposition. We have treated these two patients with allopurinol but we have done renal transplantation because she progressed to end stage renal disease at 16 year old age.

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Safety and efficacy of pemetrexed for the treatment of lung adenocarcinoma in patients with various stages of chronic kidney disease

  • Yang, Jieun;park, Ji Eun;Jo, Jaemin;Kim, Young Ree;Chang, Jee Won;Han, Sang Hoon;Han, Chi Wha
    • Journal of Medicine and Life Science
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    • v.19 no.1
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    • pp.14-19
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    • 2022
  • We investigated the safety and efficacy of pemetrexed monotherapy in patients with lung adenocarcinoma and various renal conditions, including chronic kidney disease. We also analyzed whether baseline renal function affected progression-free survival (PFS). We retrospectively analyzed 71 patients who received maintenance-and second-line pemetrexed monotherapy. Patients were divided into two groups according to estimated glomerular filtration rate (eGFR): fair eGFR (>60 mL/min/1.73 m2) and lower eGFR (59 mL/min/1.73 m2 or less). The safety and efficacy were evaluated for each group. Median ages were 73.2 years in the lower eGFR group (n=28) and 64.5 years in the fair eGFR group (n=43). Patients with a lower eGFR achieved a median PFS of 4.7 months, while the median PFS for patients with a fair eGFR was 2.7 months. The difference between the two groups was not statistically significant (P=0.075). Both groups showed treatment-related low-grade hematological and non-hematological adverse events. Pemetrexed monotherapy is safe and effective in patients with lung adenocarcinoma with a lower eGFR.

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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    • v.19 no.2
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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.

Effectiveness of exercise for improving physical and renal function in older adults with pre-dialysis chronic kidney disease: A systematic review and meta-analysis (운동중재가 투석 전단계 만성 신질환 노인의 신체기능 및 신기능 향상에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Lee, Hyeon-Ju;Son, Youn-Jung;Jang, So Eun
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.34-47
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    • 2023
  • Purpose : Exercise may prevent the worsening of chronic kidney disease (CKD) and progression of cardiovascular diseases in patients with CKD. This review aims to identify the best type of exercise modality and summarizes the beneficial effects of exercise on physical and renal function among older adults with pre-dialysis CKD. Methods : A systematic search of PubMed, Embase, CINAHL, Cochrane Library, Web of Science, SCOPUS, and domestic database was performed for randomized controlled trials (RCTs) assessing the effect of exercise intervention on older adults with pre-dialysis CKD published until February 2023. A random-effects meta-analysis was conducted. The risk of bias was assessed using a Cochrane tool for assessing the risk of bias in RCTs (RoB 2.0). Results : The systematic review included 11 RCTs (n = 591, average age 60.2-76), of which 8 could be included for meta-analysis. Exercise was significant in increasing peak oxygen consumption and knee muscle strength among physical functions, and also in improving glomerular filtration rate among kidney functions. Conclusion : Exercise has beneficial effects on physical and renal function among older adults with pre-dialysis CKD. In the future, it is necessary to verify the effectiveness of exercise by subdividing it by type, intensity, duration, and delivery.

Familial Juvenile Hyperuricemic Nephropathy and Uromodulin Gene Mutation

  • Lee, Young-Ki;Lee, Dong Hun;Noh, Jung-Woo
    • Journal of Genetic Medicine
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    • v.10 no.1
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    • pp.7-12
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    • 2013
  • Familial Juvenile hyperuricemic nephropathy (FJHN) is a rare autosomal dominant disorder, characterized by early onset of hyperuricemia, gout and progressive kidney disease. Hyperuricemia prior to renal impairment and decreased fractional excretion of uric acid are hallmarks of FJHN. Renal dysfunction gradually appears early in life and results in end-stage renal disease usually between the ages of 20 and 70 years. FJHN is mostly caused by mutations in the uromodulin gene located at 16p12. The course of FJHN is highly variable. Treatment includes management for hyperuricemia, gout and progressive kidney disease. Individuals with gout have been usually treated with allopurinol. But controversy exists as to whether uric acid lowering therapy prevents the progression of chronic kidney disease.