• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.421-426
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• 2015

Purpose: The vancomycin dosage regimen is regularly modified according to the patient's glomerular filtration rate (GFR). In the present study, we aimed to assess the usefulness of serum cystatin C (Cys-C) concentration, compared with serum creatinine (SCr) concentration, for predicting vancomycin clearance (CLvcm) in neonates. Methods: We retrospectively analyzed the laboratory data of 50 term neonates who were admitted to the neonatal intensive care unit and received intravenous vancomycin, and assessed the pharmacokinetic profiles. Creatinine clearance (CLcr) and GFR based on Cys-C (GFRcys-c) were estimated using the Schwartz and Larsson formulas, respectively. Results: The mean CLvcm (${\pm}$standard deviation) was $74.52{\pm}31.17L/hr$, the volume of distribution of vancomycin was $0.67{\pm}0.14L$, and vancomycin half-life was $9.16{\pm}17.42hours$. The SCr was $0.46{\pm}0.25mg/dL$ and serum Cys-C was $1.43{\pm}0.34mg/L$. The peak and trough concentrations of vancomycin were $24.65{\pm}14.84$ and $8.10{\pm}5.35mcg/mL$, respectively. The calculated GFR based on serum creatinine concentration (GFR-Cr) and GFRcys-c were $70.2{\pm}9.45$ and $63.6{\pm}30.18mL/min$, respectively. The correlation constant for CLvcm and the reciprocal of Cys-C (0.479, P=0.001) was significantly higher than that for CLvcm and the reciprocal of SCr (0.286, P=0.044). GFRcys-c was strongly correlated with CLvcm (P=0.001), and the correlation constant was significantly higher than that for CLvcm and CLcr (0.496, P=0.001). Linear regression analysis showed that only GFRcys-c was independently and positively correlated with CLvcm (F=41.9, P<0.001). Conclusion: The use of serum Cys-C as a marker of CLvcm could be beneficial for more reliable predictions of serum vancomycin concentrations, particularly in neonates.

• 대한중풍순환신경학회지
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• 제18권1호
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• pp.13-22
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• 2017

■ Objectives This case is to report the effect of Oryeong-san and acupuncture therapy on serum creatinine level of a cerebral infarction patient with diabetic nephropathy. ■ Methods A female Korean patient was treated with Oryeong-san, acupuncture for total 32 days. We observed renal function test, input/output balance, body weight, hand and foot circumferences, and other symptoms like edema, urination, and any adverse event. ■ Results After treatment, serum creatinine level was improved to 2.48mg/dL from 3.45mg/dL at admission, and foot circumference was decreased to 18.5~18.9cm from 22.0~22.5cm without any adverse event. However, we couldn't find any significant differences on input/output balance, body weight, or symptoms of urination. ■ Conclusion This case suggests that Oryeong-san and acupuncture therapy could be effective in improving serum creatinine clearance of cerebral infarction patient with diabetic nephropathy.

• 약학회지
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• 제29권3호
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• pp.130-143
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• 1985

Bumetanide, when given intravenously in dogs, induced a potent diuresis with an increased amounts of sodium and potassium excreted in urine due to inhibition of reabsorbing them in renal tubule. Furthermore, clearances of osmolar substance and para-aminohippuric acid were increased, but clearace of free water diminished without any change of creatinine clearance. Bumetanide, administered directly into a renal artery, elicited diuresis only in the infused(experimental) kidney by the same mode of action as in the intravenous cases in renal function of the dog. Renal effects of intravenous bumetanide after pretreatment with the small dose of indomethacin (5.0mg/kg) revealed reduction only in clearance of paraaminohippuric acid. However the much dose of indomethacin (5.0mg/kg+5.0mg/kg/hr) or arachidonic acid showed a significant inhibition in the change rates of all renal function by bumetanide. Morover, pretreatment of probenecid also made a marked reduction in renal effects induced by bumetanide. From the above results, it is thought that bumetanide causes diuretic action due to dual mechanism inhibiting reabsorption of electrolytes in loop of Henle and increasing blood flow in kindney, that are provoked through the mediation of prostaglandins.

• Archives of Pharmacal Research
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• 제12권3호
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• pp.154-159
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• 1989

Pharmacokinetics and urinary excretion of sulfamethoxazole were investigated in healthy sheep. From the plasma disappearance curves after intravenous bolus injection (50 mg/kg), the half-life and volume of distribution were found to be 76 $\PM$14 min and 0.41 $\PM$ 0.18 lit/kg respectively. Body clearance was 4.06 $\PM$ 1.03 ml/kg/min. Very low Concentration of ddrug was present in plasma after 3 hours of administration and plasma level at 6 hour was only 4.4 $\PM$ 2.0 $\mu$g/ml. The renal clearance of sulfamethoxazole (22 $\PM$ 2.17 ml/min/10 kg) exeeded the creatinine clearance (9.78 $\PM$ 1, 57 ml/min/ 10 kg) which may be due to involvement of active tubular secretion and pH dependent back diffusion. Half of the dose of sulfamethoxazole was excreted as unchanged free drug while acetylated amine comprised of 20 percent within the first 6 hours of drug administration.

• 동의생리병리학회지
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• 제17권2호
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• pp.423-427
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• 2003

The present study was aimed to investigate whether ethanol-extract of Allium wageki has an ameliorative effect on the renal function in high fructose-diet induced hypertensive rats .. The urine osmolality (Uosmol) was decreased in rats with high fructose-diet (60%) during the whole experiment period without change of the urine volume (UV). The urinary excretion of sodium (UNaV) and chloride (UCIV) were decrease significantly in rats with fructose-induced hypertensive rats, whereas urinary excretion of potassium (UKV) was Increased. The creatinine clearance (Ccr) and solute-free water reabsorption were also decreased by treatment of fructose-rich diet. Among these renal functional parameters, Ccr was partially restored by the administration of ethanol-extract of Allium wageki. The Uosmol was also partially restored by the administration ethanol-extract of Allium wageki at the end of the experimental period. Taken together, ethanol-extract of Allium wageki has the ameliorative effect on glomerular filtration rate in rats with high fructose-diet induced hypertension.

• 대한한의학회지
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• 제17권1호
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• pp.212-221
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• 1996

The aim of this experiment was to elucidate the effects of Saseuptang water extract on the renal function plasma renin activity and plasma levels of atrial natriuretic peptide and aldosterone in rat The results were as follows; 1. Water balance decreased significantly after the administration of Saseuptang water extract, 0.4 and 0.8ml/kg. 2. Urine volume increased significantly after the administration of Saseuptang water extract, $0.4\;m{\ell}/kg$. 3. Urinary excretion of chloride increased significantly after the administration of Saseupthang water extract, $0.8\;m{\ell}/kg$. 4. Free water clearance increased significantly after the administration of Saseuptang water extract, $0.8\;m{\ell}/kg$. 5. Urinary excretion of creatinine increased significantly after the administration of Saseuptang water extract, $0.8\;m{\ell}/kg$. 6. Plasma levels of atrial natriuretic peptide (ANP) decreased significantly after administration of Saseupthang water extract, $0.8\;m{\ell}/kg$. These results suggest that the changes of urine volume after the administration of Saseuptang water extracts are related to the increments of glomerular filtration rate and free water clearance, and it is suggested that the changes of renal function by which Saseuotang may related to the renin-angiotensin and atrial natriuretic peptide system.

• 한방안이비인후피부과학회지
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• 제12권2호
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• pp.53-66
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• 1999

This study has been carried out to investigate the effects of Dojuksan on the renal functions and internal secretion system, as water balance, urine volume, urinary excretion of sodium and potassium, free water clearance, urinary excretion of creatinine, plasma levels of artrial natriuretic peptide (ANP), plasma levels of aldosterone and plasma renin activity, comparing experimental group which Dojuksan water extract were administrated with control group. Sprague-Dawley rats, about 200-250 g, were used for this experiment. The results of this study were as follows: 1. Water balance decreased significantly after the administration of Dojuksan water extract. 2. Urine volume increased significantly after the administration of $100{\mu}l$ Dojuksan water extract per 100g rat. 3. Urinary excretion of sodium increased significantly but urinary excretion of potassium did not change after the administration of Dojuksan water extract. 4. Free water clearance decreased significantly after the administration of Dojuksan water extract 5. Urinary excretion of creatinine increased significantly after the administration of Dojuksan water extract 6. Plasma renin activity did not change after the administration of Dojuksan water extract 7. Plasma levels of artrial natriuretic peptide (ANP) did not change after the administration of Dojuksan water extract 8. Plasma levels of aldosterone decreased significantly after the administration of 200 ${\mu}Dojuksan water extract per l00g rat The results suggest that Dojuksan increase the urinary excretion of sodium. and thus reduce the water balance, which resulted from suppression of sodium reabsorption into renal tubule by increasing glomerular filtration rate and decreasing aldosterone.

• Childhood Kidney Diseases
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• 제17권2호
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• pp.57-64
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• 2013

목적: 소아에서 24시간 소변 수집의 단점을 대체하기 위해 $^{99m}Tc$-MAG3 신장 스캔을 통한 신기능을 측정하여, 크레아티닌 청소율과 혈청 cystatin C과 크레아티닌에 의한 사구체 여과율 추정식을 비교하여 연관성을 확인하였다. 방법: 2011년 7월부터 2012년 8월까지 101명의 18세 미만의 환자들을 대상으로 의무기록 후향적 조사로 실시하였고 $^{99m}Tc$-MAG3 신장 스캔을 시행하여 사구체 여과율을 측정하였다. 24시간 소변과 혈액을 체취하여 크레아티닌 청소율을 측정하였고 5개의 추정식을 통해 사구체 여과율을 측정하였다. 결과: 크레아티닌 청소율과 $^{99m}Tc$-MAG3 신장 스캔을 이용한 사구체 여과율의 Pearson 상관 계수는 0.389(P<0.001)이었다. $^{99m}Tc$-MAG3 신장 스캔과 Schwartz 식, Counahan-Barratt 식, MDRD 식, Cockcroft-Gault 식, Filler and Lepage 식, Bokencamp 식에 의한 사구체 여과율의 Pearson 상관 계수는 각각 0.265 (P=0.007), 0.128(P=0.044), 0.216 (P=0.030), 0.230 (P=0.021), 0.356 (P<0.001), 0.355 (P<0.001) 로 확인되었다. 사구체 및 비사구체 신질환의 비교에서 $^{99m}Tc$-MAG3 신장 스캔에 의한 사구체 여과율은 모두 유의한 상관성을 가졌고, 신기능의 저하 유무에 상관없이 $^{99m}Tc$-MAG3 신장 스캔에 의한 사구체 여과율은 크레아티닌 청소율과 유의한 연관성을 보였다. 결론: 크레아티닌 청소율과 $^{99m}Tc$-MAG3 신장 스캔에 의한 사구체 여과율 간에는 유의한 상관성이 있으며 $^{99m}Tc$-MAG3 신장 스캔에 의한 사구체 여과율은 신질환의 기원과 신기능의 정상 여부 모두에서 크레아티닌 청소율을 대체할 수 있는 방법임을 확인할 수 있었다. $^{99m}Tc$-MAG3 신장 스캔 이용 시 정확하고 빠른 결과를 얻을 수 있으리라 생각된다.

• 핵의학기술
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• 제13권1호
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• pp.98-103
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• 2009

Purpose: Correct estimation of Glomerular filtration rate (GFR) is very important for an accurate clinical assessment of the kidney function. This study compares four GFR markers, a serum creatinine-based estimation using MDRD formula, Cystatin-C, Cr-51 EDTA 2 samples and 6 samples. Materials and Methods: Serum creatinine concentrations, Cystatin-C serum concentrations and Cr-51 EDTA clearance are measured in 43 patients who received or donated kidney. Results: The correlation coefficient between serum based estimated GFR (MDRD) and Cr-51 EDTA 6 samples was 0.817 (p<0.01). The correlation coefficient between Cystatin-C based GFR and EDTA 6 samples was 0.7322 (p<0.01). Regression analysis showed a statistically significant correlation between Cr-51 EDTA 2 samples and 6 samples (r=0.971, p<0.01). Mean value and ${\pm}2SD$ for the difference between Cr-51 EDTA 2 samples and 6 samples were 4.7 mL/min and ${\pm}9.3$ respectively. Conclusions: The estimation of two samples Cr-51 EDTA showed that the method can be simplified by reducing blood samples without losing its high accuracy.

• The Korean Journal of Physiology and Pharmacology
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• 제12권6호
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• pp.331-336
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• 2008

The present study was aimed to determine whether there is an altered regulation of tubular transporters in gentamicin-induced nephropathy. Sprague-Dawley male rats ($200{\sim}250\;g$) were subcutaneously injected with gentamicin (100 mg/kg per day) for 7 days, and the expression of tubular transporters was determined by immunoblotting and immunohistochemistry. The mRNA and protein expression of OAT was also determined. Gentamicin-treated rats exhibited significantly decreased creatinine clearance along with increased plasma creatinine levels. Accordingly, the fractional excretion of sodium increased. Urine volume was increased, while urine osmolality and free water reabsorption were decreased. Immunoblotting and immunohistochemistry revealed decreased expression of $Na^+/K^+$-ATPase, NHE3, NBC1, and AQP1 in the kidney of gentamicin-treated rats. The expression of OAT1 and OAT3 was also decreased. Gentamicin-induced nephropathy may at least in part be causally related with a decreased expression of $Na^+/K^+$-ATPase, NHE3, NBC1, AQP1 and OAT.