• The Journal of Korean Medicine
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• v.44 no.4
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• pp.163-169
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• 2023

Methods: This study presents a comprehensive case study of an elderly male diagnosed with acute kidney injury (AKI) resulting from severe dehydration, supported by an extended follow-up with laboratory findings. Results: An 83-year-old male patient experienced severe diarrhea overnight, leading to hospitalization due to symptoms of dehydration and hypotension. His laboratory results displayed a typical AKI pattern, including a significant increase in creatinine levels (5.19 mg/dL) and the presence of hyperkalemia and hyponatremia. Following general treatments, including the administration of an herbal drug (Bulhwangeumjeonggi-san), the estimated glomerular filtration rate (eGFR) improved from 10 ml/min (Stage 5) to 34 ml/min (Stage 3) within five days when he was discharged. Although subsequent eGFR tests, conducted one and two months later as an outpatient, revealed an improvement of 42 ml/min, the patient still experienced mild chronic dysfunction as a consequence. Conclusion: This study presents a noteworthy case of acute kidney injury attributed to severe dehydration, emphasizing the importance of medical awareness regarding diarrhea-induced kidney function impairment, especially in the elderly population.

• Journal of Korean Biological Nursing Science
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• v.20 no.2
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• pp.67-75
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• 2018

Purpose: The aim of this study was to explore the prevalence of major chronic diseases related to daily oral water intake and to identify the physiological parameters related to dehydration in Korean elderly. Methods: The data were collected from the sixth Korea Health and Nutrition Examination Survey (KHANES), which was a nationwide and cross-sectional survey in 2015. We analyzed 1,392 participants using t-test and logistic regression. All participants were divided into the adequate water intake (AWI) group and the non-adequate water intake (NAWI) group based on the dietary reference intakes for Koreans. Results: There was a significant difference in the water intake between the AWI (6.8 cups in a day) and NAWI (2.8 cups) groups (p< .001). There was no statistically significant association between the level of water intake and any of the major chronic diseases. Blood urea nitrogen (BUN) and BUN/Creatinine (Cr) ratio were significantly higher in the NAWI group. Especially, BUN/Cr ratio shows that the NAWI group reached dehydration status. Older age (adjusted odd ratio, OR= 1.07, 95% confidence interval, CI [1.04-1.10]), female gender (adjusted OR= 1.56, 95% CI [1.05-2.33]), lower body mass index (BMI) (adjusted OR = 1.00, 95% CI [0.92-1.00]), higher BUN (adjusted OR = 1.04, 95% CI [1.01-1.08]), and higher urine specific gravity (USG) (adjusted OR= 1.56, 95% CI [1.19-2.05]) were factors associated with the NAWI group. Conclusion: The findings suggest that the level of water intake needs to be considered in relation to age, gender, BMI, BUN, and USG. These are sensitive physiological parameters used for predicting dehydration of the elderly according to their daily oral water intake. It would be helpful to develop strategies to prevent dehydration in elderly individuals and enhance their water intake.

• Journal of the East Asian Society of Dietary Life
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• v.27 no.4
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• pp.477-490
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• 2017

The objective of this study was to analyze the relationship between blood pressure and serum mineral concentration in hypertension patients subjected to dehydration. The data were collected and analyzed for 7,109 patients who visited a hospital for their health checkup from 2011 till 2015. Respondents were classified into four groups depending upon their state of hypertension and dehydration: control group (no hypertension and no dehydrated), dehydrated group, hypertension group, and dehydrated with hypertension group. Hypertension group was found to have higher levels of serum sodium, calcium, and uric acid than the normal group, whereas the dehydrated group was found to have higher levels of serum sodium and potassium than the normal group. In effect, no significant correlation was directly observed between the hypertension group and dehydration group. However, there were significant negative correlations between dehydration of the old-aged group and their serum mineral concentrations, which are reportedly related to hypertension. Thus, dehydration prevention measures in the elderly over 65 could mitigate hypertension problems.

• Korean Journal of Community Nutrition
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• v.6 no.1
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• pp.76-83
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• 2001

This study was designed to determine serum osmolality and to investigate the association among serum osmolality, health-related factors and biochemical indices. Two hundred thirty seven elderly(86 male, 151 female : mean age 73.8) residing in the chungbuk area participated. Sociodemographic data and self-perceived health status were obtained by interview, and biochemical parameters were measured. The mean serum osmolaity was 301.2$\pm$10.1 mOsm/kg(range 240.8~328.9 mOsm/kg) and serum osmolality of the females(302.4 mOsm/kg) was significantly(p＜0.05) higher than that of the males(299.0 mOsm/kg). Only 11.0% of the elderly were within the accepted normal range(280~295 mOsm/kg) and the majority of the subjects were in a hyperosmolar state(60.8% : 296~307 mOsm/kg). It was observed that serum osmolality was reduced with increasing age but not statistically significant. There was no significant difference in serum osmolality according to marital status. Serum osmolality was significantly lower(p＜0.05) in the elderly with higher self-perceived health scores than the elderly with lower self-perceived health scores, however no significant difference was observed between the presence or absence of disease. Serum osmolality tended to be higher(p=0.06) in the elderly with difficulty in mobility than the elderly who have no problem in mobility. Serum osmolality tended to be higher(p=0.06) among drug users compared to that of non-users. There was a significant association between serum osmolality and serum albumin in females but not in males. Significant associations were shown between serum osmolality and serum transferrin in both sexes. However, there was no significant correlation between serum osmolality and hemoglobin or hematocrit except with hematocrit in females only. The results of this study indicated that the elderly were dehydrated and hydration state seems to influence health status and, the elderly should be encouraged to drink an adequate amount of fluids. Also, the hydration state is required to be assessed and considered for the interpretation of biochemical parameters.

• The Journal of Korean Physical Therapy
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• v.10 no.2
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• pp.161-171
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• 1998

Balance can be defined as the ability to maintain the body's center of gravity within the base of support with minimal sway. Falls occur frequently in the elderly persons by the physiological change and dysfunction with age. Injuries resulting from falls include soft tissue damage and fractures of the radius, humerus, and femoral neck other consequences of falls include decreased mobility, reduced confidence, long lies (which can give rise to hypothermia, dehydration and pneumonia), and death Risk factors for falls have beau classified as intrinsic (those related to the individual) and extrinsic(those associated with environmental features), Intrinsic factors include decreased strength, visual deficits, vestibular dysfunction, and decreased vibratory sensation in the feet. Improvement of the balance related to the increased probability for fells in the elderly persons and is important for fall preventions and improvement of the living quality ef the elderly persons

• 한국노년학
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• v.38 no.3
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• pp.537-550
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• 2018

The purpose of this study was to investigate the status of total body water and it's influencing factors in community elderly. In this descriptive study, data were collected from 135 elderly at senior citizen center, from October 4 2016 to February 28 2017. Surveys using questionnaire and anthropometric measurements for BMI and total body water were done for data collection. The results of the study showed that while most of the subjects of the study showed total body water within the appropriate range, some elderly especially elderly women show a degraded total body water. Total body water showed significant difference according to sex, body mass index, number of chronic illness, number of medication and urinary incontinence levels. Significant influencing factors were BMI(${\beta}=-0.51$, p=<.001), sex(${\beta}=-0.47$, p=<.001) and this regression model explained 51% of the variance in total body water. In the future, attention needs to be paid to the total body water of the elderly in the local community, especially to the elderly women with risk factors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.130-133
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• 2017

Noroviruses have been recognized as the leading cause of epidemic and sporadic gastroenteritis since the advent of molecular diagnostic technique. They have been documented in 5-31% of pediatric patients hospitalized with gastroenteritis. Although norovirus gastroenteritis is typically mild and self-limited, it causes severe, but sometimes fatal, conditions in the vulnerable population such as immunocompromised patients, young children, and the elderly. Bowel perforation due to norovirus infection is rare. We report a case of small bowel perforation with norovirus gastroenteritis in the infant with Down syndrome during the hospitalization with pneumonia. Severe dehydration may cause bowel ischemia and could have triggered bowel perforation in this case. Physicians should be alert to the potential surgical complications followed by severe acute diarrhea, especially in high risk groups.

• 한국노년학
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• v.27 no.2
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• pp.357-370
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• 2007

The purposes of this study were to 1) develop fluid intake enhancing program for the institutionalized elderly and 2) examine the effect of fluid intake enhancing program on amount of daily fluid consumed, urine specific gravity, and urine color. Data were collected from 39 nursing home residents in a nursing home located in urban Chung-chung providence. With a convenient sample of 39 nursing home residents, consecutive three days of 24 hour fluid intake, were measured and recorded. Urine samples were obtained and urine specific gravity, urine color were analyzed at pre-intervention, 4 weeks, and 6 weeks following the intervention. When compared to pre-intervention, the average amount of daily fluid intake was significantly increased at 4 weeks and 6 weeks following the intervention. The proportion of subjects who consumed less than Adequate Intake(AI) was 35.9% at pre-intervention and was decreased to 10.3%, 7.7%. In conclusion, inadequate fluid intake among institutionalized elderly is prevalent. From careful employment of the fluid intake enhancing program, increase in fluid consumption among institutionalized elderly can be expected.

• Korean Journal of Clinical Pharmacy
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• v.27 no.4
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• pp.214-220
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• 2017

Background: Dapagliflozin is an oral selective inhibitor of sodium-glucose cotransporter 2(SGLT2), the kidney transporter chiefly responsible for glucose reabsorption from the glomerular filtrate. Because this mechanism does not require the action of insulin, dapagliflozin rarely causes hypoglycemia. Dapagliflozin may affect blood glucose control as well as blood pressure and the body weight which are one of the cardiovascular disease risk factors. However, dehydration and ketoacidosis are reported as the side effects of the dapagliflozin treatment and the safety issues have been occurred. The aim of this study is to analyze the effectiveness and adverse events of dapagliflozin in Korean patients. Methods: From December 2014 to August 2015, we retrospectively reviewed the electronic medical records of type 2 diabetes patients who were prescribed dapagliflozin at Severance Hospital. Results: A total of 202 Korean patients were enrolled in this study. The effectiveness in the reduction of blood glucose was statistically significant(p<0.001). Dapagliflozin decreased 0.74% of HbA1c after 24 weeks. Significantly more participants achieved the target HbA1c level(HbA1c<7%) after 24 weeks(n=42, 35.3%) than before taking dapagliflozin(n=21, 17.6%). Blood pressure decreased 5.7 mmHg systolic blood pressure(SBP), 1.9 mmHg diastolic blood pressure(DBP) after 24 weeks. More than one quarter of participants(n=35, 29.4%) experienced weight loss. Most common adverse event was genitourinary symptoms. Conclusion: In this study, the effectiveness of dapagliflozin in improving glycemic control, blood pressure control, and weight loss was statistically significant. However, elderly and female patients, who have higher incidence of adverse events, should use dapagliflozin cautiously.