• 대한한의학회지
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• 제44권4호
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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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• 제20권2호
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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.

• 동아시아식생활학회지
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• 제27권4호
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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.

• 대한지역사회영양학회지
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• 제6권1호
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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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• 제10권2호
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• pp.161-171
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• 1998

낙상은 노인에서 중요한 건강문제와 직결된다. 노인의 활동력 저하와 노화로 인한 생리학적 변화는 균형과 기능적 가동성 감소를 초래하고 낙상의 주요 요인이 된다. 노년기의 신체활동은 근력유지뿐만 아니라 균형감각 같은 신경계의 기능유지를 위해서도 필요하다. 노화 되어감에 따라 활동이 줄어들고 대근의 활동보다는 소근의 활동을 중심으로 소일하는 경우가 대부분이다. 따라서 신체의 운동범위가 좁아짐에 따라 활동할 때 신체균형감각이 둔화되어 낙상을 일으키게 되고 심각한 사회적 문제를 초래하게 된다. 그러므로 노인의 낙상방지와 생활의 질적 향상을 위해 적당한 강도의 운동과 균형수행력을 향상시키는 훈련이 필요하다.

• 한국노년학
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• 제38권3호
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• pp.537-550
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• 2018

본 연구는 지역사회 재가노인의 체수분정도 및 영향요인을 파악하기 위해 시행되었다. 본 연구는 서술적 조사연구로서 65세 이상 노인 135명을 대상으로 하였으며 자료수집기간은 2016년 10월-2017년 2월까지였다. 자료수집 방법으로는 일대일 면담을 통한 설문지조사와 신체계측이 사용되었다. 연구 결과 연구 대상자의 대부분은 적정 체수분율 보이는 것으로 나타났다. 그러나 일부 노인 특히 여성노인에서는 체수분율이 저하된 상태였다. 지역사회 재가노인의 체수분정도는 성별, 체질량지수, 만성질환 수, 약물복용 수, 요실금정도에 따라 유의한 차이가 있었으며 유의한 영향요인은 체질량지수(${\beta}=-0.51$, p=<.001), 성별(${\beta}=-0.47$, p=<.001)이었고 이 회귀모형의 설명력은 51%이었다. 앞으로 지역사회 재가노인의 체수분정도에 대한 지속적 관심이 필요하며 특히 위험요인을 가지고 있는 여성노인에 대한 집중적인 관심이 필요하다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권2호
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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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• 제27권2호
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• pp.357-370
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• 2007

본 연구는 시설노인을 위한 수분 섭취 강화 프로그램을 개발하고 적용하여 그 효과를 평가하고자 수행되었다. 자료 수집은 충청지역에 위치한 일개 노인요양시설에 거주하는 39명의 노인을 대상으로 하였으며 프로그램 적용 전, 4주후, 6주후의 연속 3일 측정한 수분 섭취량의 평균, 소변색, 요비중의 평균, 요비중이 탈수 내지 임박한 탈수의 범위에 속하는 대상자의 비율을 비교하였다. 수분 섭취 강화 프로그램 적용 전 1일 평균 수분 섭취량은 프로그램 적용 4주후, 6주후에 통계적으로 유의한 증가를 나타냈다. 1일 수분 충분섭취량인 1,100mL 미만을 섭취한 대상자의 비율은 프로그램 적용 전에 비해 4주, 6주후에 감소하였다. 요비중이 임박한 탈수 혹은 탈수의 범위에 속하는 대상자 비율은 중재 전 보다 중재 4주후에 감소하였으나 6주후 증가하였고 요비중의 평균은 프로그램 적용 4주후, 6주후에 통계적으로 유의한 차이를 나타내었다. 소변색은 중재 전, 후 모두 정상범위를 나타내었다. 본 연구의 결과는 시설노인 수분 섭취 강화프로그램은 노인의 수분 섭취를 증진하는데 기여할 수 있는 가능성을 시사하며 추후 임상에서의 적용을 위하여 해결해야 할 문제점들을 논의하였다.

• 한국임상약학회지
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• 제27권4호
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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.