• 비만대사연구학술지
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• 제1권2호
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• pp.66-73
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• 2022

Obesity is an increasing public health and medical issue worldwide. It has been associated with several comorbidities, including diabetes, cardiovascular disease, stroke, and cancer. Chronic kidney disease (CKD) is another important comorbidity of obesity. Other major causes of CKD include hypertension and diabetes. However, the association between obesity and CKD is often overlooked. Among patients with CKD, patients with obesity were more vulnerable to have rapid kidney function decline than that of those with normal weight. Additionally, CKD is more prevalent among patients with obesity. These aggravations are induced through multiple mechanisms, specifically metabolic impairment of obesity and mechanical burden because of increasing intraabdominal renal pressure. Furthermore, the inflammation and lipotoxicity, caused by obesity, are critical in the CKD aggravation in patients with obesity. To prevent this, all adult patients with obesity are tested for CKD. The workup includes the estimated glomerular filtration rate and regular follow-up. Step-wise management is required for patients with obesity with CKD. Prompt reduction and management of obesity effectively delay CKD progression among patients with obesity and CKD. Therefore, weight loss is a core management for patients with obesity and CKD. Based on several studies, this article focused on the association between CKD and obesity, as well as the diagnosis and weight management of patients with obesity and CKD.

• Childhood Kidney Diseases
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• 제25권2호
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• pp.78-83
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• 2021

Background: Uric acid levels in urine are measured using urine specimens 24 hours or by uric acid glomerular filtration rate (UAGFR) with spot urine, which additionally requires a blood sample. This study aimed to investigate whether urinary uric acid creatinine ratio (UUACr) obtained by spot urine alone could be recognized as a substitute for UAGFR value, and hyperuricosuria can be screened by UUACr. UUACr is known to vary with age and regional differences. This study focused on the reference value of each value in Korean young populations. Method: We enrolled Korean subjects 1-20 years with normal kidney function, from a single hospital, classified into 5 age groups, 1-5 years, 6-8 years, 9-12 years, 13-15 years, and 16-20 years. We checked spot urine uric acid, creatinine and serum uric acid, creatinine levels on the same day from February 2014 to December 2018. We measured the average of UAGFR and UUACr in each groups. The UUACr cut-off value of the upper 2 standard deviation (SD) of UAGFR were taken. Results: The upper 2 SD of UUACr (mg/mg) and UAGFR (mg/dL) were determined in all age groups. UUACr decreased with grown up (P=0.000), but UAGFR were not statistically different among the groups. UUACr and UAGFR were not significantly different by gender. UUACr and UAGFR were positively correlated; UUACr cut-off value of upper 2 SD UAGFR (0.54 mg/dL) was 0.65 mg/mg in total age. Conclusions: UUACr could potentially be used to screen for hyperuricosuria.

• The Korean Journal of Physiology
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• 제19권1호
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• pp.35-48
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• 1985

One of most frequently used anesthetic agents is barbiturate derivatives. Pentobarbital or thiopental sodium have been used most frequently in the laboratory or clinical practice. There have been reports on the renal effects of barbiturate anesthesia in human and laboartory animals. Renal effects of thiopental sodium anesthesia, however, are still controversial. One of the discrepancies may be derived from the doses used. It has been reported that subanesthetic small dose of thiopental sodium influences the renal function directly. To clarify possible central effects of very small amounts of thiopental sodium on the renal function, experiments have been done in conscious rabbits. Thiopental sodium was infused into the lateral cerebroventricle for 10 minutes. Intracerebroventricular thiopental sodium induced increased urinary volume, glomerular filtration rate and renal plasma flow by doses of $0.1{\sim}1.0\;mg/10 min/rabbit$. Filtration fractions were not changed. Sodium, chloride and potassium excretions were increased by 0.065 mg/10 min/rabbit of thiopental sodium without significant changes of renal hemodynamics. Higher doses of thiopental sodium $(0.1{\sim}1.0\;mg/10 min/rabbit)$ induced greater increases of electrolytes excretion and renal hemodynamics. Free water clearance was not changed by thiopental sodium, but the fractional excretion of free water showed a tendency of decrease. Fractional excretion of sodium was increased by doses of 0.065 to 1.0 mg of thiopental sodium . Highly significant correlation between the changes of glomerular filtration rate and the changes of sodium excretion were found in the higher doses. Plasma renin concentration (activity) was not changed by the centrally administered thiopental sodium. Intravenous thiopental sodium, 1.0 mg/rabbit, induced no changes of renal function in conscious rabbit. These data suggest that intracerebroyentricular thiopental sodium can increase urinary sodium excretion directly by inhibition of sodium reabsorption in the renal tubules and/or indirectly by increasing the renal hemodynamics.

• Asian-Australasian Journal of Animal Sciences
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• 제9권2호
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• pp.165-170
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• 1996

Two experiments were conducted to search factor(s) affecting the plasma allantoin concentration in infant calves. In experiment 1, five male Holstein calves aged 1 week were given only milk replacer free from nucleic acids for 28 days Plasma allantoin concentration varied in a reverse proportion to daily amounts of milk replacer, and the concentration when calves received 750 g/d of milk replacer was significantly lower than that when they received 250 g/d. Contrary to plasma allantoin concentration, glomerular filtration rate(GFR) was directly proportional to daily amounts of milk replacer, leading to a constant filtration of allantoin across the glomeruli. Renal handling of allantion was also unaffected by the amount of milk replacer, resulting in the constant urinary excretion of allantoin. These results suggested that GFR, which was affected by the nutritional status, could affect plasma allantoin concentration. In experiment 2, the effect of age-related changes in nutritional status after weaning on GFR was examined in eight calves weaned at 5 weeks of age. The GFR expressed as body weight basis was lower immediately after weaning, but linearly increased up to the 19th week post-weaning. The present results suggested that the changes in GFR in response to nutritional status would be one of the possible causes of atypical plasma allantoin concentration immediately after weaning. We conclude that plasma allantoin concentration would not be a proper estimator of intestinal flow of microbial protein in cattle.

• 한국임상수의학회지
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• 제29권2호
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• pp.130-133
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• 2012

동적 컴퓨터단층촬영을 이용하여 연령에 따른 CT-GFR 수치에 대한 패턴을 살펴보기 위해 본 연구를 실시하였다. 품종이나 성별에 대한 제한 없이 다양한 연령으로 15마리의 개를 이용하였다. 혈액검사, 요검사, 영상학적 검사를 실시하여 개의 건강 상태를 확인한 후, propofol-isoflurane을 이용한 호흡마취를 실시하여 CT 촬영을 하였다. Iohexol (1 ml/kg, 300 mgI/ml)을 3 ml/s 일정한 속도로 2분간 주입하면서 1.5초 간격으로 총 80개의 영상을 촬영하여 파트락 분석을 통해 사구체여과율 (ml/min/kg)을 측정하였다. 양측 신장의 사구체여과율의 범위는 2.57-6.60 ml/min/kg이었다. 연구에서 연령에 따라 사구체여과율의 유의적인 차이는 확인되지 않았다.

• 약학회지
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• 제25권1호
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• pp.15-25
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• 1981

This study was attempted to investigate the action of debrisoquine, a sympathetic blocking agent presently employed in treating hypertension, on renal function and to elucidate the mechanism of its action. Debrisoquine, given intravenously, elicited increased urine flow, osmolar and free water clearances, along with marked increases in excretion of both sodium and potassium. Glomerular filtration rate also increased, but renal plasma flow tended to decrease, so that the filtration fraction tended to increase. Rates of reabsorption of sodium and potassium in renal tubules were also significantly diminished. The diuresis induced by debrisoquine was completely blocked by treatment with phentolamine and reserpine, and also markedly inhibited by acute renal denervation. Debrisoquine, when injected directly into a renal artery, produced antidiuretic effect and a reduction in urinary excretion of sodium and potassium, along with diminished renal plasma flow and increased filtration fraction. The above observations indicate that debrisoquine, when given intravenously, induces diuresis in the dog as a result of both diminished tubular reabsorption of electrolytes and of renal hemodynamic changes, which seem to be related to its inhibitory action of catecholamine-release from the sympathetic nerve endings.

• 대한핵의학회지
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• 제19권1호
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• pp.127-136
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• 1985

To evaluate change of serum $beta_2-microglobulin$ concentration$(s\beta_2-MG)$ and the usefulness of $s\beta_2-MG$ and $s\beta_2-MG/serum$ creatinine concentration(sCr) ratio in various renal diseases, $s\beta_2-MG$ and sCr were measured in 25 normal controls and 90 patients of various renal diseases(16 cases of glomerulonephritis, 12 cases of acute renal failure, 8 cases of chronic renal failure, 24 cases of nephrotic syndrome, 15 cases of tubulointerstitial diseases and 15 cases of lupus nephritis) using $Phadebas^\circledR$ $Beta_2-Micro$ Test kits. The results were as follows; 1) In normal control, the mean value of $s\beta_2-MG$ was $1.65{\pm}0.41mg/l$ and the mean value of $s\beta_2-MG/sCr$ ratio was $0.14{\pm}0.05$. 2) In various renal diseases, the mean value of $s\beta_2-MG$ was $6.74{\pm}5.47mg/l$. The mean value of $s\beta_2-MG/sCr$ ratio was $0.24{\pm}0.11$ and significantly elevated than that of normal control. (p<0.05) 3) The correlation between $s\beta_2-MG$ and sCr in glomerular and tubulointerstitial disease was log $s\beta_2-MG-0.90$ log sCr-0.48 and its correlation coefficient was 0.78(p<0.05). 4) In glomerular disease, the correlation between $s\beta_2-MG$ and sCr was log $s\beta_2-MG-0.89$ log sCr-0.46(r - 0.76) and in tubulointerstitial disease, it was log, $s\beta2-MG-0.95$ log sCr-0.59 (r-0.87). There was no significant difference between the two groups(p<0.05). 5) Among 32 cases of glomerular and tubulointerstitial disease patients, whose sCr was within normal range, 17 cases showed elevated $s\beta_2-MG$. The mean values of $s\beta_2-MG/sCr$ ratio in these patients was $0.30{\pm}0.14$ and significantly elevated than that of normal control(p<0.05). 6) In 15 cases of lupus nephritis, 12 cases showed elevated $s\beta_2-MG$ with normal sCr and 12 cases showed elevated $s\beta_2-MG/sCr$ ratio. With above results, it was found that the $s\beta_2MG$ can be used as an index of glomerular filtration rate as in the case of sCr and that $s\beta_2-MG/sCr$ ratio can be used as a tool in early detection of slightly decreased glomerular filtration rate and in detection of the renal disease of increased $\beta_2-MG$ production.

• 한국임상약학회지
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• 제29권2호
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• pp.115-124
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• 2019

The purpose of this systematic review and meta-analysis was to assess the preventive effect of theophylline on acute kidney injury and the ameliorative effect of theophylline on renal function in asphyxiated neonates. A literature search of the PubMed/Medline, Embase, and Cochrane Library databases for information published up to February 2019 was conducted. All studies that reported the incidence rate of acute kidney injury, serum creatinine level, and glomerular filtration rate after the randomized administration of theophylline or placebo were included. In total, eight studies involving 498 neonates were eligible. The incidence rate of acute kidney injury was significantly lower in the theophylline group than in the placebo group (risk ratio [RR]: 0.42, 95% confidence interval [CI]: 0.32-0.55, p < 0.001). The changes in serum creatinine level in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 and 5 days of age (weighted mean difference [WMD]: -0.51, 95% CI: -0.62 to -0.40, p < 0.001, and WMD: -0.26, 95% CI: -0.34 to -0.18, p < 0.001, respectively). The changes in glomerular filtration rate in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 days of age and the last day of follow-up (WMD: 12.30, 95% CI: 9.39-15.21, p < 0.001, and WMD: 9.35, 95% CI: 6.43-12.27, p < 0.001, respectively). These results suggested that theophylline has a beneficial effect on the prevention of acute kidney injury in neonates with perinatal asphyxia.

• 한국임상약학회지
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• 제22권2호
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• pp.103-112
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• 2012

Performance of coronary angiography for exact diagnosis and treatments of cardiovascular disease have been increased recently and it also brings increase of the contrast-induced nephropathy (CIN) referred from increasing use of radiological contrast agents. The variation of estimated glomerular filtration rate (eGFR) is an indicator of CIN, which is known to increase when renal function is decreased. Therefore, this study was to evaluate the affecting factors including concomitant drug on variation of eGFR of patients who underwent coronary angiography according to the conditions of renal function. Medical records of 66 patients were evaluated retrospectively and the patients underwent coronary angiography or angioplasty with nonionic and isotonic contrast media (iodixanol) at Chungnam national university hospital from 1 Jan 2008 to 30 Jul 2010. Patients group was divided into 2 groups; the patients in stages 3-4 chronic kidney disease (CKD) and the patients in stage 2 CKD. Each group was researched about the effect of concomitant drug and clinical characteristics on eGFR variation. The change of eGFR was compared among baseline and 2 or 3 day after coronary angiography. In results, the eGFR variation in group over age 75 was significantly decreased after radiological contrast agents exposure (p $$\leq_-$$ 0.05). The eGFR variation in anemia was significantly decreased after radiological contrast agents exposure in stage 2 CKD (p > 0.05). The eGFR variation in group under $HbA_{1c}$ 6.5% was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, angiotensin converting enzyme inhibitors, calcium channel blockers and nitroglycerin was increased after radiological contrast agents exposure in stage 2 CKD (p $$\leq_-$$ 0.05). The eGFR variation by using of diuretics was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). The eGFR variation by taking statins, nitroglylcerin was increased after radiological contrast agents exposure in stages 3-4 CKD(p > 0.05). The eGFR variation in group over contrast dosage 150 ml was significantly decreased after radiological contrast agents exposure in stages 3-4 CKD (p $$\leq_-$$ 0.05). Therefore, when undergoing coronary angiography, contrast dosage should be minimized less than 150 ml, and diuretics should be restricted as possible in stages 3-4 CKD. Patients over age 75 require special attention to prevent CIN, and if patients undergo coronary angiography in stages 3-4 CKD, $HbA_{1c}$ is also requried to maintain below 6.5% to prevent CIN.

• Clinical and Experimental Pediatrics
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• 제52권9호
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• pp.999-1004
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• 2009

목 적 : cystatin C가 creatinine보다 연령, 성별, 근육량, 약물 등에 영향을 적게 받는 등 사구체 여과율 추정에 더 우수하다는 연구가 많이 나오면서 cystatin C를 이용하여 사구체 여과율을 추정하는 방법이 많이 나오고 있다. 그러나 이런 사구체 여과율을 추정하는 여러 방법들 간에 어느 정도 차이가 있는지에 대해 실제적인 데이터가 많지 않아 대표적으로 이용되고 있는 creatinine 청소율과 이외 다른 식에 의한 사구체 여과율 값의 관계 및 cystatin C의 유용성에 대해 확인해 보고자 하였다. 방 법 : 2005년 1월부터 2008년 3월까지 중앙대학교 용산병원 소아청소년과를 내원한 20세 미만의 환아들로서 다양한 신질환을 가지고 있는 211명을 대상으로 하였다. 사구체 여과율을 구하기 위한 여러 가지 추정 식 중 혈중 creatinine을 사용한 Schwartz 식, Counahan-Barratt 식 그리고 cystatin C를 이용한 Filler & Lepage식, Bokencamp식, Grubb 식에 의한 값을 creatinine 청소율과 비교하였다. 결 과 : 각 식에 의한 사구체 여과율과의 상관계수를 구한 결과 Schwartz식으로 구한 사구체 여과율이 Counahan식으로 구한 사구체 여과율보다 상관성이 더 높고, 또한 cystatin C를 기초로 한 세가지 식(Filler, Bokencamp, Grubb)으로 구한 사구체 여과율보다 creatinine을 기초로 한 식으로 구한 사구체 여과율 값이 상관성이 더 높은 것을 알 수 있다. 또한 진단적 정확성을 분석한 결과 Schwartz 식으로 구한 사구체 여과율이 더 진단적 가치가 있었다. 결 론 : 사구체 여과율 감소를 진단하는데 있어서도 cystatin C를 이용한 경우가 혈청 creatinine을 이용한 식보다 더 좋다고 말할 수 없다. 또한 신기능 저하가 심하지 않을 것으로 예측되는 환아들의 사구체 여과율의 추정에서 cystatin C의 유용성을 확인할 수 없었다.