• Title/Summary/Keyword: proteinuria

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Alport Syndrome Associated with Poststreptococcal Glomerulonephritis in Brothers (알포트 증후군 형제에서 동시에 발병된 급성 연쇄상 구균 감염 후 사구체 신염 2례)

  • Shin Hye-Kyoung;Kim Ji-Hee;Hong Young-Sook;Lee Joo-Won;Kim Soon-Kyum;Won Nam-Hee;Cheong Hae-Il;Yoo Kee-Hwan
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.67-72
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    • 2003
  • Alport syndrome is the most common type of hereditary nephritis, and acute poststreptococcal glomerulonephritis(APSGN) is a common disease in children. We experienced the clinical and pathologic findings of Alport syndrome and APSGN in brothers of one family. Both patients presented with heavy gross hematuria and proteinuria. ASO titer was elevated in both cases, and the C3 level was reduced in one of the cases. In renal pathology, both showed characteristics of Alport syndrome as well as the glomerular changes of APSGN with hump-like subepithelial deposits by electron microscopy. These clinical observation indicated that the patients had APSGN superimposed on Alport syndrome, and that the episode of APSGN might exacerbate the clinical course of Alport syndrome.

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A Case of Microscopic Polyangiitis Initially Suspected with Henoch-Sch$\ddot{o}$nlein Purpura Nephritis (Henoch-Sch$\ddot{o}$nlein 자반병 신염으로 의심했던 현미경적 다발혈관염 1례)

  • Im, Jong Geun;Moon, Kyung Chul;Koo, Ja Wook
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.132-137
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    • 2012
  • Microscopic polyangiitis (MPA) is systemic small vessel vasculitis that is very rare in childhood. MPA is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. Approximately 90% of patients have glomerulonephritis that is accompanied by a variety of other organ involvement. A 10-year-old girl visited our clinic with clinical manifestations suggestive Henoch-Sch$\ddot{o}$nlein purpura nephritis such as purpuric skin rash, abdominal pain, arthralgia on both knees, massive proteinuria and microscopic hematuria. So initially we suspected Henoch-Sch$\ddot{o}$nlein purpura nephritis. However, later her perinuclear-antineutrophil cytoplasmic antibodies(p-ANCA) test was positive, and her renal biopsy was consistent with microscopic polyangiitis. We began steroid therapy, combined with cyclophosphamide, ACE inhibitor. Currently she is a 12-year old, and until now she has been regularly examined in the outpatient. We report a case of microscopic polyangiitis initially suspected with Henoch-Sch$\ddot{o}$nlein purpura nephritis.

A Case of Nephrotic Syndrome with Swine-origin H1N1 Influenza Virus (H1N1 인플루엔자 바이러스 감염과 동반되어 발생한 신증후군 1례)

  • Kim, Sae-Yoon;Kim, Myoung-Uk;Lee, Sang-Su;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.218-222
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    • 2010
  • Nephrotic syndrome is a clinical syndrome characterized by heavy proteinuria, hypoalbuminemia, edema and hyperlipidemia. Causes of idiopathic nephrotic syndrome include minimal change nephrotic syndrome (MCNS), focal segmental glomerulosclerosis (FSGS) and mesangial proliferation. Other causes of nephrotic syndrome are rare genetic disorders and secondary diseases associated with drugs, infections, or neoplasia. Since February 2009, a swine-origin H1N1 influenza virus (S-OIV) from Mexico has been spread among humans in unexpected rapidity. S-OIV is markedly different from seasonal influenza, in that many of those affected are previously healthy young people. While pulmonary complications of S-OIV infection have been frequently documented, renal complications have not been as widely recognized. We report a case of 4 year-old boy who had developed nephrotic syndrome after S-OIV infection with good response after steroid treatment.

A Case of Diabetic Nephropathy in a Child with Type 1 Diabetes (제 1형 당뇨병 소아환자에서 발생한 당뇨병성 신병증 1례)

  • Jung, Hwan-Hee;Park, Sung-Sin;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.250-255
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    • 2008
  • Diabetes mellitus(DM) is a metabolic syndrome caused by deficiency of insulin secretion and a consequence of insulin resistance. Poor glycemic control is a common finding in children with Type 1 DM(T1DM). Approximately 60% of the young patients with T1DM develop abnormalities in the eyes and 15-20% in the kidney. Diabetic nephropathy (DN) is a serious metabolic complication of T1DM that leads to renal failure. Some clinical studies report that the duration of prepubertal diabetes may contribute less to the development of microvascular complications than pubertal and postpubertal duration. There have been few cases of DN in prepubertal patients with T1DM in Korea. Thus we report a case of a 12-year-old female with T1DM who had poor glycemic control and was diagnosed as DN in a prepubertal period. It was proven by renal biopsy after microscopic hematuria and proteinuria were detected through the mass school urinary screening program.

A Case of Struvite Urolithiasis in a One-month-old Korean Sapsal Dog (1개월령 삽살개에서 발생한 Struvite요도결석 1례)

  • Oh, Won-Seok;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.453-456
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    • 2010
  • A one-month-old, 0.9 kg BW, male Korean Sapsal dog with anorexia, anuria, ataxia and depression was referred. On physical examination, the dog was showed tachycardia, hypothermia and pale mucous membrane. Hematologic values showed leukocytosis and mild anemia. Serum chemistry profile results revealed increased BUN (57.3 mg/dl) and $NH_3$ ($584\;{\mu}g/dl$), decreased albumin, sodium and potassium. Urinalysis showed hematuria, proteinuria, glucosuria, bacteriuria (Staphylococcus spp.) and magnesium ammonium phosphate crystalluria. On radiographic finding, urinary bladder was enlarged and 2 mm diameter radiopaque urolith was showed between os penis and prescrotal region. Urolithiasis was surgically corrected by urethrostomy.

An Experimental Study for Radiation Nephritis in Rabbits (가토(家兎)를 이용(利用)한 방사선신염(放射線腎炎)의 실험적(實驗的) 연구(硏究))

  • Kim, Myung-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.6 no.2
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    • pp.7-20
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    • 1972
  • Experimental radiation nephritis was produced in 15 rabbits by X-irradiation. About $2,000{\gamma}$ (tissue doses) were given to both kidneys of a rabbit in 5 days. Other tissues and organs except both kidneys were protected with 2mm thickened lead plates. 5 weeks after the last irradiation, blood pictures, blood pressures, B.U.N., serum creatinine, Ca, Mg, Fe levels and serum erythropoietin activity of the irradiated rabbits were studied. After finishing above studies, rabbits were sacrificed and both kidneys were removed and examined histopathologically. Same laboratory and pathological studies were performed in 6 control rabbits. In this study, the author obtained following results. 1) Both kidneys of rabbitis with experimental raditation nephritis showed marked histopathological changes, i.e.: renal tubules showed diffuse cloudy swelling, impacted intraluminal hyaline casts and focal precipitations of lime salts on the tubular epithelium. Diffuse interstitial fatty necrosis and various degrees of fibrotic infiltrations on the interstitium were also seen in association with focal lymphocytic infiltrations. Hyaline degenerations were observed on the glomeruli and small vessels. 2) Experimental radiation nephritis rabbits showed marked lowering in R.B.C. counts, decreased hemoglobin levels, low hematocrit values and leucopenia in comparison with those of control rabbits. (P<0.01). (Table 1 & 2). 3) Mild proteinuria were observed in experimental radiation nephritis in rabbits. 4) The levels of B.U.N. and serum creatinine increased in experimental radiation nephritis. (P<0.01). (Table 1,3 & 4) 5) The levels of serum Ca and Mg Showed no statistical difference in comparison with those of control rabbits. (P>0.05) (Table 3 & 4). 6) No statistical correlations were observable between the levels of B.U.N. and Hb. values. (${\gamma}=-0.223$) No close correlations (${\gamma}=-0.328$) were noticed between the levels of B.U.N. and serum iron levels. 7) Erythropoietin activity (R.B.C. $^{59}Fe$ Incorporation) was measured by the modified Fried method. No change in its activity was noticed in radiation nephritis group comparing with that of the control group. (P>0.05). (Table 1,3 & 5). 8) Carotid artery blood pressures showed also no difference. (P>0.05). (Table 1 & 2).

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The trend of national health insurance service use among pregnant and postpartum women aged 35 years and older (35세 이상 고령 임산부 진료실적 추이에 관한 연구)

  • Hwang, Rah-Il;Kim, Kyung-Ha;Yoon, Ji-Won;Lee, Jung-Suk
    • Health Policy and Management
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    • v.21 no.4
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    • pp.585-598
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    • 2011
  • This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

Ginseng total saponin modulates the changes of ${\alpha}$-actinin-4 in podocytes induced by diabetic conditions

  • Ha, Tae-Sun;Choi, Ji-Young;Park, Hye-Young;Nam, Ja-Ae;Seo, Su-Bin
    • Journal of Ginseng Research
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    • v.38 no.4
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    • pp.233-238
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    • 2014
  • Background: The actin cytoskeleton in podocytes is essential for the maintenance of its normal structure and function. Its disruption is a feature of podocyte foot-process effacement and is associated with proteinuria. ${\alpha}$-Actinin-4 in podocytes serves as a linker protein binding the actin filaments of the cytoskeleton. Methods: To investigate the effect of ginseng total saponin (GTS) on the pathological changes of podocyte ${\alpha}$-actinin-4 induced by diabetic conditions, we cultured mouse podocytes under normal glucose (5mM) or high glucose (HG, 30mM) conditions, with or without the addition of advanced glycosylation end products (AGE), and treated with GTS. Results: In confocal imaging, ${\alpha}$-actinin-4 colocalized with the ends of F-actin fibers in cytoplasm, but diabetic conditions disrupted F-actin fibers and concentrated ${\alpha}$-actinin-4 molecules at the peripheral cytoplasm. GTS upregulated ${\alpha}$-actinin protein in a time- and dose-dependent manner, and suppressed the receptor for AGE levels in western blotting. Diabetic conditions, including HG, AGE, and both together, decreased cellular ${\alpha}$-actinin-4 protein levels at 24 h and 48 h. Such quantitative and qualitative changes of ${\alpha}$-actinin-4 protein induced by diabetic conditions were mitigated by GTS. Conclusion: These findings imply that both HG and AGE have an influence on the distribution and amount of ${\alpha}$-actinin-4 in podocytes that can be recovered by GTS.

Diagnostic Imaging of Renal Hemangiosarcoma in a Dog (개 신장 혈관육종의 진단 영상 1례)

  • Choi, Ji-Hye;Ban, Hyun-Jung;Jang, Jae-Young;Kim, Hyun-Wook;Kim, Hye-Jin;Kim, Hak-Sang;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.24 no.1
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    • pp.51-55
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    • 2007
  • A 13-year-old male Yorkshire terrier was Presented with Persistent weight loss anorexia and dark brown urine of 3-month duration. On physical examination, a firm oval mass was palpated at left renal region. In hematology and blood chemistry, neutrophilia, anemia, thrombocytopenia and elevation of ALKP were found. Abdominal radiography, ultrasonography and ultrasound-guided percutaneous pyelogram revealed masses originated from left kidney, mildly dilated renal Pelvis and intact ureter. Urinalysis showed hematuria and proteinuria. Because the state of dog became deteriorated during transfusion and the frail renal tumor was suspected to be the cause of inflammation and anemia, nephrectomy was performed. Renal masses, approximately $2{\times}3cm\;and\;5{\times}4cm$ respectively in size, was surrounded by swollen and congested mesentery and ascites. Metastatic lesion was not found in other organs. During recovery, the dog showed cardiopulmonary arrest and did not respond to critical care. Histologically the kidney was affected by necrotic and hemorrhagic change. This hemangiosarcoma most likely arose from the renal parenchyma resulting In diffuse lesions in the kidneys thought to be the cause of chronic anorexia and weight loss.

Primary Renal Hemangiosarcoma Complicated with Hematuria and Hemoperitoneum in a Dog (개에서 발생한 혈뇨와 복강 내 출혈을 동반한 신장원성 혈관육종)

  • Yeo, Jung-Jin;Sur, Jung-Hyang;Eom, Ki-Dong;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.165-168
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    • 2012
  • A 14-year-old intact male Siberian Husky was presented with hematuria, lethargy, and anorexia of 1-month duration. The physical examination revealed mild abdominal distension and pain. The hematology and serum chemistry revealed anemia and severe azotemia. The radiographic examination revealed renomegaly and the ultrasonographic examination, indistinct cortico-medullary junction, increased renal cortex echogenicity, and irregular margination. The urinalysis showed proteinuria and hematuria. The differential diagnosis included renal failure, cystitis, pyelonephritis, and neoplasia. The patient's condition continued to deteriorate, and the dog eventually died. The gross findings from the necropsy revealed hemoperitoneum and a bilateral renal mass. HSA was diagnosed by histopathological examination. This case report describes primary bilateral renal hemangiosarcoma (HSA), which is uncommon in dogs.