• Title/Summary/Keyword: renal disease(腎臟病)

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A Case of Renovascular Hypertension Due to Renal Artey Stenosis Related to Moyamoya Disease (모야모야병과 동반된 신 동맥 협착에 따른 신성 고혈압을 보인 1례)

  • Kim, Joung-A;Kim, Seung;Kim, Hyo-Sun;Shin, Jae-Il;Jeong, Il-Cheon;Kim, Dong-Seok;Kim, Myung-Joon;Lee, Do-Yun;Lee, Jae-Seung
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.294-298
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    • 2007
  • Moyamoya disease is a progressive cerebrovascular disorder with stenosis or occlusion of the bilateral internal carotid arteries with abnormal vascular networks at the base of the brain. Previous reports have shown that there are extracranial vascular involvements in Moyamoya disease, especially in the renal artery. We report a 7-year-old patient with Moyamoya disease associated with renovascular hyper tension, who presented in infancy with seizures and hemiparesis. Renal angiography showed multiple stenoses of the right renal artery. Although renal artery stenosis in Moyamoya disease has been effectively treated with balloon angioplasty, stent implantation, or surgery, bat-loon angioplasty could not be done in this patient due to multiple stenoses. His blood pressure was successfully controlled with medical treatment, and remained normotensive during the follow up period of 6 months.

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Diabetic Nephropathy in Childhood and Adolescence (I) : Clinical Features (소아청소년기 당뇨병성 신병증(I); 임상 소견을 중심으로)

  • Ha, Tae-Sun
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.1-13
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    • 2009
  • Type 1 diabetes mellitus commonly occurs in childhood and adolescence, although the prevalence of type 2 diabetes mellitus in these age groups is now being increased in the western world and Korea. Diabetic nephropathy developing in 15-25% of subjects with type 1 diabetes mellitus and in similar or higher percentage of type 2 diabetes mellitus patients is the leading cause of end-stage renal disease worldwide. Although prepubertal diabetic duration may contribute less to the development of microvascular complications than pubertal and postpubertal duration, diabetic nephropathy in susceptible patients almost certainly begins soon after disease onset and may accelerate during adolescence, leading to microalbuminuria or incipient DN. Type 1 diabetes is commonly associated with a period of hyperfiltration followed by the development of persistent microalbuminuria after as little as 7-10 years of type 1 diabetes. Microalbuminuria is associated with pathologic lesions that are so advanced as to overlap with those seen in patients with overt proteinuria and declining kidney function, therefore, microalbuminuria currently considered the best clinical indicator of overt diabetic nephropathy risk. This review covers the natural history and renal manifestations of diabetic nephropathy in children and adolescents.

Slowing the Progression of Chronic Kidney Disease in Children and Adolescents (소아 청소년 만성 콩팥병의 진행 억제)

  • Ha, Il-Soo;Choi, Yong
    • Childhood Kidney Diseases
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    • v.14 no.1
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    • pp.1-9
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    • 2010
  • Slowing the progression of chronic kidney disease is much more important in children and adolescents with a relatively longer remaining life span. A practical way to assess the rate of progression of chronic kidney disease is to measure the change of GFR estimated by formulae. To slow the progression, hypertension and proteinuria have to be controlled strictly, and hypoplastic anemia must be treated with erythropoietin. If not contraindicated, ACE inhibitor or angiotensin receptor blocker is recommended with monitoring of the side effects. Trials to slow the progression should be commenced as soon as the chronic kidney disease is confirmed and needs to be continued until renal transplantation as long as residual renal function remains. An online system, the Korean Pediatric Chronic Kidney Disease Registry (http://pedcrf.or.kr/), provides tools that are useful in evaluation and management of the children and adolescents with chronic kidney diseases.

$17{\beta}$-estradiol Attenuates Renal Fibrosis in Mice with Obstructive Uropathy (폐쇄성 요로병증에서 $17{\beta}$-estradiol에 의한 신섬유화 감소 효과에 대한 연구)

  • Cho, Min-Hyun;Jang, Hee-Seong;Jung, Kyung-Jin;Park, Kwon-Moo
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.125-137
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    • 2011
  • Purpose : Men are generally more prone to chronic renal disease and progression to end stage renal disease than women. The purpose of this study is to prove the effect of gender and sex hormone on renal fibrosis in mice with unilateral ureteral obstruction (UUO) and to elucidate the specific underlying mechanisms. Methods :We compared the expression of ${\alpha}$-smooth muscle actin (${\alpha}$-SMA) in female and male mice with complete UUO (day 7). After this, we estimated the changes of renal fibrosis in the female mice with oophorectomy and in the female mice with oophorectomy and replacement of $17{\beta}$-estradiol, respectively. Results : The level of ${\alpha}$-SMA in the female kidney with UUO was significantly lower than that in the male kidney with UUO. oophorectomy and replacement of $17{\beta}$-estradiol did not change the expression of angiotensin II type 1 (AT1) receptor in the female kidney with UUO, whereas the expression of angiotensin II type 2 (AT2) receptor was significantly more elevated in the intact female (IF) and the oophorectomized female with estrogen (OF+E) than that in the oophorectomized female (OF). The expressions of inducible nitric oxide synthase (iNOS) in the IF and OF+E mice were significantly more elevated than that in the OF mice, which was similar to the expression of AT2 receptor. Conclusion : The female gender is associated with resistance to renal fibrosis in obstructive uropathy and this gender difference may originate from the existence of $17{\beta}$-estradiol, which has an anti-fibrotic effect via upregulation of the AT2 receptor and iNOS.

A Novel Method of Measuring the state of Kidney by Analysing the Color and Gloss of the Patient's Face (안면 색윤(色潤) 분석을 통한 신장 기능 측정 방법 제안)

  • Lee, Se-Hwan;Cho, Dong-Uk;Kang, Eung-Taek
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.35 no.7C
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    • pp.634-641
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    • 2010
  • End Stage Renal Disease resulting from complications of the 4 top causes of death including diabetes and hyperpiesia becomes one of the major social problems these days in the context that this disease unaffordably increases the medical cost and decreases the quality of life. For a kidney disease, it is hard to diagnose, cure and recover as there are few subjective symptoms. Therefore, the prevention is very important. In this paper, we propose a method, which checks the abnormal state of the kidney, using the patient's face color and gloss which is employed for diagnosis in the oriental medicine. This method composes of two processes. The first is to acquire the patient's face data applying a polarizing filter and the next is to analyse relations between kidney disease and this data.

Hypertensive Cardiomyopathy in a Pomeranian Dog Complicated with Chronic Kidney Disease (포메라니언 개에서 발생한 만성 신장질환과 합병된 고혈압성 심근증)

  • Lee, Joon-Seok;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.170-175
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    • 2009
  • A 7-year-old, intact male Pomeranian(weighing 2.2 kg), was presented with clinical signs of prolonged anorexia, polydypsia/polyuria, severe azotemia, proteinuria and heart murmur. Diagnostic studies found chronic kidney disease, severe hypertension and hypertrophic cardiomyopathy. The dog was treated with 2-day peritoneal dialysis, blood transfusion, anti-hypertensive therapy with amlodipine and conservative therapies direct to chronic renal failure. This is a rare case of hypertensive cardiomyopathy complicated with chronic kidney disease in dogs.

Correlation between Clinicomorphologic Findings and Clinical Outcome in Childhood $Henoch-Sch\"{o}nlein$ Purpura Nephritis (소아 $Henoch-Sch\"{o}nlein$ 자반병 신염의 임상양상 및 병리소견과 임상경과)

  • Huh Yun-Jung;Shin Jae-Il;Park Jee-Min;Jeong Hyeon-Joo;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.30-37
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    • 2003
  • Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is usually a self-limited disease with a good eventual outcome. The prognosis of HSP is mainly determined by the renal involvement. In this study, We evaluated children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis about the clinical outcome correlated with renal manifestation and morphologic findings. Methods : The clinical features, initial laboratory and pathologic findings, and clinical out-come were evaluated in 60 children with biopsy-proven $Henoch-Sch\"{o}nlein$ purpura nephritis at Yonsei University Severance Hospital during the period from Jan. 1990 to Dec. 2002. Results : The ratio of male to female patients was 1.2:1. The interval between the onset of $Henoch-Sch\"{o}nlein$ purpura and renal manifestation was less than 3 months in 81% of the patients. Initial renal manifestation was microscopic hematuria in 100% of patients, isolated hematuria in 15%, acute nephritic syndrome in 7%, nephrotic syndrome In 22% of patients. Renal manifestation correlated with clinical outcome. Grade II and III were the most common in histologic grades of ISKDC. Renal pathologic finding correlated with clinical outcome. Conclusion : Renal manifestation and pathologic findings correlated with the clinical out-come. It is necessary to evaluate the correlation between pathologic findings and treatment.

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Evaluation of Cerebral Blood Flow Using Arterial Spin Labeling in Patients with Chronic Kidney Disease (만성 콩팥병 환자들에서 동맥 스핀 표지 기법을 이용한 뇌 관류상태의 평가)

  • Se Won Oh;Samel Park;Nam-jun Cho;Hyo-Wook Gil;Eun Young Lee;Hyung Geun Oh;Sung-Tae Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.912-919
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    • 2020
  • Purpose This study aimed to compare the brain perfusion status of patients with chronic kidney disease to a normal control group to identify any significant differences. Materials and Methods The perfusion state of the brain was measured by MRI using the arterial spin labeling technique in 36 patients undergoing hemodialysis due to chronic kidney disease and 36 normal controls. Images were then analyzed in a voxel-wise manner to detect brain areas showing significant perfusion differences between the two groups. Results Patients with chronic kidney disease showed increased perfusion in the form of large clusters across the right fronto-parieto-temporal lobe and the left parieto-occipital lobe. In addition, perfusion increased in the bilateral thalami, midbrain, pons, and cerebellum (p < 0.01, familywise error corrected). Conclusion Brain perfusion appears to increase in patients with chronic kidney disease compared to normal controls. Uremic toxicity is thought to be the cause of this increase as it can cause damage to the microscopic blood vessels and their surrounding structures.

Acute Tubulointerstitial Nephritis with Renal Failure Complicated by Typhoid Fever (장티푸스 환아에서 병발한 급성 신부전을 동반한 급성 간질성 신염 1례)

  • Oh, Jung-Min;Lee, Na-Ra;Yim, Hyung-Eun;Yoo, Kee-Hwan;Jeong, Woon-Yong;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.236-239
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    • 2010
  • Typhoid fever is a systemic infectious disease which affects many organs. In children, few cases have been reported of acute nephritic syndrome in typhoid fever. We report an immunocompetent 9-year old girl with typhoid fever complicated by acute tubulointerstitial nephritis who presented with prolonged fever and acute renal failure.

The Role of Increased Oxidative Stress in the Development of Diabetic Nephropathy (당뇨병성 신증의 발생에 있어서 산화성 스트레스의 역할)

  • Jang Yeon-Jin;Park Hyoung-Sup;Kim Hyoun-Sik;Hong Hea-Nam;Kim Mi-Kyung
    • The Korean Journal of Pharmacology
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    • v.31 no.1 s.57
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    • pp.95-102
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    • 1995
  • The pathogenesis of diabetic nephropathy is still not completely understood while renal disease is one of the most common disabling complications of diabetes. We, in the present study, investigated the possible involvement of oxidative stress in the development of diabetic nephropathy. To hasten the development of diabetic nephropathy, streptozotocin was injected to unilaterally nephrectomized rats (NEPH-STZ). Eight weeks later, NEPH-STZ rats developed severe hyperglycemia, proteinuria, and hypertension. The kidneys of these rats showed compensatory hypertrophy and mesangial expansion. In contrast, the rats with streptozotocin injection alone (STZ) did not increase urinary protein excretion. Nephrectomized non-diabetic rats (NEPH) developed increased urine protein excretion, but without prominent renal morphological changes. However, oxidation of renal cortical tissue protein significantly increased in all 3 groups of NEPH, STZ and NEPH-STZ in comparison to control rats (CONT). The result indicates the non-specificity of the oxidative tissue damage and suggests that the oxidative damage is hardly a sole mechanism leading to the development of the diabetic nephropathy. However, it would still be a contributing factor considering that the oxidative stress is a common final pathway mediating tissue damages in chronic diabetic complications and other serious illness.

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