• The Monthly Diabetes
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• s.287
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• pp.49-51
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• 2013

최근 만성콩팥병 환자의 생존율이 증가하였고, 환자들도 정상적인 삶을 살고자 하는 요구가 증가되면서 삶의 질에 대한 관심이 고조되고 있다. 그러나 만성콩팥병 환자의 투병생활은 질병자체의 고통 뿐 아니라 지속적인 검사, 치료 그리고 잦은 입 퇴원으로 경제적인 부담감, 완치가 아닌 기계에 의존한 생명 연장의 수단이기 때문에 죽음에 대한 불안과 위협, 가정 내역할과 책임의 변화로 가족갈등의 심화, 신체상의 변화로 원활한 대인관계 어려움, 사회적 고립 및 삶에 대한 의미상실 등을 초래할 수 있다. 이렇듯 만성콩팥병 환자는 여러 어려움을 직면하게 되는데 이를 구체적으로 살펴보고자 한다.

• 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.

• Phonetics and Speech Sciences
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• v.14 no.4
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• pp.45-56
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• 2022

This paper proposes an optimal methodology for automatically diagnosing and predicting the severity of the chronic kidney disease (CKD) using patients' utterances. In patients with CKD, the voice changes due to the weakening of respiratory and laryngeal muscles and vocal fold edema. Previous studies have phonetically analyzed the voices of patients with CKD, but no studies have been conducted to classify the voices of patients. In this paper, the utterances of patients with CKD were classified using the variety of utterance types (sustained vowel, sentence, general sentence), the feature sets [handcrafted features, extended Geneva Minimalistic Acoustic Parameter Set (eGeMAPS), CNN extracted features], and the classifiers (SVM, XGBoost). Total of 1,523 utterances which are 3 hours, 26 minutes, and 25 seconds long, are used. F1-score of 0.93 for automatically diagnosing a disease, 0.89 for a 3-classes problem, and 0.84 for a 5-classes problem were achieved. The highest performance was obtained when the combination of general sentence utterances, handcrafted feature set, and XGBoost was used. The result suggests that a general sentence utterance that can reflect all speakers' speech characteristics and an appropriate feature set extracted from there are adequate for the automatic classification of CKD patients' utterances.

• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.980-983
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• 2010

본 연구는 말기콩팥질환자의 대체요법 이용에 영향을 미치는 요인을 파악하기 위해 시도하였다. 자료수집은 2010년 4월 13일부터 5월 13일까지 서울의 한 종합병원 신장내과에 내원한 201명을 대상으로 설문 및 면접조사를 실시하였다. 연구결과 첫째, 이용기간과 연령과는 양의 상관관계를 보였다(r=0.159, p<0.05). 둘째, 만성콩팥병의 대체요법 이용에 영향요인은 연령이 많을수록(${\beta}$=1.64), 대체이용기간이 길수록(${\beta}$=0.059), 월비용이 높을수록(${\beta}$=0.003), 질병이환기간(${\beta}$=2.147)이 길수록 대체요법 이용은 증가하였다. 따라서 초기에는 말기 콩팥질환자들에게 대체요법의 효과와 한계를 지도해야 하며 환자들에게 영향을 주는 가족들에게도 올바른 정보를 제공해야 할 것이다.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.7-12
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• 2014

Cardiovascular disease (CVD) has been identified as one of the most important factors influencing the long-term prognosis of patients with chronic kidney disease (CKD). However, in pediatric CKD, the clinical importance of CVD tends to be overlooked due to the lack of typical manifestations of CVD in this population. The literature has identified several traditional risk factors of CVD that originate from CKD, including hypertension, diabetes mellitus, dyslipidemia and obesity, in addition to new and non-traditional risk factors including anemia, secondary hyperparathyroidism, oxidative stress and inflammation. In cases of pediatric CKD, cardiovascular disease is usually restricted to subclinical manifestations such as left ventricular hypertrophy, thickening of intimal media on the carotid artery and calcification of the coronary artery. Therefore, risk factors of CVD in pediatric CKD patients should be closely monitored.

• 식품문화 한맛한얼
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• v.4 no.1
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• pp.58-61
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• 2011

• 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.

• The Korean Journal of Medicine
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• v.99 no.2
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• pp.61-68
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• 2024

Chronic Kidney Disease (CKD) is a major global health burden. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated potential in slowing CKD progression. We evaluated the expanding role of SGLT2 inhibitors, emphasizing their renoprotective benefits in diabetic and non-diabetic CKD patients. We also investigated the underlying mechanisms, including the reduction of glomerular hypertension via modulation of tubuloglomerular feedback. Our study critically analyzed current indications for SGLT2 inhibitor therapy based on recent clinical trial data. To optimize patient outcomes, we present a comprehensive analysis of practical considerations for the prescription of SGLT2 inhibitors, including the potential initial decline in the estimated glomerular filtration rate and a review of adverse events.

• Journal of the Korean Society of Radiology
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• v.11 no.3
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• pp.153-159
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• 2017

Chronic kidney disease can be treated if it is detected early, but as the disease progresses, it becomes impossible to recover. Finally, renal replacement therapy such as transplantation or dialysis should be used. Ultrasonography is used to diagnose kidney cancer, inflammatory disease, nodular disease, and chronic kidney disease. It is used to identify information about degree of inflammation using information such as kidney size, internal echo characteristics. Currently, the degree of disease in the clinic uses the value of glomerular filtration rate. However, even in ultrasound, changes in the degree of inflammation and disease can be observed. In this study, we used ultrasound images to quantify the changes in brightness, size, cortex, and subclinical changes of the kidney with progression of the disease, and compared them with the glomerular filtration rate used in clinical practice. In 105 cases, we performed 35 cases of normal kidney, 35 cases of early kidney disease, and 35 cases of terminal kidney. The brightness of the cortex of the image was obtained and the difference in brightness between the cortex and the proximal portion was obtained by the slope. The graph of the portion which was not smooth due to the ultrasonic characteristics was used as the function regrass. The size reduction was obtained from the original data. The results were as follows: It was proportional to the glomerular filtration rate. It is considered that the algorithm can be applied to the disease if the algorithm study continues.

• Journal of Nutrition and Health
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• v.57 no.5
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• pp.481-495
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• 2024

Purpose: Malnutrition is a prevalent condition leading to a high risk of morbidity and mortality in hemodialysis patients. This study examined the malnutrition risk and the influence of diabetes on clinical characteristics, nutritional knowledge, and dietary intake in chronic kidney disease (CKD) patients on hemodialysis. Methods: Seventy-six patients (37 with diabetes and 39 without diabetes) enrolled in an internal medicine hemodialysis unit in Seoul were examined. A questionnaire, anthropometric, biochemical, and three-day dietary record data were collected. The nutritional risk was screened by the Patient-Generated Subjective Global Assessment (PG-SGA), compared to the Global Leadership Initiative on Malnutrition (GLIM). Results: The overall prevalence of malnutrition was 56.6% and 27.6% by PG-SGA and GLIM, respectively, showing the low sensitivity (34.9%) and agreement (kappa = 0.16) of GLIM compared to the PG-SGA. CKD patients with diabetes had a higher malnutrition risk and more comorbidities than those without diabetes (p < 0.05). More than 60% of patients had anemia and hypocholesterolemia. Despite the fair level of nutritional knowledge, the intakes of energy per ideal body weight, calcium, vitamin A, vitamin B₆, folate, and vitamin C were below the nutritional guidelines for hemodialysis patients in more than 70% of the patients. When stratified according to sex, female patients showed marked differences, with lower energy, protein, fat, calcium, phosphorus, vitamin B₂, folate, and vitamin B₁₂ intakes in diabetic patients compared to non-diabetic patients. The most challenging aspect of diet therapy for hemodialysis patients was achieving the appropriate protein intake for diabetic patients and restricting phosphorus intake for non-diabetic patients (p < 0.05). Conclusion: These findings suggest that attention should be paid to the malnutrition of diabetic hemodialysis patients. Individualized nutritional counseling and management are needed for the nutritional care of hemodialysis patients to address the nutritional deficiency.