• Title/Summary/Keyword: 만성콩팥병

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Risk Factors for Renal Function Impairment Following Radiofrequency Ablation of Renal Tumors (신장 종양 고주파 절제술 이후 신장 기능 저하의 위험요소)

  • Il Cheol Park;Seong Kuk Yoon;Dong Won Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.317-330
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    • 2022
  • Purpose To evaluate the various factors that affect renal function following percutaneous radiofrequency ablation (RFA) therapy in patients with renal tumors. Materials and Methods Between 2010 and 2018, 91 patients diagnosed with renal tumors using ultrasonography and CT-guided RFA were enrolled. We retrospectively investigated the serum creatinine (SCr) level and estimated glomerular filtration rates immediately prior to RFA and during post-treatment follow-up. The patients were divided into two groups based on the degree of change in SCr level (0.3 mg/dL). Group comparisons were performed using univariable and multivariable logistic regression analyses to determine the factors impacting renal function. Results Impaired renal function was associated with solitary kidney, chronic kidney disease (CKD) over stage 3, and pyeloureteral injury. Sex, age, other cancers, tumor size, location, growth pattern, and proximity to the collecting system were not significantly associated with impaired renal function. There was a difference in the overall change over time between the association with and without solitary kidney, CKD stage 3, and pyeloureteral injury. Conclusion Among the medical conditions present prior to RFA, solitary kidney and CKD over stage 3 could be considered as risk factors for impaired renal function. Post-procedural pyeloureteral injury can also be considered a risk factor.

Management of Chronic Kidney Disease in Obesity Patients (비만환자의 만성콩팥병 관리)

  • Han, Kunhee
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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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.

Recent Progress in Hemodialysis Membrane: A Review (혈액투석막의 최근 연구 동향: 리뷰)

  • Gayatri Bhamidipati;Rajkumar Patel
    • Membrane Journal
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    • v.34 no.2
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    • pp.105-113
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    • 2024
  • Chronic kidney disease leads to many people getting diagnosed with end stage renal disease. This disease is treated by hemodialysis which is the process by which blood is cleaned by a membrane and dialyzer. The membrane for hemodialysis is an important first step of this process as it is responsible for selectively removing impure elements from the blood. Although there are membranes made up of different polymers that are used, they have various disadvantages including hemocompatibility and low selectivity. To combat this, various studies have used a mixture of different polymers to change pore size, increase hemocompatibility and increase selectivity. It was seen that in all the studies conducted, a mixed membrane has greater advantages.

A Case Report on Posterior Circulation Cerebral Infarction with Early Neurological Deterioration in an Elderly Patient with Chronic Kidney Disease (고령의 만성콩팥병 환자에서 발생한 초기 신경학적 악화가 동반된 후방순환뇌경색 치험 1례)

  • Kim, Jun-seok;Lee, Yoo-na;An, Yu-min;Baek, Kyung-min
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.727-737
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    • 2021
  • Objectives: This study investigated the effect of Korean medicine on an elderly patient with posterior circulation cerebral infarction, chronic kidney disease (CKD), and early neurological deterioration (END). Methods: The patient, who already had CKD, was treated with Korean medicine, comprising herbal medicine, acupuncture, moxa, and cupping combined with Western medicine (antiplatelet, diabetes) and physical therapy. A manual muscle test (MMT) and a modified Barthel index (MBI) were used to observe the treatment effects, and blood tests were performed to check estimated glomerular filtration rate (eGFR), creatinine and blood urea nitrogen (BUN), which represent renal function. Results: After the treatment, MMT, MBI, and renal function scores had increased. Conclusions: This study suggests that Korean medicine can effectively treat posterior circulation cerebral infarction with END in CKD, but further studies should be conducted.

Analysis of the Relationship between Abdominal Ultrasound Based Kidney Stones, Obesity and Metabolic Syndrome (복부 초음파 검사 기반 신장결석과 비만 및 대사증후군 관련성 분석)

  • Kim, Ju Hee;Jang, Hyon Chol;Cho, Pyong Kon
    • Journal of the Korean Society of Radiology
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    • v.14 no.4
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    • pp.495-502
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    • 2020
  • Kidney stones are a common disease with an annual prevalence of about 30,000 people in Korea, and are deeply related to an increase in chronic kidney disease, high blood pressure, coronary artery disease, metabolic syndrome, type 2 diabetes, hyperlipidemia, and abdominal obesity. Therefore, in this study, 135 examinees who visited a general hospital in Dalseong-gun from May 2019 to June 2020 for a medical examination were examined. The relationship between kidney stones and factors related to obesity and metabolic syndrome were found in abdominal ultrasound. I tried to find out the relevance. As a result of the study, the risk of kidney stones in the abnormal group was increased by 4.255 times compared to the normal group in total cholesterol factor, and the risk of kidney stones in the abnormal group was increased by 2.072 times compared to the normal group in the low-density lipoprotein cholesterol factor. Total cholesterol factor and low-density lipoprotein cholesterol It was found that the factor affects the prevalence of kidney stones and metabolic syndrome. Since the risk of kidney stones is related to total cholesterol and low-density lipoprotein cholesterol factors, active attention should be paid to preventive purposes through health check-ups.

Atherectomy in Peripheral Artery Disease: Current and Future (말초동맥질환에서의 죽종절제술: 현재와 미래)

  • Yohan Kwon;Jinoo Kim;Je-Hwan Won;Seong Ho Kim;Jeong-Eun Kim;Sung-Joon Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.551-561
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    • 2021
  • Atherectomy has become a promising treatment option for peripheral artery disease caused by diabetes mellitus or end-stage renal disease. Atherectomy refers to the removal of atheromatous tissue by mechanical method, resulting in an enlarged lumen of the treated blood vessel. Based on this method, the term is limited to the percutaneous minimally invasive approach, and there are currently two types of atherectomy devices available in Korea. The increased prevalence of atherectomy has led to the concept of "vascular preparation" and a new treatment concept of "leave nothing behind." Various studies have proven the safety and effectiveness of atherectomy; however, there are some limitations. We need to remain focused on patient selection and subsequent large-scale research.

The Effect of Social Support and Resilience on Sick Role Behavior of Hemodialysis Patients (혈액투석환자의 사회적지지, 회복탄력성이 환자역할행위 이행에 미치는 영향)

  • Noh, Sung Bae;Lim, HyoNam;Lee, Mi Hyang;Kim, Doo Ree
    • Journal of the Korea Convergence Society
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    • v.10 no.5
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    • pp.385-395
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    • 2019
  • This was a descriptive study to investigate the effect of social support and resilience on sick role behaviors of hemodialysis patients, and aims to provide base data on nursing intervention programs for improving the sick role behaviors of hemodialysis patients. The study subjects was patients with chronic kidney disease undergoing hemodialysis treatment at a general hospital in D city. The final analysis has been made on 131 questionnaires. The average of social support score was $3.93{\pm}0.84$, and resilience score was $2.67{\pm}0.80$. At last sick role behavior score was $3.99{\pm}0.80$. According to the analysis on the correlations among the study subjects' social support, resilience and sick-role behaviors, the social support had statistically and significantly positive correlation. In regression analysis, frequency of dialysis, social support and resilience have appeared to be the variables influencing sick role behavior, and the explanatory power of this model is 44.0%.

Factors related to Meaning of Life of patients with Hemodialysis (혈액투석 환자의 생의 의미에 영향을 미치는 요인)

  • Lee, Sun Ra;Park, Yoonjin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.743-750
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    • 2021
  • Purpose: The purpose of this study was to analyze factors affecting the meaning of life in patients on hemodialysis. Methods: The sample consisted of 176 adults diagnosed with chronic kidney disease at hospitals in Seoul and Gyeonggi-do who had been receiving hemodialysis for more than three months. The patients volunteered to participate in the study. Data collection instruments used were the Meaning in Life (ML) scale, Resilience scale, Beck Depression Inventory-II (BDI-II) and Fatigue scale questionnaire. The SAS9.2 version was used for descriptive analysis, independent t-test, one-way ANOVA, Pearson's correlation coefficients and stepwise multiple regression. Results: The mean total item score on the meaning of life scale was 133.68 (total score:180), which was low. There was a significant relationship between the ML scale and resilience, depression, and fatigue. Stepwise multiple regression analysis showed that resilience, religion, depression, and fatigue were predictors of the meaning of life. Conclusion: These results indicate a need to develop nursing interventions to increase resilience and reduce depression and fatigue to promote the meaning of life in patients on hemodialysis.

Association of food intake with serum levels of phosphorus and potassium in hemodialysis patients (혈액투석 환자의 일상식품군 섭취량에 따른 혈청 인, 칼륨 농도의 상관성 분석)

  • Woo, Hye Jin;Lee, Yeon Joo;Oh, Il Hwan;Lee, Chang Hwa;Lee, Sang Sun
    • Journal of Nutrition and Health
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    • v.47 no.1
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    • pp.33-44
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    • 2014
  • Purpose: Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. Methods: This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items. Results: The mean body mass index (BMI) was $22.2{\pm}3.0kg/m^2$, mean serum phosphorus level was $4.50{\pm}1.52mg/dl$, and mean serum potassium level was $4.74{\pm}0.73mEq/l$. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was $7.9{\pm}7.3$ years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05). Conclusion: The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.