• Title/Summary/Keyword: 신부

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Rapid Development of Diffuse Myocardial Calcification in a Patient after Recovery from Sepsis and Renal Failure: A Case Report (패혈증과 신부전에서 회복된 환자에서 급속하게 발생한 미만성 심근 석회화: 증례 보고)

  • Mi Hyun Kang;Song Soo Kim;Byung Joo Sun;Jae-Hyeong Park
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1104-1108
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    • 2022
  • Myocardial calcification can develop owing to several conditions. It is a rare complication following sepsis and renal failure. We report a case of rapid development of left ventricular mid-wall calcification observed using CT and cardiac MRI in a patient after recovery from sepsis and acute renal failure.

Continuous Renal Replacement Therapy of Chronic Kidney Disease with Uncontrolled Azotemia in Six Dogs (개선되지 않는 질소혈증 동반한 만성신부전 환자에서 지속적 신대체 요법의 적용)

  • Han, Sei-Myoung;Kim, Jong-Taek;Lee, Jong-Bok;Seo, Kyoung-Won;Song, Woo-Jin;Ryu, Min-Ok;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.440-444
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    • 2015
  • The purpose of this case report was to present the treatment of continuous renal replacement therapy (CRRT) in dogs with end-stage CKD with uncontrolled uremia. Hemodialysis were carried out 6 patients who failed to improve clinical status with conventional management for CKD. Four dogs with urea reduction ratio (URR) range of 57-72% and 1 dog with URR of 37.3% showed good outcome with decreasing tendency of pre-dialysis Therefore, we suggest that CRRT could be recommended for use in CKD dogs with uncontrolled azotemia or uremia and should be monitor carefully throughout the CRRT.

Measurement of Total Plasma Homocysteine in Patients with Chronic Renal Failure Using HPLC/FLD (만성신부전증환자에서 HPLC/FLD를 이용한 혈장 Homocysteine의 측정)

  • Kyung-Ok Lee;Bo-Kyung Kang;Hyung-Jin Roh;Kwang-Suk Ryoo;Jeong-Yeon Yoo;Man-Jeong Paik;Kang-Hyeob Lee
    • Biomedical Science Letters
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    • v.3 no.1
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    • pp.29-35
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    • 1997
  • Cardiovascular disease has been the leading cause of death among patients with chronic renal failure. Many reports have been described that homocysteine is one of the independent risk factor to the occulsive vascular disease. In this study, HPLC/FLD (high performance liquid chromatography-fluorescence detector) technique was used to measure homocysteine level in patients with chronic renal failure and normal control group. The detection limit and recovery of total plasma homocysteine using HPLC/FLD were 98.6$\pm$5.8% and 0.2 nmol/ml, respectively. The linearity of this method was established in concentration range of 2~50 nmol/ml (correlation coefficient=0.9997). The concentrations of total plasma homocysteine were 6.81$\pm$1.54 nmol/ml and 27.28$\pm$14.94 nmol/ml in normal control (n=20) and patient group (n=90), respectively (p<0.05). In this study, the HPLC/FLD method showed high sensitivity and reproducibility for a routine clinical laboratory testing. Moreover determination of homocysteine level in plasma might be useful for a biochemical marker for predicting the cardiovascular diseases and for monitoring of therapeutic effect of lowering homocysteine in patients with chronic renal failure.

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Bronchial Hyperresponsiveness in Chronic Renal Failure Undergoing Hemodialysis (만성 신부전 환자에서 혈액투석 전후의 기관지 과민반응검사)

  • Hwang, Young-Sil;Shim, Dae-Suk
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.548-554
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    • 1995
  • Background: Cardiogenic pulmonary edema increases nonspecific airway responsiveness in humans and animals. Increased extravascular lung water from overt pulmonary edema to subclinical interstitial edema is a common finding in patients with chronic renal failure. Several studies carried out to assess pulmonary function disturbances in this condition have documented a reduction in forced expiratory volume that usually reverses after hemodialysis, suggesting airway edema as the underlying mechanism. This interstitial edema may also lead to nonspecific bronchial hyperresponsiveness. We hypothesized that patients with chronic renal failure may present nonspecific bronchial hyperresponsiveness due to subclinical interstitial pulmonary edema. Methods: We studied 18 chronic renal failure undergoing regular hemodialysis 3 times a week(New York Heart Association Class II) without concomittent disease. These patients were checked pulmonary function test and metacholine provocation test before hemodialysis and same procedure was repeated if responsive, after hemodialysis. Results: 1) 12 out of 18 patients before hemodialysis were reactive in metacholine provocation test(66.7%) before hemodialysis. This airway hyperresponsiveness were decreased after hemodialysis. 2) Pulmonary function was improved after hemodialysis and change in $FEV_1$ was correlated with change in weight(r=-0.62, p<0.01). 3) There was a close correlation between log $PD_{20}$ and $FEF_{25}$, which is one of the variables of the peripheral airways(r=0.58, p<0.05). Conclusion: We speculated interstitial pulmonary edema may play a significant role in bronchial hyperresponsiveness and lung function impaired in patients with chronic renal failure.

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Coronary Artery Bypass Surgery in Patients with End-Stage Renal Disease (말기 신부전 환자에서의 관상동맥 우회수술)

  • Kim, Kun-Il;Song, Hyun;Yu, Yang-Gi;Jo, Min-Seop;Matsuda, Naruto;Sorokin, Vitaly A.;Choo, Suk-Jung;Lee, Jae-Won;Song, Meung-Gun;Yi, Joon-Seung;Kim, Soon-Bae;Park, Su-Kil;Park, Jung-Sik
    • Journal of Chest Surgery
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    • v.34 no.4
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    • pp.338-344
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    • 2001
  • 배경: 말기 신부전 환자에서 심장병, 특히 관상 동맥 질환의 이환이 늘어나면서 관상동맥 우회수술의 대상 환자가 지속적으로 증가하고 있다. 이들 환자군은 수술후 유병률과 사망률이 매우 높고 고위험군으로 알려져 있다. 대상 및 방법: 1996년 3월부터 2000년 5우러까지 서울 중앙 병원 흉부외과에서 술전 말기 신부전증으로 진단 받은 후 관상 동맥 우회수술을 시행받은 환자 25명을 대상으로 의무 기록을 중심의 후향적 분석을 하였다. 술전 위험 인자 및 술전 신기능, 수술 결과, 술후 경과, 수술후 합병증, 사망률 및 생존률 등을 분석하였다. 결과: 술전 평균 크레아티닌 청소율은 12.7$\pm$5ml/mim였고 술전 평균 혈중 크레아티닌 치는 6.2$\pm$3mg/dl(1.7-14.4)였다. 술전 투석을 시행중인 환자는 11례(44%)였고 술전 투석을 시행하지 않았던 14례(56%)중 8례(8/14, 57.1%)는 수술전후로 새로이 투석이 필요하였다. 술전 혈액 투석 중이었던 9례중 2례에서 수술후 복막 투석으로 전환하였다. 수술 사망률은 2례(8%)로 흡인성 폐렴과 종격동염으로 1례, 그리고 수술후 출형과 종격도염으로 1례가 사망하였다. 수술후 합병증은 14명(56%)의 환자에서 발생하여 매우 높은 발생율을 보였다. 만기사항은 2례(8%)에서 발생하였으며 사망원인은 카테터에 의한 복막염이었다. 생존 환자의 4년 생존률은 82$\pm$13% 였다. 결론: 말기 신부전 환자에서의 관상동맥 우회수술을 비교적 만족스러운 범위의 수술 사망률(8%)을 보였으나 합병증 발생률이 매우 높고 합병증 발생 시 사망률이 매우 높아 수술주위 감염 예방과 세심한 환자 관리가 필요하다.

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Renal Effects of a Low Protein Diet and Antihypertensive Drugs on the Progression of Early Chronic Renal Failure in 5/6 Nephrectomized Rats (저단백 식이 및 항고혈압제의 투여가 만성신부전증의 진행에 미치는 영향에 관한 실험적 연구)

  • Kim, Kyo-Sun;Kim, Kee-Hyuk;Kim, Sang-Yun;Kang, Yong-Joo;Maeng, Won-Jae
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.125-132
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    • 1998
  • Purpose : To study whether a low protein diet increase the efficacy of antihypertensive therapy on the progression of renal failure, we conducted an experimental study using 5/6 nephrectomized rats(n=63). Methods : At 7 days after surgery, rats were randomly assigned to three groups according to receiving antihypertensive drug: no antihypertensive drug (U), enalapril (E), and nicardipine (N), respectively and fed a low protein diet (6$\%$ protein). Proteinuria, mesangial matrix expansion score and glomerular volume were assessed at 4, 12 and 16 weeks after renal ablation. Results : Group U rats on a low protein diet developed progressive hypertension ($140{\pm}8,\;162{\pm}5,\;171{\pm}5\;and\;184{\pm}11\;mmHg$ at 4, 8, 12 and 16 weeks) which were controlled by E and N. Group U rats on a low protein diet developed proteinuria ($74{\pm}15\;mg/day$ at 16 weeks) which were decreased by E ($42{\pm}12 mg/day$) or N ($48{\pm}8 mg/day$) (p<0.05). Mesangial matrix expansion score and glomerular volume were not different between groups U, E and N on a low protein diet regardless of the antihypertensive drugs administered. Conclusion : A low protein diet did not affect blood pressure. Enalapril and nicardipine-treated rats on a low protein diet did not have different mesangial matrix expansion and glomerular volumes from rats on a low protein diet at 12 weeks and 16 weeks, in spite of the better controlling of systemic hypertension and lessening of proteinuria. Thus, combined treatment with a low protein diet and antihypertensive drugs didn't appear to show any addition,11 effects to attenuate glomerular injury.

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Clinical Study on Hemolytic Uremic Syndrome in Children: Review of 23 Cases (소아 용혈성 요독 증후군 23예에 대한 임상적 고찰)

  • Oh Seungjin;Yook Jinwon;Kim Ji Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.136-143
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    • 2000
  • Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.

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