• Title/Summary/Keyword: 혈액복막

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혈액투석 및 복막투석 환자에서의 carumonam(AMA-1080)의 약동 학적 변화에 관한 연구

  • 김성권;조종태;신상구;이경훈
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1992.05a
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    • pp.59-59
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    • 1992
  • 간헐적 혈액투석 또는 지속적 복막투석 요법을 받고 있는 만성 신부전 환자에서 carumonam의 약동학적 변화를 분석하여 이 환자들에서 적절한 투여용법을 고안하고, 이들 특수 질환군에서의 임상시험모형을 도굴하고자 하였다. 혈액투석환자는 carumonam 1g을 20분간 지속 정주 후 약물의 분포기 종료가 예상되는 시간에 혈액투석을 4-5시간 시행하였으며, 혈액, 투석액, 뇨를 경시적으로 채취하였다. 지속적 복막투석 환자군에 있어서는 1일 3회(6, 6, 12시간) 복막 투석을 시행하는 환자를 대상으로 carumonam 1g을 정주하고 24시간동안 혈액 및 투석액, 뇨를 경시적으로 채취하였다. 혈액, 투석액 및 뇨중 carumonam의 농도는 HPLC방법으로 측정하였으며, 경시적인 혈장 carumonam 농도변화 및 투석에 따른 약물의 제거를 혈액 투석환자는 2 compartmental model, 복막투석환자에서는 bidirectional 2 compartmental model에 의해 그 약동학적 성상을 분석하였다.

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혈액 투석 및 지속성 복막투석 환자에서 Carumonam (AMA-1080)의 약동학적 특성에 관한 연구

  • 김성권;이정상;한진석;조종태;임동석;이경훈;장인진;신상구
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.333-333
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    • 1994
  • 목적 : 만성신부전환자에서 carumonam의 약동학적 특성을 검토하고, 동시에 투석에 의한 carumonam의 제거 양상을 분석하여 이들 환자에서 carumonam의 적절한 투여용량 및 용법을 고안하고자 하였다. 방법 : 혈액투석(HD) 또는 지속성 복막투석(CAPD)을 받고 있는 14명의 말기 신부전중 환자를 대상으로 하였다. HD환자에서는 carumonam 1 g을 20분간 지속정주하고 4시간 이후 혈액투석을 4 또는 5 시간 시행하였으며 투약 후 36시간까지 경시적으로 혈액 및 투석액을 채취하여 체액내 약물 농도를 측정하였다. CAPD환자는 1일 3회 (6.6, 12 시간) 투석액을 교환하는 환자를 대상으로 하였고 투석직후 carumonam 1g을 지속정주하고, 투약후 36시간 후까지 경시적으로 혈액 및 투석액을 채취하여 CAPD 환자에서 carumonam의 약동학적 특성을 검토하였다. 체내 동태는 HD의 경우 dialyser를 포함하는 2-compartmental model에 의한 분석을 시행하였고, CAPD를 시행받는 환자의 경우에는 체액과 투석액사이에 bidirectional clearance 개념을 도입한 모델을 이용하여 분석하였다.

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The Characteristics of Blood Pressure Control in Chronic Renal Failure Patients Treated with Peritoneal Dialysis (복막 투석중인 만성 신부전 환자의 혈압 조절에 관한 연구)

  • Jung, Hang-Jae;Bae, Sung-Hwa;Park, Jun-Bum;Jo, Kyoo-Hyang;Kim, Young-Jin;Do, Jun-Young;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.333-341
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    • 1999
  • Background and Methods: In order to evaluate characteristics and modulatory factors of blood pressure in peritoneal dialysis(PD), studies were conducted on the 69 patients who had underwent peritoneal equilibration test(PET). Results: The results were as follows; 1) All patients received an antihypertensive drug before PD, but, 15 of 69 patients successfully quit taking the antihypertensive drug after peritoneal dialysis. 2) During peritoneal dialysis, mean arterial pressure(MAP) was significantly decreased for the first 3 months, and this lasted for 1 year, and antihypertensive drug requirements were significantly decreased continuously up to 9 months(p<0.05). 3) After changing the modality from hemodialysis to peritoneal dialysis, MAP(mmHg, from $107.0{\pm}4.5$ to $98.6{\pm}8.8$, p<0.05), antihypertensive drug requirements(from $5.6{\pm}2.6$, to $2.0{\pm}2.5$, p<0.01) and erythropoietin dosages(Uint/week, from $4600{\pm}2660$ to $2000{\pm}1630$, p<0.05) were decreased. 4) Multiple logistic regression analysis showed that MAP(p<0.01) and daily ultrafiltration volume(p<0.05) can contribute to the determination of antihypertensive drug requirements. However the relationship between antihypertensive drug requirements and PET results or dialysis adequacy indices(weekly Kt/V, weekly creatinine clearance) was not revealed. Conclusion: In conclusion, the prescription of antihypertensive drugs should be considered according to daily ultrafiltration volume, especially during first year after initiating PD, and follow-ups for over a year may be needed.

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Peritoneal Dialysis in Dogs: 20 cases (2006-2008) (개에서 복막투석 적용: 20 증례 (2006-2008))

  • Nam, So-Jeong;Choi, Ran;Oh, Won-Seok;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.23-28
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    • 2009
  • Peritoneal dialysis (PD) is a clinical technique that therapeutically removes toxic solutes from body fluids and normalizes endogenous solutes whose aberrant concentrations disrupt normal physiology. This study retrospectively evaluated clinical outcomes and complications of PD in 20 dogs with renal failure. Blood works (total count of red blood cells (RBC), packed cell volume (PCV), the serum biochemical, and electrolyte values related to renal insufficiency) and complications associated with peritoneal dialysis, and clinical outcomes were recorded before and after PD. Additionally, creatinine reduction ratio (CRR) and urea nitrogen reduction ratio (URR) were calculated for evaluating the efficacy of PD. PD resulted in a significant (p < 0.05) reduction in blood urea nitrogen (BUN) concentration in 19 dogs, while a significant (p < 0.05) reduction in creatinine concentration in 17 dogs. The complications of PD were hypoalbuminemia (12/20, 60%), anemia (10/20, 50%), subcutaneous dialysate leakage (9/20, 45%), bacterial peritonitis (6/20, 30%), dialysate retention (5/20, 25%) and limb edema (4/20, 20%). This study demonstrated that PD was effective in reducing the magnitude of azotemia in dogs with renal failure especially in acute phase, although the complication rate was high but manageable.

Changes of Renal Function and Treatment after CABG in Patients with Elevated Serum Creatinine (크레아티닌치가 높은 환자에서 관상동맥우회술 후 신장기능의 변화와 처치)

  • Choi Jong Bum;Lee Mi Kyuong;Lee Sam Youn
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.146-151
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    • 2005
  • Background: Preoperative elevated serum creatinine values are associated with increased risk for both morbidity and mortality in patients undergoing on-pump coronary artery bypass surgery (CABG). We investigated the postoperative changes of renal function and proper management in the patients. Material and Method: Among 74 consecutive patients who underwent isolated on-pump CABG, 17 patients with increased serum creatinine level $(creatinine\;\geqq\;1.5\;mg/dL)$ within preoperative one week wereincluded in the study. Seven patients showed pre­operative serum creatinine level of 2.0 mg/dL or higher, and 3 of them had been undergoing hemodialysis. Preoperative hemodialysis was performed in the 3 patients due to end-stage renal failure (ESRD) the day before the operation. We started peritoneal dialysis immediately after the cardiopulmonary bypass in patients with ESRD or postoperative acute renal failure if it was necessary to remove intravascular volume and lower serum creatinine level. Result In most of the patients with CABG, postoperative serum creatinine level increased and recovered to the preoperative level at the discharge. In 2 of the 4 patients with serum creatinine level of 2.0 mg/dL or higher and 3 patients with ESRD, intravascular volume, serum creatinine level and serum electrolyte were controlled with peritoneal dialysis. Conclusion: Postoperative serum creatinine level increased transiently in most of CABG patients, and intravascular volume and serum creatinine level were controlled by peritoneal dialysis only in the patients with acute renal failure postoperatively and those depending on hemodialysis.

만성 신부전 투석환자의 영양소 섭취실태 및 관련 요인에 관한 연구

  • 이계연;정윤미;서정숙
    • Proceedings of the KSCN Conference
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    • 2004.05a
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    • pp.416.1-416
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    • 2004
  • 본 연구는 투석치료를 받고 있는 만성 신부전환자의 영양소 섭취량과 이에 영향을 미치는 요인을 분석함으로써, 환자들의 영양상태를 개선하기 위한 자료를 제공하고자 실시하였다. 연구 대상자는 대구지역 대학병원에 내원하는 혈액투석 환자 51명과 복막투석환자 50명을 대상으로 직접면담법으로 자료를 수집하였다. 설문지 내용은 영양소 섭취량에 영향을 미치는 요인으로 일반적 특성, 기호도, 영양지식과 태도, 스트레스 자각 정도, 식습관, 식품섭취빈도조사 등이었다. 조사대상자의 신장질환 유병기간은 혈액투석 환자군은 55.8 $\pm$ 61.3개월, 복막투석 환자군은 68.6 $\pm$ 61.5개월이었다.(중략)

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신장질환자의 약물요법 및 혈액ㆍ복막투석

  • Kim, Hyeong-Gyu
    • The Monthly Diabetes
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    • s.184
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    • pp.24-27
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    • 2005
  • 일반적으로 만성신부전이라고 부르는 상태가 되면 치료의 목표는 신장기능의 악화를 막는 것에서 신장기능악화로 인하여 생기는 합병증을 예방하거나 치료하는 쪽으로 이동하게 된다.

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Therapeutic Efficacy and Complications of Automated Peritoneal Dialyzer in Dogs with Renal Failure (신부전 개에서 자동 복막투석기를 이용한 복막투석에 대한 평가)

  • Kwon, Heejung;Choi, Wonjin;Lee, Dong-Guk;Tan, David;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.399-403
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    • 2015
  • Peritoneal dialysis (PD) is a treatment for renal failure and acute poisoning, and uses the patient's peritoneum in the abdomen as a membrane across which fluids and dissolved substances are exchanged from the blood. In this study, we evaluated the therapeutic efficacy and complications of automated peritoneal dialyzer (APD) in dogs with renal failure. PD was performed in 10 dogs using a swan neck catheter (Neonatal, Coviden) and automatic APD. The efficacy for each dog was assessed by calculating urea reduction ratio (URR) and creatinine reduction ratio (CRR). Mean concentrations of pre-dialysis creatinine and blood urea (BUN) were $7.09{\pm}3.84$ and $145.8{\pm}48.5$, respectively. The mean number of peritoneal dialysis cycles applied was $6{\pm}1$ cycles. Peritoneal dialysis resulted in a significant decrease in BUN concentration in 7/10 dogs, while a significant decrease in creatinine concentration in 9/10 dogs. The mean of URR was higher than that of CRR ($0.39{\pm}0.16$ vs $0.38{\pm}0.13$). The mean CRR and URR per dialysis cycles were $0.064{\pm}0.023$ and $0.065{\pm}0.023$, respectively. Complications found in this study were catheter occlusion, subcutaneous dialysate leakage, septic peritonitis, hypoalbuminemia and overhydration. This study found PD using a swan neck catheter and APD machine showed acceptable efficacy for successful peritoneal dialysis in dogs. However, close monitoring is required to minimize the risk of complication.