• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.373-383
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• 2018

Background: Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this study was to evaluate the usefulness of estimating USE in a prospective low-salt diet education cohort (ESPECIAL). Methods: A new formula was developed on the basis of morning fasting urine samples from 228 CKD patients in the ESPECIAL cohort. This formula was compared to the previous four formulas in the prediction of 24-hour USE after treatment with olmesartan and low-salt diet education. Results: Most previously reported formulas had low predictability of the measured USE based on the ESPECIAL cohort. Only the Tanaka formula showed a small but significant bias (9.8 mEq/day, P < 0.05) with a low correlation (r = 0.34). In contrast, a new formula showed improved bias (-0.1 mEq/day) and correlation (r = 0.569) at baseline. This formula demonstrated no significant bias (-1.2 mEq/day) with the same correlation (r = 0.571) after 8 weeks of treatment with olmesartan. Intensive low-salt diet education elicited a significant decrease in the measured USE. However, none of the formulas predicted this change in the measured urine sodium after diet adjustment. Conclusion: We developed a more reliable formula for estimating the USE in CKD patients. Although estimating USE is applicable in an interventional study, it may be unsuitable for estimating the change of individual sodium intake in a low-salt intervention study.

• The Korean Journal of Physiology
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• 제9권1호
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• pp.23-32
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• 1975

In order to study the dally metabolism of sodium chloride and of nitrogen, 24-hour urine samples were collected from 1,593 normal Korean females whose ages varied from 2 to 80 years old. The volume, the concentration of chloride and the osmolality of the urine, add the total nitrogen were determined, along with the resting pulse rate and the blood pressure. The daily urine volume was maintained at $1,000{\sim}1,300\;ml/m^2/day$ in all age groups while the chloride concentration and osmolality of the urine samples were approximately 200 mEq/liter and 600 milliosmoles, respectively, in most of age groups. Hence the daily urinary output of sodium chloride was estimated to be approximately $15g/m^2$/day in adult groups. On the other hand, the daily excretion of total nitrogen amouted to approximately $5{\sim}6g/m^2/day$. These findings indicated that the average Korean females live on low-protein and high-salt diets throughout their life. Despite a known correlation between the incidence of hypertension and the high salt intake, none of the subjects employed in this work showed any sign of hypertension.

• Journal of Yeungnam Medical Science
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• 제3권1호
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• pp.229-235
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• 1986

rat에 주사된 lithium 이온의 배설에 미치는 수종의 corticosteroid의 영향을 검색한 결과 다음과 같은 결론을 얻었다. 1. fludrocortisone을 10mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, lithium의 뇨중 배설량도 증가시켰다. 2. dexamethasone을 0.1mg/kg 투여하여 혈청내 lithium 농도를 줄일 수 있었고, 1mg/kg을 투여하여 lithium의 뇨중 배설량도 증가시켰다. 3. dexamethasone에 의하여서는 혈중 $Na^+$의 $K^+$에 대한 농도비가 감소하였고, 반대로 뇨중 $Na^+$의 $K^+$에 대한 농도비가 감소하였다. 이상의 실험 결과를 미루어 corticosteroid는 lithium의 뇨중 배설량을 증가시키고 그 혈중 농도를 감소시킬 수 있으나, 이러한 작용은 신장을 통한 $Na^+$ 이나 $K^+$의 이동과는 전혀 상관이 없다고 생각된다.

• Journal of Nutrition and Health
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• 제18권3호
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• pp.194-200
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• 1985

The purpose of this study was to investigate sodium intake and protein metabolism for pregnant women in Korea. The relationship between salt consumption and hypertension, electrolyte changes in pregnancy, and the tendency of weight gain of pregnant women were also examined. The dietary survey and twelve or twenty-four hour's urine collection was performed in this study. The subjects were pregnant women who came to gynecology clinic for prenatal care from July to August in 1984. The results were as follows: 1) Intakes of calorie and iron of Korean pregnant women were 2,036 Kcal and 16mg per day per person. The calorie composition consists of 65% carbohydrate, 16% protein, and 19% lipids. The average level of all nutrients was about 87% of Korean Recommended Dietary Allowances. 2) The sodium intakes in pregnant women estimated by dietary survey was 318.6 mEq Na (7,966 mg Na), which is equivalent to 20.2 g NaCl. 3) Daily sodium excretion was 112.5 mEq per liter, that is equal to 147.4 mEq. Potassium excretion was 24.95 mEq per liter and creatinine excretion was 594.0 mg per day. 4) There were statistically significant correlations between sodium intake and the excretions of sodium, potassium and creatinine. The blood pressure was positively correlated with sodium intakes. As sodium and potassium ratio was increased, systolic blood pressure and diastolic blood pressure were also significantly increased 5) Urinary nitrogen and creatinine ratio known to be reliable index for nutritional status of protein was 5.5 : 1. These values were comparable to the values in American pregnant women. 6) The weight gain during the pregnancy was examined. There was little weight gain during the first trimester, because of nausea, vomit and decrease of appetite. The weight gain during the second trimester was 4.9Kg, and 11.1Kg for third trimester.

• 대한지역사회영양학회지
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• 제12권5호
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• pp.545-558
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• 2007

This study was performed to assess the sodium intakes of Korean adults using a 24-hr urine analysis and dish frequency questionnaire (DFQ) according to each dish group and the regional area. The subjects of this study were comprised of 522 adults (male : 267, female : 285), aged 20-59yr residing in the metropolitan area (N=200), Chungcheng-Do (N=117), Jeolla-Do(N=117), and Gueongsang-Do provinces (N=118). The subjects were recruited from the residents who once participated or are participating in the various health programs offered by the public health center. The number of subjects who completed the 24-hr urine collection was 205 (male : 110, female : 95). The mean age and BMI of the subjects were $39.0{\pm}$11.7y and $23.1{\pm}2.9 kg/m^2$, respectively. The mean systolic and diastolic blood pressure was $119.5{\pm}15.4 mmHg$, and $77.1{\pm}11.1 mmHg$, respectively. Eighteen percent of the subjects responded that they are currently smoking, 36% drinking and 50.4% exercising. Twenty point six percent of the subjects were assessed as having hypertension according to their systolic or diastolic blood pressure($SBP{\ge}140mmHg$ or $DBP{\ge}90mmHg$) measurements in the present study. Salt intake of the subjects estimated with 24-hr sodium excretion was 12.7g/d (male : 13.4g/d, female : 12.1g/d) based on the sodium excretion rate as 82%. Salt intake estimated with DFQ was 14.7g/d (male : 16.2g/d, female : 13.4g/d), 2 g more than the salt intake estimated with 24-hr urine analysis. The four dish groups that contributed most to the sodium intake in order were kimchi (11571.4mg), soup and stew (1260.5mg), fish and shellfish(706.3mg) and noodle and ramyeon(644.3mg). Salt intake estimated with DFQ was the highest in the subjects of Gueongsang-Do(17.0g/d), second highest Chungcheong-Do (16.4g/d) and the lowest in the metropolitan area (13.0g/d). Subjects of Gueongsang-Do showed the highest sodium intakes in most of the dish group, whereas subjects of the metropolitan area showed the lowest. Residents of Chungcheong-Do revealed the highest sodium intake with kimchi and of Jeolla-Do the higher sodium intake with main dish (meat, fish and beans). The highest salt percentage of kimchi ($3.0{\pm}0.8%$) and soybean paste ($14.5{\pm}5.1%$) were observed in Gueongsang-Do, whereas individuals of the metropolitan area were observed as having kimchi ($1.6{\pm}0.5%$) and soybean paste ($7.4{\pm}1.6%$) with the lowest salt percenage. Men were observed as having more salty kimchi ($2.4{\pm}0.1%$) than women ($2.1{\pm}0.1%$).

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.269-279
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• 1984

The optimum conditions for measuring cadmium content of less than 0.2ppm by flame atomic absorption spectrophotometry were investigated. The cadmium in urine was extracted by APDC-MIBK for the analysis by atomic absorption spectrophotometry after ashing them by a wet method. 1. Optimum conditions by APDC-MIBK and DDTC-MIBK extractions. The acidic aqueous solution was prepared with appropriate amount of 0.IN nitric acid, 5ml of 25% (W/V) sodium potasstum tartarate, 10ml of saturated ammonium sulfate, and 2ml of 2% APDC(or 1 ml of 5% DDTC) chelating agent. The total volume of solution was adjusted to 55 ml and pH to $2{\sim}10$ (or$7{\sim}10$). The aqueous solution was extracted with 10ml MIBK. Concentration of Triton X-100 did not effect the absorbance for APDC-MIBK extraction of cadmium, but absorbance decreased as the concentration increased for DDTC-MIBK extraction. The sensitivity and detection limits for the cadmium determination from APDC-MIBK extraction were 0.0038ppm and 0.0102, 0.0022ppm and 0.0116 for DDTC-MIBK, and 0.0132ppm and 0.0034 for 0.1N nitric acid. APDC-MIBK and DDTC-MIBK extractions were 3 times higher than 0.1N nitric acid for the sensitivity. 2. Excretion of cadmium in 24-hour urine by APDC-MIBK extraction. Determination of cadmium in urine by atomic absorption spectrophotometry of A.A. (Cd=2 mA) mode and B.C. (Cd=4 mA) mode and B.C. (Cd=4mA, $D_2=20mA$) mode showed some difference (p<0.05). The difference of cadmium determination and recovery according to method of standard additions and standard calibration curve method in urine was not significant (p>0.05, $93.48{\pm}11.78%,\;94.83{\pm}22.00%$). Excretion of cadmium in 24-hour urine collection from normal person and variance analysis within measurement variation was not significant (p>0.05), but between interindividual was significant (0.05). Determination of cadmium content by two different methods of flame atomic absorption spectrophotometry and dithizone colorimetry showed that the results from the two methods can be described by a regression line with a good correlation (y=1.0153x-0.2927, x=Cd by D.C., y=Cd by A.A.S., $r=0.8651^*$, p<0.01).

• Childhood Kidney Diseases
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• 제2권2호
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• pp.133-137
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• 1998

목 적 : 1987년 정주용 면역글로불린(Intravenous immunoglobulin: IVIG)에 의한 급성신부전의 첫 증례가 보고된 이후 성인에서는 고용량의 IVIG와 관련된 신손상의 보고들이 다수 있었다. 이에 저자들은 고용량 IVIG의 사용이 보편화되어 있는 가와사끼병과 특발성 혈소판 감소성 자반증 환아에서 IVIG의 신독성 여부를 관찰하고자 하였다. 방 법 : 1996년 1월에서 8월까지 이대 부속 목동 병원에 입원하여 가와사끼병(23례)과 특발성 혈소판 감소성 자반증(7례)으로 고용량의 정주용 면역글로불린(2 g/kg)을 투여받은 환아를 대상으로 하였다. IVIG투여후 1일, 3일에 요량, BUN, 혈청 creatinine, Ccr, FENa, TRP, 24 시간뇨 ${\beta}_2$-microglobulin/cr 비 및 microalbumin/cr 비의 변화를 관찰하였다. 통계는 repeated measurement ANOVA test와 t-test를 사용하여 검정하였다. 결 과 : 고용량의 IVIG 투여후에 요량, BUN, 혈청 creatinine, Ccr, TRP, 24 시간뇨 ${\beta}_2$-microglobulin/cr 비 및 microalbumin/cr비의 유의한 변화는 없었다. IVIG투여후 1일에 일시적으로 증가한 FENa만이 유의한 변화였다. 결 론 : 소아에서 흔히 사용되는 고용량 IVIG는 정상 신기능 상태에서는 유의한 신손상을 일으키지 않았다.

• 농촌의학ㆍ지역보건
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• 제16권1호
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• pp.27-32
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• 1991

한국인은 많은 양의 염류를 섭취하며 저단백식을 주로 한다는 사실이 1960년대로부터 알려져왔다. 일련의 연구로부터, 한국인이 많은 양의 염류를 섭취하는 것은 저단백식과 관계가 있는 것으로 여겨져왔다. 지난 30년간 한국인의 식사중 단백성분은 크게 증가해 왔다. 본 연구는 1990년 현재 한국 농촌지역 거주자의 소변 중에 배설되는 나트륨과 칼륨의 양 및 총 소변 배설량을 측정하여 유의할 만한 변화가 있었는지를 알아보기 위하여 실시되었다. 또, 도시지역 거주자와의 비교를 위해 34명의 농촌지역 거주자와 9명의 도시지역 거주자를 대상으로 하였다. 조사기간중 조사대상자를 일상생활을 그대로 영위하도록 하였다. 34시간 동안 배설된 소변을 수집하여 그중의 나트륨, 칼륨, 크레아티닌 농도를 측정하였다. 마지막 뇨 수집 시에는 정맥혈을 채취하여 혈장 중의 나트륨, 칼륨, 총단백 농도를 측정하였다. 그 결과는 다음과 같다. 1) 혈장 중의 나트륨, 칼륨, 총단백 농도는 정상범위 내에 있었다. 2) 농촌인구에서는 24시간 소변중의 나트륨, 칼륨 배설량은 각각 $255{\pm}95.6$mEq/day, $45{\pm}15.1$mEq 이었으며 24시간동안 수집된 소변의 총량은 $1800{\pm}514.3$ml/day이었다. 이 수치를 1960년의 자료와 비교할 때 수집된 나트륨 배설량은 감소추세를 보였으나 칼륨과 총 소변배설량에 있어서는 별 변화를 발견할 수 없었다. 3) 농촌거주자의 소변중 Na/K 비는 도시거주자에 비해 유의하게 높았으며 도시지역거주자에 있어서 소변중 나트륨 배설량의 감소추세가 더욱 두드러졌다. 4) 이 수치를 서양인의 수치와 비교하면 아직도 한국 농촌지역 거주자의 염분 섭취가 높음을 보이고 있는 반면 칼륨에 있어서는 서양인에 비해 훨씬 낮음을 알 수 있다. 5) 염분과 단백의 섭취 사이에 있을 수 있는 관계를 고찰했다.

• Childhood Kidney Diseases
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• 제11권2호
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• pp.168-177
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• 2007

목 적 : 육안적 또는 현미경적 혈뇨를 주소로 24시간 소변화학검사를 시행한 환아들의 의무 기록을 후향적으로 조사하여 고칼슘뇨군과 비고칼슘뇨군으로 나누어 두 군의 혈액 및 소변화학검사와 그로부터 계산된 각 용질의 배설량, 청소율, 분획배설 등에 있어서 두 군간에 차이점이 있는지 비교하였다. 방 법 : 1997년 2월부터 2007년 2월까지 10년간 가톨릭의대 의정부성모병원 소아과에서 육안 또는 현미경적 혈뇨를 주소로 24시간 소변검사를 시행한 환아 중, 단백질 배설량이 4 mg/$m^2$/시간 이상으로 단백뇨가 동반된 경우는 제외하고, 소변 칼슘 배설량이 4 mg/kg/일 이상으로 특발성 고칼슘뇨증으로 진단 받은 30명과 소변 칼슘배설량이 3mg/kg/일 미만인 비고칼슘뇨군 환아 41명을 대상으로 하여 혈액화학검사, 기본 소변검사, 24시간 소변화학검사로부터 각종 소변 용질의 배설량, 청소율, 분획배설 등을 구하여 두 군간에 차이점이 있는지를 비교 분석하였다. 결 과 : 고칼슘뇨군(30명)과 비고칼슘뇨군(41명)에서 육안적 혈뇨는 각각 24명(80%), 17명(42%)으로 고칼슘뇨군에서 육안적 혈뇨의 비가 높았다. 임의채취뇨의 Ca/Cr 비는 각각 $0.34{\pm}0.15,\;0.15{\pm}0.13$이었으며 고칼슘뇨군 30명 중 28명의 임의채취뇨 Ca/Cr 비는 0.2 이상이었고, 비고칼슘뇨군 41명 중 36명의 임의채취뇨 Ca/Cr 비가 0.2 미만이었다. 혈액화학검사에서 고칼슘뇨군과 비고칼슘뇨군의 혈청 칼슘은 각각 $9.8{\pm}0.5 mg/dL,\;9.5{\pm}0.5 mg/dL$로 고칼슘뇨군이 통계학적으로 유의하게 높았다(P=0.033). 24시간 소변의 칼슘농도는 각각 $14.7{\pm}7.7 mg/dL,\;3.3{\pm}2.2 mg/dL$로 고칼슘뇨군이 유의하게 높았고(P<0.001), 칼슘배설량도 각각 $6.1{\pm}2.9 mg/kg/$일, $1.5{\pm}0.9 mg/kg/$일로 고 칼슘뇨군에서 유의하게 높았다(P<0.001). 크레아티닌 청소율로 구한 사구체여과율은 각각 $93.7{\pm}31 mL/min,\;79.5{\pm}32.0 mL/min$로 고칼슘뇨군이 유의하게 높았다(P=0.048). 24시간 소변의 요소농도는 각각 $797{\pm}316 mg/dL,\;569{\pm}329 mg/dL$로 고칼슘뇨군에서 유의하게 높았고(P=0.015), 요소배설 량도 각각 $341 {\pm}102 mg/kg/$일, $233{\pm}123 mg/kg/$일로 고칼슘뇨군에서 유의하게 높았다(P=0.002). 나트륨 배설량은 두 군간에 차이가 없었으나 나트륨 분획배설(FENa)은 각각 $1.0{\pm}0.4%,\;1.3{\pm}0.6%$로 고칼슘뇨군에서 유의하게 낮았다(P=0.029). 소변배설량은 두 군간에 차이가 없었으나 소변의 삼투질농도는 각각 $393{\pm}103 mOsm/kg\;H_2O,\;304{\pm}96 mOsm/kgH_2O$로 고칼슘뇨군에서 더 농축된 소변을 보았다(P=0.003). 결론 :고칼슘뇨군의 소변화학검사의 가장 특징적인 소견은 요소 배설과 사구체여과율의 증가로서 이는 고칼슘뇨군이 비고칼슘뇨군에 비하여 고단백식이를 하고 있을 가능성을 시사한다. 나트륨과 칼슘은 사구체 여과가 증가함에 따라 원위세뇨관 및 집합관에 도달하는 양도 증가하고 그 곳에서 나트륨의 재흡수 기전이 매우 정교하게 이루어지는데 비하여 칼슘의 그 것은 그렇지 못하여 고칼슘뇨증을 일으켰을 가능성이 있다. 향후 고칼슘뇨 환아를 진료함에 있어서 단백질 섭취 등식이 습관의 문진과 함께 식이요법도 고려해 보아야 할 것으로 생각된다.

• Journal of Nutrition and Health
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• 제13권4호
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• pp.187-194
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• 1980

To estimate the amount of daily salt intake by source of food and urinary sodium excretion, a dietary survey was conducted from August 27th to September 3, 1980. The salt concentration of six kinds of food was measured. The families of 25 womens' club leaders and 25 families of hypertensive patients were studied after they had been given a short course of education on lowsalt diet. The results were as follows: 1. The average amount of high-salt foods eaten daily by the study group were as follows: 4.5 Gm. in the form of table salt 16.8 ml of home-made soy sauce 6.20 ml of commercial soy sauce 11.9 Gm. of home-made red-pepper bean paste 12.0 Gm. of home-made soy-bean paste 120.7 Gm. of Kimchi 2. The average NaCl concentration of each food was as follows: 99.5% in table salt, 22.5% in home made soy sauce, 11.9% in Commercial soy sauce, 6.8 Gm% in home made red pepper bean paste, 9.2 Gm% in home-made soy-bean paste and the average concentration of various kinds of Kimchi was 2.7 Gm%. 3. The total amount of daily salt intake per adult was calculated as 14.3 Gm. By sources of food 4.5 Gm from table salt, 3.9 Gm from home-made soy sauce and 3. 3 Gm from Kimchi were taken daily Three other kinds of food were also minor sources of salt intake.4. The average amounts of individual daily salt intake were not significantly different between the hypertensive group and the normotensive group: the median of the normotensive group (11.7Gm.) was significantly lower than that of the hypertensive group (14.9Gm.). Therefore the womens' club leaders appeared to respond more quickly than the hypertensive group after low-salt diet education. 5. The average amount of sodium excretion in the 24 hour urine specimen was 234.7 mEq. From this finding the daily NaCl intake was estimated to be 15.8Gm.