• Title/Summary/Keyword: Acute Renal Failure

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Clinical Analysis of Postoperative Acute Renal Failure in the Patients undergoing Cardiovascular Operation with CPB (개심술 후 발생한 급성 신부전의 임상적 고찰)

  • 편승환;노재욱;방정희;조광조;성시찬;우종수
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.494-501
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    • 1998
  • From May 1, 1993 to May 31 1995, the authers studied retrospectively 211 patients who underwent cardiovascular operation with cardiopulmonary bypass(CPB). Because we were interested in new development of ARF(prevalence, mortality rate, and main risk factors), we performed a multivariate statistical analysis about data of patients with preoperative serum creatinine values of less than 1.5 mg/dL. Normal renal function before operation(serum creatinine level less than 1.5 mg/dL) was registered in 198(74%) patients. Of these, 27(14%) patients showed postoperative renal complication, including 20(10%) patients classified as renal dysfunction(serum creatinine level between 1.5 and 2.5 mg/dL) and 7(4%) patients as acute renal failure(serum creatinine level higher than 2.5 mg/dL). The mortality rate was 5.8% in normal patients, 5% in patients with renal dysfunction, and 43% when acute renal failure developed(p=0.036). Indeed, the renal impairment proved to be an independent predictor of mortality(odd ratio 2.52∼11.25), along with cardiovascular(odd ratio 4.20) and respiratory(odd ratio 2.18) complications. Multivariate analysis identified the following variables as independent risk factors for postoperative renal impairment : advanced age(odd ratio 1), need for emergency operation(odd ratio 3.78), low-output syndrome(odd ratio 3.66), respiratory complication(odd ratio 1.30), need for deep hypothermic circulatory arrest(odd ratio 1.4). The 13 patients(7%) with preoperative renal failure showed a significantly higher morbidity and mortality rate than those without renal complications before operation. We concluded that the likelihood of severe renal complications is resonably low in the patients undergoing cardiac operation without preexisting renal dysfunction, but associated mortality remains high. A prominant role of hemodynamic factor in the development of postoperative acute renal failure must be recognized during preoperative, intraoperative, and postoperative periods.

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Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis (양측성 신동맥 협착증에서 발생한 급성 비대상성 심부전과 급성 신손상)

  • Jung, Ho Jin;Choi, Won Suk;Kang, Hyun Jae;Jung, Byung Chun;Lee, Bong Ryeol;Lee, Jong Joo;Lee, Jun-Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.146-151
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    • 2015
  • Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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The Effect of Plantaginis Semen Herbal Acupuncture on Rat by Glycerol-Induced Acute Renal Failure (차전자약침(車前子藥鍼)이 Glycerol로 유발(誘發)된 급성신불전(急性腎不全) 백서(白鼠)에 미치는 영향(影響))

  • Cho, Si-Yong;Song, Choon-Ho
    • Journal of Pharmacopuncture
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    • v.3 no.2
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    • pp.41-54
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    • 2000
  • This study was undertaken to determine if Plantaginis Semen Herbal Acupuncture(PSA) has a protective effect against glycerol-induced acute renal failure in rats. Rats were dehydrated for 24hr and then injected with 8 ml/kg of $50\%$ glycerol, one-half of dose in each hindlimb muscle. In experiments for PSA effect, rats received 0.1 ml of PSA extraction in both sides of corresponding Shenso($BL_{23}$) of human body for 3 days after injection of glycerol. The experimental group were di vided into the Normal group, the Control group, the PSA group. Glycerol injection decreased glomerular filtration rate and increased urine volume, serum creatinine, BUN level and fractional excretion of glucose, $Na^+$, $K^+$ and $CI^-$. These result show that glycerol injection result in acute renal failure. PSA significantly increased glomerular filtration rate and significantly decreased serum creatinine, BUN level and fractional excretion of glucose, $Na^+$ and $CI^-$ as compared Control group. This suggests that PSA could be used in prevention and treatment of acute renalfailure. However, the precise mechanisms of PSA protection remain to be determined.

Effects of Glycyrrhizae Radix Pharmacopuncture Intravenous Injection on Ischemia-Induced Acute Renal Failure in Rabbits (허혈로 유발된 토끼의 급성 신부전에 대한 甘草(감초) 약침액 정맥 주입의 영향)

  • Kim, Hyeong-Cheol;Kim, Gyoung-Ho;Lee, Guem-San;Kim, Hyung-Woo;Lim, Se-Hyun;Lim, Chi-Yeon;Kim, Young-Gyun;Cho, Su-In
    • Journal of Pharmacopuncture
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    • v.14 no.4
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    • pp.5-11
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    • 2011
  • Objectives: The present study was undergone to determine whether Glycyrrhizae Radix pharmacopuncture intravenous injection exerts beneficial effect against the ischemia-induced acute renal failure in rabbits. Methods: Rabbits were treated with Glycyrrhizae Radix pharmacopuncture via i.v., followed by renal ischemia/reperfusion. The fractional excretion of glucose and phosphate were measured and the malondialdehyde content was also determined. The morphological changes of cortical part of kidney also observed with light microscope. Results: Renal ischemia/reperfusion caused increase of the fractional excretion of glucose and phosphate in ischemia-induced animals, which was prevented by Radix Glycyrrhizae extract treatment. Ischemia/reperfusion increased lipid peroxidation, which was prevented and morphological changes also altered by Radix Glycyrrhizae pharmacopuncture administration. Conclusions: These results indicate that lipid peroxidation plays a critical role in ischemia-induced acute renal failure and Glycyrrhizae Radix pharmacopuncture exerts the protective effect against acute renal failure induced by renal ischemia/reperfusion.

Clinical Study of Gamdutang Complex Formula on Patients of Acute Renal Failure due to Paraquat Intoxication

  • Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.3
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    • pp.588-593
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    • 2002
  • Paraquat, one of the potent herbicides, causes fatal damage to many vital organs, when orally ingested, resulting in circulatory failure, respiratory distress syndrome, and a few other serious problems, but there is no known specific antidote against it. Of the possible problems related to paraquat intoxication, oliguric acute renal failure, which has been known to develop within 24 or 48 hours after intoxication, are notoriously life-threatening. So we attempted to investigate the clinical characteristics and progress of paraquat-induced acute renal failure and the therapeutic possibilities of herbal medicines. All of the fifteen subjects were treated with intravenous fluid injection of 5% dextrose saline or 10% dextrose water in conjunction with herbal medicines which were used for oral administration or gargling. Gamdutang, a decoction of Semen Glycin(黑豆 200g) and Radix Glycyrrhizae(甘草 100g) with addition of other herbs when necessary, was administered orally. At the same time, gargling fluid, consisted of Chinese ink(墨汁), char-frying powder of Rhei Rhizoma(大黃炒炭末), Succus phyllostachyos(竹瀝), was used to detoxify the oral cavity. Serum levels of Blood Urea Nitrogen(BUN) and Creatinine reached its peak on the third day of hospitalization, but then decreased and fell within the normal range on the 7th day and remained there. Serum levels of Na+ and K+ decreased down below the lower limits of normal range on the 7th day and on the 3rd day, respectively. Then they returned back within normal limits. Mean urine output on the 1st day of hospitalization was 1,050ml and it continuously increased to reach more than 2,000ml on the 14th day. From that day on, it stayed over 2,000ml. Fifteen cases of acute renal failure caused by paraquat intoxication were treated with combined treatments of oriental and western medicine in our hospital. However, we think that it is necessary to study further about the way to combine oriental and western medicine, to find out a more effective treatment method.

The Effect of Juglandis Semen Aquacupuncture on Diuresis of Rat in Glycerol-Induced Acute Renal Failure (호도약침(胡桃藥鍼)이 Glycerol로 유발(誘發)된 급성신부전(急性腎不全) 백서(白鼠)의 이뇨(利尿)에 미치는 영향(影響))

  • Jung, Hyun-Chol;Song, Choon-Ho
    • Journal of Acupuncture Research
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    • v.17 no.1
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    • pp.107-117
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    • 2000
  • This study was undertaken to determine if Juglandis Semen Aquacupuncture(Ja) has a protective effect against glycerol-induced acute renal failure in rats. Rats were dehydrated for 24hr and then injected with $5m{\ell}/kg$ of 50% glycerol, one-half of dose in each hindlimb muscle. In experiments for Ja effect, rats received $0.1m{\ell}$ of Ja extraction in both sides of corresponding $Sh{\grave{e}}ns{\bar{u}}$($BL_{23}$) of human body and non-acupuncture points(the root of tail) for 3 days after injection of glycerol. The experimental group were divided into the Normal group, the Control group, the Ja to $Sh{\grave{e}}ns{\bar{u}}$($BL_{23}$) group(Ja-AS), the Ja to non-acupuncture points group(Ja-AN). There were significant decrease of Urine vollume, total protein and phosphate level in Ja-AS as compared with the control group. There were not any significant change of Urine creatinine in Ja-AS as compared with the control group. There were significant decrease of Unine glucose in Ja-AS, Ja-AN as compared with the control group. This suggests that Ja-AS could be used in prevention and treatment of acute renal failure. However, the precise mechanisms of Ja protection remain to be determined.

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Beneficial Effect of Semen Plantaginis Herbal-Acupuncture on Cisplatin-Induced Acute Renal Failure in Rabbits (차전자약침(車前子藥鍼)이 Cisplatin에 의해 유발된 급성 신부전에 미치는 영향)

  • Park, Chun-ha;Chae, Woo-seok;Yun, Yeo-choong
    • Journal of Acupuncture Research
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    • v.21 no.2
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    • pp.155-166
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    • 2004
  • Objective : The present study was carried out to determine if Semen Plantaginis Herbal-Acupuncture exerts beneficial effect against the cisplatin-induced acute renal failure in rabbits. Method : Semen Plantaginis was selected in the basis of invigorating kidney-QI which can eliminate pathogens. The oxidative stability determined by the Rancimat technique showed higher antioxidative index when compared with control. Rabbits were treated with Semen Plantaginis Herbal-Acupuncture on Shin-shu point for 3 days, followed by cisplatin injection(5mg/kg body weight). Results : Cisplatin injection caused an increase in serum creatinine level, which was accompanied by a reduction in GFR. The fractional excretion of $Na^{+}$, $K^{+}$, glucose and phosphate increased in cisplatin-induced animals, which was partially prevented by Semen Plantaginis Herbal-Acupuncture treatment. Cisplatin injection increased lipid peroxidation, which was not prevented by Semen Plantaginis Herbal-Acupuncture. Conclusions : These results indicate that lipid peroxidation plays a critical role in cisplatin-induced acute renal failure. Semen Plantaginis Herbal-Acupuncture exerts the protective effect against acute renal failure induced by cisplatin, and its effect may be attribued to an antioxidant action.

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Effect of Hemodialysis on Dogs with Acute Renal failure Induced by Bilateral Ligation of the Ureter (양측 요관 결찰에 의해 유발된 급성신부전증 개에 대한 혈액투석 효과)

  • Cho, Hyo-Gueon;Lee, Jung-Yeon;Lee, Sang-Eun;Song, Kun-Ho;Chung, Byung-Hyun;Kim, Duck-Hwan
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.267-271
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    • 2006
  • The present study was performed to clarity the effect of hemodialysis(HD) on acute renal failure induced by bilateral ligation of the ureter. HB was applied on 48 hours(1st HD) and 72 hours(2nd HD) after ligation of the ureter, respectively. Clinical signs including nausea, vomiting, diarrhea and depression were observed in all cases(6 heads), however, those symptoms were much improved after HD. Hematological values including WBC, PCV and PLT were increased after ligation of the ureter, however, those values were decreased by HD without significance, compared with those of before HD. In addition, serum BUN, creatinine, Ca and P levels were increased after ligation of the ureter, however, BUN(p<0.05), creatinine(p<0.05) and P(p<0.05) were significantly decreased by HD, compared with before HD, respectively. Considering above findings, it was thought that HD was effective for improvement of clinical symptoms of dogs with induced acute renal failure.

Beneficial Effect of Paljeong-san Pharmacopuncture Treatment Combined with Peritoneal Injection on Glycerol-Induced Acute Renal Failure in Rabbits (팔정산(八正散) 약침(藥鍼) 및 복강(腹腔) 주입 병용 시술이 글리세롤로 유발된 토끼의 급성 신부전에 미치는 영향)

  • Lim, Chi-Yeon;Kim, Min-Ho;Lee, Geum-San;Kim, Hyung-Woo;Kim, Bu-Yeo;Yun, Yeo-Choong;Cho, Su-In
    • Journal of Pharmacopuncture
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    • v.13 no.3
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    • pp.73-80
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    • 2010
  • Purpose: The present study was carried out to determine if Paljeong-san extract (PJS) treatment exerts beneficial effect against the glycerol-induced acute renal failure in rabbits. Material and Method: PJS was selected in the basis of invigorating kidney which can eliminate pathogens. Rabbits were treated with PJS pharmacopuncture on Shin-shu ($BL_{23}$) point for 5 days right after the injection of 50% concentration of glycerol ($5m{\ell}/kg$ body weight). Results and Conclusions: Glycerol injection caused an increase in serum creatinine and BUN level and urine glucose secretion, which were accompanied by a reduction in GFR. PJS Pharmacopuncture treatment combined with peritoneal injection showed beneficial effect on glycerol-induced acute renal failure by inhibition of serum creatinine increase and GFR decrease.