• Childhood Kidney Diseases
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• v.1 no.1
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• pp.79-81
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• 1997

Minimal change nephrotic syndrome is characterized by proteinuria, hypoproteinemia, edema, and hyperlipidemia. Children with onset of nephrotic syndrome between the age of 1 and 8 year are likely to have steroid response to minimal chage disease, but we experienced one case of minimal change disease which failed to respond to steroid therapy at beginning and subsequently developed acute renal failure. It was seen in a 5 year-old male child that presented with edema and gross hematuria. Peritoneal dialysis was performed for acute renal failure for 11 days. Patient was completely recorvered from acute renal failure and renal biopsy was done at 27th day after onset of disease which revealed typical picture of minimal change disease complicated by acute tubular necrosis. We beleive this case is very unusual and it may be the first case in the literature in terms of pediatric cases.

• Childhood Kidney Diseases
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• v.15 no.2
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• pp.101-106
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• 2011

Acute renal failure means that the word does not contain a mild kidney injury. In addition, the criteria for acute renal failure per researcher are different, and it is difficult in interpreting the results of research on acute renal failure. Therefore, rather than acute renal failure, a new term "acute kidney injury" meaning to include all the levels of injury is introduced. In 2002, to diagnose by means of serum creatinine, glomerular filtration rate and urine output, a detailed classification of acute kidney injury, the RIFLE criteria has been proposed. In 2007, the RIFLE criteria by transforming, AKIN criteria has been proposed. The pediatric RIFLE criteria for children has also been proposed. The author reviews here these criteria by comparing them.

• Neonatal Medicine
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• v.17 no.2
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• pp.161-167
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• 2010

Acute kidney injury (AKI), formerly referred to as acute renal failure (ARF) is defined as the sudden impairment of kidney function (estimated from the glomerular filtration rate [GFR]) that results in the lack of excretion of waste products. More than 30 definitions of AKI exist in the literature, most of which are based on serum creatinine. Lack of a uniform and multidimensional AKI definition has led to failure to recognize significant renal injury, delays in treatment, and inability to generalize single-study results. The RIFLE criteria were developed to standardize the diagnosis of ARF and in the process the term AKI has been proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to requirement for renal replacement therapy. Large prospective studies are needed to test definitions and to better understand risk factors, incidence, independent outcomes, and mechanisms that lead to poor short- and long-term outcomes. Early biomarkers of AKI need to be explored in critically ill neonates.

• Journal of Cardiovascular Imaging
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• v.31 no.4
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• pp.169-177
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• 2023

BACKGROUND: Acute worsening of cardiac function frequently leads to kidney dysfunction. This study aimed to identify clinical and imaging parameters associated with impaired kidney function in patients with acute decompensated heart failure with reduced ejection fraction (HFrEF). METHODS: Data from 131 patients hospitalized with acute decompensated HFrEF (left ventricular ejection fraction, < 40%) were analyzed. Patients were divided into two groups according to the glomerular filtration rate (GFR) at admission (those with preserved kidney function [GFR ≥ 60 mL/min/1.73 m²] and those with reduced kidney function [GFR < 60 mL/min/1.73 m²]). Various echocardiographic parameters and perirenal fat thicknesses were assessed by computed tomography. RESULTS: There were 71 patients with preserved kidney function and 60 patients with reduced kidney function. Increased age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.04-1.12; p = 0.005), increased log N-terminal pro b-type natriuretic peptide (OR, 1.74; 95% CI, 1.14-2.66; p = 0.010), and increased perirenal fat thickness (OR, 1.19; 95% CI, 1.10-1.29; p < 0.001) were independently associated with reduced kidney function, even after adjusting for variable clinical and echocardiographic parameters. The optimal average perirenal fat thickness cut-off value of > 12 mm had a sensitivity of 55% and specificity of 83% for kidney dysfunction prediction. CONCLUSIONS: Thick perirenal fat was independently associated with impaired kidney function in patients hospitalized for acute decompensated HFrEF. Measurement of perirenal fat thickness may be a promising imaging marker for the detection of HFrEF patients who are more susceptible to kidney dysfunction.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.52-56
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• 2011

Acute renal injury induced by ischemia is a major cause of high morbidity and mortality in hospitalized patients and a common complication in hospitalized patients. Thus, the work with acute renal failure and renal ischemia has been studied for many years. Although serum creatinine concentration that is widely used as an index of renal function performs fairly well for estimating kidney function in patients with stable chronic kidney disease, it performs poorly in the setting of acute disease. Thus, an ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury in hospitalized patients, acute tubular necrosis, early and accurately, and may aid to risk-stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay and mortality. In this study, renal ischemia and reperfusion were performed by clapming and un-clamping right renal artery in miniature pigs. Plasma blood urea nitrogen (BUN) and creatinine were examined at pre- clamping, after-clamping at 0, 1 and 3 hours. And we searched initial indicators in these samples. Also, renal tissue was collected and searched the initial indicator by PCR and western blotting. As a result, hypoxia inducible factor $1{\alpha}$ ($HIF1{\alpha}$), nuclear factor kappa-B ($NF{\kappa}B$), $I{\kappa}B$, erythropoietin (EPO), erythropoietin receptor (EPOR), angiopoietin-1 and vascular endothelial growth factor (VEGF) were showed significant changes among the renal protein. $HIF1{\alpha}$, EPO, and EPOR were showed significant changes among the renal gene. Thus, these markers will be used as initial diagnosis of acute renal failure.

• Journal of Yeungnam Medical Science
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• v.1 no.1
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• pp.13-23
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• 1984

Acute renal failure refers to a rapid reduction in renal function that usually occurs in an individual with no known previous renal disease. Development of a complication of acue renal failure in critically ill surgical patients is not unusual, and it causes high morbidity and mortality. Acute renal failure can be divided as Pre-renal (functional), Renal (organic), and Post-renal (obstructive) azotemia according to their etiologies. Early recognition and proper correction of pre-renal conditions are utter most important to prevent an organic damage of kidney. These measures include correction of dehydration, treatment of sepsis, and institution of shock therapy. Prolonged exposure to ischemia or nephrotoxin may lead a kidney to permanent parenchymal damage. A differential diagnosis between functional and organic acute renal failure may not be simple in many clinical settings. Renal functional parameters, such as $FENa^+$ or renal failure index, are may be of help in these situations for the differential diagnosis. Provocative test utilyzing mannitol, loop diuretics and renovascular dilators after restoration of renal circulation will give further benefits for diagnosis or for prevention of functional failure from leading to organic renal failure. Converting enzyme blocker, dopamine, calcium channel blocker, and propranolol are also reported to have some degree of renal protection from bioenergetic renal insults. Once diagnosis of acute tubular necrosis has been made, all measures should be utilized to maintain the patient until renal tubular regeneration occurs. Careful regulation of fluid, electrolyte, and acid-base balance is primary goal. Hyperkalemia over 6.5 mEq/l is a medical emergency and it should be corrected immediately. Various dosing schedules for medicines excreting through kidney have been suggested but none was proved safe and accurate. Therefore blood level of specific medicines better be checked before each dose, especially digoxin and Aminoglycosides. Indication for application of ultrafiltration hemofilter or dialysis may be made by individual base.

• Korean Journal of Acupuncture
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• v.20 no.2
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• pp.55-66
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• 2003

Objectives : The aim of this experiment is to investigate the effects of moxibustion on SP6, Sp9 and BL28 in uranyl acetate-induced acute renal failure in rats. Methods : To induce experimental acute renal failure, uranyl acetate was intraperitoneally injected to rats by 5mg/kg. 3 days later moxibustion treatment was done at SP6, Sp9 and BL28 bilaterally of the rats. And then 4 days later, we measured rats' body weight, kidney weight, serum BUN, creatinine and serum electrolytic levels(Na, K and Cl). Results : In the SP6 group, serum BUN were significantly decreased (p<0.01). In the BL28 group, serum Na level were significantly decreased (p<0.05). In the $SP6{\cdot}SP9$ group, serum creatinine level were significantly increased but serum Na level, serum Cl level were significantly decreased(p<0.05). In the $SP6{\cdot}BL28$ group, hypertrophy index of kidney and serum creatinine level were significantly decreased(p<0.01) and serum BUN were marginally significantly decreased (0.1

• Neonatal Medicine
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• v.17 no.2
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• pp.168-180
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• 2010

Acute renal failure (ARF) is common in the neonatal period, however, there are no uniform treatment strategies of ARF. The main treatment strategies are conservative management including medical treatment and the renal replacement therapy. Because ARF in the newborn is commonly acquired by hypoxic ischemic injury and toxic insults, removal of all the offending causes is important. Aminoglycoside, indomethacin, and amphotericin-B are the most common nephrotoxic drugs of ARF. To relieve the possible prerenal ARF, initial fluid challenge can be followed by diuretics. If there is no response, fluid restriction and correction of electrolyte imbalance should begin. Adequate nutritional support and drug dosing according to the pharmacokinetics of such drugs will be difficult problems. Renal replacement therapies may be provided by peritoneal dialysis, intermittent hemodialysis, or hemofiltration. New promising agents, bioartificial kidney, and stem cell will enable us to extend our therapeutic repertoire.

• Journal of Acupuncture Research
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• v.19 no.6
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• pp.49-60
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• 2002

Objective : The aim of this experiment is to investigate the effect of acupuncture and moxibustion at SP6(Sanyinjiao) and BL28(Pangguanshu) on uranyl acetate-induced acute renal failure in rats. Methods : To induce experimental acute renal failure, uranyl acetate was intraperitoneally injected to rats by 5mg/kg. 3 days later acupuncture and moxibustion treatment was done at SP6(Sanyinjiao) and BL28(Pangguanshu) bilaterally of the rats. And then 4 days later, we measured rats' body weight, kidney weight, serum BUN, creatinine and serum eletrolyte levels(Na, K and Cl). Results : In the moxibustion group, hypertrophy index of kidney and serum BUN level were decreased marginally significantly, and serum creatinine, K levels were decreased significantly. But in the acupuncture group, there was no significance at this experiment. Conclusions : SP6(Sanyinjiao) and BL28(Pangguanshu) moxibustion can decrease serum BUN, creatinine, and serum eletrolyte levels on uranyl acetate-induced acute renal failure in rats. And the study will be done continuously about non-effect in the acupuncture group at this experiment.

• The Journal of Internal Korean Medicine
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• v.32 no.2
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• pp.278-287
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• 2011

Objectives : The object of this study was to observe the nephroprotective effects of Sojongchobisunki-tang (SCST), which has traditionally been used as Korean medicine for treating various renal diseases, on cisplatin-induced rat acute renal failure. Methods : Three different dosages of SCST were orally administered once a day for 23 days before cisplatin treatment (5 mg/kg, single intraperitoneally administered) and 5 days after cisplatin treatment (once a day for 28 days). 6 groups, of 8 rats per group were used in the present study after 7 days of acclimatization. Changes of the body weight, kidney weight, serum BUN and creatinine levels were observed, as well as changes of the kidney MDA and GSH contents. The results were compared with captopril 100 mg/kg of which the effects on cisplatin-induced acute renal failures are already confirmed. Results : Acute renal failure induced by cisplatin were induced by oxidative stress and related lipid peroxidation in the present study. However, these acute renal failures and inhibition of antioxidant effects induced by cisplatin were dose-dependently reduced by treatment at all three different dosages of SCST extracts. Conclusions : This study suggests that SCST extracts showed favorable effects on the cisplatin-induced rat ARF.