• Childhood Kidney Diseases
• /
• 제24권1호
• /
• pp.14-18
• /
• 2020

Chronic kidney disease-mineral bone disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism caused by CKD. Patients with early-stage CKD who present with disordered regulation of bone and mineral metabolism may be asymptomatic. However, if untreated, the condition can be a significant barrier in achieving optimal bone strength, linear growth, and cardiovascular health in pediatric patients with CKD. Thus, the current study evaluated the definition, pathogenesis, diagnosis, and management of pediatric CKD-MBD.

• Journal of Preventive Medicine and Public Health
• /
• 제55권4호
• /
• pp.313-320
• /
• 2022

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

• Childhood Kidney Diseases
• /
• 제27권2호
• /
• pp.82-88
• /
• 2023

Chronic kidney disease (CKD) causes numerous changes that destabilize homeostasis, of which anemia is one of its important complications. Anemia significantly reduces the quality of life in children with CKD and plays a crucial role in the progression of cardiovascular disease such as left ventricular hypertrophy, a major cause of mortality in those with advanced CKD. The treatment of anemia is a pivotal factor in reducing morbidity and mortality rates in children with CKD, representing one of the methods for enhancing patients' quality of life.

• Childhood Kidney Diseases
• /
• 제25권1호
• /
• pp.1-7
• /
• 2021

Chronic kidney disease (CKD) in children is associated with various complications, including poor growth and development, mineral bone disorder, cardiovascular disease, kidney failure, and mortality. Slowing down the progression of CKD is important since CKD is often not curable. Prospective cohort studies have been conducted to understand the progression and outcomes of CKD in children, and these studies have identified non-modifiable and modifiable risk factors. Recognition of known risk factors and early intervention are important to delay the progression of kidney function decline in children.

• Childhood Kidney Diseases
• /
• 제28권2호
• /
• pp.51-58
• /
• 2024

Patients with chronic kidney disease (CKD) bear a significant financial burden and face numerous complications and higher mortality rates. The progression of CKD is associated with glomerular injury caused by glomerular hyperfiltration and oxidative stress. Factors such as uncontrolled hypertension, elevated urine protein levels, anemia, and underlying glomerular disease, contribute to CKD progression. In addition to conservative treatment, several medications are available to combat the progression of CKD to end-stage kidney disease. Renin-angiotensin-aldosterone system blockers could slow the progression of CKD by reducing glomerular hyperfiltration, lowering blood pressure, and decreasing inflammation. Mineralocorticoid receptor antagonists inhibit the mineralocorticoid receptor signaling pathway, thereby attenuating inflammation and fibrosis. Sodium-glucose cotransporter 2 inhibitors exhibit protective effects on the kidneys and against cardiovascular events. Tolvaptan, a selective vasopressin V2-receptor antagonist, decelerates the rate of increase in total kidney volume and deterioration of kidney function in patients with rapidly progressive autosomal dominant polycystic kidney disease. The protective effects of AST-120 remain controversial. Due to a lack of evidence regarding the efficacy and safety of these medications in children, it is imperative to weigh the benefits and adverse effects carefully. Further research is essential to establish the efficacy and safety profiles in pediatric populations.

• 한국임상수의학회지
• /
• 제38권3호
• /
• pp.115-119
• /
• 2021

This study was designed to investigate the characteristics of corneal ulcers in dogs with chronic kidney disease (CKD). Medical records of dogs that had been diagnosed with corneal ulcers and chronic kidney disease at Haemaru Referral Animal Hospital between April 1, 2011 and March 31, 2016 were investigated. A control group was randomly selected during the same time period. This group included patients with corneal ulcers but no evidence of systemic disease. The mean healing time of superficial corneal ulcers in the CKD group was 21.0 ± 15.0 days. This was a significantly longer healing time than was observed in the control group (11.0 ± 6.6 days, p = 0.019). The incidence rates of uveitis and keratoconjunctivitis sicca in the CKD group were significantly higher than in the control group (p = 0.000 and p = 0.026, respectively). Additionally, non-healing ulcers had significantly elevated white blood cell counts, while those with healing ulcers had WBC counts within the normal range in CKD group (p = 0.000). This study revealed that corneal ulcers in CKD patients would be delayed epithelial healing process and accompanied by ocular disease which affected to corneal healing compared to non-CKD patients.

• 셀메드
• /
• 제10권2호
• /
• pp.17.1-17.5
• /
• 2020

Background: Chronic kidney disease (CKD) is affective a large portion of the world population prompting the need for extensive healthcare resources such as lifelong dialysis or kidney transplantation. The beneficial effect of conventional therapy in controlling the CKD progression remains a challenge due to their relative efficacy, safety, and accessibility. On the other hand, Unani medicine provides a therapeutic regimen that consists of a combination of treatment from rehabilitation to herbal pharmacotherapy. Methods: Two cases of chronic kidney disease were treated with dietotherapy, regimenal therapy ('bukhoor aam') and oral herbal drugs for 2-3 weeks. Endpoints of evaluation were symptoms and signs of the CKD, kidney function test, urine albumin, urine RBC, hemoglobin and liver function test. Result: Notable improvement was observed in the endpoints. Conclusion: Unani treatment was observed preliminarily beneficial in the treatment of chronic kidney disease. Rigorous pharmacological and clinical studies should be performed to warrant their efficacy and safety in CKD individuals.

• 한국임상약학회지
• /
• 제24권3호
• /
• pp.199-205
• /
• 2014

Objectives: Current studies are debating on the association of vascular calcification and the benefit of treatment to lower serum phosphorus level in patients with chronic kidney disease. The aim of this study was to evaluate the association of mortality and risk of vascular calcification in patients with CKD who were taking phosphate binders. Methods: This study was conducted through retrospective medical chart review for 420 patients aged 18 years and older who were admitted for chronic kidney disease. Results: Vascular calcification was not statistically significantly associated with increased mortality in patients with CKD [16.7% vs. 19.2%; 95% CI; 0.388 to 1.818 (p=0.656)]. Intervention of calcium-based phosphate binders was not significantly associated with vascular calcification in patients with CKD [9.1% vs. 12.5%; 95% CI; 0.364 to 1.358 (p=0.292)]. Ca x P product ${\geq}55mg^2/dL^2$ was not significantly associated with increased 1 year mortality in patients with CKD [25.4% vs. 17.5%; 95% CI; 0.851 to 3.013 (p=0.142)]. Intervention of sevelamer was significantly associated with reduced 1 year mortality in patients with CKD than that of patients who did not take sevelamer [6.3% vs. 25.3%; 95% CI; 0.044 to 0.880 (p=0.020)]. Conclusion: There was not a statistically significant association between vascular calcification and phosphate binder's use. But phosphate binder use was significantly associated with decreased mortality in patients with CKD.

• 비만대사연구학술지
• /
• 제1권2호
• /
• pp.66-73
• /
• 2022

Obesity is an increasing public health and medical issue worldwide. It has been associated with several comorbidities, including diabetes, cardiovascular disease, stroke, and cancer. Chronic kidney disease (CKD) is another important comorbidity of obesity. Other major causes of CKD include hypertension and diabetes. However, the association between obesity and CKD is often overlooked. Among patients with CKD, patients with obesity were more vulnerable to have rapid kidney function decline than that of those with normal weight. Additionally, CKD is more prevalent among patients with obesity. These aggravations are induced through multiple mechanisms, specifically metabolic impairment of obesity and mechanical burden because of increasing intraabdominal renal pressure. Furthermore, the inflammation and lipotoxicity, caused by obesity, are critical in the CKD aggravation in patients with obesity. To prevent this, all adult patients with obesity are tested for CKD. The workup includes the estimated glomerular filtration rate and regular follow-up. Step-wise management is required for patients with obesity with CKD. Prompt reduction and management of obesity effectively delay CKD progression among patients with obesity and CKD. Therefore, weight loss is a core management for patients with obesity and CKD. Based on several studies, this article focused on the association between CKD and obesity, as well as the diagnosis and weight management of patients with obesity and CKD.

• Childhood Kidney Diseases
• /
• 제18권1호
• /
• pp.7-12
• /
• 2014

만성 콩팥병의 장기 예후를 결정하는 요인 중 심혈관계 합병증의 중요성은 잘 알려져 있다. 그러나 소아 환자의 경우 전형적인 증상 발현이 적어 그 임상적 중요성이 간과되는 경향이 있다. 현재까지 알려진 심혈관계 합병증의 위험인자로는 고혈압, 당뇨병, 이상지질혈증, 비만과 같은 전통적인 위험 인자와 빈혈, 이차성 부갑상선 기능항진증, 산화 스트레스, 염증과 같은 새로운 위험 인자 등이 알려져 있다. 소아 만성 콩팥병의 경우 주로 좌심실 비대나 경동맥 내중막 두께의 증가 및 관상동맥의 석회화 같이 대부분 겉으로 드러나지 않는 증상이므로 위험 인자에 대한 철저한 관리와 지속적인 추적 관찰이 필수적이다.