• 대한약리학회지
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• 제26권2호
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• pp.161-166
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• 1990

Kallikrein-kinin계는 신장의 혈류역학과 수분 및 전해질 배설의 조절자로서 역할을 하는 것으로 알려져 있다. Kallikrein-kinin계의 유효한 펩타이드중 하나인 bradykinin(BK)을 신동맥에 주입시 전해질 배설이 증가하는데 이 작용이 신혈류역학적 변동에 기인하는지 또는 신세뇨관의 전해질 운반에 대한 직접적인 작용에 기인하는지 아직 확실치 않다. 따라서 본 연구에서는 원위세뇨관(DT)과 피질집합관(CCT)에서의 전해질운반 의존성 산소소비에 대한 BK의 영향을 관찰하였다. BK$(0.1\;{\mu}M)$은 DT과 CCT의 산소소비를 유의하게 감소시켰으며 이 작용은 Na부재시 나타나지 않았고 ouabain전처치에 의해 차단되었다. 또한 이 작용은 mepacrine에 의해 유의하게 차단되었으며 indomethacin에 의하여는 차단되지 않았다. 이상의 결과는 BK이 DT과 CCT에서 Na운반과 관련한 산소소비를 억제시키며 이 작용에는 prostaglandin들이 관여하고 있지 않음을 시사한다.

• Childhood Kidney Diseases
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• 제14권2호
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• pp.120-131
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• 2010

Renal tubular acidosis (RTA) is a metabolic acidosis due to impaired excretion of hydrogen ion, or reabsorption of bicarbonate, or both by the kidney. These renal tubular abnormalities can occur as an inherited disease or can result from other disorders or toxins that affect the renal tubules. Disorders of bicarbonate reclamation by the proximal tubule are classified as proximal RTA, whereas disorders resulting from a primary defect in distal tubular net hydrogen secretion or from a reduced buffer trapping in the tubular lumen are called distal RTA. Hyperkalemic RTA may occur as a result of aldosterone deficiency or tubular insensitivity to its effects. The clinical classification of renal tubular acidosis has been correlated with our current physiological model of how the nephron excretes acid, and this has facilitated genetic studies that have identified mutations in several genes encoding acid and base ion transporters. Growth retardation is a consistent feature of RTA in infants. Identification and correction of acidosis are important in preventing symptoms and guide approved genetic counseling and testing.

• 약학회지
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• 제38권5호
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• pp.568-578
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• 1994

This study was performed in order to investigate the effect of diltiazem, which is a $Ca^{2+}$ channel blocker of benzothiazepine derivatives, on renal function in the dog. Diltiazem, when infused into the vein or carotid artery, produced the antidiuresis accompanied with the decreased excretion rates of sodium and potassium in urine$(E_{Na},\;E_K)$ and the increased reabsorption rates of sodium and potassium in renal tubules$(R_{Na},\;R_K)$. Diltiazem, when infused into a renal artery, exhibited the diuresis along with the increased renal plasma flow(RPF), osmolar clearance$(C_{osm})$, $E_{Na}$ and $E_K$, and decreased $R_{Na}$ and $R_K$ in only infused kidney. Above results suggest that diltiazem possess both antidiuretic action through central action and diuretic action by direct inhibition of electrolytes reabsorption rates in renal tubules, mainly distal tubule.

• 생명과학회지
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• 제17권10호
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• pp.1347-1353
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• 2007

성장과정 중 흰쥐 신장에서 나타나는 복합당질의 변화를 알아보기 위해 18일 태자부터 성체에 이르는 신장을 형태적 관찰과 더불어 9가지 lectin (SBA, DBA, PNA, BSL-1, RCA-1, sWGA, UEA-1, LCA 및 Con A)으로 검색하였다. 신장 발생단계에서 성숙한 신원구조와 함께 미성숙한 구조물 즉 소포와 요관아 등이 생후 14일에 이르기까지 관찰되었으며 생후 21일에 이르러 성체와 유사한 구조적 특성을 보였다. 복합당질의 변화를 보면 사구체에서 RCA-1, LCA및 Con A에 반응을 나타내며 RCA-1 및 LCA는 태자와 신생쥐에서 일시적으로 증가하다 성체에서 관찰되지 않으나 Con A는 성장과 더불어 증가하였다. 근위곡요세관은 UEA-1을 제외한 모든 lectin에 반응하며 DBA, SBA, PNA, BSL-1, RCA-1 및 Con A반응이 성장과 더불어 증가하며 특히 RCA-1과 BSL-1반응이 현저하였다. 이에 비해 sWGA와 LCA반응은 성장과정에 일시적으로 증가하며 성체에 이를수록 감소하였다. 원위곡요세관도 근위곡요세관 유사하게 DBA, SBA, PNA, BSL-1 및 RCA-1반응은 성숙과 함께 증가하나 LCA반응은 성숙과정에 일시적으로 증가하며 성체에서 감소하였다. 집합관에서는 DBA, SBA, PNA, sWGA반응이 성숙과 동시에 증가하나 BSL-1, RCA-1, LCA반응은 미성숙관에서 일시적으로 증가하였다. 이상의 반응으로 보아 신장발생과정에서 형태적 기능적 성숙과 함께 다양한 복합당질의 변화를 보이는데 대체로 성숙에 따라 반응이 증가하는 복합당질군과 미성숙기에 일시적으로 증가하며 성체에서 감소하는 복합당질군으로 대별할 수 있었다. 이러한 출생전후 복합당질의 변화는 신장의 기능적 성숙과정과 연관성을 가지며 발생과정에서 현저한 변화를 나타내는 복합당질은 정상 신장발생에 대한 표지인자로 유용할 것이다.

• 동의생리학회지
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• 제14권2호통권20호
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• pp.189-198
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• 1999

Aminoglycosides, including gentamicin, have been used as antibiotics for the various infections by gram-negative bacteria. However, there are some restrictions for using these drugs. Gentamicin, a typical aminoglycoside, has the side effect of nephrotoxicity, including polyuria, glycosuria, proteinuria, glomerulonephritis, and uremia. The aims of this study were to examine the prevention or reduction effects of Jinmootang on the gentamicin-induced nephrotoxicity and to investigate the possible mechanisms on the effect of Jinmootang. The subcutaneous injections of 60mg of gentamicin per kg of boby weight to Sprague-Dawley rats for 8 days induced typical symptoms of nephrotoxicity by aminoglycosides. 0.6ml of water extract Jinmootang (100ml/chup) was orally treated in the experimental animal. 24-hour urine was collected with the metabolic cage and plasma was sampled from the abdominal aorta. The plasma concentration of sodium was significantly decreased by the treatment of gentamicin but it was not-significantly changed by the treatment of Jinmootang to the animal. The concentration of potassium was greatly decreased in the gentamicin-treated animals. However. it was returned to the normal level in the Jinmootang-treated animals. The concentrations of creatinine and urea were increased by gentamicin treatment. But, Jinmootang reduced these concentrations. Nevertheless, the osmolalities of plasma in both group were not different from each other. Even though the plasma concentration of aldosterone was not significantly changed, the mean value was increased by the gentamicin intoxication. The concentration of aldosterone was decreased by the treatment of Jinmootang. The reduction of aldosterone level in plasma could be a factor to improve the hypokalemia. The fractional excretion of potassium was much higher than normal by the treatment of gentamicin and it was decreased by 50% in the Jinmootang-treated rats. Therefore, the reabsorption of potassium was significantly increased by the treatment of Jinmootang, even though the filtered load of potassium in the experimental group was much highter than control. Even though the concentration of plasma aldosterone was decreased by the treatment of Jinmootang, the fractional excretion of sodium was not increased, slightly lower. These data suggested that Na reabsorption was increased in the proximal tubule by Jinmootang. The filtered load of glucose in the Jinmootang-treated group was greater than in control. Nevertheless, the fractional excretion of glucose in the experimental group was not different from that in control. These results indicate that glucose reabsorption was increase in the proximal tubule by Jinmootang treatment. The results of this study suggest that Jinmootang could improve the some nephrotoxic symptoms induced by gentramicin treatment. Hypokalemia, the reduced glomerular filtration rate, and dysfunctions of renal proximal tubule and distal nephron were significantly recovered to normal level. The increase of glomerular filtration rate by Jinmootang might contribute to eliminate the waste product, including creatinine and urea, and/or gentamicin through the kidney.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.101-105
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• 2017

Gitelman syndrome is a condition caused by a mutation of the thiazide sensitive Na-Cl cotransporter gene on the distal convoluted tubule. It results in a variety of clinical features, including hypokalemia, hypomagnesemia, hypocalciuria, and metabolic alkalosis. It is often diagnosed in asymptomatic adults presented with unexplained hypokalemia; however, it is sometimes associated with muscular cramps, numbness, fatigue, weakness, or paralysis. We experienced a case of rheumatoid arthritis accompanied by Gitelman syndrome, presented with hand tremor. We diagnosed her using renal clearance study and genetic analysis. Here, we report our experiences regarding this case along with a literature review.

• The Korean Journal of Physiology and Pharmacology
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• 제2권4호
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• pp.503-510
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• 1998

Effects of cadmium exposure on renal $Na^+$ and $K^+$ transports were studied in rats. During the course of cadmium treatment (2 mg Cd/kg/day, s.c. injections for 3 weeks) renal tubular transports of $Na^+$ and $K^+$ were evaluated by lithium clearance technique. During the early phase (first week) of cadmium treatment, urinary $Na^+$ excretion decreased drastically and this was due to an increased $Na^+$ reabsorption both in the proximal and distal nephrons. During the late phase (third week) of cadmium treatment, filtered $Na^+$ load was decreased by reduction in GFR, but the renal $Na^+$ excretion returned to the control level due to impaired $Na^+$ transport in the proximal tubule. Urinary excretion of $K^+$ did not change during the early phase, but it rose markedly during the late phase of cadmium treatment. These results indicate that a light cadmium intoxication induces a $Na^+$ retention, and a heavy intoxication results in a $K^+$ loss. Possible mechanisms for these changes are discussed.

• 약학회지
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• 제45권2호
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• pp.205-213
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• 2001

The dopaminergic receptors were consisted of two distinct subtypes, $D_1$and $D_2$, each having different function. The present study was attempted to investigate the effects of R(-)-2,10,11-trihydroxy-N-n-propylnoraporphine (TNPA), a dopamine $D_2$receptor agonist, on renal function in dog. TNPA (5.0~15.0 $\mu$g/kg), when given into the vein, produced a dose-dependently antidiuresis along with the decrease in osmolar clearance ( $C_{osm}$) and urinary excretion of sodium and potassium ( $E_{Na}$ , and $E_{K}$). It also increased reabsorption rates of sodium and potassium in renal tubules ( $R_{Na}$ , $R_{K}$) without any changes in glomerular filtration rate (GFR), renal plasma flow (RPF) and free water clearance ( $C_{H2o}$). TNPA (0.5~1.5 $\mu$g/kg/min) infused into a renal artery decreased urine flow both in the experimental and the control kidneys. TNPA (1.5~5.0 $\mu$g/kg) administered via the carotid artery also greatly exhibited antidiuresis even at intravenously ineffective doses. Changes of renal function by TNPA given into both the renal artery and the carotid artery were almost the same aspect to those induced by intravenous TNPA. These results obtained from the present study suggest that TNPA produces antidiuresis by increasing the reabsorption rates of electrolytes in renal tubules, mainly distal tubule, through changing of central function.unction.

• Clinical and Experimental Pediatrics
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• 제45권3호
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• pp.413-417
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• 2002

증후군은 원위세뇨관 Na-Cl 공동운반체 유전자 이상으로 발생하는 상염색체 열성 유전질환으로, 저칼륨혈증, 저마그네슘혈증, 대사성 알칼리증, 그리고 저칼슘뇨증 등의 임상적 특징을 보이는 질환이다. 저자들은 Bartter 증후군과의 감별진단과 Gitelman 증후군의 확진을 위해 임상적으로 Gitelman 증후군이 의심되는 두명의 환아에서 신장청소검사를 시행하였다. 각각의 환아는 밤사이 금식을 시킨 후 물 20 mL/kg를 30분에 걸쳐 경구 투여하였고, 곧 이어 half saline을 정맥을 통해 분당 5 mL의 속도로 투여하기 시작하였다. 소변양이 분당 10 mL에 도달했을 때의 검체로 삼투질제거율, 유리수분제거율, 염소제거율, 원위분획염소재흡수율을 계산하였다. 그 후에 첫째 날은 furosemide, 둘째 날은 hydrochlorothiazide를 각각 투여하고 나서 같은 신장청소검사를 시행하였다. 이뇨제를 투여하기 전 원위분획염소재흡수율은 각각 73%, 75%로 정상범위에서 약간 감소되어 있었다. furosemide를 투여한 후 삼투질제거율은 증가하였고 유리수분제거율은 감소하였다. 염소제거율은 10배 이상 증가하였으며, 원위분획염소재흡수율은 현저한 감소를 보였다. Thiazide를 투여한 후에는 위와 같은 청소율의 변화들을 관찰할 수 없었다. 신장청소 검사의 소견은 본 연구의 환아들이 헨레의 고리 상행각의 이상보다는 원위세뇨관 Na-Cl 공동운반체의 이상이 있음을 보여주고 있어 Gitelman 증후군의 병태 생리와 잘 일치한다고 사료된다.

• 대한한방내과학회지
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• 제35권1호
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• pp.106-110
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• 2014

Objectives : To report a case of the treatment of primary hypertension by Oryung-san (五苓散: Wulingsan in Chinese, Goreisan in Japanese) monotherapy. Methods : The blood pressure (BP) fluctuation was checked of a woman who had sudden BP elevation without a history of hypertension treatment. There were no specific history of disease and results for the laboratory examination and image diagnosis including MRI. The woman was diagnosed with primary hypertension and she was given supple of Oryung-san extract (Hanpoong Pharm Co.) 3 g, three times a day for three months. The BP has been checked with digital sphygmomanometer (HEM-7111, Omron Japan) in brachial artery at home. Results and Conclusions : The patient had had stable BP since three weeks after Oryung-san treatment was initiated. There were no subjective symptoms, then Oryung-san medication also had quit after three months treatments. This shows some possibility to control hypertension using Oryung-san, which resembles thiazide that acts on the distal convoluted tubule and inhibit sodium-chloride reabsorption. For further evaluation of the effectiveness, well-designed randomized controlled trials should be undertaken.