• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.40-44
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• 2019

Purpose Glomerular filtration rate (GFR) is an important index for evaluation of renal function, renal disease diagnosis and progress monitoring. Therefore, accurate measurement of GFR is clinically important. Among the factors that affect the GFR result, there have been many discussions on the methods such as the correction of the kidney depth, net syringe count, and the method of setting the ROI. However there has been no consideration of counting in the most basic factors like height and weight measurement. In this study, we investigate how height and weight changes affects the result of GFR and review the importance of standardized body measurements. Materials and Methods Fifty patients who underwent GFR test were randomly sampled and examined for changes in height and body weight within one month. From the normal patients without renal disease to the patients with severely decreased GFR, we applied the GFR formula of Gate with varying height and weight. Results: The result showed variation of the height at maximum three centimeters and six kilograms of weight. The first calculation of GFR was done with fixed height value and control variable as weight. Weight was incremented by one kilogram each time up to six kilograms. The GFR showed increased result with increasing weight. The result of GFR showed ten percent increase with six kilograms of weight increase. On the other hand, when height value was incremented by one centimeter up to three centimeters showed decreased GFR result with fixed weight value. Up to three centimeters of height increase showed two percent of decreased GFR with fixed weight. Conclusion This study showed varying GFR result when height and weight changes. Therefore it is clinically crucial not only to maintain and manage body measuring instrument but also to have a standardized measurement methods to derive accurate measured values and to achieve reproducibility.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.145-154
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• 2019

This study examined the relationship between the estimated glomerular filtration rate (eGFR) and urine microalbumin/creatinine ratio (uACR) with ferritin in Korean adults. This study included 4,948 adults aged ${\geq}20years$ from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) data. A covariance test adjusted for covariates was performed for the ferritin levels in relation to the decreased eGFR (eGFR<$60ml/min/1.73m^2$) and elevated uACR ($uACR{\geq}30mg/g$). Several key findings were made in the present study. First, after adjusting for the related variables, the ferritin level was higher in the decreased eGFR group [$103.04{\pm}6.59mL/min/1.73m^2$; 95% confidence interval (CI), 90.12~115.96] than in the normal eGFR group ($84.87{\pm}1.16mL/min/1.73m^2$; 95% CI, 82.59~87.14; P=0.007). Second, after adjusting for the related variables, the ferritin level ($M{\pm}SE$) was similar in the normal uACR group ($85.70{\pm}1.20mg/g$; 95% CI, 83.35~88.05) and elevated uACR group ($82.72{\pm}4.09mg/g$; 95% CI, 74.71~90.73) (P=0.487). Chronic kidney disease was positively associated with the ferritin level in Korean adults but albuminuria was not.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.22.1-22.9
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• 2023

Background: Shift work increases the risk of chronic diseases, including metabolic diseases. However, studies on the relationship between shift work and renal function are limited. The aim of this study was to investigate the association between shift work and a decreased glomerular filtration rate (GFR). Methods: Data were evaluated for 1,324,930 workers who visited the Korean Medical Institute from January 1, 2016 to December 31, 2020 and underwent a health checkup. Daytime workers were randomly extracted at a ratio of 1:4 after matching for age and sex. In total, 18,190 workers aged over 40 years were included in the analyses; these included 3,638 shift workers and 14,552 daytime workers. Participants were categorized into the shift work group when they underwent a specific health checkup for night shift work or indicated that they were shift workers in the questionnaire. The odds ratio was calculated using a conditional logistic regression to investigate the relevance of shift work for changes in GFR. Results: 35 workers in the shift group and 54 in the daytime group exhibited an estimated GFR (eGFR) value of < 60 mL/min/1.73m² (p < 0.01). The difference in eGFR values between two checkups differed significantly depending on the type of work (p < 0.01); the difference in the shift work group (-9.64 mL/min/1.73 m²) was larger than that in the daytime work group (-7.45 mL/min/1.73 m²). The odds ratio for eGFR reduction to < 60 mL/min/1.73 m² in the shift group versus the daytime group was 4.07 (95% confidence interval: 2.54-6.52), which was statistically significant. Conclusions: The results of this study suggest that eGFR decreases by a significantly larger value in shift workers than in daytime workers; thus, shift work could be a contributing factor for chronic kidney disease (CKD). Further prospective studies are necessary to validate this finding and identify measures to prevent CKD in shift workers.

• Journal of Nutrition and Health
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• v.33 no.2
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• pp.134-140
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• 2000

This study was performed to investigate the effects of n-3 fatty acids on renal function in male Sprague-Dawley rats of different ages 5-, 15- and 19-months old. The rats were fed a 20%(w/w) lipid diet containing 10% fish oil, compared with control animals fed a 20% lipid diet without fish oil for 4 weeks. The results were as follows: kidney weights were significantly higher in fish oil-fed rats compared to control rats. Plasma levels of total lipid, total cholesterol, and triglyceride markedly increased, with aging and LDL-cholesterol showing a significantly lower level in fish oil-fed rats than control rats. The urinary protein and glomerular filtration rate (GFR) increased with aging. GFR was higher in fish oil-fed rats. However, urinary protein was the same in the two groups. Renal medulla thromboxane B$_2$(TXB$_2$)tended to be lower in fish oil-fed 19-month-old rats. Urinary TXB$_2$and PGE$_2$were found to be higher proteinuria. Light microscopic examination showed interstitial inflammation, tubular atrophy, interstitial fibrosis and glomerular mesangium increase. Although glomerular sclerosis increased with aging, fish oil in the diet had no effect on histological changes. In conclusion, plasma lipid, urinary protein excretion and renal histological change showed a significant increase with aging. The reduction of TXB$_2$in the medulla and increase of GFR caused by fish oil indicated n-3 fatty acid could affect renal function in line with the hypolipidemic effect.

• Childhood Kidney Diseases
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• v.25 no.1
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• pp.8-13
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• 2021

Pediatric kidney transplantation is the best option since it can achieve near normal glomerular filtration rate, adequate fluid balance, and autonomic endocrine function of the kidney in end-stage kidney disease. However, pediatric kidney transplantation is difficult because children are developing and growing, management and complications of pediatric kidney transplantation are different from those of adults. This review covers the current status of pediatric kidney transplantation in Korea, key considerations that must be taken before kidney transplantation in children, and management strategy of immunosuppression and common complications.

• Biomolecules & Therapeutics
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• v.8 no.2
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• pp.132-139
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• 2000

This study was performed far investigation of influence on renal function of idazoxan, $\alpha_{2}$-adrenergic antagonist, using the dog. Idazoxan, when giver. into vein, produced the decrease of urine volume(vol) accompanied with the reduction of free water clearance($C_{H2O}$), amounts of sodium excreted in urine($E_{Na}$), with the increase of potassium excreted in urine($E_{K}$), and so ratios of potassium against sodium($K^{+}/Na^{+}$) were elevated, at this time, greatened reabsorption rate of sodium and diministered that of potassium in renal tubules were appeared. Idazoxan administered into a renal artery elicited the augmentation of vol, glomerular filtration rate(GFR), renal plasma flow(RPF) and no change of filtration fraction(FF) in only ipsilateral kidney, whereas $E_{Na},\;E_{K}\;and\;K^{+}/Na^{+}$ were increased and $C_{H2O}$ was decreased in both control and experimental kidney. Idazoxan given into carotid artery showed partial increased vol, remarkable expanded RPF and unchanged GFR, and so filtration fraction(FF) was markedly reduced. Above results suggest that anti- diuretic action of idazoxan given into vein is mediated by reduction of $C_{H2O}\;and\;E_{Na}$, diuretic action only in the ipsilateral kidney by idazoxan given into a renal artery is caused by hemodynamic improvement through expansion of vas afferens in glomeruli.

• YAKHAK HOEJI
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• v.17 no.1
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• pp.31-39
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• 1973

The influence of guanethidine on the renal function was investigated in the rabbit. Guanethidine, 1-10mg/kg, i.v., produced no marked change in the renal function, while second and successive doses of guanethidine elicited a significant increase in urine flow and electrolyte excretion as well as renal plasma flow and glomerular filtration rate. It was suggested that the diuretic action was brought about by improvement of hemodynamic state in the kidney ; increased filtration as a result of increased renal perfusion. Atropine alone did not significantly influence the renal function but pretreatment of animals with atropine, 4 mg/kg i.v., completely abolished the diuretic action of guanethidine. It is suggested that guanethidine influences the renal function by activating parasympathetic nervous system or some cholinergic mechanism in the kidney.

• YAKHAK HOEJI
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• v.22 no.4
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• pp.207-214
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• 1978

Influence of Akebiae Lignum on the renal function of the dog was observed with water-extract, utilizing clearance technique. Akebiae Lignum water-extract (AWE) given intravenously in does of 3.0mg/kg and 30.0mg/kg elicited a marked antidiuretic effect and produced a distinguished decrease of glomerular filtration rate and renal plasma flow as reduction of sodium and potassium excretion in urine, positive free water clearance and osmolar clearance. AWE infused into a renal artery in doses of 0.03mg/kg/min and 0.1mg/kg/min exhibited identical results to the intravenous action confined only to the infused kidney. These results suggest that AWE elicits antidiuresis in the dog by decreasing glomerulor filtration and renal plasma flow, which are caused by the constriction of vas afferens in the glomeruli.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4695-4698
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• 2012

Objective: To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors. Materials and methods: In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4. Results: Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively). Conclusions: Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.49-54
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• 1989

Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintrgraphy. We measured $^{99m}Tc-DTPA$ renal clearance with Jackson's method during the routine $^{99m}Tc-DTPA$ renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of $Cl_{DPDA}$ was from 19.9 ml/min to 170 ml/min and the correlation of $Cl_{DPDA}$ and creatinine clearance was discribed by Y=16.2570+0.7852 X($X=Cl_{DTPA}$ Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that $^{99m}Tc-DTPA$ renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine $^{99m}Tc-DTPA$ renal scintigraphy simultaneously.