• 한국생물물리학회:학술대회논문집
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• 한국생물물리학회 2001년도 학술 발표회 진행표 및 논문초록
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• pp.25-25
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• 2001

Diabetes is the leading cause of end-stage renal disease worldwide. In Korea, diabetic kidney disease accounted for 39％ of all new dialysis patients in 1998. Diabetic nephropathy is characterized by glomerular hyperfiltration, albuminuria, and expansion of glomerular mesangium. Since glomerular mesangial cells regulate glomerular filtration rates and are capable of producing extracellular matrix (ECM) proteins, the functional abnormalities of mesangial cells under diabetic milieu play an important role in the development and progression of diabetic nephropathy.(omitted)

• 대한의생명과학회지
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• 제5권1호
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• pp.75-84
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• 1999

선천성 고혈압 흰쥐를 이용하여 puromycin Aminonucleoside (PAN)로 유도된 미세 변화신증에 대한 $\alpha$-tocopherol acetate의 효과를 알아보기 위하여, 정상군, PAN 투여군 (30 mg/kg), 비타민 E 투여군 (200 mg/kg) 그리고 PAN+비타민 E 투여 군으로 나누었다. 각 군은 약물 투여 후 2, 4, 8, 16일째 처치하여 혈청 생화학적 변화, 조직학적 변화, 그리고 미세구조적 변화를 관찰하였다. 실험동물의 체중은 PAN 투여군이 가장 낮은 증가율을 보였고, 비타민 E 투여군이 가장 높은 증가율을 보였다. 혈청 총단백질의 함량은 PAN투여 8일군에서 가장 낮았고, 혈중 요소성 질소와 크레아티닌의 함량은 P투여 8일군에서 가장 높게 나타났다. PAN+비타민 E 투여군에서는 PAN 투여군과 비교하여 혈청 총단백질의 함량이 증가되었고, 혈중 요소성 질소와 크레아티닌의 함량은 감소되었다. 조직학적 관찰 결과, 요세관 공간의 소실과 혈관사이세포의 증식이 PAN 투여 4일군에서 나타나기 시작하여, PAN투여 8일군에서 가장 현저하였으나 비타민 E 투여로 이러한 변화 정도는 감소되었다. PAS 염색 관찰 결과, 염색 정도가 PAN투여 8일군에서 가장 강하게 나타났고, 비타민 E 투여로 염색 정도는 감소되어 나타났다. 미세구조의 변화는 PAN투여 8일군에서 족돌기의 융합과 소실, 모세 혈관 내피세포의 공포화, 그리고 혈관사이세포와 사구체 기저막의 증식이 관찰되었고, 비타민 E투여로 감소되었다. 이러한 결과들로 보아 PAN으로 유도된 사구체 손상은 고혈압에 의해 가중될 수도 있으며, 사구체의 기능이상은 산화적 손상에 의한 것임을 간접적으로 시사하고 있다.

• Childhood Kidney Diseases
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• 제17권1호
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• pp.13-18
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• 2013

발세포병증은 발세포의 손상을 특징으로 하는 사구체질환이다. 발세포의 손상은 여러 사구체질환에서 관찰될 수 있으나, 미소변화질환과 FSGS에서 주요 병인으로 작용한다. 이 글에서는 FSGS에서 발세포 손상의 형태 변화와 분절경화의 유형을 설명하고자 한다. 발세포가 손상되면 형태 변화로 발돌기의 소실, 발세포 세포질 내 공포, 발세포하 낭 등이 관찰되며, 심하면 발세포의 탈락 및 자멸사가 관찰된다. 그러나 분절경화가 초래되기까지에는 일정 수준 이상의 발세포의 소실이 있어야 하며, 손상된 발세포는 동일한 사구체 소엽 내 주변 발세포로 손상을 전파하여 병변이 커지게 된다. FSGS는 광학현미경 소견을 기초로 NOS형, perihilar형, cellular형, tip형, collapsing형의 다섯 가지 유형으로 나뉜다. 각 아형에 따라 임상 경과나 스테로이드 치료에 대한 반응이 다르고 흔히 동반되는 임상 조건들도 다르다고 보고되었으나 이에 대하여는 아직도 논란이 있는 실정이다. 앞으로 FSGS 발생에 관여하는 유전 정보와 혈액 내 투과인자의 성분 등 관련된 인자들에 대한 체계적인 연구가 이루어지면 FSGS에서 관찰되는 조직 변화나 병태생리를 더 잘 설명할 수 있을 것으로 기대해 본다.

• 대한약리학회지
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• 제31권3호
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• pp.323-331
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• 1995

사구체내 단핵구의 침윤은 면역학적뿐 아니라 비면역학적 사구체 질환 발생 초기에 특징적으로 관찰된다. 단핵구에서 합성되는 대표적인 사이토 카인인 tumor necrosis factor $(TNF){\alpha}$의 합성이 각종 사구체 질환과 관련되어 증가할 뿐 아니라 외부에서 투여한 $TNF{\alpha}$는 사구체 질환의 발생과 진행에 수반된 유사한 증세를 초래한다. 따라서 본 연구에서는 사구체 질환의 표적세포인 혈관간 세포를 이용하여 $TNF{\alpha}$에 의한 세포독성 기전을 검색하고자 하였다. 표준화된 체걸름법을 이용하여 사구체를 분리한후 collagenase로 처리하여 배양하므로써 혈관간 세포의 특징을 지닌 일차 배양 혈관간 세포계를 수립하였다. 세포독성의 지표로서 지질과산화물을 측정했을때, $TNF{\alpha}$는 용량의존적으로 배양 혈관간 세포의 지질과산화를 증가시켰다. 배양혈관간 세포를 $45^{\circ}C$에서 30분간 처리했을 때 heat shock protein 70의 합성이 증가함을 western 분석으로 확인하였을 뿐 아니라, $TNF{\alpha}$에 의한 지질과산화 증가를 효과적으로 억제함을 관찰하였다. 이상의 결과는 $TNF{\alpha}$에 의한 지질과산화 증가가 사구체 질환의 발생이나 진행에 관하여할 수 있음과 고온 전처리에 의해서 heat shock 반응을 초래하므로써 $TNF{\alpha}$에 의한 사구체 손상을 보호할 수 있음을 시사하였다.

• 동의생리병리학회지
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• 제31권5호
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• pp.264-269
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• 2017

Prunella vulgaris, well-known traditional medicinal plant, is used for the cure of abscess, scrofula, hypertension and urinary diseases. Diabetic nephropathy is the most common cause of end-stage renal disease. The pathological characteristics of diabetic nephropathy are glomerular and tubular basement membrane thickening. The aim of the present study was to evaluate the effect of Prunella vulgaris, on diabetic glomerular injury in streptozotocin-induced diabetes rats. Diabetes mellitus was induced by a single intraperitoneal injection of streptozotocin (STZ; 45 mg/kg) and confirmed by random glucose level higher than ${\leq}300mg/dL$. The experimental rats were divided into five groups: control group (Male SD rats), STZ group (Male SD rats injected STZ), Aminoguanidine group (Male SD rats injected STZ + AG 100 mg/kg/day), Low dose group (Male SD rats injected STZ + APV 100 mg/kg/day), High dose group (Male SD rats injected STZ + APV 300 mg/kg/day). AG or APVs were administered once a day for 8 weeks. Body weight and food/water intake were measured every four weeks. At the end of study, the kidneys were collected and cut into pieces for immunohistochemistry and western blot analysis. Our study showed that body weight and water/food intake were no significant differences between untreated STZ-induced diabetic rat and APV treated-STZ rat. However, phosphorylation of receptor-regulated Smads (Smad3) was significantly decreased in APV treated-STZ rat as compared with the diabetic group. In addition, APV was improved nephrin level in kidney tissue. Therefore, we suggest that APV has a protective effect against STZ-induced diabetic glomerular injury.

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

• 한국임상약학회지
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• 제29권2호
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• pp.115-124
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• 2019

The purpose of this systematic review and meta-analysis was to assess the preventive effect of theophylline on acute kidney injury and the ameliorative effect of theophylline on renal function in asphyxiated neonates. A literature search of the PubMed/Medline, Embase, and Cochrane Library databases for information published up to February 2019 was conducted. All studies that reported the incidence rate of acute kidney injury, serum creatinine level, and glomerular filtration rate after the randomized administration of theophylline or placebo were included. In total, eight studies involving 498 neonates were eligible. The incidence rate of acute kidney injury was significantly lower in the theophylline group than in the placebo group (risk ratio [RR]: 0.42, 95% confidence interval [CI]: 0.32-0.55, p < 0.001). The changes in serum creatinine level in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 and 5 days of age (weighted mean difference [WMD]: -0.51, 95% CI: -0.62 to -0.40, p < 0.001, and WMD: -0.26, 95% CI: -0.34 to -0.18, p < 0.001, respectively). The changes in glomerular filtration rate in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 days of age and the last day of follow-up (WMD: 12.30, 95% CI: 9.39-15.21, p < 0.001, and WMD: 9.35, 95% CI: 6.43-12.27, p < 0.001, respectively). These results suggested that theophylline has a beneficial effect on the prevention of acute kidney injury in neonates with perinatal asphyxia.

• Childhood Kidney Diseases
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• 제27권2호
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• pp.64-69
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• 2023

Membranoproliferative glomerulonephritis (MPGN) is a complex group of renal diseases characterized by a specific pattern of glomerular injury that includes thickening of the capillary wall and mesangial expansion, leading to a heterogeneous group of conditions. This review article offers a comprehensive overview of MPGN, its new classification, pathophysiology, diagnostic evaluation, and management options.

• Neonatal Medicine
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• 제17권2호
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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.

• 대한한의학회지
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• 제44권4호
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• pp.163-169
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• 2023

Methods: This study presents a comprehensive case study of an elderly male diagnosed with acute kidney injury (AKI) resulting from severe dehydration, supported by an extended follow-up with laboratory findings. Results: An 83-year-old male patient experienced severe diarrhea overnight, leading to hospitalization due to symptoms of dehydration and hypotension. His laboratory results displayed a typical AKI pattern, including a significant increase in creatinine levels (5.19 mg/dL) and the presence of hyperkalemia and hyponatremia. Following general treatments, including the administration of an herbal drug (Bulhwangeumjeonggi-san), the estimated glomerular filtration rate (eGFR) improved from 10 ml/min (Stage 5) to 34 ml/min (Stage 3) within five days when he was discharged. Although subsequent eGFR tests, conducted one and two months later as an outpatient, revealed an improvement of 42 ml/min, the patient still experienced mild chronic dysfunction as a consequence. Conclusion: This study presents a noteworthy case of acute kidney injury attributed to severe dehydration, emphasizing the importance of medical awareness regarding diarrhea-induced kidney function impairment, especially in the elderly population.