• Title/Summary/Keyword: Nephrology

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Occupational Lifting Tasks and Retinal Detachment in Non-Myopics and Myopics: Extended Analysis of a Case-Control Study

  • Mattioli, Stefano;Curti, Stefania;De Fazio, Rocco;Mt Cooke, Robin;Zanardi, Francesca;Bonfiglioli, Roberta;Farioli, Andrea;Violante, Francesco S.
    • Safety and Health at Work
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    • v.3 no.1
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    • pp.52-57
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    • 2012
  • Objectives: Lifting heavy weights involves the Valsalva manoeuvre, which leads to intraocular pressure spikes. We used data from a case-control study to further investigate the hypothesis that occupational lifting is a risk factor for retinal detachment. Methods: The study population included 48 cases (patients operated for retinal detachment) and 84 controls (outpatients attending an eye clinic). The odds ratios (OR) of idiopathic retinal detachment were estimated with a logistic regression model (adjusted for age, sex and body mass index). Three indexes were used to examine exposure to lifting; 1) maximum load lifted, 2) average weekly lifting, 3) lifelong cumulative lifting. Results: For all indexes, the most exposed subjects showed an increased risk of retinal detachment compared with the unexposed (index 1: OR 3.57, 95% confidence interval [CI] 1.21-10.48; index 2: OR 3.24, 95% CI 1.32-7.97; index 3: OR 2.23, 95% CI 1.27-8.74) and dose-response relationships were apparent. Conclusion: These results reinforce the hypothesis that heavy occupational lifting may be a relevant risk factor for retinal detachment.

Metformin induced acute pancreatitis and lactic acidosis in a patient on hemodialysis (혈액투석 환자에서 메트포르민 복용으로 발생한 급성췌장염과 젖산산증)

  • Lee, Yeon-Kyung;Lim, Kihyun;Hwang, Su-Hyun;Ahn, Young-Hwan;Shin, Gyu-Tae;Kim, Heungsoo;Park, In-Whee
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.33-36
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    • 2016
  • Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

A Study on the Professional Self Concept, Self Efficacy and Job Satisfaction of Nephrology Nurses (신장실 간호사의 전문직 자아개념, 자기효능감과 직무만족도에 관한 연구)

  • Choi, Eun Young;Kim, Gun Hyo
    • Korean Journal of Adult Nursing
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    • v.12 no.3
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    • pp.345-355
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    • 2000
  • The purpose of this study was to explain the relationship of professional self-concept, self-efficacy and job satisfaction among nephrology nurses. The subject consisted of 84 nephrology nurses who work at 17 hospitals in Kwangju, Chonnam, Chonbuk and Cheju-do. The instrument of this study was a structured questionnaire on professional self-concept, self-efficacy and job satisfaction. The data were collected from August 16 to September 10, 1999 and analyzed by Cronbach alpha, descriptive statistics, t-test, ANOVA, Scheffe's test and Pearson's correlation coefficient by using the SPSS/PC+ program. The results of the research were as follows : 1. The average item scores were 2.73 for professional self-concept and 7.16 for selfefficacy. The average item score of job satisfaction was 3.05. Professional status (3.56) among the component factors of the job satisfaction had the highest value followed by the interaction(3.46), task requirements(3.28), autonomy(2.98), organizational requirement(2.70), and pay(2.22) was the lowest. 2. The relationship between general characteristics and professional self-concept shows a significant difference with regard to position and the nurses' intention to stay. The relationship between general characteristics and self-efficacy shows a significant difference with regard to position and shift. 3. A significant positive correlation between professional self-concept and self-efficacy (r=0.462, p<0.01) was found. A significant positive correlation between professional self-concept and job satisfaction(r=0.486, p<0.01) was found. In conclusion, professional self-concept and job satisfaction of nephrology nurses are significantly related. A professional self-concept is an important factor for job satisfaction of nephrology nurses. Therefore, this study suggested that we should develop programs and policies to increase the professional self-concept of nephrology nurses for their job satisfaction.

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Vesicoureteral reflux-associated hydronephrosis in a dialysis patient treated with percutaneous nephrostomy

  • Ju Hwan Oh;Min Woo Kim;Jung Hwa Kim;A Young Cho;In O Sun;Kwang Young Lee
    • Journal of Medicine and Life Science
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    • v.19 no.2
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    • pp.66-69
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    • 2022
  • Patients with vesicoureteral reflux (VUR), the retrograde flow of urine from the bladder to the kidney, are known to experience renal scarring; this results in the worsening of renal function. Reflux nephropathy is a cause of chronic kidney disease, and VUR has also been observed in dialysis patients. VUR is a major underlying precursor condition of urinary tract infection (UTI) and is sometimes accompanied by hydronephrosis. However, there are no guidelines for the management of UTI due to VUR-associated hydronephrosis in patients with end-stage kidney disease. Herein, we report a case of UTI caused by VUR-associated hydronephrosis in a dialysis patient treated with percutaneous nephrostomy.

Hookworm Infection Caused Acute Intestinal Bleeding Diagnosed by Capsule: A Case Report and Literature Review

  • Tan, Xia;Cheng, Meichu;Zhang, Jie;Chen, Guochun;Liu, Di;Liu, Yexin;Liu, Hong
    • Parasites, Hosts and Diseases
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    • v.55 no.4
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    • pp.417-420
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    • 2017
  • Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.

Changes in bioimpedance analysis components before and after hemodialysis

  • Kim, Hyunsuk;Choi, Gwang Ho;Shim, Kwang Eon;Lee, Jung Hoon;Heo, Nam Ju;Joo, Kwon-Wook;Yoon, Jong-Woo;Oh, Yun Kyu
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.393-403
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    • 2018
  • Background: This study compared nutritional parameters in hemodialysis (HD) subjects and controls using bioimpedance analysis (BIA) and investigated how BIA components changed before and after HD. Methods: This cross-sectional study included 147 subjects on maintenance HD from two hospitals and 298 propensity score-matched controls from one healthcare center. BIA was performed pre- and post-HD at mid-week dialysis sessions. Results: Extracellular water/total body water (ECW/TBW) and waist-hip ratio were higher in the HD patients; the other variables were higher in the control group. The cardiothoracic ratio correlated best with overhydration (r = 0.425, P < 0.01) in HD subjects. Blood pressure, hemoglobin, creatinine, and uric acid positively correlated with the lean tissue index in controls; however, most of these nutritional markers did not show significant correlations in HD subjects. Normal hydrated weight was predicted to be higher in the pre-HD than post-HD measurements. Predicted ultrafiltration (UF) volume difference based on pre- and post-HD ECW/TBW and measured UF volume difference showed a close correlation ($r^2=0.924$, P < 0.01). Remarkably, the leg phase angle increased in the post-HD period. Conclusion: The estimated normal hydrated weight using ECW/TBW can be a good marker for determining dry weight. HD subjects had higher ECW/TBW but most nutritional indices were inferior to those of controls. It was possible to predict UF volume differences using BIA, but the post-HD increase in leg phase angle, a nutritional marker, must be interpreted with caution.

Augmenter of Liver Regeneration Alleviates Renal Hypoxia-Reoxygenation Injury by Regulating Mitochondrial Dynamics in Renal Tubular Epithelial Cells

  • Long, Rui-ting;Peng, Jun-bo;Huang, Li-li;Jiang, Gui-ping;Liao, Yue-juan;Sun, Hang;Hu, Yu-dong;Liao, Xiao-hui
    • Molecules and Cells
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    • v.42 no.12
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    • pp.893-905
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    • 2019
  • Mitochondria are highly dynamic organelles that constantly undergo fission and fusion processes that closely related to their function. Disruption of mitochondrial dynamics has been demonstrated in acute kidney injury (AKI), which could eventually result in cell injury and death. Previously, we reported that augmenter of liver regeneration (ALR) alleviates renal tubular epithelial cell injury. Here, we gained further insights into whether the renoprotective roles of ALR are associated with mitochondrial dynamics. Changes in mitochondrial dynamics were examined in experimental models of renal ischemia-reperfusion (IR). In a model of hypoxia-reoxygenation (HR) injury in vitro, dynamin-related protein 1 (Drp1) and mitochondrial fission process protein 1 (MTFP1), two key proteins of mitochondrial fission, were downregulated in the Lv-ALR + HR group. ALR overexpression additionally had an impact on phosphorylation of Drp1 Ser637 during AKI. The inner membrane fusion protein, Optic Atrophy 1 (OPA1), was significantly increased whereas levels of outer membrane fusion proteins Mitofusin-1 and -2 (Mfn1, Mfn2) were not affected in the Lv-ALR + HR group, compared with the control group. Furthermore, the mTOR/4E-BP1 signaling pathway was highly activated in the Lv-ALR + HR group. ALR overexpression led to suppression of HR-induced apoptosis. Our collective findings indicate that ALR gene transfection alleviates mitochondrial injury, possibly through inhibiting fission and promoting fusion of the mitochondrial inner membrane, both of which contribute to reduction of HK-2 cell apoptosis. Additionally, fission processes are potentially mediated by promoting tubular cell survival through activating the mTOR/4E-BP1 signaling pathway.

Disseminated adenovirus infection in a 10-year-old renal allograft recipient

  • Lee, Bora;Park, Eujin;Ha, Jongwon;Ha, Il Soo;Cheong, Hae Il;Kang, Hee Gyung
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.414-417
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    • 2018
  • Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.