• BMB Reports
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• 제36권4호
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• pp.373-378
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• 2003

Effects of L-arginine and NG-nitro-L-arginine methyl ester (L-NAME) on the renal dysfunction that is induced by cisplatin (CDDP) were investigated. A single dose of CDDP (7.5 mg/kg i.p.) induced renotoxicity, which was manifested by increasing the sensitivity of isolated urinary bladder rings to acetylcholine (ACh), together with a significant elevation of serum urea and creatinine, and a severe decrease in serum albumin. Moreover, renal dysfunction was further confirmed by a significant decrease of enzyme activities, such as glutathione peroxidase, GSH-Px (E.C 1.11.1.9), catalase (E.C 1.11.1.6), as well as a significant increase in lipid peroxides that were measured as malondialdhyde (MDA) in kidney tissue homogenates. The administration of L-arginine (70 mg/kg/d p.o in drinking water 5 d before and 5 d after the CDDP injection) significantly ameliorated the renotoxic effects of CDDP, as judged by restoring the normal responses of isolated bladder rings to Ach, and also by an improvement in a range of renal function indices, which included serum urea and creatinine concentrations and kidney weight. In addition, L-arginine prevents the rise of MDA, as well as a reduction of GSH-Px and catalase activities in kidney tissues homogenates. On the other hand, the administration of L-NAME (4 mg/kg/d p.o) resulted in no protection against renal dysfunction that was induced by CDDP treatment. The findings of this study suggest that L-arginine can attenuate kidney injury that is produced by CDDP treatment. In addition, L-arginine may be a beneficial remedy for CDDP-induced renal toxicity, and could be used to improve the therapeutic index of CDDP.

• 한국임상수의학회지
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• 제34권5호
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• pp.313-317
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• 2017

Symmetric dimethylarginine (SDMA) is a new renal biomarker for kidney function. It is almost exclusively eliminated by renal filtration. The purpose of this retrospective study was to evaluate the changes in serum ceatinine (CREA), blood urea nitrogen (BUN) and SDMA concentrations in dogs with chronic mitral valve insufficiency (CMVI), according to the severity of CMVI. The evaluation of the severity of CMVI was performed according to the American College of Veterinary Internal Medicine (ACVIM) classification of heart failure. The dogs were classified into two groups: group 1 (ACVIM B; n = 11) and group 2 (ACVIM C; n = 15). In dogs with advanced CMVI, the serum SDMA concentrations were significantly increased above the normal reference range and were independent of body weight (BW), systolic blood pressure (SBP), or sex. No dog in either group had higher serum CREA concentrations than the upper limit. The serum SDMA concentration may be a better renal marker than serum CREA concentrations for the early diagnoses of renal dysfunction in dogs with CMVI.

• Childhood Kidney Diseases
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• 제23권1호
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• pp.48-52
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• 2019

The ketogenic diet (KD) has been used as an effective antiepileptic therapy for intractable childhood epilepsy. However, various adverse effects have been reported with use of the KD. We report a case of a child who developed acute tubular necrosis subsequent to therapy with KD. A 5-year-old girl had myoclonic epilepsy with developmental delay. She was under the treatment with antiepileptic drugs since the age of 3 months and on the KD during the past 18 months. Proteinuria persisted intermittently with the initiation of the KD and subsequently increased in the past 2 months. She was admitted with intermittent mild fever, vomiting, and lethargy for the past 3-4 weeks. At the time of admission, she presented with hypertriglyceridemia, heavy proteinuria, renal Fanconi syndrome, and acute kidney injury. Renal sonography showed a marked increase in the size and parenchymal echogenicity of both kidneys. A renal biopsy revealed acute tubular necrosis accompanied by early interstitial fibrosis. After the withdrawal of the KD and supportive therapy, without changing other anticonvulsants and their dosages, improvement of renal function was observed. Proteinuria had disappeared after 1 month and kidney size returned to normal after 8 months. It is hypothesized that the KD can induce and/or aggravate the renal tubulointerstitial injury in some patients who are under the treatment with anticonvulsants.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.41-46
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• 2017

Purpose: Thin glomerular basement membrane nephropathy (TBMN) is, along with the IgA nephropathy, the most common cause of asymptomatic hematuria in Korean children. TBMN is usually a benign renal disease not requiring treatment and is associated with a good prognosis, but some cases hematuria is indicative of a state of progressive renal insufficiency. We aimed to retrospectively evaluate clinical manifestations and renal prognosis of patients with TBMN. Methods: Among the 428 renal biopsies performed on children at Yeungnam University Hospital between January 2000 and February 2017, 167 patients were diagnosed as having TBMN. We retrospectively investigated 167 pediatric patients and identified 59 children with follow-up duration >3 years. Results: Among 59 patients, there were 33 boys and 26 girls. Mean age of onset of hematuria was $7.18{\pm}2.64$ years, and mean time from onset of disease until a renal biopsy was performed was $2.48{\pm}2.10$ years. There were no clinical features or laboratory findings among studied children to indicate decreased renal function during follow-up; however, one case progressed to chronic kidney disease (CKD) due to an unknown cause. There were seven patients among these related a positive family history of hematuria or renal insufficiency. Concluson: Although almost all patients had normal renal functions during follow-up, there were one patient who progressed to CKD and seven patients with family history of hematuria or renal insufficiency. Moreover, four among the 428 patients over 17 years underwent repeat renal biopsies, which showed results different from their earlier biopsies.Thus, large-scales studies may be required to determine long-term prognosis of TBMN in children, and further evaluation for Alport syndrome in TBMN cases is essential.

• Annals of Clinical Neurophysiology
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• 제3권2호
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• pp.136-142
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• 2001

Background : Nervous system dysfunction is a major complication of end stage renal disease. Although severe neurologic symptoms are partially or completely reversed by adequate hemodialysis, even optimally dialyzed patients will usually not return to normal neurocognitive function. To investigate the influence of chronic renal failure and hemodialysis on higher cognitive function electrophysiologically, we studied auditory P300 event-related potentials in 14 hemodialysis patients and 14 age- and sex-matched normal healthy controls. Methods : The subjects consisted of 14 patients(M: 6, F: 8) with chronic renal failure(CRF) for 1 to 10 years and 14 age- and sex-matched healthy controls(M: 5, F: 9). For the reliability of study, patients with diabetes mellitus, abnormal brain CT findings, or low mini-mental state score(below 20) were excluded. Event related potentials(ERPs) for hemodialysis patients were performed at pre- and post-hemodialysis. To obtain ERPs, subjects underwent 2-tone auditory discrimination test(oddball paradigm). Results : Although the age(control: $48.79{\pm}10.31years$, CRF: $51.21{\pm}7.61years$) and mini-mental state score(control: $27.00{\pm}1.71points$, predialysis CRF: $25.07{\pm}3.58points$) were not different in normal control and CRF groups significantly(P>0.05), P300 latencies at Cz(control: $288.11{\pm}17.36msec$, predialysis CRF: $332.35{\pm}42.34msec$) were significantly delayed(P<0.05)and the duration of Trail making test A was significantly prolonged(control: $64.2{\pm}24.2sec$, CRF: $118.9{\pm}101sec$) in CRF group. P300 latencies between pre- and post-hemodialysis CRF patients(predialysis CRF: $332.35{\pm}42.34msec$, postdialysis CRF: $325.82{\pm}38.69msec$) were not significantly different. The P300 latency was not related with the duration of CRF(Spearman's correlation test, r=0.25, P>0.05) and the frequency of hemodialysis(Spearman's correlation test, r=0.28, P>0.05). Conclusions : From these results, we suggest that P300 latency is valuable in evaluating cognitive brain dysfunction in patients with CRF and hemodialysis does not have a significant effect on cognitive brain dysfunction in patients with CRF.

• The Korean Journal of Physiology and Pharmacology
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• 제10권3호
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• pp.137-141
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• 2006

The systolic and diastolic pressures in anesthetized Sprague-Dawley male rats were greatly decreased after single-dose of Cd treatment without significant changes in heart rate. There was a fluid-shift into the third space and/or -loss through the kidney, since plasma $Na^+$ concentration and hematocrit ratio were significantly increased by acute Cd exposure. The present study showed that the sustained hypotensive effect of single-dose Cd on the cardiovascular system might have resulted from the systemic hypovolemia. Furthermore, renal excretion of electrolytes, including $Na^+$ and $K^+$, and urine flow rate were increased by Cd intoxication. Interestingly, the ratio of $Na^+/K^+$ excretion was increased and reached the maximum level 3 hours after Cd injection and returned to the normal level after 7 hours. Nevertheless, there was no difference in the regression analysis of $Na^+$ excretion and urine flow rate in both groups. Therefore, the increase in the urine volume seemed to enhance the excretion of $Na^+$. This study strongly suggest that the hypotensive effect of Cd is mediated by systemic $Na^+$ loss through the kidney and/or hypovolemia via fluid-shift.

• Childhood Kidney Diseases
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• 제28권1호
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• pp.16-26
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• 2024

Patients with kidney disease require frequent blood tests to monitor their kidney function, which is particularly difficult for young children and the elderly. For these people, the standard method is to evaluate serum creatinine or cystatin C or drug levels through venous sampling, but more recently, evaluation using dried blood spots has been used. This narrative review reports information from the literature on the use of dried blood spots to quantify the main markers used to detect kidney diseases. The ScienceDirect and PubMed databases were searched using the keywords: "dried blood on filter paper," "markers of renal function," "renal function," "creatinine," "cystatin C," "urea," "iohexol," and "iotalamate." Studies using animal samples were excluded, and only relevant articles in English or Spanish were considered. Creatinine was the most assessed biomarker in studies using dried blood spots to monitor kidney function, showing good performance in samples whose hematocrit levels were within normal reference values. According to the included studies, dried blood spots are a practical monitoring alternative for kidney disease. Validation parameters, such as sample and card type, volume, storage, internal patterns, and the effects of hematocrit are crucial to improving the reliability of these results.

• 핵의학기술
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• 제13권3호
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• pp.61-66
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• 2009

목적: 사구체여과율(Glomerular Filtration Rate, GFR)은 신장 기능의 평가, 의심되는 신장질환의 진단 및 만성적인 신질환에서의 질병의 경과 관찰에 중요한 지표가 되며 다양한 방법을 이용하여 측정할 수 있다. 본 연구에서는 Gates 방법으로 측정되는 사구체여과율, 혈청 크레아티닌을 기초로 한 Cockcroft-Gault (C-G), Modification of Diet in Renal Disease (MDRD) 공식으로 계산한 사구체여과율을 비교하고자 하였다. 실험재료 및 방법: 18세 이상의 다양한 신기능을 가진 217명(남자 127명, 여자 90명, 평균 연령 $51.3{\pm}16.9$세)을 대상으로 하였다. $^{99m}Tc$-DTPA GFR과 혈청 크레아티닌(Serum Cr)을 기초로 한 C-G공식, MDRD 공식으로 계산한 사구체여과율을 비교 분석하였다. 결과: $^{99m}Tc$-DTPA (Gates) GFR은 C-G공식(r=0.864, p<0.0001) 및 MDRD 공식(r=0.831, p<0.0001)과 각각 유의한 상관관계가 있었고, C-C 공식과 MDRD 공식을 이용한 사구체 여과율 사이에도 상관관계가 우수하였다(r=0.933, p<0.0001). 혈청 크레아티닌의 평균은 $3.0{\pm}3.1\;mg/dL$으로 정상 신기능(Scr<1.5mg/dL) 환자에서 $^{99m}Tc$-DTPA GFR (Gates)과 C-G공식(p<0.0001), MDRD 공식(p<0.0001)은 통계적으로 유의하였다. 경증 신부전(Scr 1.5~4.0 mg/dL) 환자에서 Tc-99m DTPA (Gates) GFR과 C-G 공식(p=0.181), MDRD 공식(p=0.127)은 유의한 차이는 없었다. 중증 신부전(Scr>4.0 mg/dL) 환자에서 $^{99m}Tc$-DTPA (Gates) GFR과 C-G 공식(p<0.0001), MDRD 공식(p<0.0001)은 통계적으로 유의하였다. 결론: Gates 방법을 이용한 사구체여과율, C-G, MDRD 공식으로 계산한 사구체여과율 사이에 유의한 상관관계를 확인하였다. 정상 신기능 환자에서 $^{99m}Tc$-DTPA (Gates) GFR은 C-G, MDRD 공식보다 각각 낮았다. 경증 신부전 환자에서 $^{99m}Tc$-DTPA (Gates) GFR과 C-G 공식, MDRD 공식으로 계산한 사구체여과율은 유사하였고, 중증 신부전 환자에서 $^{99m}Tc$-DTPA (Gates) GFR은 C-G, MDRD 공식에 비해 사구체여과율을 과대평가하였다. 신기능의 정도에 따라 사구체여 과율을 평가하는데 있어 어떠한 측정방법이 더 우월한지는 분명하지 않다.

• 대한핵의학회지
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• 제1권2호
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• pp.75-84
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• 1967

$^{131}I$-labeled-O-iodohippurate renograms in 15 cases of epidemic hemorrhagic fever(E.H. fever)during oliguric, diuretic and convalescent phase were analysed quantitatively and qualitatively, namely by its configuration, Tmax T 1/2 and renal index of Hirakawa. The results were as following: 1) Changes on the renograms in E.H. fever showed simultaneous bilateral renal impairment. 2) The characteristic configurations of renogram in the oliguric phase were: (1) Moderately decreased absolute amplitude of initial spike. (2) Continous rising second slope. (3) No appearance of terminal descent. Those were mast likely to those of renograms in acute ureteral obstruction or acute dehydration state. 3) During the diuretic phase, the renogram showed the point of maximal amplitude, but the steepness of 2nd slope was markedly decreased. The appearance of terminal descents was observed with unusually high amplitude despite of the tremendously large amount of urinary output during this phase. 4) In convalescence, the renograms were essentially normal in configuration, but the renal index of Hirakawa was not recovered until this phase. 5) Renograms in E.H. fever showed the characteristic patterns in each phase of its clinical course. 6) $^{131}I$-OIH-Renogram might be an useful method for the evaluation of renal function in E.H. fever during its course.

• 한방비만학회지
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• 제22권2호
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• pp.167-172
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• 2022

Obesity is known as the most common risk factor for non-alcoholic fatty liver disease. Weight loss is needed to prevent liver function damage from progressing to non-alcoholic hepatosteatosis (NASH) and NASH-related liver cirrhosis. The purpose of this study was to observe the recovery of liver function in obese patients with liver dysfunction through traditional Korean obesity treatment. Body weight, liver function levels and renal function levels were examined by prescribing traditional Korean medicine in obese patients with mild elevation of liver function test. Blood tests were conducted at intervals of one month, and it was observed that liver function recovered to the normal range in three patients.