• Title/Summary/Keyword: Renal failure, acute

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Two Cases of Acute Renal Failure Complicating Paroxysmal Nocturnal Hemoglobinuria in Children (급성 신부전을 동반한 발작 야간 혈색소뇨증 2례)

  • Ryu, Jung-Min;Ahn, Yo-Han;Lee, So-Hee;Choi, Hyun-Jin;Lee, Beom-Hee;Kang, Hee-Gyung;Kang, Hyoung-Jin;Shin, Hee-Young;Ha, Il-Soo;Cheong, Hae-Il;Ahn, Hyo-Seop;Choi, Yong
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.221-226
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    • 2008
  • Paroxysmal nocturnal hemoglobinuria(PNH) is an acquired hematologic disorder characterized by intravascular hemolysis, nocturnal hemoglobinuria, thrombotic events and bone marrow failure. It rarely occurs in children and can be complicated by acute renal failure(ARF). Here, we present two cases of ARF complicating PNH which has not been reported yet in Korean children. We suggest that PNH should be considered in differential diagnosis of ARF in children associated with intravascular hemolysis.

Two cases of Neonatal Renal Venous Thrombosis (신생아 신정맥 혈전증 2례)

  • Lim Jung-Sub;Paek Kyong-Hoon;Han Hyo-Jung;Lee Jun-Ho;Cheong Hae-Il;Choi Yong;Ko Kwang-Wook;Kim In-One
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.161-165
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    • 1997
  • Renal venous thrombosis (RVT) in neonatal period is a rare disease and usually complicated to clinical situations with reduced renal blood flow and hypercoagulability ; like acute blood loss, sepsis, shock, and birth asphyxia. RVT should be suspected in sick babies with hematuria, anemia, thrombocytopenia, enlarged kidney and acute renal failure. And the diagnosis can be confirmed by renal ultrasonography. We report two cases of neonatal renal venous thrombosis with review of literatures. One case, associated with E. coli sepsis, recovered completely, and the other, follwed respiratory distress in the neonate, revealed permanent renal functional impairment.

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Clinical characteristics of hypertensive encephalopathy in pediatric patients

  • Ahn, Chang Hoon;Han, Seung-A;Kong, Young Hwa;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.60 no.8
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    • pp.266-271
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    • 2017
  • Purpose: The aim of this study was to assess the clinical characteristics of hypertensive encephalopathy according to the underlying etiologies in children. Methods: We retrospectively evaluated 33 pediatric patients who were diagnosed as having hypertensive encephalopathy in Chonbuk National University Children's Hospital. Among the patients, 18 were excluded because of incomplete data or because brain magnetic resonance imaging (MRI) was not performed. Finally, 17 patients were enrolled and divided into a renal-origin hypertension group and a non-renal-origin hypertension group according to the underlying cause. We compared the clinical features and brain MRI findings between the 2 groups. Results: The renal group included renal artery stenosis (4), acute poststreptococcal glomerulonephritis (2), lupus nephritis (2), and acute renal failure (1); the nonrenal group included essential hypertension (4), pheochromocytoma (2), thyrotoxicosis (1), and acute promyelocytic leukemia (1). The mean systolic blood pressure of the renal group ($172.5{\pm}36.9mmHg$) was higher than that of the nonrenal group ($137.1{\pm}11.1mmHg$, P<0.05). Seizure was the most common neurologic symptom, especially in the renal group (P<0.05). Posterior reversible encephalopathy syndrome (PRES), which is the most typical finding of hypertensive encephalopathy, was found predominantly in the renal group as compared with the nonrenal group (66.6% vs. 12.5%, P<0.05). Conclusion: We conclude that the patients with renal-origin hypertension had a more severe clinical course than those with non-renal-origin hypertension. Furthermore, the renal-origin group was highly associated with PRES on brain MRI.

Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

  • Kang, Ji-Hyoun;Lee, Donghyun;Park, Yunchul
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.299-304
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    • 2021
  • Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

Effects of Alismatis Rhizoma Pharmacopuncture at BL23 on Cisplatin-Induced Acute Renal Failure in Rats (신수(BL23) 택사약침이 Cisplatin으로 유발된 급성신부전 백서에 미치는 영향)

  • Kim, Myung Sik;Kim, Jae Hong;Youn, Dae Hwan;Jeong, Hyun Woo;Cho, Myoung Rae
    • Korean Journal of Acupuncture
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    • v.36 no.1
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    • pp.63-73
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    • 2019
  • Objectives : This study was designed to investigate the effects of Alismatis Rhizoma (AR) pharmacopuncture at BL23 on acute renal failure induced by cisplatin. Methods : The Sprague-Dawley rats were divided into Normal group (no injection of cisplatin and no treatment), Control group (cisplatin injection without treatment), Acu group (needling at BL23 after cisplatin injection), AR-PA1 group (treated with $0.3571mg/kg/20{\mu}l$ of AR pharmacopuncture at BL23 after cisplatin injection), and AR-PA2 group (treated with $1.7855mg/kg/20{\mu}l$ of AR pharmacopuncture at BL23 after cisplatin injection). Each treatment was given once daily for 8 days. Changes in body weight, kidney weight, tumor necrosis factor-alpha ($TNF-{\alpha}$), interleukin-6 (IL-6), Cu-Zn superoxide dismutase (Cu-Zn SOD), glutathione peroxidase (GPx), serum blood urea nitrogen (serum BUN), and serum creatinine were observed. Results : Body weight was significantly increased in AR-PA1 on $4^{th}$ and $6^{th}$ days and AR-PA2 on $2^{nd}$ day. $TNF-{\alpha}$ was significantly decreased in Acu, AR-PA1 and AR-PA2 groups. Cu-Zn SOD was significantly increased in AR-PA2 group. GPx was significantly increased in AR-PA1 and AR-PA2 groups. But kidney weight, IL-6, serum BUN and serum creatinine were not significantly changed in any groups compared to control group. Conclusions : In acute renal failure induced by cisplatin, AR pharmacopuncture has a mitigating effect on the inflammatory reaction related to the increase of $TNF-{\alpha}$ in the kidney tissue and a protective effect on the oxidative stress of the kidney tissue. However it is unlikely to restore the glomerular function or inhibit the renal swelling.

$^{99m}Tc$-MDP Bone Scan in the Cases of Muscle Necrosis Associated with Acute Renal Failure (급성(急性) 신부전(腎不全)이 동반(同伴)된 근양사(筋壤死)에 있어서의 $^{99m}Tc$-MDP 골주사(骨走査))

  • Moon, H.B.;Han, J.S.;Kim, S.Y.;Cho, B.Y.;Lee, J.S.;Koh, C.S.;Cho, K.S.
    • The Korean Journal of Nuclear Medicine
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    • v.14 no.2
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    • pp.61-66
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    • 1980
  • We studied four patients with muscle necrosis associated with acute renal failure to evaluate the diagnostic value of the bone scan in this disease. The illness followed carbon monoxide poisoning in two patients, acute physical exertion in one and contaminated intramuscular injection in the other. Whole-body rectilinear bone scans using technetium 99m-methyldiphosphonate were done. In all patients, increased muscle labelling at the regions of suspected muscle injury was showed, and in one, it was after normalization of serum muscle enzyme levels. In one patient, the bone scan was rechecked 8 months later and showed no residual abnormality. Above all, the site and precise extent of muscle injury could be detected and the degree of muscle labelling seemed to correlate with the severy of muscle injury. These findings suggest that isotope scanning may be useful in the diagnosis of patients with acute muscle necrosis.

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A Case of Chronic Renal Failure Associated with Systemic Capillary Leak Syndrome (전신성 모세혈관 누출 증후군으로 인한 만성 신질환 1예)

  • Baek, Seon Ha;Shin, Nara;Kim, Hyo Jin;Han, Mi Yeun;Choi, Dong-Ju;Bang, Soo-Mee;Kim, Sejoong;Paik, Jin Ho
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.145-149
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    • 2012
  • Systemic capillary leak syndrome (SCLS) is an unusual entity characterized by hypovolemic shock, hemoconcentration, and hypo-albuminemia associated with paraproteinemia as a result of marked capillary hyper-permeability. Complications of this syndrome can include compartment syndromes, pulmonary edema, thrombosis, and acute kidney injury. This paper reports a case of severe SCLS accompanied by acute tubular necrosis caused by hypoperfusion and myoglobinuria secondary to rhabdomyolysis, which resulted in chronic kidney disease that necessitated hemodialysis. However, there have been rare data of residual end-organ damage after acute attacks in Korea. Therefore, this paper reports a case of complicated SCLS enough to hemodialysis and that developed into chronic kidney disease.

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Hypokalemic Muscular Paralysis Causing Acute Respiratory Failure in a Chronic Glue Sniffer (만성 본드 흡입 환자에게 발생한 호흡부전 1례)

  • Choi, Yoon-Hee;Lee, Dong-Hoon;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.63-66
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    • 2005
  • Toluene is an aromatic hydrocarbon found in glues, cements, and solvents. It is known to be toxic to the nervous system, hematopoietic system, and causes acid-base and electrolyte disorders. Acute respiratory failure with hypokalemia and rhabdomyolysis with acute renal failure should be considered as potential events in protracted glue sniffing. We reported the case of 26-year-old woman was admitted to the emergency department with the development of respiratory failure and altered mentality due to hypokalemia after chronic glue sniffing. She was weaned from the ventilator 3 days later after potassium and sodium bicarbonate replacement and was discharged without respiratory symptoms and other complications.

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Drug Interaction of Warfarin with Simvastatin / Gemfibrozil : high levels of ALT/AST, rhabdomyolysis and acute renal failure (Warfarin과 Simvastatin/Gemfibrozil의 약물 상호 작용 : 높은 수치의 ALT/AST, 횡문근 융해와 급성 신장 장애)

  • Yoon, Hyon-Ok;Osun, Babatunde
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.270-275
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    • 2011
  • 이 증례는 드물게 보는 경우로 simvastatin과 gemfibrozil을 오랫동안 함께 복용했음에도, 특이한 문제가 발현되지 않았지만, 이들을 warfarin와 함께 치료하는 경우, 아주 높은 alanine aminotransferase (ALT), aspartate aminotransferase(AST) 혈중 농도, rhabdomyolysis, 급성 신장 장애가 발생하였다. 그 후, Simvastatin와 gemfibrozil을 복용 중단시켰더니, ALT/AST는 빠르게 정상수치로 돌아온 경우이다. 이 증례 보고서는 의료인들에게 simvastatin과 gemfibrozil을 함께 혹은 따로 warfarin과 함께 복용시켜 치료할 경우, creatine phosphokinase (CPK) 와 creatinine 혈중 수치들을 포함하여 ALT/AST 농도들을 주의 깊게 모니터하도록 경각심을 주고자 한다.

Studies on the Efficacy of Combined Preparation of Crude Drugs(XXVIII) -Effects of Paeryung-tang and Kamipaeryung-tang on Diuresis, Antipyretic, Anti-inflammatory and Analgesic Activity- (생약(生藥) 복합(複合) 제제(製劑)의 약효(藥效) 연구(硏究)(제28보)(第28報) -패령탕(敗岺湯) 및 가미패령탕(加味敗岺湯)의 이뇨(利尿), 해열(解熱), 소염(消炎) 및 진통작용(鎭痛作用)에 대하여-)

  • Hong, Nam-Doo;Doo, Ho-Kyung;Cho, Young-Whan;Kim, Chul-Chung;Kim, Nam-Jae
    • Korean Journal of Pharmacognosy
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    • v.17 no.3
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    • pp.206-214
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    • 1986
  • These studies were conducted an attempt to investigate effects of 'Paeryungtang' and 'Kamipaeryungtang' water extracts on diuretic, antipyretic, antiinflammatory and analgesic actions. The results of these studies were summarized as follows; Increase in urinary volume, urinary $Na^+$ excretions were significantly recognized in normal rat. Increase in urinary volume, urinary $Na^+\;and\;Cl^-$ excretions were significantly shown in rat with 2mg/kg $HgCl_2$-induced acute renal failure. Antipyretic, anti-inflammatory and analgesic effects of 'Paeryungtang' and 'Kamipaeryungtang' were recognized in mice, rats and rabbits.

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