• 제목/요약/키워드: Renal tubular dysfunction

검색결과 30건 처리시간 0.022초

Lowe 증후군을 동반한 소아치과 환자의 전신 마취 경험 -증례 보고- (An Anesthetic Management in a Pedodontic Patient with Lowe Syndrome - A case report -)

  • 최영규;오재열;김동옥;신옥영;이긍호
    • 대한치과마취과학회지
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    • 제2권1호
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    • pp.33-37
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    • 2002
  • The oculo-cerebro-renal syndrome of Lowe (Lowe syndrome) is an X-linked recessive disorder involving the eyes, nervous systems, and kidneys. The clinical manifestation of this syndrome is characterized by congenital cataracts, glaucoma, seizure disorder, psychomotor growth retardation, hypotonia, renal tubular acidosis, aminoaciduria, rickets, and osteoporosis. We report a 5-year old boy underwent general anesthesia for the treatment of multiple dental carries. During intraoperative period, marked metabolic acidosis was noted and such acidosis was partially corrected by hyperventilation. We suggest that patients with Lowe's syndrome should be attention and treated to possible anesthetic hazards such as metabolic acidosis due to renal tubular dysfunction, rise of intraocular pressure in patient with glaucoma, the fragility of the bone structures due to rickets and osteoporosis.

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Beneficial Effects of Cynaroside on Cisplatin-Induced Kidney Injury In Vitro and In Vivo

  • Nho, Jong-Hyun;Jung, Ho-Kyung;Lee, Mu-Jin;Jang, Ji-Hun;Sim, Mi-Ok;Jeong, Da-Eun;Cho, Hyun-Woo;Kim, Jong-Choon
    • Toxicological Research
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    • 제34권2호
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    • pp.133-141
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    • 2018
  • Anti-cancer drugs such as cisplatin and doxorubicin are effectively used more than radiotherapy. Cisplatin is a chemotherapeutic drug, used for treatment of various forms of cancer. However, it has side effects such as ototoxicity and nephrotoxicity. Cisplatin-induced nephrotoxicity increases tubular damage and renal dysfunction. Consequently, we investigated the beneficial effect of cynaroside on cisplatin-induced kidney injury using HK-2 cell (human proximal tubule cell line) and an animal model. Results indicated that $10{\mu}M$ cynaroside diminished cisplatin-induced apoptosis, mitochondrial dysfunction and caspase-3 activation, cisplatin-induced upregulation of caspase-3/MST-1 pathway decreased by treatment of cynaroside in HK-2 cells. To confirm the effect of cynaroside on cisplatin-induced kidney injury in vivo, we used cisplatin exposure animal model (20 mg/kg, balb/c mice, i.p., once a day for 3 days). Renal dysfunction, tubular damage and neutrophilia induced by cisplatin injection were decreased by cynaroside (10 mg/kg, i.p., once a day for 3 days). Results indicated that cynaroside decreased cisplatin-induced kidney injury in vitro and in vivo, and it could be used for improving cisplatin-induced side effects. However, further experiments are required regarding toxicity by high dose cynaroside and caspase-3/MST-1-linked signal transduction in the animal model.

Changes in Phosphate Transporter Activity Evaluated by Phosphonoformic Acid Binding in Cadmium-Exposed Renal Brush-Border Membranes

  • Chung, Jin-Mo;Ahn, Do-Whan;Kim, Kyoung-Ryong;Park, Yang-Saeng
    • The Korean Journal of Physiology and Pharmacology
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    • 제3권5호
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    • pp.513-519
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    • 1999
  • Direct exposure of renal tubular brush-border membranes (BBM) to free cadmium (Cd) causes a reduction in phosphate (Pi) transport capacity. Biochemical mechanism of this reduction was investigated in the present study. Renal proximal tubular brush-border membrane vesicles (BBMV) were isolated from rabbit kidney outer cortex by Mg precipitation method. Vesicles were exposed to $50{\sim}200\;{\mu}M\;CdCl_2$ for 30 min, then the phosphate transporter activity was determined. The range of Cd concentration employed in this study was comparable to that of the unbound Cd documented in renal cortical tissues of Cd-exposed animals at the time of onset of renal dysfunction. The rate of sodium-dependent phosphate transport $(Na^+-Pi\;cotransport)$ by BBMV was determined by $^{32}P-Iabeled$ inorganic phosphate uptake, and the number of $Na^+-Pi$ cotransporters in the BBM was assessed by Pi-protectable $^{14}C-labeled$ phosphonoformic acid $([^{14}C]PFA)$ binding. The exposure of BBMV to Cd decreased the $Na^+-Pi$ cotransport activity in proportion to the Cd concentration in the preincubation medium, but it showed no apparent effect on the Pi-protectable PFA binding. These results indicate that an interaction of renal BBM with free Cd induces a reduction in $Na^+-Pi$ cotransport activity without altering the carrier density in the membrane. This, in turn, suggest that the suppression of phosphate transport capacity $(V_{max})$ observed in Cd-treated renal BBM is due to a reduction in $Na^+-Pi$ translocation by existing carriers, possibly by Cd-induced fall in membrane fluidity.

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Familial Juvenile Hyperuricemic Nephropathy 2례 (Two cases of Familial Juvenile Hyperuricemic Nephropathy)

  • 박진호;최보화;이소영;유은실;박영서
    • Childhood Kidney Diseases
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    • 제1권2호
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    • pp.183-188
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    • 1997
  • Familial juvenile hyperuricemic nephropathy is an autosomal dominant disease characterized by progressive renal disease and hyperuricemia or gout, affecting young people of either sex equally. There are two biochemical markers of this disorder. The first is hyperuricemia disproportionate to the degree of renal dysfunction; the second is a grossly reduced clearance of uric acid relative to creatinine, dispropotionate to age, sex and degree of renal failure. We experienced 2 family members with hyperuricemia. One family member, a 13-year-old girl who had suffered from tophaceous gout and chronic renal failure. Her younger brother also had hyperuricemia and moderately reduced renal function. Their urinary excretion fractions of uric acid($FE_{uric\;acid}$) were reduced and renal biopsy specimens showed interstitial fibrosis with tubular atrophy and interstitial urate crystal deposition. We have treated these two patients with allopurinol but we have done renal transplantation because she progressed to end stage renal disease at 16 year old age.

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티오아세트아미드(thioacetamide) 복강투여로 인한 무지개송어, Oncorhynchus mykiss의 간장 및 신장 독성 반응 연구 (Hepatic and renal toxicity study of rainbow trout, Oncorhynchus mykiss, caused by intraperitoneal administration of thioacetamide (TAA))

  • 허민도;정다혜
    • 한국어병학회지
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    • 제36권2호
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    • pp.415-422
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    • 2023
  • In veterinary medicine for mammals, studies are being conducted to confirm the effects of antioxidants using pathological toxicity model studies, and are also used to confirm the effect of mitigating liver or kidney toxicity of specific substances. It was considered necessary to study such a toxicity model for domestic farmed fish, so thioacetamide (TAA), a toxic substance that causes tissue damage by mitochondrial dysfunction, was injected into rainbow trout (Oncorhynchus mykiss), a major farmed freshwater fish species in Korea. The experiment was conducted with 40 rainbow trout (Oncorhynchus mykiss) weighting 53 ± 0.6 g divided into two groups. Thioacetamide(TAA) 300mg/kg of body weight was intraperitoneally injected into rainbow trout and samples were taken 1, 3, 5, 7 days after peritoneal injection. As a result, in serum biochemical analysis, AST levels related to liver function decreased 3 and 5 days after intraperitoneal injection and increased after 7 days, and ALT levels also increased after 7 days. In addition, creatinine related to renal malfunction increased 3 and 5 days after TAA injection. In histopathological analysis, pericholangitis and local lymphocyte infiltration were observed in the liver from 1 day after intraperitoneal injection of TAA, and hepatic parenchymal cell necrosis was also observed from 3 days after intraperitoneal injection. Hyaline droplet in renal tubular epithelial cell was observed from 1 day after TAA injection, and acute tubular damage such as tubular epithelial cell necrosis appeared from 3 days after TAA injection. Accordingly, it is thought that it will be able to contribute to studies that require a toxicity model.

국내역학조사에 기초한 한국인의 카드뮴 PTWI 설정 연구 (A study on the Establishment of Korean PTWI for Cadmium Based on The Epidemiological Data)

  • 최찬웅;문진현;박형수;염태경;이광호;이효민
    • 한국식품위생안전성학회지
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    • 제24권4호
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    • pp.378-384
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    • 2009
  • 카드뮴에 대한 다양한 인체안전기준이 알려지고 있고, 각 국가마다 신장기능이상을 나타내는 뇨 중 카드뮴 농도에 차이를 나타내고 있어 국내의 역학자료를 고려한 카드뮴 인체안전기준을 검토 제안하므로 위해관리의 효율을 향상시키고자 본 연구를 수행하였다. WHO, USEPA, ATSDR에서 식이섭취량과 뇨 중 카드뮴 농도와의 상관관계를 PBPK 모델로 정립 제안한 방법 등이 검토되었으며, 최종적으로 WHO의 1일 인체섭취량 산출 모델에 따라 계산하였다. 국내 역학자료(병산리 폐광지역 인체역학조사)에 의하면 뇨 중 카드뮴 최고농도인 11.63 ug/g creatinine 수준에서도 단백뇨 등의 신장기능이상이 확인되지 않아, WHO 등 국외 역학자료를 검토하여 신장이상을 나타내기 시작하는 뇨 중 카드뮴 농도를 2.5 ug/g creatinine으로 결정하였다. 카드뮴 오염원 노출과 무관할 것으로 예측되는 우리나라 성인의 뇨 중 카드뮴 수준 0.38 ug/g creatinine과 최근에 평가된 식품섭취를 통한 카드뮴 섭취량(8.3~10.4 ug/day)의 비율이 21.8~27.3 수준에 해당됨을 확인하여 이를 WHO에서 제안된 모델에 적용하였다. 식이섭취량과 신장 이상과의 상관관계 중 카드뮴 생체이용률 10%, 흡수된 카드뮴의 배출량을 50%로 가정한 결과를 국내 인체안전기준 설정에 적용한 결과(이 가정에서 사용된 식이섭취량에 대한 뇨 중 카드뮴 농도의 비율은 24), 신장이상이 발생되기 시작하는 뇨 중 카드뮴 농도인 2.5 ug/g creatinine에 대해 예측된 카드뮴 1일 섭취량은 1 ug/kg bw/day여서, 이를 근거로 국내 카드뮴 PTWI를 7 ug/kg bw/week로 제안하였다.

개심술시 혈청 $\beta_2$-microglobulin 의 변동에 관한 연구 (Perioperative Changes of Serum $\beta_2$-microglobulin Concentration in Open Heart Surgery)

  • 류지윤;조광현
    • Journal of Chest Surgery
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    • 제22권2호
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    • pp.191-201
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    • 1989
  • Nowadays, in spite of the remarkable development of the results of open heart surgery, the incidence of postoperative acute renal failure [ARF] has been increased due to the expansion of the candidates and prolonged operation time for complicated cases. It is also well known that ARF after open heart surgery, if once occurred, is a critical complication, therefore early diagnosis and treatment about it are very important for prognosis. Recently a low molecular weight [2 * microglobulin [[2* MG]has been used as a indicator of renal function. Because of the properties of [2 * MG, serum concentration of it is increased in glomerular dysfunction and urine excretion of it is increased in tubular dysfunction. Author studied about the perioperative changes of serum [2* MG and BUN concentration in 25 children and 30 adults for evaluation of significances of [2* MG as a parameter of postoperative renal function in open heart surgery, and the results were obtained as follows. l. In open heart surgery, the serum [2* MG concentration was elevated postoperatively in the all cases from the first postoperative day. 2. There were a significant correlation between the preoperative BUN and [2* MG concentration [P< 0.01]. The correlation factor[r] in child group was 0.8512, and in adults 0.8636. 3. The maximum level of serum [2* MG in the both child and adult groups were noticed in 4th postoperative day as 2.61*0.80mg/ 1 in child group and 3.39*1.47 mg/ 4 in adult group, and there was a significant difference between the two groups statistically[P < 0.05]. 4. The pattern of changes of serum concentration of [2* MG with time was very similar with the changes of BUN, but in a case of ARF [expired with it] the changes of [2* MG was more remarkable. 5. There was a significant differences in the maximum level of [2* MG between the 2 group according to the ECC time [groups of below and above 60 minutes] [P< 0.01].

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Chronic Cadmium Intoxication and Renal Injury Among Workers of a Small-scale Silver Soldering Company

  • Choi, Won-Jun;Kang, Seong-Kyu;Ham, Seunghon;Chung, Wookyung;Kim, Ae Jin;Kang, Myunghee
    • Safety and Health at Work
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    • 제11권2호
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    • pp.235-240
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    • 2020
  • Background: Cadmium exposure may induce chronic intoxication with renal damage. Silver soldering may be a source of cadmium exposure. Methods: We analyzed working environment measurement data and periodic health screening data from a small-scale silver soldering company with ten workers. Concentrations of cadmium in air from working environment measurement data were obtained. Concentrations of blood and urinary cadmium, urine protein, and urine β2-microglobulin (β2M) were obtained. The generalized linear model was used to identify the association between blood and urine cadmium and urine β2M concentrations. Clinical features of chronic cadmium intoxication focused with toxicological renal effects were described. Results: The mean duration of work was 8.5 years (standard deviation [SD] = 6.9, range = 3-20 years). Cadmium concentrations in air were ranged from 0.006 to 0.015 mg/㎥. Blood cadmium concentration was elevated in all ten workers, with a highest level of 34.6 ㎍/L (mean = 21.288 ㎍/L, SD = 11.304, range = 9.641-34.630 ㎍/L). Urinary cadmium concentration was elevated in nine workers, with a highest level of 62.9 ㎍/g Cr (mean = 22.151 ㎍/g creatinine, SD = 19.889, range = 3.228-62.971 ㎍/g creatinine). Urine β2M concentration was elevated in three workers. Urinary cadmium concentration was positively associated with urine protein concentration (beta coefficient = 10.27, 95% confidence interval = [4.36, 16.18]). Other clinical parameters were compatible with renal tubular damage. Conclusion: Cadmium intoxication may occur at quite low air concentrations. Exposure limit may be needed to be lowered.

Protective effect of ginsenosides Rk3 and Rh4 on cisplatin-induced acute kidney injury in vitro and in vivo

  • Baek, Seung-Hoon;Shin, Byong-kyu;Kim, Nam Jae;Chang, Sun-Young;Park, Jeong Hill
    • Journal of Ginseng Research
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    • 제41권3호
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    • pp.233-239
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    • 2017
  • Background: Nephrotoxicity is the major side effect in cisplatin chemotherapy. Previously, we reported that the ginsenosides Rk3 and Rh4 reduced cisplatin toxicity on porcine renal proximal epithelial tubular cells (LLC-PK1). Here, we aimed to evaluate the protective effect of ginsenosides Rk3 and Rh4 on kidney function and elucidate their antioxidant effect using in vitro and in vivo models of cisplatin-induced acute renal failure. Methods: An enriched mixture of ginsenosides Rk3 and Rh4 (KG-KH; 49.3% and 43.1%, respectively) was purified from sun ginseng (heat processed Panax ginseng). Cytotoxicity was induced by treatment of $20{\mu}M$ cisplatin to LLC-PK1 cells and rat model of acute renal failure was generated by single intraperitoneal injection of 5 mg/kg cisplatin. Protective effects were assessed by determining cell viability, reactive oxygen species generation, blood urea nitrogen, serum creatinine, antioxidant enzyme activity, and histopathological examination. Results: The in vitro assay demonstrated that KG-KH ($50{\mu}g/mL$) significantly increased cell viability (4.6-fold), superoxide dismutase activity (2.8-fold), and glutathione reductase activity (1.5-fold), but reduced reactive oxygen species generation (56%) compared to cisplatin control cells. KG-KH (6 mg/kg, per os) also significantly inhibited renal edema (87% kidney index) and dysfunction (71.4% blood urea nitrogen, 67.4% creatinine) compared to cisplatin control rats. Of note, KG-KH significantly recovered the kidney levels of catalase (1.2-fold) and superoxide dismutase (1.5-fold). Conclusion: Considering the oxidative injury as an early trigger of cisplatin nephrotoxicity, our findings suggest that ginsenosides Rk3 and Rh4 protect the kidney from cisplatin-induced oxidative injury and help to recover renal function by restoring intrinsic antioxidant defenses.

가와사키 질환에서의 신증상과 영상 검사 소견 (Renal Manifestations and Imaging Studies of Kawasaki Disease)

  • 오지영;박세진;김선정;장광천;김유리아;신재일;김기혁
    • Childhood Kidney Diseases
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    • 제17권2호
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    • pp.86-91
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    • 2013
  • 목적: 본 연구는 가와사키 질환의 신장 침범에 대하여 비교적 덜 침습적이며, 특이도와 민감도가 높은 검사인 Technetium-99m dimercaptosuccinic acid scintigraphy (DMSA renal SPECT)을 통하여 밝혀보고자 한다. 방법: 2011년 3월부터 10월까지 국민건강보험 일산병원에서 가와사키로 진단된 15명의 환아들을 대상으로 진행하였다. 15명의 환아 모두 가와사키의 급성기에 DMSA renal SPECT를 시행하였다. 또한 신장 세뇨관 손상 지표인 요중 ${\beta}2$-microglobulin (${\beta}2$-MG)을 측정하여 이를 통한 가와사키 환아에서 신장 손상의 조기 진단 가능 여부를 연구해보았다. 결과: 환아 15명 모두의 신기능 검사는 정상이었다. 소변 검사상 현미경적 혈뇨와 농뇨가 각각 13%, 33%에서 관찰되었다. 요중 ${\beta}2$-MG는 46%에서 증가된 소견을 보였다. 또한 환아들을 요중 ${\beta}2$MG를 기준으로 증가되어 있는 군과 증가되지 않은 군으로 나누어 비교, 분석해 보았으며, 두군간에 임상 증상, 임상 검사, 초음파 검사 및 심초음파 검사에서 유의한 차이를 보이지 않았다. 모든 환아에서 DMSA renal SPECT는 정상 소견을 보였다. 결론: 본 연구에서 가와사키 질환의 신장 침범은 경한 소변 검사 이상 및 일부 환아에서의 요중 ${\beta}2$-MG의 상승 소견을 보였으며, DMSA renal SPECT에서 관찰될 정도의 신장 침범은 보이지 않았다.