• Title/Summary/Keyword: Renal volume

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Evaluation of Diuretic and Hemodynamic Effect of Extract from Akebia quinata Decaisne in Dogs (개에서 목통(Akebia quinata Decaisne) 추출물의 이뇨효과 평가)

  • Han, Suk-Hee;Kim, Ye-Won;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.29 no.3
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    • pp.203-206
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    • 2012
  • Treatment for heart failure is directed to reduce atrial volume overload by diuretic agents, to lessen ventricular pressure overload by vasodilatory agents and to increase myocardial performance through inotropic agents. Of those cardiac therapeutics, diuretic agents are the most important to control heart failure in dogs, although long-term use often causes detrimental side-effects such as acute renal failure and electrolyte abnormalities. Thus, this study was designed to find a new diuretic agent from medicinal herbs which has better diuretic effect and less unfavorable complications in dogs. In a preliminary study performed with 5 normal healthy dogs, the extract from Akebia quinata Decaisne showed mild to moderate diuretic effect (0.3-0.5 potency of furosemide 2 mg/kg) and minimal changes in serum chemistry and electrolyte. Although the study population was not large enough and study period was not sufficient enough, this study found a good alternative diuretic agent which can replace or reduce the use of furosemide in dogs with heart failure.

Two Cases of Severe Pancytopenia Associated with Low-Dose Methotrexate Therapy in Patients with Chronic Kidney Disease and Rheumatoid Arthritis (류마티스 관절염을 가진 만성신질환 환자에서 저용량 methotrexate 투여 후 발생한 중증 범혈구 감소증 2예)

  • Kim, Hong-Ik;Lee, Woo-Hyun;Oh, Jang-Seok;Hong, Hyo-Rim;Lee, In-Hee
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.60-69
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    • 2011
  • Due to its efficacy and tolerability, low dose oral methotrexate (MTX) therapy has been widely used for treatment of rheumatoid arthritis (RA). However, it can rarely cause serious, life-threatening hematologic toxicities, such as pancytopenia. We report here on two patients with chronic kidney disease (CKD), who developed severe pancytopenia after 5 years (cumulative dose 1,240 mg) and 4 years (cumulative dose 1,320 mg) of low dose MTX therapy for treatment of RA, respectively. Both patients presented with renal insufficiency, hypoalbuminemia, concurrent use of nonsteroidal anti-inflammatory drugs, and elevated mean corpuscular volume of red blood cells (RECs), all of which are known as risk factors of MTX-induced pancytopenia. Despite receiving treatment, which included REC and platelet transfusions, antibiotic therapy, granulocyte colony stimulating factor, and leucovorin rescue, one patient died of sepsis. Based on our case study, prompt investigation of risk factors associated with MTX toxicity is required for all patients receiving MTX therapy. MTX treatment, even at a low dose, should be discontinued in patients with advanced CKD.

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Hypokalemia-induced Polyuria with Nocturia after Intravenous Methylprednisolone Pulse Therapy in a Henoch-Sch$\ddot{o}$nlein Purpura Nephritis Patient (Henoch-Sch$\ddot{o}$nlein Purpura 신염 환자에서 경정맥 고용량 스테로이드 충격요법 후 발생된 저칼륨혈증으로 인한 다뇨증과 야간뇨)

  • Kim, Geun-Jung;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.230-235
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    • 2010
  • Patients with moderate to severe degrees of Henoch-Sch$\ddot{o}$nlein purpura (HSP) nephritis receive high-dose intravenous methylprednisolone pulse therapy (IMPT). Although the regimen is generally safe and effective, various complications occasionally develop. administration of excessive corticosteroid can induce urinary potassium wasting leading to hypokalemia. Polyuria, one of the complications of hypokalemia, is related to both increased thirst and mild nephrogenic diabetes insipidus. And hypokalemia itself also impairs the maximal renal urinary concentration ability. Although polyuria or nocturia after IMPT is not common, it is correctable immediately by oral potassium supplementation. Therefore, during IMPT, careful history taking of nocturia as well as monitoring urine volume, serum and urine potassium level at regular follow-up are necessary because even mild hypokalemia can provoke urine concentrating ability defect. We experienced a case of 11 year-old boy with HSP nephritis who suffered from hypokalemia-induced polyuria with nocturia right after IMPT.

Effects of Polyporus Herbal-acupuncture at KI10 on LPS-induced nephritis in rats (LPS로 유도된 흰쥐의 신장염에 대한 음곡(KI10) 저령약침의 효과)

  • Lee, Jeong-Yun;Jang, Seung-Hoon;Jeon, Jong-Ik;Yim, Yun-Kyoung
    • The Journal of Korean Medicine
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    • v.36 no.3
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    • pp.73-83
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    • 2015
  • Objectives: The purpose of this study was to evaluate the effects of Polyporus Herbal-acupuncture(PO-HA) at KI10 (Umgok) on nephritis induced by lipopolysaccharide(LPS) in rats. Methods: Rats were allocated into normal, control, and 2 experimental groups. The rats in the control group were intra-peritoneally injected with LPS for nephritis induction. The rats in the groups of experiment 1 and experiment 2 were treated with Saline injection, and PO-HA, respectively at KI10 three times for a week and then intra-peritoneally injected with LPS. To evaluate the effects of PO-HA at KI10, WBC count in blood, creatine, tumor necrosis factor-alpha (TNF-${\alpha}$), cytokine-induced neutrophil chemoattractant 1(CINC-1) in serum, urinary volume, creatinine, total protein in urine, myeloperoxidase(MPO) in kidney were measured. Results: PO-HA at KI10 significantly suppressed the increase of WBC in blood, TNF-${\alpha}$, CINC-1 in serum, MPO in kidney of LPS-stimulated rats. PO-HA at KI10 significantly suppressed the increase creatinine, total protein in urine of LPS-stimulated rats. Conclusions: According to these results, it is postulated that PO-HA at KI10 has an anti-inflammatory and renal-protective effects on LPS-induced nephritis in rats. Therefore, it is suggested that PO-HA at KI10 may be an useful therapeutics for nephritis in clinical field after further researches.

Attenuation of Anemia by Relmα in LPS-Induced Inflammatory Response

  • Lee, Mi-Ran
    • Journal of the Korea Society of Computer and Information
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    • v.23 no.10
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    • pp.135-141
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    • 2018
  • In this paper, we propose to evaluate the effect of resistin-like molecule alpha ($Relm{\alpha}$) on the progression of anemia of inflammation. Anemia of inflammation is a common feature of inflammatory disorders, including chronic kidney disease, infections, and rheumatoid arthritis. $Relm{\alpha}$ is highly up-regulated in various inflammatory states, especially those involving asthma, intestinal inflammation, and parasitic diseases, and regulates the pathogenesis of those diseases. However, the role of $Relm{\alpha}$ in anemia of inflammation is unknown. To explore the roles of $Relm{\alpha}$ in anemia of inflammation in vivo, we generated mouse model of the disease by injecting 0.25 mg/kg lipopolysaccharides (LPS) intraperitoneally into $Relm{\alpha}-deficient$ and wild-type (WT) mice daily for 10 days. Research data was expressed as differences between LPS-treated $Relm{\alpha}-deficient$ and WT mice by a two-tailed non-parametric Mann-Whitney U-test using GraphPad Instat program. The results of the study are as follows: LPS-treated $Relm{\alpha}-deficient$ mice had significantly (p<0.05) lower hemoglobin contents, hematocrit levels and red blood cell indices including mean corpuscular volume, mean corpuscular hemoglobin than WT controls. This decrease was accompanied by significant (p<0.05) increase in total white blood cell and monocyte counts in the blood. However, there was no significant difference in mRNA levels of hepatic hepcidin and renal erythropoietin between the two animal groups. Taken together, these results indicates that $Relm{\alpha}$ deficiency exacerbates the anemia by increasing inflammation, suggesting therapeutic value of $Relm{\alpha}$ in the treatment of anemia of inflammation.

Prevalence Rates of Major Chronic Adult Diseases among Korean Employees (한국 직장성인의 만성 주요 질환 유병률과 행태에 관한 연구)

  • Lee, Gyu-Jang;Kim, Soon-Ki;Kim, Jeong-Hwa;Cho, Kyung-Jin
    • Korean Journal of Clinical Laboratory Science
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    • v.41 no.4
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    • pp.196-207
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    • 2009
  • For the estimation of prevalence state of major chronic adult disease and their relationships with drinking and smoking habits in the Korean employees, we analyzed a medical check-up data of 155,799 subjects that was accumulated during the year of 2008. In age and sex distribution of the sample, male subjects were 106,229 and female 51,827 showing the ratio of 2:1 and the majorities were 30s and 40s covering 70.7% of the total. The prevalence rates of major chronic diseases were obesity 29.8% (male 38.3%, female 12.3%), hypertension 4.1%, HBV carrier inactive 3.3%, diabetes mellitus 2.9%, hypothyroidism 1.7% (male 1.3%, female 2.4%), hyperlipidemia 1.1%, hyperthyroidism 1.4% (male 1.1%, female 2.1%), osteoporosis 1.4% (male 1.4%, female 1.4%), anemia 0.9% (male 0.3%, female 2.0%) and renal disease 0.9%. The frequency of and volume of drinking in male group were 4.6 times and 7.5 times higher than female group respectively. The 33.8% of the workers were smoking currently. In the serological tests, all the items such as AST, ALT, ${\gamma}-GTP$, LDH for liver function, Cholesterol, TG, uric acid for hyperlipidemia and BP systolic, Fasting blood sugar, BMI for metabolic syndrome were significantly higher in the more drinking and more smoking groups than other groups (p<0.001). The higher prevalence rates in male group in the liver disease seems to be strongly related with the drinking and smoking habits in male employees. We suggest that employees should rather relying on leisure or hobbies than drinking and smoking for the stress relief.

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Effects of the Administration of 5-(4'- Pipweisinomwrhylphwnly)-2,3-dihydroimidazo[2,1-a] is pquinoline (SDZ-62-434) on Rat Kidney

  • Yi, E.Y.;Ma, Y.;Choi, W.J.;Park, J.S.;Cheon, S.H.;Lim, D.K.
    • Toxicological Research
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    • v.12 no.2
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    • pp.277-281
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    • 1996
  • To evaluate the renal toxicity of the antitumor agent, 5-(piperidonomethylphenyl)-2,3-dihydroimidazo[2,1-a]isoquinoline (SDZ-62-434), rats were treated with SDZ-62-434 of 50 mg/Kg, i.p., once and 10 mg/Kg, i.p., daily for 7 days. The kidney weights and urine volume after and during the treatment were observed. The concentrations of urinary creatinine, protein, and the activities of N-acetyl-$\beta $D-glucosaminidase (NAG), alanine aminopeptidase (AAP), $\gamma$-glutamyl transpeptidase (GGT) and lactate dehydrogenase (LDH) in 24 hr urine were also determined. The kidney weights after acute and subacute administration was not affected. The urine excretions were increased 5 days after the acute administration and increased after the daily 3rd day-administration. The excretion of creatinine was similar as that of urine excretion. The excretion of creatinine was increased 5 days after the acute and subacute administration. However, the protein excretion didn't changed in both treatment. Those indicate that SDZ-62-434 might induce the diuresis and also suggest that diuresis might be due to the some metabolites rather than the compound itself. The urinary activities of NAG and LDH were not affected after the acute treatment. However, the urinary activities of AAP and GGT were slightly increased 3 days after the acute administration but, returned to the control value. In subacute treatment, the activities of GGT was not changed. And the activities of NAG were declined after the 7th day-administration. However, the activities of AAP were significantly increased after the 5th day-administration. Furthermore, the urinary activities of LDH were continuously increased during the subacute administration. These results indicate that the high and subacute administration might induce a weak damage on the kidney cells. Furtherrnore, the present results suggest that SDZ-62-434 might have relatively slow-emerging and mild toxicity to the kidney.

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A Clinical Study on Polycythemia Vera (진성다혈증(眞性多血症)에 관(關)한 임상적고찰(臨床的考察))

  • Lee, Gwon-Jun;Hong, Kee-Suck;Cho, Kyung-Sam;Kim, Byoung-Kook;Kim, Noe-Kyeong;Koh, Chang-Soon;Lee, Mun-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.11 no.1
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    • pp.59-70
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    • 1977
  • Eight patients with polycythemia vera were diagnosed from 1965 through 1977 among the patients of Seoul National University Hospital. In our series there were 4 men and 4 women with average age of 54 years at the time of diagnosis. Symptoms of facial plethora, headache, pruritus and dizziness were the most frequent manifestations of disease in order of frequency. At inital examination 8 of 8 patients had facial plethora, 6 of 8 patients splenomegaly and 4 if 8 patients hepatomegaly. The laboratory data revealed mean Red cell volume of 55+10ml/kg which was elevated in all cases. Leukocytosis was observed in 5 of 8 patients and thrombocytosis 2 of 8 patients. Leukocyte alkaline phosphatase was increased in all cases. Bone marrow aspiration disclosed typical panmyelosis in 5 of 8 patients. In one patient there was diffuse myelofibrosis on bone marrow biopsy. The combined diseases included 2 patient with hypertension and 1 patient with thrombosis of aorta and left renal artery. The patients were treated with phlebotomy alone in 2 patients, chemotherapy with busulfan in 1 patient and $^{32}P$ in 5 patients with favorable results. During the mean 29.9 months follow up period, there were development of iron deficiency in 3 patients, hyperuricemia in 2 patients and thrombosis in 1 patient. The occurrence of acute leukemia of myelofibrosis was not observed in the course of disease.

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Correlation Study Between Anemias with Higher MCV and Lower MCHC

  • Choi, Woo-Soon;Kim, Hee-Sang
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.1
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    • pp.12-18
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    • 2011
  • The purpose of this study was to evaluate the significance of higher than normal mean corpuscular volume (MCV) and lower than normal mean corpuscular hemoglobin concentration (MCHC) in 20 patients. The hemoglobin (Hb), red blood cell indices (MCV, MCH, MCHC,), red cell distribution width (RDW), serum ferritin, serum iron (Fe) and total iron binding capacity (TIBC) were measured and the transferrin saturation were calculated. 18 (90.0%) cases were categorized as chronic diseases. Chronic renal failure, malignancy, and bleeding were all related to the cases. The mean values of hemoglobin was $9.5{\pm}2.14g/dL$; the MCV was $29.0{\pm}2.8fL$; the MCH was $30.9{\pm}1.0pg$; the MCHC was $31.2{\pm}0.5%$; the RDW was $17.0{\pm}3.6%$; serum Fe was $39{\pm}21{\mu}g/dL$; the TIBC was $219.7{\pm}108.8{\mu}g/dL$; transferrin saturation was $19.2{\pm}9.9%$ and ferritin was $445.5{\pm}499.6{\mu}g/L$ in the patients. The WHO criteria for hemoglobin of patients confirms anemia in 18 of the 20 (90.0%) cases. Anemia of chronic disease was shown in 11 (73.3%) cases; acute gastric ulcer with hemorrhage in 1 (6.7%) case; iron deficiency anemia in 1 (6.7%) case; 2 patients (13.3%) were of normal cases. There were changes in the baseline Hb level results of the 19 (95.0%) cases while no change was shown in 1 case. As a result, diseases associated with anemia and bleeding where the MCV is higher than the normal range and MCHC is lower than normal range are considered relevant findings.

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Acute kidney injury in childhood-onset nephrotic syndrome: Incidence and risk factors in hospitalized patients

  • Kim, Mi Young;Cho, Myung Hyun;Kim, Ji Hyun;Ahn, Yo Han;Choi, Hyun Jin;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.347-355
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    • 2018
  • Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.