• Title/Summary/Keyword: creatinine clearance (Ccr)

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Estimation of Glomerular Filtration Rate from Plasma Creatinine and Height in Children (소아에서 신장과 혈장 Creatinine 농도를 이용한 사구체여관율 측정)

  • Kim, Jeong-Lan;Park, Yong-Hoon;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.93-100
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    • 1988
  • In clinical practice, creatinine clearance(Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate(GFR) could be obtained from the simple determinations of plasma creatinine(Pcr) and body length(L) : GFR($m{\ell}/min/1.73m^2$=k L(cm)/Pcr(mg/$100m{\ell}$), (k=constant). The subject of this study were ill children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III. from 11 to 15 years old. The results were as following ; 1) Measured creatinine clearance($Ccr_M$, $m{\ell}/min/1.73m^2$) were $109.73{\pm}9.97$ in group I, $108.26{\pm}9.02$ in group II, $96.20{\pm}4.72$ in group III and $105.48{\pm}5.23$ in all age group. 2) Measured k($k_M$) obtained from $Ccr_M=k$ Ht/Pcr were $0.49{\pm}0.03$ in group I, $0.48{\pm}0.02$ in group II, $0.43{\pm}0.02$ in group III, and $0.47{\pm}0.02$ in all age group.(Ht ; height) 3) Linear equations and correlation coefficients between Ht/Pcr(x) and Ccr(y) were y=0.822x-65.63(r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44(r=0.54) in group III and y=0.58x-22.13(r=0.81) in all age group. 4) $Ccr_E$ was again estiamted from linear equations between Ht/Pcr and $Ccr_M$ and $k_E$ was calculated with Ht/Pcr and $Ccr_E$ were $0.48{\pm}0.01$ in group I, $0.49{\pm}0.01$in group II, $0.43{\pm}0.01$ in group III and $0.47{\pm}0.00$ in all age group. 5) Consistant values of $k_E$ and $k_M$ were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k($k_M$) according to the age in easy and rapid way.

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Effects of Silver Spike Point Electrical Stimulation on Glomerular Filtration Rate in Volunteer (은침점전기자극의 인체적용이 신사구체여과율(Glomerular Filtration Rate)에 미치는 효과)

  • Chon, Ki-Young;Kim, Soon-Hee;Min, Kyung-Ok;Choi, Young-Duk;Lee, Joon-Hee;Kim, Jung-Hwan
    • Journal of Korean Physical Therapy Science
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    • v.11 no.1
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    • pp.28-35
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    • 2004
  • The purpose of the present study was to investigate the effectiveness of silver spike point (SSP) low frequency electrical stimulation on glomerular filtration rate (GFR), specifically, such as diuretic action in 24 hour urine and in plasma analysis from normal volunteer. The current of 1 Hz continue type (CT) of SSP low frequency electrical stimulation significantly decreased in plasma creatine from normal volunteer. However, the urine creatinine clearance (Ccr) was significantly increased by SSP low frequency electrical stimulation in normal volunteer. These results suggest that the SSP low frequency electrical stimulation, especially current of 1 Hz continue type, significantly regulates urine creatinine clearance and glomerular filtration rate from normal volunteer. Therefore, the SSP low frequency electrical stimulation is a good regulator through a diuretic action of hypertension.

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Effects of Ethanol-Extract of Lotus Root on the Renal Function and Blood Pressure of Fructose-Induced Hypertensive Rats (연근의 에탄올 추출물이 과당으로 유도된 고혈압 흰쥐의 혈압과 신장 기능에 미치는 효과)

  • Park Sung-Hye;Ham Tae-Sick;Han Jong-Hyun
    • Journal of the East Asian Society of Dietary Life
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    • v.15 no.2
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    • pp.165-170
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    • 2005
  • The present study was aimed to investigate whether ethanol-extract of Nelumbo nucifera has an ameliorative effect on the renal function in high fructose-diet induced hypertensive rats. The urine osmolality (Uosmel) was decreased in rats with high fructose-diet ($60\%$) during the whole experiment period without change of the urine volume (UV). The urinary excretion of sodium and chloride were decrease significantly in rats with fructose induced hypertensive rats, wheras urinary excretion of potassium was increased. The creatinine clearance (CCr) and solute-free water reabsorption were also decreased by treatment of fructose rich diet. Among these renal functional parameters, CCr was partially restored by the administration of ethanol-extract of Nelumbo nucifera. The Uosmol was also partially restored by the administration ethanol-extract of Nelumbo nucifera at the end of the experimental period. Taken together, ethanol-extract of Nelumbo nucifera has the ameliorative effect on glomerular filtration rate in rats with high fructose-diet induced hypertension.

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Renal Toxicity of High-dose Intravenous Immunoglobulin in Children with Kawasaki Disease and Idiopathic Thrombocytopenic Purpura (가와사끼병과 특발성 혈소판 감소성 자반증 환아에서 고용량 정주용 면역글로불린의 신독성 유무)

  • Jung Ji Ah;Kim Hye Soon;Seo Jeong Wan;Lee Seung Joo
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.133-137
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    • 1998
  • Purpose : To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. Methods : 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine ${\beta}_2$-microglobulin/creatinine(${\beta}_{2}MG/cr$) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. Results : There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine ${\beta}_{2}MG/cr$ and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change. Conclusion : There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.

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Effects of Ethanol-extract of Allium wageki on the Renal Function of Fructose-induced Hypertensive Rats (쪽파 에탄올 추출물이 과당 유도 고혈압 백서의 신장 기능에 미치는 영향)

  • Kang Dae Gill;Lee An Sook;Lee Yun Mi;Sohn Eun Jin;Yeum Kee Bok;Lee Ho Sub
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.423-427
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    • 2003
  • The present study was aimed to investigate whether ethanol-extract of Allium wageki has an ameliorative effect on the renal function in high fructose-diet induced hypertensive rats .. The urine osmolality (Uosmol) was decreased in rats with high fructose-diet (60%) during the whole experiment period without change of the urine volume (UV). The urinary excretion of sodium (UNaV) and chloride (UCIV) were decrease significantly in rats with fructose-induced hypertensive rats, whereas urinary excretion of potassium (UKV) was Increased. The creatinine clearance (Ccr) and solute-free water reabsorption were also decreased by treatment of fructose-rich diet. Among these renal functional parameters, Ccr was partially restored by the administration of ethanol-extract of Allium wageki. The Uosmol was also partially restored by the administration ethanol-extract of Allium wageki at the end of the experimental period. Taken together, ethanol-extract of Allium wageki has the ameliorative effect on glomerular filtration rate in rats with high fructose-diet induced hypertension.

Glomerular Filtration Rate Measurements Using $^{99m}$Technetium-mercaptoacetyltriglycine Dynamic Renal Scintigraphy in Children with Renal Disease (신장 질환이 있는 소아에서 $^{99m}$Technetium-mercaptoacetyltriglycine ($^{99m}Tc$-MAG3) 신장 스캔에 의한 사구체 여과율 측정)

  • Yoon, In Ae;Yun, Ki Wook;Lim, In Seok;Choi, Eung Sang;Yoo, Byung Hun
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.57-64
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    • 2013
  • Purpose: In children, 24-hour urine collections are unreliable for evaluating glomerular filtration rate (GFR) because of the difficulty of regulating voiding and the daily variation of urinary creatinine up to 25%. Additionally, creatinine clearance (Ccr) based on urinary creatinine is considered inaccurate. The purpose of this study was to compare estimated GFR determined using Ccr, formulas with serum cystatin C and creatinine, and $^{99m}Tc$-mercaptoacetyltriglycine (MAG3) dynamic renal scintigraphy. Methods: This retrospective study included 101 patients (age, <18 years) who visited Chung-Ang University Hospital between July 2011 and August 2012. GFR was estimated using 24-hour urinary creatinine, five formulas with serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan. Results: Of the 101 patients, glomerular renal diseases were present in 60 patients (59.4%) and non-glomerular diseases were present in 41 patients (40.6%). There was a significant correlation between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and Ccr (r=0.389, P <0.001). The correlation values between estimated GFR determined using $^{99m}Tc$-MAG3 renal scan and each formula of Schwartz, Counahan-Barratt, Cockcroft-Gault, Filler and Lepage, and Bokencamp were 0.265 (P=0.007), 0.128 (P=0.044), 0.230 (P=0.021), 0.356 (P<0.001), and 0.355 (P <0.001), respectively. $^{99m}Tc$-MAG3 renal scan was correlated with estimated-GFR by all formulas in decreased renal function. Conclusion: Estimated GFRs determined using serum creatinine and cystatin C, and $^{99m}Tc$-MAG3 renal scan correlated well with estimated GFR determined using Ccr. $^{99m}Tc$-MAG3 renal scan may be replaced for evaluation of renal function with convenience in patients with renal disease and decreased renal function in childhood.

Effects of the Renal Function of Complex Herbal Medication in 20 Diabetic Nephropathy Patients (당뇨병성 신증 환자 20예에서 복합한약전탕액이 신기능에 미치는 영향)

  • Choi Woo-Jung;Kim Dong-Woung;Shin Sun-Ho;Lee Un-Jung;Choi Jin-Young;Shin Hak-Soo;Cho Gwon-Il;Lee Kwang-Souk
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.2
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    • pp.580-584
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    • 2003
  • Diabetic Nephropathy is one of the major causes of chronic renal failure. It is a common microvascular complication and clinically defined as the presence of persistent Proteinuria. We studied the effects and change of the renal function of Complex Herbal medication of the 20Diabetic Nephropathy patients. We measured the initial levels of Total Protein, Creatinine Clearance Rate(Ccr), Serum Creatinine(Serum-Cr), Urine Creatinine(Urine-Cr) and HbA1C on admission and followed up the level changes of Total Protein, Ccr, Serum-Cr and Urine-Cr on discharge. The results are following : Complex Herbal Medication does not cause the renal toxicity. The longer hypertension period is, the higher Serum-Cr level and Urine-Cr level. In an older age group, Urine-Cr is lower. 4.From the 'Deficiency in Origin and Excess in Superficiality(本虛表實)'points of view, Complex Herbal Medication improves the Serum-Cr in Diabetic Nephropathy patients. According to this results, it could be suggested that Complex Herbal Medication does not cause the renal toxicity in Diabetic Nephropathy patients and intensive controls of blood sugar, blood pressure and Complex Herbal Medication prevent the renal failure in Diabetic Nephropathy patients with early stage of Microalbumiuria.

Clinical Outcomes of Intracardiac Echocardiography-Guided Contrast Agent-Free Cryoballoon Ablation in Atrial Fibrillation Patients With Renal Insufficiency

  • Dong Geum Shin;Jinhee Ahn;Sang Hyun Park;Sang-Jin Han;Hong Euy Lim
    • Korean Circulation Journal
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    • v.54 no.3
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    • pp.113-123
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    • 2024
  • Background and Objectives: Previous studies have reported an association between impaired renal function and poor outcomes after radiofrequency catheter ablation in patients with atrial fibrillation (AF). However, outcomes of cryoballoon ablation (CBA) in patients with renal insufficiency are not fully elucidated. This study aimed to compare outcomes of CBA in AF patients with chronic kidney disease (CKD) versus those without CKD and to assess changes in renal function over 12 months following CBA. Methods: A total of 839 patients (65.1% with non-paroxysmal AF [PAF]) who underwent de novo CBA were prospectively enrolled. We divided patients into two groups based on creatinine clearance rate (CCr) and performed intracardiac echocardiography (ICE)-guided contrast agent-free CBA. Results: In comparison with patients without CKD (CCr >50, n=722), those with CKD (CCr ≤50, n=117) were older and predominantly female, had a lower body mass index, and showed a higher prevalence of heart failure and hypertension. Mean CHA2DS2-VAS score was significantly higher in CKD group than in non-CKD group. Procedure-related complications were not significantly different between two groups. During a mean follow-up period of 25.4±11.9 months, clinical recurrence occurred in 182 patients (21.7%) and not significantly different between two groups. In multivariate analysis, non-PAF and left atrial size were independent predictors of AF recurrence. CCr levels significantly improved over 12 months after CBA in CKD group. Conclusions: ICE-guided contrast-agent-free CBA showed comparable long-term clinical outcomes without increasing procedure-related complications and improvement of renal function over 12 months following CBA in AF patients with CKD.

Correlation between glomerular filtration rate and urinary N acetyl-beta-D glucosaminidase in children with persistent proteinuria in chronic glomerular disease

  • Hong, Jeong-Deok;Lim, In-Seok
    • Clinical and Experimental Pediatrics
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    • v.55 no.4
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    • pp.136-142
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    • 2012
  • Purpose: Urinary excretion of N acetyl-beta-D glucosaminidase (NAG) and ${\beta}_2$-microglobulin (${\beta}_2$-M) was increased in the presence of proximal tubular damage. Based on these urinary materials, we investigated the ability of expecting renal function in chronic glomerular diseases. In this study, we evaluated the relationship between glomerular filtration rate (GFR) urinary NAG, and urinary ${\beta}_2$-M. Methods: We evaluated 52 children with chronic kidney disease at the Chung-Ang University Hospital between January 2003 and August 2009. We investigated the 24-hour urinalysis and hematologic values in all 52 patients. Serum creatinine, creatinine clearance (Ccr), serum cystatin C, urinary ${\beta}_2$-M and urinary NAG were measured. Results: Out of 52 patients, there were 13 children with minimal change in disease, 3 children with focal segmental glomerulosclerosis, 17 children with immunoglobulin A nephropathy, 15 children with Henoch-Sch$\ddot{o}$nlein purpua nephritis, 3 children with poststreptococcal glomerulonephritis, and 1 child with thin glomerular basement membrane disease. In these patients, there were significant correlation between the Ccr and urinary NAG (r=-0.817; $P$ <0.01), and between the GFR (as determined by Schwartz method) and urinary NAG (r=-0.821; $P$ <0.01). In addition, there was a significant correlation between the GFR (as determined by Bokencamp method) and urinary NAG (r=-0.858; $P$ <0.01). Conclusion: In our study, there was a significant correlation between the GFR and urinary NAG, but there was no correlation between the GFR and urinary ${\beta}_2$-M, suggesting that the GFR can be predicted by urinary NAG in patients with chronic glomerular disease.

Population Pharmacokinetics for Gentamicin in Korean and Caucasian Appendicitis Patients Using Nonparametric Expected Maximum (NPEM) Algorithm (한국인과 코카시안 충수돌기염 환자에서 비모수적 기대최대치(NPEM) 연산방법에 의한 겐타마이신의 모집단 약물동태학)

  • Burm, Jin-Pil
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.2
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    • pp.74-80
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    • 2011
  • Population pharmacokinetics for gentamicin were compared with 20 Korean patients (14 male and 6 female) and 25 Caucasian appendicitis patients (16 male and 9 female). Two to six blood specimens were collected from all patients at the following times : just before a regularly scheduled infusion and at 0.5 hour after the end of a 0.5 hour infusion. Nonparametric expected maximum(NPEM) algorithm for population modeling was used. The estimated parameters were the elimination rate constant(K), the slope(KS) of the relationship between K versus creatinine clearance(Ccr), the apparent volume of distribution (V), the slope(VS) of the relationship between V versus weight, gentamicin clearance(CL) and the slope(CS) of the relationship between CL versus Ccr and the V. The output includes two marginal probability density function(PDF), means, medians, modes, variance, skewness, kurtosis, and CV%. The mean K(KS) were$0.402{\pm}0.129hr^{-1}$ ($0.00486{\pm}0.00197[hr{\cdot}mL/min/1.73m^2]^{-1}$) and $0.425{\pm}0.137hr^{-1}$($0.00432{\pm}0.00168[hr{\cdot}mL/min/1.73m^2]^{-1}$) for Korean and Caucasian populations, respectively. The mean V(VS) were not different at $14.3{\pm}3.69L$($0.241{\pm}0.0511L/kg$) and $15.8{\pm}4.81L$($0.236{\pm}0.0531L/kg$) for Korean and Caucasian populations, respectively (P>0.2). The mean CL(CS) were $5.68{\pm}1.69L/hr$ ($0.0714{\pm}0.0222L/kg[hr{\cdot}mL/min/1.73m^2]$) and $6.29{\pm}1.84L/hr$ ($0.0629{\pm}0.0189L/kg[hr{\cdot}mL/min/1.73m^2]$) for Korean and Caucasian populations, respectively. There are no differences in gentamicin pharmacokinetics between Korean and Caucasian appendicitis patients.