• Title/Summary/Keyword: glomerular filtration rate (GFR)

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Two-Case Report on Chronic Renal Failure Treated with Herbal Enteroclysis (한약 관장법으로 호전된 신부전 환자 2례)

  • Cho, Min-Jung;Oh, Jae-Joon;Joo, Ye-Jin;Jung, Hye-Mi;Yoon, Cheol-Ho
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.1115-1122
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    • 2008
  • Chronic renal failure (CRF) is defined as a permanent reduction in glomerular filtration rate (GFR) sufficient to produce detectable alterations in well-being and organ function. This usually occurs at GFR below 25 ml/min. In this report, is a 75-year-old woman who had back pain and diarrhea as chief complaints. She was diagnosed with CRF on March. 2008. is a 62-year-old man who had whole body weakness, anorexia and dyspepsia as chief complaints. He was diagnosed with CRF on 2008. We used herbal enteroclysis solution. which consists of Radix et Rhizoma Rhei. Concha Ostreae and Radix Glycyrrhizae or Radix Salviae Miltiorrhizae. Herbal enteroclysis was done for 15 min once a day. Enteroclysis solution was controlled at 37-39 $^{\circ}C$ and inserted 15-20cm depth for intubation. We found the patient's BUN, creatinine and GFR were improved through enteroclysis. In both and , the patient's BUN and creatinine decreased, and GFR increased favorably. This result suggests that herbal enteroclysis used for CRF is effective in clinical therapy.

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Assessment of Hepatic Cytochrome P450 3A Activity Using Metabolic Markers in Patients with Renal Impairment

  • Kim, Andrew HyoungJin;Yoon, Sumin;Lee, Yujin;Lee, Jieon;Bae, Eunjin;Lee, Hajeong;Kim, Dong Ki;Lee, SeungHwan;Yu, Kyung-sang;Jang, In-Jin;Cho, Joo-Youn
    • Journal of Korean Medical Science
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    • v.33 no.53
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    • pp.298.1-298.10
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    • 2018
  • Background: The renal function of individuals is one of the reasons for the variations in therapeutic response to various drugs. Patients with renal impairment are often exposed to drug toxicity, even with drugs that are usually eliminated by hepatic metabolism. Previous study has reported an increased plasma concentration of indoxyl sulfate and decreased plasma concentration of $4{\beta}$-hydroxy (OH)-cholesterol in stable kidney transplant recipients, implicating indoxyl sulfate as a cytochrome P450 (CYP) inhibiting factor. In this study, we aimed to evaluate the impact of renal impairment severity-dependent accumulation of indoxyl sulfate on hepatic CYP3A activity using metabolic markers. Methods: Sixty-six subjects were enrolled in this study; based on estimated glomerular filtration rate (eGFR), they were classified as having mild, moderate, or severe renal impairment. The plasma concentration of indoxyl sulfate was quantified using liquid chromatography-mass spectrometry (LC-MS). Urinary and plasma markers ($6{\beta}$-OH-cortisol/cortisol, $6{\beta}$-OH-cortisone/cortisone, $4{\beta}$-OH-cholesterol) for hepatic CYP3A activity were quantified using gas chromatography-mass spectrometry (GC-MS). The total plasma concentration of cholesterol was measured using the enzymatic colorimetric assay to calculate the $4{\beta}$-OH-cholesterol/cholesterol ratio. The correlation between variables was assessed using Pearson's correlation test. Results: There was a significant negative correlation between MDRD eGFR and indoxyl sulfate levels. The levels of urinary $6{\beta}$-OH-cortisol/cortisol and $6{\beta}$-OH-cortisone/cortisone as well as plasma $4{\beta}$-OH-cholesterol and $4{\beta}$-OH-cholesterol/cholesterol were not correlated with MDRD eGFR and the plasma concentration of indoxyl sulfate. Conclusion: Hepatic CYP3A activity may not be affected by renal impairment-induced accumulation of plasma indoxyl sulfate.

Neurotoxicity by Cefepime: Case-Control Study (Cefepime에 의해 발생한 신경독성에 관한 환자대조군연구)

  • Kang, Joong Koo;Kim, Soon Bae
    • Journal of Neurocritical Care
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    • v.7 no.2
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    • pp.104-110
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    • 2014
  • Background: Cefepime is a fourth-generation cephalosporin widely used for empiric treatment of severe infections. Neurotoxicity by cefepime have been reported due to γ-aminobutyric acid A receptor inhibition or other mechanisms. The aim of this study was to evaluate the risk factors for cefepime-induced neurotoxicity between group showing cefepime-induced neurotoxicity and group without neurotoxicity. Methods: From Jan 2005 to June 2010, a total of 2,461 patients (older than 20) who used cefepime were considered in this study. We compared patients who developed cefepime-induced neurotoxicity (patient group, n=21) to patients who had no cefepime-induced neurotoxicity (control group, n=31). We analyzed demographic, underlying diseases, and metabolic parameters before cefepime treatment and during cefepime treatment between the two groups. Statistical analysis was performed using SPSS 18 software. Results: Of the total 2461 patients, 21 (0.85%) were diagnosed with cefepime-induced neurotoxicity. Impaired glomerular filtration rate (GFR at 15-30 ml/min) before cefepime use were significantly (P<0.05) higher risk for developing cefepime-induced neurotoxicity in patient group compared to that in the control group. Age, sex, and other metabolic parameters except GFR before and during, usage of cefepime did not show any statistical difference between the two groups. Conclusion: The present study revealed that cefepime-induced neurotoxicity was prone to develop in patients with impaired renal function before cefepime usage.

Effects of Hwangryunhaedok-tang plus Yukmijihwang-tang add Chogudeung on Blood Pressure and Renal Function in Spontaneously Hypertensive Rats (황연해독탕 합 육미지황탕 가 조구등이 자발적 고혈압 백서의 혈압 및 현장 기능에 미치는 영향)

  • Sohn Eun Jin;Kang Dae Gill;Lee An Sook;Kim Bok Hae;Lee Ho Sub
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.359-364
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    • 2002
  • The present study examined the effects of water extract of Hwangruynhaedoktang plus Yukmijihwangtang add Chogudeung (HYC) on the blood pressure and renal function in spontaneously hypertensive rats (SHR). The HYC water extract blocked increase of systolic blood pressure (SBP) in SHR. The urinary volume (UV), sodium (UNaV), potassium (UkV), and chloride (UclV) excretions were significantly increased in SHR administered with high dose of water extract of HYC, but urinary osmolality was not changed. The creatinine clearance (Ccr), which is index of glomerular filtration rate (GFR), was increased by administration of HYC, while solute-free water reabsorption (TcH2O) was not changed. Taken together, these results suggest that the depressor effects of HYC, at least in part, caused by diuretic effect due to increase of glomerular filtration rate.

Cancer Survivors Aged 40 Years or Elder are Associated with High Risk of Chronic Kidney Disease: The 2010-2012 Korean National Health and Nutrition Examination Survey

  • Shin, Hyun-Young;Linton, John A.;Shim, Jae-Yong;Kang, Hee-Taik
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1355-1360
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    • 2015
  • Background: The number of cancer survivors is increasing globally and recently, higher rates of comorbidities in cancer survivors have been reported. However, no studies have investigated whether cancer survivors have a higher risk of chronic kidney disease (CKD). Accordingly, our study evaluated the association between cancer survivors and the risk of CKD using the 2010-2012 Korean National Health and Nutrition Examination Survey. Materials and Methods: A total of 11,407 participants aged 40 years and over were categorized into two groups according to cancer experience. Multiple variables were compared and the odds ratios (ORs) for CKD prevalence were calculated using a weighted logistic regression analysis between the two groups. Results: Cancer survivors were older than were those in the non-cancer group, on average, the percentages of glomerular filtration rate(GFR) lower than $60mL/min/1.73m^2$, proteinuria, and CKD were significantly higher in cancer survivors when compared to controls. Weighted logistic regression analyses demonstrated that cancer survivors had a higher risk for CKD after adjusting for multiple variables (OR (95% confidence interval), 2.88 (1.48-5.59)). Conclusions: Our study demonstrated a possible association between CKD and cancer survival in Korean adults. Identifying and correcting risk factors for cancer survivors would positively affect prevention of CKD and result in a better cancer prognosis.

Comparative study of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional hilar control, laparoscopic partial nephrectomy (HCLPN) for renal tumors: One-year follow-up results of renal function change

  • Kang, Su Hwan;Rhew, Hyun Yul;Kim, Taek Sang
    • Kosin Medical Journal
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    • v.33 no.2
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    • pp.191-199
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    • 2018
  • Objectives: We designed the study to compare the oncologic and renal function outcomes of off-clamp, laparoscopic partial nephrectomy (OCLPN) and conventional laparoscopic partial nephrectomy (HCLPN) for renal tumors. Methods: Between March 2008 and July 2015, 114 patients who underwent laparoscopic partial nephrectomy (LPN) of a renal neoplasm were studied. We performed LPN without hilar clamp on 40 patients (OCLPN, Group 1), and conventional LPN with hilar control and renorrhaphy on another 40 patients (HCLPN, Group 2). We retrospectively reviewed the medical records of each patient's age, sex, R.E.N.A.L. nephrometry score (RNS), operation time, complications, hospitalization period, tumor size, positive resection margin, histologic classification of tumor, pathologic stage, Fuhrman grade, estimated blood loss (EBL), warm ischemic time (WIT), and estimated glomerular filtration rate (eGFR) before and one year after surgery. Results: There were no significant differences in age, sex, preoperative eGFR, EBL, surgical (anesthesia) time, and tumor size between the two groups. The mean eGFR was not significantly different between the OCLPN and HCLPN groups 1 month (95 and $86.2mL/min/1.73m^2$, respectively; P = 0.106), 6 months (92.9 and $83.6mL/min/1.73m^2$, respectively; P = 0.151) and 12 months (93.8 and $84.7mL/min/1.73m^2$, respectively; P = 0.077) postoperatively. The change in eGFR after one year was 3.9% in the OCLPN group and -7.9% in the HCLPN group. Conclusions: OCLPN was superior to HCLPN in preserving renal function one year after surgery, and there was no statistically significant difference in tumor treatment results.

Effect of Yohimbine on the Renal Action of Clonidine in Dog (Clonidine의 개 신장작용에 대한 Yohimbine의 영향)

  • Ko, Suk-Tai;Choe, In
    • Biomolecules & Therapeutics
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    • v.1 no.2
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    • pp.151-159
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    • 1993
  • Effect of yohimbine, a specific antagonist for presynaptic adrenoceptor, on the renal action of clonidine, a specific presynaptic adrenoceptor agonist, was investigated in dog. Clonidine, when given intravenously, produced diuretic action accompanied with augmentation of osmolar and free water clearance (Cosm and 4C_{H_2O}$), and elicited the increase of amounts of sodium and potassium excreted in urine ($E_{Na}\; and\; E_k$). These actions of clonidine were inhibited by yohimbine either injected intravenously or infused into a renal artery. Clonidine, when infused into a renal artery, produced antidiuretic action accompanied with decreased of glomerular filtration rate (GFR) and renal plasma flow (RPF), and exhibited the reduced amounts of sodium and potassium in urine. These actions of clonidine injected into a renal artery were blocked by yohimbine administered either into vein or into a renal artery. Above results suggest that yohimbine block the renal action of clonidine only in central system, do not in kidney.

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End Stage Renal Disease caused by IgA Nephropathy : One Case Report (IgA 신증에 의한 말기 신질환에 대한 증례보고)

  • Jeong, Jong Jin;Sun, Seung Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.6
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    • pp.823-826
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    • 2013
  • This case is to report the effect of renal function of chronic kidney disease(CKD) caused by IgA nephropathy. A 37-year-old man visited a Korean medicine hospital, who has been diagnosed with end stage renal disease(ESRD), 5 stage of CKD, caused by IgA nephropathy, has had no improvement of western medical treatment, and wanted to be treated using Korean medicine before renal transplantation. The decrease of creatinine value, the increase of glomerular filtration rate(GFR), and the decrease of CKD stage (5 to 4) was observed after combination treatment of Ikkigeonbiisuhwalhyeoltang and saam acupuncture was applied. This case report is suggested that combination treatment of acupuncture and herbal medicine could be effective to renal function of CKD in spite of a single case.

Acute Kidney Injury in the Newborn: Etiology, Pathophysiology and Diagnosis (신생아의 급성신손상)

  • Kim, So-Young
    • Neonatal Medicine
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    • v.17 no.2
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    • pp.161-167
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    • 2010
  • Acute kidney injury (AKI), formerly referred to as acute renal failure (ARF) is defined as the sudden impairment of kidney function (estimated from the glomerular filtration rate [GFR]) that results in the lack of excretion of waste products. More than 30 definitions of AKI exist in the literature, most of which are based on serum creatinine. Lack of a uniform and multidimensional AKI definition has led to failure to recognize significant renal injury, delays in treatment, and inability to generalize single-study results. The RIFLE criteria were developed to standardize the diagnosis of ARF and in the process the term AKI has been proposed to encompass the entire spectrum of the syndrome from minor changes in renal function to requirement for renal replacement therapy. Large prospective studies are needed to test definitions and to better understand risk factors, incidence, independent outcomes, and mechanisms that lead to poor short- and long-term outcomes. Early biomarkers of AKI need to be explored in critically ill neonates.

Effects of Jeo Ryong-tang water Extract on Renal Function in Rabbit and Dog (저령탕전탕액(猪令湯煎湯液)이 가토(家兎) 및 개의 신장기능(腎臟機能)에 미치는 영향(影響))

  • Jo, Sang-Seop
    • Journal of Sasang Constitutional Medicine
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    • v.2 no.1
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    • pp.213-221
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    • 1990
  • Effect of Jeo Ryong-Tang water Extract on Renal Function in Rabbit and Dog. In order to investigate the Pharmacological action of Jeo Ryoung-Tang on renal function, this study was performed in rabbit and dog, making use of it's water extract. Jeo Ryoung-Tang water extract (JRWE), when given into ear vein of rabbits, produced diuresis in a small dose, but antidiuresis in a large dose. Diuretic action of JRWE accompanied the increase of glomerular filtration rate (GFR), renal plasma flow (RPF) and amounts of $Na^+$ in exdreated in urin, but fractional excretion of filtered $Na^+$ was not changed. JRWE, when injected into proleg's vein of dog, produced diuresis, At this time, changes of renal function were similar to that of diuresis in rabbit. JRWE, when infused into a renal artery of dog, exhibited the diuresis in both kidney. It is thought that JRWE, when given into vein of rabbit or dog, induces the diuresis, and the mechanism of it's diuresis is the increase of renal plasma flow through secondary action by some endogenous humoural substance.

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