• Title/Summary/Keyword: improvement of renal function

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Effect of Hemodialysis on Left and Right Ventricular Volume and Function (말기신질환에서 혈액투석에 따르는 좌우심실용적 및 기능변화에 관한 연구)

  • Han, Jin-Suk;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.19 no.2
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    • pp.43-50
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    • 1985
  • With the improvement of hemodialysis, the course of the disease in patient with endstage renal disease has been clearly improved. Nevertheless, among several shortcomings to our present mode of renal replacement therapy, cardiovascular complications have been the leading cause of morbidity and mortality. Several factors such as anemia, arteriovenous shunting of blood, intermittent extracorporeal circulation and hypertension may be contributing. But little is known about the quantitative cardiac hemodynamic characteristics occurred during hemodialysis. The purpose of this study is to observe the sequential hemodynamic changes before, during and after the hemodialysis and to investigate reliable parameters in the detection of ventricular dysfunction. In the present study, equilibrium radionuclide cardiac angiography was performed and left and right ventricular volume indices, ejection phase indices of both ventricular, performance were measured in the 16 stable patients with chronic renal failure treated with maintenance hemodialysis sequentially i.e. before, during (early and late phase) and after the hemodialysis. The results obtained were as follows; 1) The indices of the left ventricular function were not changed during the hemodialysis but increased after the hemodialysis. 2) The indices of the right ventricular function(EF, SVI) were significantly decreased in the early phase (15, 30 minutes after starting extracorporeal circulation) but recovered after the hemodialysis. 3) The ratio of right ventricular to left ventricular ejection fraction was significantly decreased in the early phase and the lung volume indices were significantly increased at the same phase. As a conclusion, hemodialysis improves left ventricular function maybe due to increased contractility, and effects on the right ventricular function maybe due to the increased lung volume in the early phase of hemodialysis.

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Balloon Angioplasty in a Pediatric Renal Artery Occlusion (소아 신장 동맥 폐색에서의 풍선 혈관성형술)

  • Song, Hwayoung;Jung, Hye Doo;Kim, Jeong-Eun;Lee, Sang Min;Hong, Wonju;Lee, Kwanseop
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.332-336
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    • 2018
  • Renal artery injury is a rare complication in blunt trauma, but can cause devascularization of the kidney, leading to renal failure. It requires early diagnosis and management. The treatment of renal artery injury still remains controversial, but recent studies have reported the successful treatment outcome with endovascular stent placement. Nevertheless, there is no standard treatment strategy in cases of pediatric patients. We report a case of a 16-year-old girl with right renal artery occlusion associated with a grade IV liver laceration. She was treated with only balloon angioplasty, and the kidney showed marked improvement of parenchymal perfusion with normalized renal function. Treatment with only balloon angioplasty can be a treatment option in pediatric patients with renal artery injury.

The Role of Initial Relative Renal Function in Unilateral Hydronephrosis (일측 폐색성 및 역류성 수신증에서 술전 상대적 신기능의 의미)

  • Han Sang-Won;Kang Seon-Jung;Kwon Min-Jung;Kim Dae-Joong;Choi Seung-Kang;Lee Tack
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.203-208
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    • 1999
  • Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.

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Effect of Weight Loss and Improvement of Liver Function through Korean Medicinal Treatment: Case Report (한약치료의 체중 감량 효과와 간기능 개선: 증례보고)

  • Sejin Kim;Changhyun Ko
    • Journal of Korean Medicine for Obesity Research
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    • v.22 no.2
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    • pp.167-172
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    • 2022
  • Obesity is known as the most common risk factor for non-alcoholic fatty liver disease. Weight loss is needed to prevent liver function damage from progressing to non-alcoholic hepatosteatosis (NASH) and NASH-related liver cirrhosis. The purpose of this study was to observe the recovery of liver function in obese patients with liver dysfunction through traditional Korean obesity treatment. Body weight, liver function levels and renal function levels were examined by prescribing traditional Korean medicine in obese patients with mild elevation of liver function test. Blood tests were conducted at intervals of one month, and it was observed that liver function recovered to the normal range in three patients.

Acute decompensated heart failure and acute kidney injury due to bilateral renal artery stenosis (양측성 신동맥 협착증에서 발생한 급성 비대상성 심부전과 급성 신손상)

  • Jung, Ho Jin;Choi, Won Suk;Kang, Hyun Jae;Jung, Byung Chun;Lee, Bong Ryeol;Lee, Jong Joo;Lee, Jun-Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.146-151
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    • 2015
  • Atherosclerotic renal artery stenosis (RAS) may result in hypertension, azotemia, and acute pulmonary edema. We report on a renal angioplasty with stent placement for bilateral RAS in a patient with acute decompensated heart failure and acute kidney injury. A 67-year-old female patient was admitted to our hospital with acute shortness of breath and generalized edema. Echocardiography showed left ventricular wall motion abnormality and the follow up electrocardiography showed T wave inversion in the precordial leads. We performed a coronary angiography to differentiate ischemic heart disease from non-cardiac origin for the cause of the heart failure. The coronary angiography showed no significant luminal narrowing, but bilateral RAS was confirmed on the renal artery angiography, therefore, we performed renal artery revascularization. After the procedure, the pulmonary edema was improved and the serum creatinine was decreased. Two weeks later, an echocardiography showed improvement of the left ventricular systolic function.

The Effect of Theophylline on Improvement of Renal Function in Asphyxiated Neonates: A Systematic Review and Meta-analysis (주산기 가사가 있는 신생아에서 theophylline의 신기능 개선 효과에 대한 체계적 문헌고찰 및 메타분석)

  • Lee, Joo Won;Lee, So Yeon;An, Sook Hee
    • Korean Journal of Clinical Pharmacy
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    • v.29 no.2
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    • pp.115-124
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    • 2019
  • The purpose of this systematic review and meta-analysis was to assess the preventive effect of theophylline on acute kidney injury and the ameliorative effect of theophylline on renal function in asphyxiated neonates. A literature search of the PubMed/Medline, Embase, and Cochrane Library databases for information published up to February 2019 was conducted. All studies that reported the incidence rate of acute kidney injury, serum creatinine level, and glomerular filtration rate after the randomized administration of theophylline or placebo were included. In total, eight studies involving 498 neonates were eligible. The incidence rate of acute kidney injury was significantly lower in the theophylline group than in the placebo group (risk ratio [RR]: 0.42, 95% confidence interval [CI]: 0.32-0.55, p < 0.001). The changes in serum creatinine level in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 and 5 days of age (weighted mean difference [WMD]: -0.51, 95% CI: -0.62 to -0.40, p < 0.001, and WMD: -0.26, 95% CI: -0.34 to -0.18, p < 0.001, respectively). The changes in glomerular filtration rate in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 days of age and the last day of follow-up (WMD: 12.30, 95% CI: 9.39-15.21, p < 0.001, and WMD: 9.35, 95% CI: 6.43-12.27, p < 0.001, respectively). These results suggested that theophylline has a beneficial effect on the prevention of acute kidney injury in neonates with perinatal asphyxia.

Diagnostic Criteria of $^{99m}Tc$-diethylenetriaminepentaacetic acid Captopril Renal Scan for the Diagnosis of Renovascular Hypertension by Unilateral Renal Artery Stenosis ($^{99m}Tc$-diethylenetriaminepentaacetic acid 캅토프릴 신장스캔의 단측 신동맥 협착에 의한 신혈관성고혈압 진단 기준)

  • Choi, Seung-Jin;Hong, Il-Ki;Chang, Jae-Won;Park, Su-Kil;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.498-505
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    • 2004
  • Purpose: We compared captopril renal scintigraphic criteria for the diagnosis of renovascular hypertension by unilateral renal artery stenosis. Materials and Methods: The study group consisted of 24 patients (m/f : 16/8, age: $39{\pm}18$ years) with unilateral renal artery stenosis who underwent renal artery revascularization and captopril renal scintigraphy with $^{99m}Tc$-diethylenetriaminepentaacetic acid between May 1995 and April 2004. The blood pressure response was classified as cure/improvement or failure. We evaluated captopril-induced changes in relative function (BCfun) and renogram grade (0 to 5: 0=normal, and 5=renal failure pattern without measurable uptake) (CBren) and the difference of renograms between the normal and stenotic kidney on captopril scan (CNren). Results: light of 24 patients were cured and 11 improved and 5 patients were classified as failed revascularization. Significant predictors of a cure or improvement of blood pressure were younger age, stenosis by fibromuscular dysplasia or arteritis, BCfun, CBren and CNren. Areas under the receiver operating characteristic curve of age, BCfun, CBren and CNren were not significantly different. Positive and negative predictive values of predictors were 100% and 42% (age ${\leq}38$): 92% and 50% (BCfun ${\geq}1%$): 92% and 75% (CBren ${\geq}1$), and 90% and 60% (CNren ${\geq}1$), respectively. Conclusion: Captopril induced changes in renal function and renogram can reliably predict hypertension response to revascularization. Renogram pattern on captopril scan can diagnose renovascular hypertension without baseline data in patients with unilateral renal artery stenosis.

Protective Effects of Houttuynia cordata Thunb. on Gentamicin-induced Oxidative Stress and Nephrotoxicity in Rats

  • Kang, Changgeun;Lee, Hyungkyoung;Hah, Do-Yun;Heo, Jung Ho;Kim, Chung Hui;Kim, Euikyung;Kim, Jong Shu
    • Toxicological Research
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    • v.29 no.1
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    • pp.61-67
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    • 2013
  • Development of a therapy providing protection from, or reversing gentamicin-sulfate (GS)-induced oxidative stress and nephrotoxicity would be of great clinical significance. The present study was designed to investigate the protective effects of Houttuynia cordata Thunb. (HC) against gentamicin sulfate-induced renal damage in rats. Twenty-eight Sprague-Dawley rats were divided into 4 equal groups as follows: group 1, control; group 2, GS 100 mg/kg/d, intraperitoneal (i.p.) injection; group 3, GS 100 mg/kg/d, i.p. + HC 500 mg/kg/d, oral; and group 4, GS 100 mg/kg/d i.p. + HC 1000 mg/kg/d, oral administration). Treatments were administered once daily for 12 d. After 12 d, biochemical and histopathological analyses were conducted to evaluate oxidative stress and renal nephrotoxicity. Serum levels of creatinine, malondialdehyde (MDA), and blood urea nitrogen (BUN), together with renal levels of MDA, glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) were quantified to evaluate antioxidant activity. Animals treated with GS alone showed a significant increase in serum levels of creatinine, BUN, and MDA, with decreased renal levels of GSH, SOD, and CAT. Treatment of rats with HC showed significant improvement in renal function, presumably as a result of decreased biochemical indices and oxidative stress parameters associated with GS-induced nephrotoxicity. Histopathological examination of the rat kidneys confirmed these observations. Therefore, the novel natural antioxidant HC may protect against GSinduced nephrotoxicity and oxidative stress in rats.

Evaluation of Pharmacist Intervention Program for Dosage Adjustment and IV-to-PO Conversion for $H_2$-Receptor Antagonist (신기능을 고려한 $H_2$-receptor antagonist의 용량, 용법 및 투여경로의 적절성 및 약사자문의 수용성)

  • Hwang, Bo Young;Oh, Jung Mi
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.230-240
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    • 2002
  • Background : The purpose of this study was to develop, implement and evaluate the pharmacist intervention program designed to identify and correctly adjust the dosage of $H_2$-receptor antagonists ($H_2RA$) in renally impaired patients and promote timely conversion of $H_2RA$ from IV to PO therapy. Methods : The study population consisted of renally impaired patients who received $H_2RA$ therapy from April 9 to May 8, 2001 at Hallym Medical Center. Each morning a specifically developed software program identified patients with serum creatinine (Scr) greater than 1.2 mg/dl or age greater than 65 years. The pharmacist, then screened the pharmacy profiles of the identified patients to determine if the patient was on $H_2RA$. For these patients on $H_2RA$ with renal impairement the creatinine clearance (CrCl) was calculated using Cockroft & Gault equation. The pharmacist determined the proper dosage for each identified patients based on the calculated CrCl and the oral dosage that would be appropriate for whom IV therapy was no longer indicated. Result : A total of 149 cases (101 patients) were monitored during the study period. The dosage was inappropriately prescribed for renal function in 61 of 149 cases (41%), and of those, pharmacist made recommendations for 58 cases of which 33 cases (57%) were accepted by the physicians. The administration route of H2RA was inappropriately used as IV in 22 of 53 cases (42%), and pharmacist made recommendations for those 22 cases of which 15 cases (68%) were accepted. Conclusion : Monitoring of patients with renal dysfunction by a pharmacist improved the dosing of $H_2RA$ and a dosing program of patients with renal impairment would be of benefit to other clinicians and institutions seeking to optimize patient care.

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Beneficial effects of Paeo-tang on cardiovascular and renal function in L-NAME-induced hypertensive rats (파어탕의 L-NAME 유도 고혈압 동물군에서의 혈압강하효과 및 심신기능 개선 효과)

  • Na, Se Won;Hong, Mi Hyeon;Kim, Hye Yoom;Jang, Youn Jae;Yoon, Jung Joo;Lee, Yun Jung;Kang, Dae Gill;Lee, Ho Sub
    • Herbal Formula Science
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    • v.28 no.3
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    • pp.271-280
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    • 2020
  • Hypertension has been approved to cause disharmony between the heart and kidney such as cardiac hypertrophy and kidney dysfunction. In traditional oriental medicine Paeo-tang (PET) has been shown to have effects on blood circulation improvement. However, the beneficial effect of PET on hypertension remains unknown. In this study, we investigated that PET attenuates blood pressure and improves cardiovascular and renal function in NG-nitro-L-arginine methylester (L-NAME) rat model. Hypertensive rat models were induced by the administration of L-NAME (40 mg/kg/day) and then PET (50 or 100 mg/kg/day) or Olmetec was treated for 2 weeks. PET treatment significantly suppressed the systolic blood pressure and decreased intima-media thickness in the thoracic aorta. PET ameliorated endothelium-dependent and independent vascular relaxation in the L-NAME-induced vascular dysfunction. PET ameliorated the functional decline in the kidney such as albumin and blood urea nitrogen in plasma. These results demonstrated that PET possesses protective effects against L-NAME-induced hypertension.