• Title/Summary/Keyword: renal Failure

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A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure (급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예)

  • Kim, Seok-Min;Chang, Kyung-Ae;Jung, Sun-Young;Park, Chan-Soh;Park, Jong-Won;Do, Jun-Young;Kim, Yong-Jin;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.58-63
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    • 2008
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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Pathological evaluation of renal changes induced by multiple nephropathogenic factors in SPF chickens II. Clinicopathological observation (신부전 요인에 의해 유발된 닭 신장변화의 병리학적 관찰 II. 임상병리학적 관찰)

  • Kang, Kyung-il;Mo, In-pil;Kwon, Yong-kuk;Kang, Min-su;Hahn, Tae-wook;Han, Jeong-hee
    • Korean Journal of Veterinary Research
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    • v.39 no.6
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    • pp.1141-1150
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    • 1999
  • Renal failure is one of the main causes of economic impacts in the poultry industry and complex syndrome with different severity of clinical signs caused by multiple nephropathogenic factors such as infectious bronchitis viral infection and excess salt and calcium in diet. To evaluate the correlation between severity of renal failure and the causative nephropathogenic factors, one-day-old specific pathogen free chickens were treated with either single causative factor or multiple causative factors described as above. Each group was designed as control for non-treated control, IB for infectious bronchitis virus (IB virus) infection, IBHNa for IB virus infection with high diet salt, IBHCa for IB virus infection with high diet calcium, IBHNC for IB virus infection with high diet salt and calcium, HNa for high diet salt, HCa for high diet calcium and HNC for high diet salt and calcium. Chickens were inoculated with IB virus at 1-day-old and remained on their respective diets until 21 day of age. Plasma $Na^+$, $Cl^-$, BUN, creatinine, calcium and uric acid values were examined. The results obtained were as follows ; IB virus and high dietary calcium combined treatment showed elevated plasma uric acid. BUN and creatinine values were not characteristic on chicken renal failure. But plasma uric acid values were increased according to renal lesion. Hypercalcemia and hyperuricemia did not induce urate deposition and mineralization in the kidney.

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Vascular Augmentation in Renal Transplantation: Supercharging and Turbocharging

  • Jeong, Euicheol C.;Hwang, Seung Hwan;Eo, Su Rak
    • Archives of Plastic Surgery
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    • v.44 no.3
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    • pp.238-242
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    • 2017
  • The most common anatomic variant seen in donor kidneys for renal transplantation is the presence of multiple renal arteries, which can cause an increased risk of complications. Accessory renal arteries should be anastomosed to the proper source arteries to improve renal perfusion via the appropriate vascular reconstruction techniques. In microsurgery, 2 kinds of vascular augmentation methods, known as 'supercharging' and 'turbocharging,' have been introduced to ensure vascular perfusion in the transferred flap. Supercharging uses a distant source of the vessels, while turbocharging uses vascular sources within the same flap territory. These technical concepts can also be applied in renal transplantation, and in this report, we describe 2 patients who underwent procedures using supercharging and turbocharging. In one case, the ipsilateral deep inferior epigastric artery was transposed to the accessory renal artery (supercharging), and in the other case, the accessory renal artery was anastomosed to the corresponding main renal artery with a vascular graft (turbocharging). The transplanted kidneys showed good perfusion and proper function. No cases of renal failure, hypertension, rejection, or urologic complications were observed. These microsurgical techniques can be safely utilized for renal transplantation with donor kidneys that have multiple arteries with a lower complication rate and better outcome.

A Contrast Nephropathy in a Preterm Infant Following Preoperative Embolization of Giant Sacrococcygeal Teratoma

  • Lee, Byong Sop
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.26-30
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    • 2017
  • Newborn infants with huge and highly vascular sacrococcygeal teratoma (SCT) are frequently subjected to renal hypoperfusion secondary to high-output cardiac failure. Any underlying renal dysfunction is a significant risk factor for the development of contrast-induced nephropathy (CIN). However, reports on CIN in infants are rare. I report here a case of a premature infant born at 28 weeks and 3 days of gestation with a huge SCT who survived preoperative embolization and surgical resection but presented with persistent non-oliguric renal failure that was suggestive of CIN. During radiological intervention, a contrast medium had been administered at about 10 times the manufacturer-recommended dose for pediatric patients. Despite hemodynamic stabilization and normalization of urine output immediately following surgery, the patient's serum creatinine and cystatin-C levels did not return to baseline until 4 months after birth. No signs of reflux nephropathy were observed in follow-up imaging studies. Dosing guidelines for the use of a contrast medium in radiological interventions should be provided for infants or young patients.

A Case of Hinman Syndrome Complicated by Chronic Renal Failure (만성 신부전을 초래한 Hinman 증후군 1례)

  • Lee Gyeong-Hoon;Lee Eun-Sil;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.2 no.1
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    • pp.90-94
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    • 1998
  • Hinman syndrome is a condition representing urinary voiding dysfunction in the neurologically intact child. The syndrome is probably caused by acquired behavioral and psychosocial disorders manifested by bladder and/or bowel dysfunction mimicking neurologic disease. Clinically, the symptom complex may include day and night time enuresis, encopresis, constipation, and recurrent urinary tract infections. Cystoscopy frequently demonstrates normal vesicourethral anatomy. Voiding films usually demonstarate a carrot-shaped proximal urethra with a persistent narrowing at the external sphincter. The bladder is large and often appears trabeculated with a thickened wall and significant postvoid residual. A 13-year-old male child was admitted due to fever, urinary tract infection, enuresis and flank pain. His neurologic examination was normal. Renal sonograms showed moderate hydronephrosis. Voiding cystourethrograms showed a huge, trabeculated bladder without vesicourethral reflux and urethral valves. No abnormal findings was found in spinal MRI.

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Growth Retardation in Chronic Renal Failure : Pathophysiology and Therapy

  • 김영미
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.11a
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    • pp.85-89
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    • 1996
  • 성장저해는 만성신부전 (chronic renal failure, CRF) 소아환자나 실험동물에게서 나타나는 합병증의 하나로, 그 발생기전이 잘 알려져 있지 않다. 성장저해를 일으키는 원인으로 비내분비적 요인 (metabolic acidosis, renal osteodystrophy, anemia)과 내분비적 요인의 복합적 결과로 생각하나, 비내분비적 요인들은 약물투여로 그 증세를 완화시켜도 성장저해에 대한 궁극적 치료효과는 나타나지 않는다. 따라서 성장 호르몬 (Growth Hormone, GH)이 관여하는 내분비적 요인의 변화에 그 병리기전이 있을 것으로 연구되어 왔다. GH는 직접적 성장 효과와 Insulin-like growth factor-1(IGF-I)을 간으로부터 유리시켜 나타나는 간접적 성장효과를 가지고 있다. 그런데 CRF환자의 GH 및 IGF-I 의 혈중 농도는 정상이거나, 흑은 오히려 증가상태에 있음에도 볼구하고 성장저해가 일어나는 것으로 보아, 환자의 말단기관 (end-organ)에 원인을 알 수 없는 저항성 (resistance)이 있다고 규정되어진다.

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Risk Factors of Acute Renal Failure after Colorectal Surgery (대장수술 후에 발생한 급성신부전의 위험인자)

  • Lee, Hae-Mi;Hwang, Chang-Jae;Kim, Jae-Hwang;Kim, Heung-Dae;Park, Dae-Pal;Seo, Il-Suk;Song, Sun-Ok;Kim, Sae-Yeon;Lee, Deuk-Hee;Jee, Dae-Lim
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.275-286
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    • 2007
  • Background : Acute renal failure is one of the leading causes of postoperative morbidity and mortality. The purpose of this study was to determine the risk factors that are associated with acute renal failure after colorectal surgery. Materials and Methods : Five hundred seventy patients who operated colorectal surgery at the Yeungnam University Medical Center over three years from 2004 to 2006 were enrolled in this study. The effects of gender, age, ASA classification, concomitant disease, surgery type and duration, reoperation, urogenital manipulation, medication, hypotension, hypovolemia, transfusion, and postoperative ventilatory care on the occurrence of acute renal failure after colorectal surgery were studied. Results : The major risk factors of acute renal failure after colorectal surgery were age of patients (P=0.003), ASA classification (P<0.001), concomitant disease (P<0.001), duration of the time surgery (P=0.034), reoperation (P=0.001), use of intraoperative diuretics (P=0.005), use of postoperative diuretics (P<0.001), intraoperative hypotension (P=0.018), intraoperative transfusion (P<0.001), postoperative transfusion (P<0.001), and postoperative ventilatory care (P=0.001). Conclusion : Multiple factors cause synergistic effects on the development of acute renal failure after colorectal surgery. Therefore, efforts to reduce the risk factors associated with acute renal failure are needed. In addition, intensive postoperative care should be provided to all patients.

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Mechanisms of Russell's Viper Venom Toxicity on Renal Function; Reversal by Antivenom

  • Chaiyabutr, Narongsak;Napathorn, Sophon;Sitprija, Visith
    • Toxicological Research
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    • v.17
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    • pp.117-125
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    • 2001
  • Envenoming by Russells viper causes a broad spectrum of renal impairment. Renal failure is an important complication in patients bitten by Russells viper. Experimental work in animals and in vitro has elucidated pathophysiological mechanisms that contribute to life threatening complications and have suggested possibilities for therapeutic intervention. The evidence in experimental animals regarding mechanisms of venom action in relation to changes in either extrarenal or intrarenal factors is presented. The cardiovascular system and renal hemodynamics are affected by venom. Reductions of renal function including renal hemodynamics are associated directly with changes in general circulation during envenomation. Possible endogenous mechanisms for releasing the hormone inducing renal vasoconstriction after envenomation are evident. Hormonal factor such as the catecholamine, prostaglandin and renin angiotensin systems induce these changes. Direct nephrotoxicity of venom action is studied in the isolated per-fused kidney. Characteristic polarization of the cell membrane, changes of mitochondrial activity and Na-K ATPase in renal tubular cells are observed. Changes in renal function and the cardiovascular system are observed of ter envenomation and are reversed by the administration of Russells viper antivenom (purified equine immunoglobulin, $Fab_2$ fragment). The neutralizing effects are more efficient when the intravenous injection of antivenom is given within 30 min after the envenomation.

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Serum Levels of CA15-3, AFP, CA19-9 and CEA Tumor Markers in Cancer Care and Treatment of Patients with Impaired Renal Function on Hemodialysis

  • Estakhri, Rasoul;Ghahramanzade, Ali;Vahedi, Amir;Nourazarian, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1597-1599
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    • 2013
  • Since renal failure causes decrease in tumor marker excretion, use of these markers in cancer care and treatment in patients with renal insufficiency or hemodialysis is controversial. The aim of this study was to investigate differences of serum levels of tumor markers CA15-3, AFP, CA19-9 and CEA in patients with impaired renal function. A total of 100 patients referred to the Tabriz Immam Reza and Amiralmomenin hospital from June 2010 to November 2011 were selected for study. Subjects were divided to 3 groups of healthy, dialysis and renal failure but non hemodialysis cases, the last category being re-grouped based on creatinine clearance. No significant relationship between different groups in serum levels of CEA (P=0.99) and CA19-9 (P=0.29) tumor markers was found. A significant correlation was observed between serum levels of AFP (P<0.001) and CA15-3 (P<0.001) and also a tendency between creatinine clearance and CEA (r=0.05, P=0.625). Creatinine clearance significantly correlated with AFP (P<0.001, r=0.53) and CA15-3 (p=0.00, r=-0.412), but not CA19-9 (P=0.089, r=-0.171). According to results of this study it appears that use of tumor markers in patients with impaired renal function should be performed with special precautions.

The Potential of Renal Progenitor Cells in Kidney Diseases: Preclinical Findings

  • Jo, Jeong Hyun;Kim, Ki Hoon;Kim, Tae Min
    • Journal of Animal Reproduction and Biotechnology
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    • v.34 no.2
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    • pp.70-74
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    • 2019
  • The kidney is a highly complex organ, and acute or chronic renal diseases can occur with various complications such as diabetes and hypertension. So far, no target specific treatment is available in acute or chronic renal failure, necessitating the development of alternative therapeutic strategy. Recent experimental findings suggest that the renal function and structure can be restored after being treated with various sources of stem/progenitor cells. In this review, we discuss up-to-date findings of the potential of renal progenitor/stem cells in alleviating renal injuries with a focus on preclinical studies. We also review cellular mechanisms underlying the therapeutic function of these cells.