• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.85-89
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• 2015

Background: We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin. Methods: From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was $6.4{\pm}4.2weeks$. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night). Results: The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed. Conclusion: Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.430-435
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• 2007

Even though we drink and excrete water without recognition, the amount and the composition of body fluid remain constant everyday. Maintenance of a normal osmolality is under the control of water balance which is regulated by vasopressin despite sodium concentration is the dominant determinant of plasma osmolality. The increased plasma osmolality (hypernatremia) can be normalized by the concentration of urine, which is the other way of gaining free water than drinking water, while the low plasma osmolality (hyponatremia) can be normalized by the dilution of urine which is the only regulated way of free water excretion. On the other hand, volume status depends on the control of sodium balance which is regulated mainly by renin-angiotensin-aldosterone system, through which volume depletion can be restored by enhancing sodium retention and concomitant water reabsorption. This review focuses on the urine concentration and dilution mechanism mediated by vasopressin and the associated disorders; diabetes insipidus and syndrome of inappropriate antidiuretic hormone secretion.

• 한국동물위생학회지
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• 제45권2호
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• pp.139-143
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• 2022

A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.

• 대한한의학회지
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• 제21권1호
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• pp.99-102
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• 2000

Central diabetes insipidus(CDI) results from deficient vasopressin(antidiuretic hormone) secretion and causes polydipsia and polyuria. Its etiologic diagnosis is confirmed with an increase of urine osmolality by administering desmopressin(DDAVP) after water restriction. Because cm is caused by deficiency of vasopressin, up to now, desmopressin, a synthetic analog of vasopressin, has been the drug of choice in the treatment of CDI. However, under such treatment, CDI patients suffer from the continual administration of DDAVP throughout one's life and high cost of the treatment We administrated oriental herb medicine on a cm patient in a state of discontinuance of DDAVP. Prior to the study, brain sella MRI was scanned to exclude germinoma. In addition, urine analysis, serum and urinary osmolality, daily urinary volume, serum electrolyte levels were measured. Chungsimyunjatang was administered for 15 days, and urine analysis, urine osmolality, daily urinary volume, serum Na were measured several times again during the therapy, As a result, urinary frequency increased, serum Na slightly elevated, but specific gravity of urine, urinary osmolality severely decreased and daily urinary volume substantially increased. However, the frequency of DDAVP treatment was reduced from four times per day to once or twice a day with the continual administration of the Chungsimyunja-tang for two months after the discharge.

• Childhood Kidney Diseases
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• 제4권1호
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• pp.6-10
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• 2000

목 적 : 출생 후 며칠간의 신생아의 creatinine수치는 모체의 영향을 받으므로 소변의 creatinine을 상수로 용질 배설 측정을 하는 것은 의미가 없을 수도 있다는 보고가 있어, 저자들은 신생아에서 일정한 간격으로 측정된 소변 creatinine이 차이가 있는가에 대하여 연구를 시행하게 되었다. 방 법 : 1998년 7월부터 8월까지 출생한 건강한 신생아를 대상으로 하여 두 번의 소변을 측정하였으며, 대조군으로는 그 기간 동안 입원한 소아과 병동의 환아를 대상으로 하였다. 신생아군은 49명이고 대조군은 33명이었으며, 신생아군의 첫 소변은 출생 첫날 시행하였고 비교군의 첫 소변시 나이는 $5.7{\pm}4.3$세였다. 신생아군과 대조군에서 처음과 두 번째 소변간의 간격은 2-3일이었다. 통계분석은 sigmastat 2.0을 사용하여 단순 선형 회귀 분석, t-test, paired t-test를 이용하였다. 결 과 : Creatinine mg/dL(Mean${\pm}$SD)은 첫 소변, 두 번째 소변에서 각각 신생아군은 $32.5{\pm}29,\;29.2{\pm}23$이고 대조군은 $57.7{\pm}51,\;58.8{\pm}51$으로 두 군 모두 첫 소변과 두 번째 소변의 소변 creatinine치는 차이가 없으며, 두 군간의 평균치의 비교분석은 유의한 차이를 보였다(P<0.01). 첫 소변과 두 번째 소변간의 creatinine평균치의 상관성에서 신생아군은 r=0.504(P<0.001)이고 대조군은 r=0.631(P<0.001)이었으며, creatinine/osmolality로 보정 후에도 각각 상관계수 0.506(P<0.001), 0.386(P<0.001)으로 유의한 상관관계를 보였다. 결 론 :신생아의 첫 소변과 두 번째 소변에서 creatinine의 비교분석에서는 유의한 차이가 없었으며 따라서 신생아에서도 용질배설 측정시 creatinine을 기준치로 사용할 수 있을 것으로 사료된다.

• Childhood Kidney Diseases
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• 제11권2호
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• pp.145-151
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• 2007

Hypertonicity (hypernatremia) of extracellular fluid causes water movement out of cells, while hypotonicity(hyponatremia) causes water movement into cells, resulting in cellular shrinkage or cellular swelling, respectively. In most part of the body, the osmolality of extracellular fluid is maintained within narrow range($285-295 mOsm/kgH_2O$) and some deviations from this range are not problematic in most tissue of the body except brain. On the other hand, the osmolality in the human renal medulla fluctuates between 50 and $1,200 mOsm/kgH_2O$ in the process of urine dilution and concentration. The adaptation of renal medullary cells to the wide fluctuations in extracellular tonicity is crucial for the cell survival. This review will summarize the mechanisms of urine concentration and the adaptation of renal medullary cells to the hyper tonicity, which is mediated by TonEBP transcription factor and its target gene products(UT-A1 urea transporter etc.).

• Clinical and Experimental Pediatrics
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• 제59권4호
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• pp.202-204
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• 2016

A 15-year-old boy, who was diagnosed with Alport syndrome and end-stage renal disease, received a renal transplant from a living-related donor. On postoperative day 1, his daily urine output was 10,000 mL despite normal graft function. His laboratory findings including urine, serum osmolality, and antidiuretic hormone levels showed signs similar to central diabetes insipidus, so he was administered desmopressin acetate nasal spray. After administering the desmopressin, urine specific gravity and osmolality increased abruptly, and daily urine output declined to the normal range. The desmopressin acetate was tapered gradually and discontinued 3 months later. Graft function was good, and urine output was maintained within the normal range without desmopressin 20 months after the transplantation. We present a case of a massive polyuria due to transient deficiency of antidiuretic hormone with the necessity of desmopressin therapy immediately after kidney transplantation in a pediatric patient.

• The Korean Journal of Physiology
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• 제9권1호
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• pp.23-32
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• 1975

In order to study the dally metabolism of sodium chloride and of nitrogen, 24-hour urine samples were collected from 1,593 normal Korean females whose ages varied from 2 to 80 years old. The volume, the concentration of chloride and the osmolality of the urine, add the total nitrogen were determined, along with the resting pulse rate and the blood pressure. The daily urine volume was maintained at $1,000{\sim}1,300\;ml/m^2/day$ in all age groups while the chloride concentration and osmolality of the urine samples were approximately 200 mEq/liter and 600 milliosmoles, respectively, in most of age groups. Hence the daily urinary output of sodium chloride was estimated to be approximately $15g/m^2$/day in adult groups. On the other hand, the daily excretion of total nitrogen amouted to approximately $5{\sim}6g/m^2/day$. These findings indicated that the average Korean females live on low-protein and high-salt diets throughout their life. Despite a known correlation between the incidence of hypertension and the high salt intake, none of the subjects employed in this work showed any sign of hypertension.

• 동의생리병리학회지
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• 제17권2호
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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.

• 동아시아식생활학회지
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• 제15권2호
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• pp.165-170
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• 2005

연근의 에탄올 추출물이 과당 유도 고혈압 백서의 신장 기능에 미치는 영향을 관찰하고자 뇨량과 전해질 배설량, 혈장의 creatinine, creatinine 청소율, 자유-수분 재흡수량 등을 측정하였다. 그 결과 연근은 과당 유도 고혈압 백서에서 나타나는 전해질 배설량의 변화를 개선시키는 효과는 없는 것으로 나타났고 단지 삼투질 농도의 배설량에만 약간의 개선 효과를 보였다. 신장의 가장 중요한 기능중 하나는 여과 기능이고 이를 나타내는 지표는 사구체 여과율인데, 고혈압 백서에서 혈장내 creatinine 농도가 증가하였고, creatinie 청소율이 크게 억제되었으나 연근추출물 투여 후 사구체 여과율의 감소가 회복되었다. 그러므로 연근은 과당으로 유도된 고혈압 흰쥐의 사구체 여과율을 개선시키는 것으로 사료된다.