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오유정 ( You Jeong Oh ),한지선 ( Ji Sun Han ),김도경 ( Do Kyong Kim ),정석희 ( Seuk Hee Chung ),김상옥 ( Sang Ock Kim ),형건덕 ( Chien Ter Hsing ),목지영 ( Ji Young Mok ),안원석 ( Won Suk An ),김성은 ( Seong Eun Kim ),김기현 ( Ki 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
Purpose: Recently the incidence of severe hyponatremia is increasing in old patients but there is no report about clinical findings of old patients with hyponatremia. We evaluated the cause and clinical manifestations of severe hyponatremia in old patients who had been admitted via emergency room. Methods: We retrospectively reviewed clinical records of the hyponatremic patients who had been admitted from 2000 to 2007. We enrolled 53 patients (Age>60 years, Na<125mEq/L) without severe liver cirrhosis, heart failure or chronic kidney disease. We analyzed data to evaluate the differences of clinical manifestations according to the presence of symptoms, taking diuretics, urine sodium concentrations and the degree of hyponatremia. Results: Mean serum sodium concentration was 111.4±6.9mEq/L and urine sodium concentration was 68.7±43.8mEq/L. There was no difference in serum sodium concentration according to age. Twenty-nine (54.7%) patients had nausea and vomiting and 19 patients (35.8%) had neurologic symptoms. Patients with neurologic symptoms showed lower serum and urine sodium concentration than patients without neurologic symptoms. The main causes of severe hyponatremia were poor oral intake (79.2%), diuretics use (37.7%) and recent operation (15.1%). The mean sodium concentration of the fluid administered to achieve 125mEq/L of serum sodium level was 336.5±160.6mEq/L. Conclusion: The urinary sodium loss, e.g., diuretics abuse, may be the main cause of severe hyponatremia in elderly patients over 60 years. In elderly patients, diuretics should be carefully administered with frequent electrolyte monitoring.
혈액투석 환자에서 관상동맥질환의 예측인자로서 단순방사선 촬영상 혈관 석회화 점수들간의 비교
김정민 ( Jung Min Kim ),안원석 ( Won Suk An ),김기현 ( Ki Hyun Kim ),김성은 ( Seong Eun Kim ),손영기 ( Young Ki Son ),정석희 ( Seuk Hee Chung ),오유정 ( You Jeong Oh ),김우재 ( Woo Jai Kim ),김동균 ( Dong Kyun Kim ),배숙향 ( Hyang 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.2
Purpose: Vascular calcification (VC) scores on simple plain radiographic films are known to be associated with coronary artery disease (CAD) and mortality. The present study was designed to demonstrate a correlation between VC scores of the hands and pelvis, and feet and lateral lumbar spine on plain radiographs. In addition, we analyzed the usefulness of checking all the plain radiographs for assessment of pre-existing CAD. Methods: We recruited 61 hemodialysis (HD) patients from OO Dialysis Center. We checked the plain radiographic films of the feet, hands, pelvis, and lateral lumbar spine and evaluated VC scores with previously reported methods. We defined CAD based on myocardial scans, echocardiography, or coronary angiography. Results: Positive associations were found between the VC scores of the feet, VC scores of the hands and pelvis, scores of abdominal aortic calcifications (AACs), and CAD. Approximately 30% of patients who had CAD could be missed based on a single VC scoring method. Patients who showed any one finding among the AAC scores >5, VC scores of the pelvis and hands >3 or arterial media calcifications of the feet on plain radiographs had a high sensitivity (93.8%) and a high negative predictive value (96.3%) for the presence of CAD. Conclusion: Each VC score was highly inter-correlated. All three VC scoring methods on plain radiographic films are useful screening tests for the presence of CAD in HD patients.