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( Seun Deuk Hwang ),( Jin Ho Lee ),( Jong Hyun Jhee ),( Joon Ho Song ),( Joong Kyung Kim ),( Seoung Woo Lee ) 대한신장학회 2019 Kidney Research and Clinical Practice Vol.38 No.2
Background: Significant increases in the prevalence of obesity have been observed among patients with peritoneal dialysis (PD). The impact of body mass index (BMI) on survival remains unknown in Korean PD patients. Methods: Among data of 80,674 patients on PD acquired from the Insan Memorial ESRD Registry database for the years 1985 to 2014, 6,071 cases were analyzed. Subjects were classified by baseline BMI; < 21.19 kg/m2 (quartile 1, n = 1,518), 21.19 to 23.18 kg/ ㎡ (quartile 2, reference; n = 1,453), 23.19 to 25.71 kg/ ㎡ (quartile 3, n = 1,583), and > 25.71 kg/ ㎡ (quartile 4, n = 1,517). Results: Mean age was 65.8 years, and baseline BMI was 23.57 kg/ ㎡. Numbers of male and diabetic patients were 3,492 (57.5%) and 2,192 (36.1%), respectively. Among 6,071 cases, 2,229 (36.7%) all-cause deaths occurred. As a whole, Kaplan-Meier survival curves according to BMI quartiles was significantly different (P = 0.001). All-cause mortality was significantly higher in quartile 4 than in the reference (hazard ratio [HR] = 1.154, 95% confidence interval [CI], 1.025-1.300; P = 0.018). There was no statistical difference in all-cause mortality among BMI quartiles in diabetic patients on PD. In non-diabetic patients, all-cause mortality of quartiles 1 and 3 was not different from the reference, but the HR was 1.176 times higher in quartile 4 (95% CI, 1.024-1.350; P = 0.022). Conclusion: Baseline BMI > 25.71 kg/ ㎡ seems to be an important risk factor for all-cause mortality in Korean PD patients.
S-526 kidney transplatation was held up due to cancer incidentally found during donor evaluation
( Jin Hee Park ),( Seun Deuk Hwang ),( Seoung Woo Lee ),( Moon-jae Kim ),( Joon Ho Song ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1
Kidney transplantation is known as the most efficient treatment method for patients with end-stage renal failure. Prior to the transplantation, it is very important to perform a physical checkup to find whether to make possible a kidney transplant. However, it is impossible to make fullbody examination. There has yet to be consensus as to how much a donor should be evaluated according to age and physical condition. A 37-year woman patient for kidney transplantation was admitted to Division of Nephrology at this hospital on Sep. 21, 2015. At that time, her recipient was a 57-year woman and her mother. In the blood examination of her kidney function, BUN 9.2, and Cr 0.68; in the urine examination, 24hr protein was 58mg/D; creatinine clearance was 95.6ml/min. In the imaging test, kidney US had no something unusual. In the renal artery CT, normal renal vascular system was found. As a result, kidney transplantation was decided. For the purpose of medical checkup, the gastroscopy and colonscopy were performed. In the colonscopy, protruding mass was found in the range of the anal verge 22cm to 25 cm. Therefore, EMR was performed. According to the biopsy, adenocarcinoma and liver metastasis were found. Liver metastasis which was not found by renal artery CT was found by PET. In the case of kidney donor examination, endoscopy can be different depending on center. As shown in the case, cancer can be found by incident. Each center needs guidelines about endoscopy for physical checkup. And it will be necessary to conduct a relevant prospective study.
( Ji-eun Kim ),( Seun Deuk Hwang ),( Seoung Woo Lee ),( Joon Ho Song ),( Kipyo Kim ) 대한전해질학회 2022 Electrolytes & Blood Pressure Vol.20 No.1
Nicorandil is an anti-anginal drug that is commonly used in the treatment of ischemic heart disease. Nicorandil acts as a nitrate donor and ATP-sensitive potassium channel agonist, inducing coronary artery vasodilation. Potassium efflux through ATP-sensitive potassium channels activated by nicorandil can cause refractory hyperkalemia, particularly in patients with chronic kidney disease (CKD). Here, we report the case of an 85-year-old man who presented with severe refractory hyperkalemia, despite proper medical management. His serum potassium level increased from 4.96 to 7.21mEq/L 7 days after restarting nicorandil. Hyperkalemia resolved shortly after discontinuation of nicorandil, which was presumed to be the offending drug. Previously, a few cases reported nicorandil-induced hyperkalemia called potassium channel syndrome in patients with CKD, and hyperkalemia can be reversed by ceasing nicorandil or using sulfonyl urea drugs. Given that CKD patients may have several contributing factors to this adverse event, clinicians should be aware of the risk of nicorandil-induced hyperkalemia, and medication review and drug discontinuation should be considered.
( Boram Cha ),( Dae Young Kim ),( Hyunil Jang ),( Seun Deuk Hwang ),( Huck Jei Choi ),( Moon-jae Kim ) 대한전해질학회 2017 Electrolytes & Blood Pressure Vol.15 No.1
Posterior reversible encephalopathy syndrome (PRES) is characterized by a clinical and radiological entity with the sudden onset of seizures, headache, altered consciousness, and visual disturbances in patients with the findings of reversible vasogenic subcortical edema without infarction. Hypertension, renal disease, and autoimmune disease are co-morbid conditions of PRES. Nevertheless, there have only been a few case reports of PRES in a patient with anti-glomerular basement membrane antibody glomerulonephritis (anti-GBM GN). This paper presents the possible first Korean case of a 36-year-old woman with the striking features of PRES. She presented with a sudden onset of visual blindness, headache, and seizure. The brain MRI images revealed hyperintense lesions in both the occipital and parietal lobes, which suggested vasogenic edema. Three months before this presentation, she was diagnosed with anti-GBM GN. Since then, she underwent immunosuppression with cyclophosphamide and steroid, and hemodialysis for renal failure with a treatment of anti-GBM GN.
Sun Kim,Yeong Seok Lee,Dong Hyun Kim,Aram Yang,Tack Lee,Seun Deuk Hwang,권대규,이지은 대한소아내분비학회 2019 Annals of Pediatirc Endocrinology & Metabolism Vol.24 No.3
Müllerian duct aplasia-renal aplasia-cervicothoracic somite dysplasia (MURCS) association is a unique development disorder with four common types of malformations that include uterine aplasia or hypoplasia, renal ectopy or agenesis, vertebral anomalies, and short stature. The majority of MURCS patients are diagnosed with primary amenorrhea from late-adolescence. However, a few cases with MURCS association are not well diagnosed during childhood and long-term outcomes are not well reported. We report a case of an 8-year-old girl with MURCS association who presented with recurrent urinary tract infections and multiple congenital malformations, and who was followed for 10 years until adulthood. MURCS association should be considered as one of the differential diagnoses when evaluating prepubertal females with vertebral and renal malformations.
( Kyeong Min Kim ),( Seon A Jeong ),( Tae Hyun Ban ),( Yu Ah Hong ),( Seun Deuk Hwang ),( Sun Ryoung Choi ),( Hajeong Lee ),( Ji Hyun Kim ),( Su Hyun Kim ),( Tae Hee Kim ),( Ho-seok Koo ),( Chang-yun 대한신장학회 2024 Kidney Research and Clinical Practice Vol.43 No.1
Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.