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( Se-yun Kim ),( Yu Ho Lee ),( Yang-gyun Kim ),( Ju-young Moon ),( Ho Jun Chin ),( Sejoong Kim ),( Dong Ki Kim ),( Suhnggwon Kim ),( Jung Hwan Park ),( Sung Joon Shin ),( Bum Soon Choi ),( Chun Soo Li 대한신장학회 2018 Kidney Research and Clinical Practice Vol.37 No.4
Background: Several epidemiologic studies have suggested that the urine sodium excretion (USE) can be estimated in lieu of performing 24-hour urine collection. However, this method has not been verified in patients with chronic kidney disease (CKD) or in an interventional study. The purpose of this study was to evaluate the usefulness of estimating USE in a prospective low-salt diet education cohort (ESPECIAL). Methods: A new formula was developed on the basis of morning fasting urine samples from 228 CKD patients in the ESPECIAL cohort. This formula was compared to the previous four formulas in the prediction of 24-hour USE after treatment with olmesartan and low-salt diet education. Results: Most previously reported formulas had low predictability of the measured USE based on the ESPECIAL cohort. Only the Tanaka formula showed a small but significant bias (9.8 mEq/day, P < 0.05) with a low correlation (r = 0.34). In contrast, a new formula showed improved bias (-0.1 mEq/day) and correlation (r = 0.569) at baseline. This formula demonstrated no significant bias (-1.2 mEq/day) with the same correlation (r = 0.571) after 8 weeks of treatment with olmesartan. Intensive low-salt diet education elicited a significant decrease in the measured USE. However, none of the formulas predicted this change in the measured urine sodium after diet adjustment. Conclusion: We developed a more reliable formula for estimating the USE in CKD patients. Although estimating USE is applicable in an interventional study, it may be unsuitable for estimating the change of individual sodium intake in a low-salt intervention study.
Oh, Yun Jung,Kim, Myounghee,Lee, Hajeong,Lee, Jung Pyo,Kim, Ho,Kim, Sejoong,Oh, Kook-Hwan,Joo, Kwon Wook,Lim, Chun Soo,Kim, Suhnggwon,Kim, Yon Su,Kim, Dong Ki Springer International ; Oxford University Press 2012 Nephrology, dialysis, transplantation Vol.27 No.6
<P>Vitamin D deficiency is known as an important risk factor for mortality in patients with chronic kidney disease (CKD). Nevertheless, the association of renal function itself with vitamin D status or serum 25-hydroxyvitamin D (25OHD) level has not been investigated thoroughly.</P>
Hwang, Jin Ho,Han, Seung Seok,Huh, Wooseong,Park, Su-Kil,Joo, Dong Jin,Kim, Myoung Soo,Kim, Yu Seun,Min, Sang-Il,Ha, Jongwon,Kim, Sang Joon,Kim, Suhnggwon,Kim, Yon Su Springer International ; Oxford University Press 2012 Nephrology, dialysis, transplantation Vol.27 No.6
<P>Idiopathic focal segmental glomerulosclerosis (FSGS) occurring at young age is known to predispose to poor graft outcome, but the outcome of adulthood-onset FSGS (A-FSGS) has not been thoroughly investigated. Here, we compared the graft outcomes between kidney recipients with A-FSGS and childhood-onset FSGS (C-FSGS).</P>
김혜영,한진석,이정상,전은실,엄재호,김근호,안규리,이서진,주권욱,김성권 대한신장학회 1999 Kidney Research and Clinical Practice Vol.18 No.1
Alcohol can cause rhabdomyolysis by either direct toxicity or associated metabolic abnormality such as hypophosphatemia and hypokalemia. It can also predispose to or cause trauma, seizures, or coma- induced ischemic pressure necrosis. In order to investigate the clinical features of acute renal failure caused by alcohol induced rhabdomyolysis, we reviewed the medical records of the 12 patients. All patients had been drinking much amounts of alcohol for several years. All patients showed elevation of muscle enzyme such as creatine phosphokinase, lactic dehydrogenase, aspartate transaminase and blood urea nitrogen and serum creatinine. Predisposing factors of rhabdomyolysis were ischemic compression due to unconsciousness and dehydration(2 cases), and hypophosphatemia and dehydration(1 case), seizure and dehydration(1 case), and only severe dehydration(3 cases). Initial symptoms were painful swelling at lesion site(5 cases), abdominal pain(2 cases), general ache(2 cases), leg pain without swelling(1 case), dyspnea(1case), and lethargy(1 case). Seven patients developed delirium tremens during recovery stage. Eight patients showed oliguric acute renal failure and 8 patients were treated with hemodialysis. Complications were disseminated intravascular coagulation(DIC)(3 cases), compartment syndrome(2 cases), capillary leak syndrome and DIC(1 case). One of 12 patients died of disseminated intravascular coagulation and other patients showed complete recovery of renal function.
이식 전 B형 간염 바이러스 감염이 이식 신의 예후에 미치는 영향
김윤구,한진석,김성권,이정상,김상준,김수태 대한내과학회 1990 대한내과학회지 Vol.38 No.1
To evaluate the impact of HBV infection on graft survial following renal transplantation, we studied 161 recipients whose Hepatitis B surface antigen(HBsAg) status was identified before transplantation by actuarial life table method and log-rank analysis. We considered graft loss as patient'’s death, return to maintenance dialysis or removal of graft. 1) Survival in the HBsAg positive group(18 losses among 22 recipients) was significantly diminished(p=0. 0001) compared with the HBsAg negative group(40 of 139 recipients) and the difference was highly significant in recipients with cyclosporine therapy but not in those with azathioprine. 2) In the HBsAg negative group, no obvious differences in survival were found among the groups categorized by the presence of anti-HBs or anti-HBc prior to transplantation. 3) In the HBsAg positive group, those with no mismatch for HLA showed better survial and there were no differences in graft survival compared with the HBsAg negative group. 4) There were 4 deaths from hepatic failure which occurred only in the HBsAg positive group and only in recipients with cyclosporine therapy. We conclude that patients with pre-existing HBs antigenemia may be poor candidates for renal transplantation.
부종 질환에서 Oxytocin이 수분대사에 미치는 영향
김혜영,이종호,한진석,이정상,전은실,김근호,안규리,이서진,주권욱,허우성,김성권 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.4
Antidiuretic action of oxytocin is confirmed by in vitro study using with rat IMCD. Vasopressin is elevated in edematous disorders and may play a pathogenetic role in the formation of edema. If oxytocin plays a sirnilar role to vasopressin in water disturbances in human, oxytocin may change as the same way as vasopressin. To verify a role of oxytocin in the regulation of water balance in human, we measured plasma and urine oxytocin with vasopressin by radioimmunoassay in thirteen patients with generalized edema(8 nephrotic syndrome, 3 liver cirrhosis, 2 acute renal failure) before and after control of edema. And they were compared them with those of seven normal controls. As a result,plasma oxytocin and vasopressin Levels of patients with edematous state were higher than those of normal controls(p$lt;0.01).Plasma oxytocin of patients decreased after control of edema(table,P$lt;0.05), but was still higher than of normal controls(table, P$lt;0.01). Plasma vasopressin did not change after control of edema and sustained at elevated level(Table) Plasma oxytocin level correlated with plasma vasopressin level(r=0.543: P$lt;0.05) and urinary oxytocin level correlated linearly with urinary vaso-pressin(r=0.983, P$lt;0.01). After control of edema, body weight of patients decreased from 65±2 to 58±2kg and fractional excretion of sodium decreased from 3.3±1.1 to 1.2±0.696(P$lt;0.05). There were no significant changes in serum and urine Na, osmolality, free water clearance, plasma renin activity, aldosterone and norepinephrine. In conclusion, oxytocin was elevated in edematous disorders, and may participate in formation of edema similar to vasopressin.
( Yong Chul Kim ),( Tae Woo Lee ),( Hajeong Lee ),( Ho Suk Koo ),( Kook-hwan Oh ),( Kwon Wook Joo ),( Suhnggwon Kim ),( Ho Jun Chin ) 대한신장학회 2012 Kidney Research and Clinical Practice Vol.31 No.2
Background: Few clinical trials have examined the replacement of steroids with other immunosuppressive drugs as a primary treatment modality for minimal change disease (MCD) in adults. We studied the efficacy of tacrolimus to induce complete remission (CR) in adults with MCD. Methods: We enrolled 14 adults with MCD and nephrotic-range proteinuria. All patients were treated with oral tacrolimus 0.05 mg/kg twice daily and prednisolone 0.5 mg/kg/day. CR was defined as a urine protein to creatinine ratio ofo0.2 g protein/g creatinine (g/g cr). The primary outcome was cumulative percentage of CR during 16 weeks. Results: The mean urine protein to creatinine ratio at enrollment was 10.9 g/g cr (range: 4.2-18.1 g/g cr). The trough tacrolimus level was maintained at 5.997 2.63 ng/mL. CR was achieved by 13/14 (92.8%) patients within 8 weeks. The cumulative CR rate was 7.7% (1/14), 64.2% (9/14), 71.3% (10/14), and 92.9% (13/14) at 1 week, 2 weeks, 4 weeks, and 8 weeks, respectively. The one remaining patient achieved CR at 20 weeks after treatment, who was followed up for a further 4 weeks. The mean time to achieve CR in the 14 patients was 4.6475.11 (1-20) weeks. Three cases suffered adverse events of abdominal pain, diarrhea, or newonset diabetes mellitus. Conclusion: Tacrolimus and low-dose prednisolone therapy induced CR rapidly (71.3% by 4 weeks and 100% by 20 weeks) and effectively in adult patients with MCD.