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혈전성 양측 신동맥 폐쇄로 인한 급성 신부전증 환자에서의 성공적인 스텐트 삽입술
최정욱 ( Choe Jeong Ug ),김장영 ( Kim Jang Yeong ),이승환 ( Lee Seung Hwan ),유종명 ( Yu Jong Myeong ),한병근 ( Han Byeong Geun ),최승옥 ( Choe Seung Og ) 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.3
Renal artery disease is one of the significant factors that lead to compromise renal function and/or aggravate hypertension in the elderly population. Since the non-surgical treatment of renal artery stenosis,percutaneous transluminal renal angioplasty, is available, it is possible to cure the decreased renal function and exacerbated hypertension. However, bilateral renal artery occlusion (BRAO) that brings about anuria and azotemia is rare. In this communication, we`d like to describe a patient who developed acute renal failure due to BRAO. His renal function was completely recovered after successful implantation of stents into both renal arteries. We are unaware of prior reports documenting the beneficial effect of a distal embolic protection device, the Percu-Surge GuardWire system (Medtronic, Minneapolis, MN, USA), in a clinical setting as described here. The GuardWire arm, a device for transient distal balloon occlusion during angioplasty or stent placement, allows recovery of any liberated plaque by aspiration before restoration of antegrade flow, and thereby performs a double service. We`d like to strongly recommend that stent implantation with adjunctive distal protection is essential to obtain a complete restoration of distal blood flow although there is sufficient collateral blood flow in elderly patients with BRAO and azotemia.
Salmonella Enteritidis 감염증 환자에게서 발생한 횡문근 융해증 및 급성 신부전 1예
김영섭 ( Young Sub Kim ),양재원 ( Jae Won Yang ),박소연 ( So Yeon Park ),송신한 ( Shin Han Song ),유종명 ( Jong Myeong Yu ),최승옥 ( Seung Ok Choi ),한병근 ( Byoung Geun Han ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.4
Rhabdomyolysis varies from transient elevation of muscular enzyme to reduction of circulating volume and development of acute kidney injury (AKI). The majority is related to trauma, excessive exercise, alcohol and seizure disorders. Systemic infections associated with salmonellosis were rarely reported. Most of Salmonella infections are caused by Salmonella Typhi. Most common manifestations are typhoid fever and gastroenteritis. Sometimes serious complications such as gastrointestinal bleeding, intestinal perforation, and encephalopathy occur. However, AKI-associated rhabdomyolysis is rarely reported in salmonellosis even though it is not considered to be a major complication. Unfortunately, the precise pathogenetic mechanisms responsible for rhabdomyolysis with Salmonella Enteritidis infection are poorly understood due to the rarity of reported cases. In this presentation, we describe a patient with Salmonella Enteritidis (serogroup D) bacteremia complicated by disseminated intravascular coagulation, rhabdomyolysis and AKI. The blood culture and stool culture from the patient yielded Salmonella Enteritidis. Rhabdomyolysis and AKI should be considered as potentially fatal complications in patients with Salmonella Enteritidis infection.