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RISS 인기검색어
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- 저자 : 이유지 ( Sung Rok Kim ) (검색결과 4 건)
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Type 2 Cardiorenal Syndrome으로 투석을 시행한 환자의 특징과 생존율
조성 ( Seong Cho ),김성록 ( Sung Rok Kim ),이유지 ( Yu Ji Lee ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.6
Purpose: We evaluated clinical outcomes in patients with type 2 cardiorenal syndrome who were treated with peritoneal dialysis (PD) or hemodialysis (HD). Methods: A retrospective database of PD or HD patients with type 2 cardiorenal syndrome from January 2002 to December 32010 was established. We evaluated the mean survival on dialysis, days of hospitalizations and NYHA class changes. Results: Thirty-two patients with mean age at the start of dialysis of 68.4±10.8 years had mean survival on dialysis of 20.5±14.4 months (median survival 17.8 months). Survival after starting dialysis is highly variable, but long term survival was proved possible. The days of hospitalization for cardiovascular causes were reduced (25.1±17.predialysis vs. 9.5±32.8 days/patient/month, postdialysis, p= 0.013). All patients showed improvement in NYHA functional class. Kidney function stabilized, while significant improvement in hemoglobin (+16.5%, p<0.001) were achieved. Conclusion: After starting dialysis for Type 2 cardiorenal syndrome, the chances of hospitalization for cardiovascular causes were reduced for all patients. Survival on dialysis in these patients was highly variable.
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조성 ( Seong Cho ),이유지 ( Sung Rok Kim ),김성록 ( Yu Ji Lee ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.1
Purpose: The first choice of vascular access is a distal radiocephalic fistula (dRCF) at the wrist. In patients with a failed dRCF or with vessels unsuitable for dRCF, the recommendation is to place a brachiocephalic fistula (BC) in the upper arm. Proximal forearm radiocephalic fistulas (pRCF) are created infrequently, but may permit a second forearm fistula before proceeding to the upper arm BC. The goal of the present study was to evaluate the effect of pRCF in hemodialysis patients. Methods: We included 80 patients who received arteriovenous fistula operation between December, 2008 and July, 2010. The type of arteriovenous fistula (dRCF, pRCF, BC) was determined according to preoperative vascular mapping using doppler ultrasonography. The fistula operation was performed by one surgeon. We compared the non-maturation rates, primary and secondary patency rates among dRCF, pRCF, and BC. Results: The numbers of patients that underwent dRCF, pRCF, and BC operation were 27, 27, and 26, respectively. Only 33.8% of patients needed creation of a dRCF potentially. Non-maturation rates were similar among the patients that underwent dRCF, pRCF and BC (11.1%, 7.4%, and 3.8%, respectively, p>0.05). The primary patency rates of dRCF, pRCF, and BC were 81.5%, 92.6%, 80.8%, respectively (p>0.05). The secondary patency rates of dRCF, pRCF, and BC were 92.3%, 96.3%, and 92.3%, respectively (p>0.05). Conclusion: pRCF had non-maturation rate, primary and secondary patency rate, comparable to those of a dRCF and, a BC. pRCF may be an attractive alternative to a BC in patients who do not have vessel suitable for creation of a dRCF.
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수술 전 혈관평가와 수술자의 차이가 동정맥루의 종류와 개존율에 미치는 영향
조성 ( Seong Cho ),김성록 ( Sung Rok Kim ),이유지 ( Yu Ji Lee ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.3
To evaluate the effects of specialty of the operator and of preoperative ultrasonic mapping at the time of AVF creation on access outcomes, we studied 224 patients who received AVF surgery by nephrologist with preoperative sonographic mapping (Group 1, n=112) or by vascular surgeon with only physical examination (Group 2, n=112) from January 2008 to December 2009. We compared the rate of autogenous fistula formation, primary failure rate (immediate failure, maturation failure) and patency rate between two groups. Group 1 had more autogenous fistula (97.4 vs. 63.0%, p<0.05), more mid-arm fistula (20.7 vs. 0%, p<0.05) compared to group 2. Immediate failure was more common in group 2 (1 vs. 9, p<0.05). Maturation failure was not different between two groups (10 vs. 10, p=ns). Group 1 had higher primary patency rate at 1 year (74.40 vs. 68.27%, p<0.05) and also had higher secondary patency rate at 1 year (87.33 vs. 81.63%, p<0.05) compared to group 2. If active preoperative sonogram is planned, outcomes of AVF created by nephrologist are comparable to outcomes of AVF created by surgeon.
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신이식 환자에서 자발적으로 발생한 저구연산뇨증 연관성 요관 결석로
나정구,공성민,이동규,김성민,장윤정,김성록,이유지 이화여자대학교 의과학연구소 2015 EMJ (Ewha medical journal) Vol.38 No.3
Urolithiasis is an uncommon complication in renal transplantation. We report a case of hypocitraturia-related ureteral steinstrasse which was spontaneously formed in a renal transplant recipient. The patient who underwent renal transplantation was admitted with acute pyelonephritis. Hydronephrosis in the transplanted kidney and multiple stones (steinstrasse) in the distal ureter were incidentally found on computed tomography scanning. After a failed attempt of ureteroscopic removal of stones, the patient underwent open ureterolithotomy and ureteroureterostomy. On stone analysis, carbonate apatite was confirmed. Urinary citric acid levels were decreased to 127.6 mg/day. Potassium citrate was administered to prevent stone recurrence by increasing urinary citrate excretion. No recurrence of stones was shown six months later. Urolithiasis in renal transplant recipients requires a high index of suspicion. Hypocitraturia can increase the risk for urolithiasis. Rapid recognition by careful surveillance, prompt removal of stones, and precautionary efforts to prevent recurrence are needed.
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