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신부전 만성도 평가에 있어 혈중 carbamylated hemoglobin 치의 유용성
김연수(Yon Su Kim),한진석(Jin Suk Han),진호준(Ho Jun Chin),이서진(Seo Jin Lee),조윤숙(Yun Suk Cho),안규리(Ahn Cu Rie),김성권(Suhng Gwon Kim),이정상(Jung Sang Lee),장인진(In Jin Jang),신상구(Sang Gu Shin),허우성(Woo Seong Huh) 대한내과학회 1996 대한내과학회지 Vol.51 No.3
N/A Objective: Differentiation of acute from chronic renal failure is an important but difficult task in treating the azotemic patients. It is known that the degree of carbamylation reflects the duration and the severity of the uremia. To assess the usefulness in differentiating acute(ARF) from chronic reanl failure (CRF), we measured the carbamylated hemoglobin (CarHb). Methods: We measured CarHb(measured as ㎍ of carbamyl valine per g hemoglobin) prospectively in 64 patients with azotemia (24 ARF, 40 CRF) referred to the Seoul National University Hospital. High performance liquid chromatography was used for measuring CarHb. Thirteen normal controls were also studied to match 64 patients. Results: Patients with ARF had lower median (range) CarHb concentration than those with CRF [56.0(24.6-97.1) ㎍CV/gHb vs 120.4(31.7-286.5) p<0.01]. It is not different from normal control [56.0 (24.6-97.1) vs 40.9(19,9-62.9); p<0.05]. The ratio of CarHb to serum creatinine(mg/dl) was lower in ARF than in CRF [10.5(4.9-34A) vs 18.2(4.7-52.2) p<0.01]. The cut-off value for CarHb to be CRF is 80 ㎍CV/gHb(sensitivity 70%, specificity 71%, positive predictive value 80%). Conclusion: The carbamylated hemoglobin is useful in determining the chronicity of the renal failure and it could be of clinical value in deciding the further management.
신증후군 환자에서 알부민 병용 투여가 Furosemide 이뇨 효과에 미치는 약력학 및 약동학적 유용성 평가
김도형 ( Doe Hyeong Kim ),엄재호 ( Jae Ho Earm ),한진석 ( Jin Suk Han ),김혜영 ( Hye Young Kim ),오태근 ( Tae Geun Oh ),허우성 ( Wooseong Huh ),이정상 ( Jung Sang Lee ),장인진 ( In Jin Jang ),신상구 ( Sang Gu Shin ) 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.4
There have been controversies on the effect of albumin in treating edema in nephrotic syndrome patients. We evaluated the additive diuretic effect of coadministration of furosernide with albumin in the six patients with nephrotic syndrome. We administered 160mg of furosemide intravenously for 1 hour with 100rnl of 20% albumin or 5% dextrose by random cross-over design. The urine and plasma furosemide concentrations were measured by HPLC. After the administration of furosemide alone, urine volume, urinary excretions of sodium and chloride were increased significantly compared to those of basal state(P<0.05). But, coadministration of furose- mide with albumin did not increase significantly the urine voume(2285+-445ml vs. 3023+-715ml), urinary excretions of sodium(194+-58rnmol/day vs. 282+-85 mmol/day) and chloride(213+- 54mmoVday vs. 286+- 74mmoVday) comparing to those of furosemide only cases. Addition of albumin to furosemide did not sig- nificantly changed pharmacokinetic parameters such as AUC(28.3+-5.5ug/ml hr vs 36.0+-6.7ug/ml hr), total plasma clearance(115+-30mVmin vs 108+-41ml/min), volume of distribution(0.13+-0.02L/kg vs 0.10+- 0.01L/kg), elirnination half life(1.4+-0.3hr vs 1.5+-0.3hr), and urine furosemide excretion(44+-8% vs 43+ 10%). We concluded that albumin infusion did not enhance the diuretic action of furosemide pharmaco-dynamically and pharmacokinetically in patients with nephrotic syndrome.