http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
만성 신장병 환자에서 레닌-안지오텐신계 억제제와 칼륨교환수지 동시 사용이 혈청 칼륨에 미치는 영향
이주학 ( Joo Hark Yi ),윤여욱 ( Yeo Wook Yun ),노유석 ( U Seok Noh ),김은영 ( Eun Young Kim ),박재일 ( Jae Il Park ),한상웅 ( Sang Woong Han ),김호중 ( Ho Jung Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.5
Purpose : This prospective study aimed to evaluate the safety and efficacy of potassium-exchange resin (PER, Kalimateⓡ or Argamateⓡ) for managing hyperkalemia induced by Renin-Angiotensin System (RAS) blockers in chronic kidney disease (CKD) patients without their discontinuation. Methods : Besides conservative remedies including low-potassium diet, all hyperkalemic CKD patients (n=21, [K] ≥5.6 mEq/L) received PER added on angiotensin-converting enzyme inhibitor (Moexipril, n=2) or angiotensin-receptor blocker (Irbesartan, n=19) with, at least, weekly monitoring of serum [K] if its level remains more than 5.5 mEq/L for more than 2 months (mean±SD, 6.8±5.9 mon; range, 2-26 mon). Results : Baseline serum [K] on RAS blocker alone (5.1±0.4 mEq/L; 4.2-6.3 mEq/L) increased to 6.0 ±0.4 mEq/L (p<0.05) before adding PER, and then it was significantly decreased to 5.3±0.6 mEq/L at the first clinic visit (p<0.05) and to 5.0±0.7 mEq/L at the last clinic visit (p<0.05) following the administration of PER added on RAS blocker. During the study period, GFR, serum creatinine and urinary protein excretion didn`t change significantly. Conclusion : The development of hyperkalemia on RAS blockers in CKD patients doesn`t necessarily lead to withdrawal of RAS blockers when the cautious add-on therapy of potassium-exchange resin with other conservative remedies launches, unless severe refractory hyperkalemia persists. II type 1 receptor blockers
저나트륨혈증 환자의 진단과 치료에서 연속적인 생리식염수 및 수분 부하검사와 Barsoum-Levine 공식의 유용성
이주학 ( Joo Hark Yi ),김원준 ( Won Jun Kim ),노유석 ( U Seok Noh ),김연재 ( Yeon Jae Kim ),고영선 ( Young Sun Ko ),한상웅 ( Sang Woong Han ),김호중 ( Ho Jung Kim ) 대한신장학회 2008 Kidney Research and Clinical Practice Vol.27 No.6
In hyponatremic patients, the assessment of extracellular fluid volume plays an essential step in diagnosing the etiology of hyponatremia and deciding how to manage it. Although various laboratory tests and diagnostic procedures have been developed for differential diagnosis of hyponatremia, there still are limits to the evaluation of the status of extracellular fluid volume due to the data that overlaps each other, leading to the difficulty in diagnosing between euvolemia and hypovolemia. Also, there is no consensus about how to guide the type and amount of fluid therapy despite many formulas including Adrogue-Madias and Barsoum-Levine formulas have been suggested. Hereby, we are reporting two hyponatremic patients (102 and 105 mEq/L) admitted simultaneously with indistinct volume status on initial clinical and laboratory examinations, but were clarified as euvolemic hyponatremia (syndrome of inappropriate antidiuretic hormone secretion) in one and hypovolemic hyponatremia in the other case after sequential intravenous saline (2 L over 24 hrs) and oral water (20 mL/kg) loading tests. When serum sodium values calculated by the above-mentioned two formulas were compared with actually measured ones during saline loading test in these cases, the Barsoum-Levine formula revealed almost no discrepancy between both the values while the Adrogue-Madias formula underestimated the measured value.
고인산혈증을 동반한 혈액 투석 환자에서 란타늄과 칼슘제재의 효과 비교
고영선 ( Young Sun Ko ),류지원 ( Ji Won Ryu ),이주현 ( Ju Hyun Lee ),이주학 ( Joo Hark Yi ),한상웅 ( Sang Woong Han ),김호중 ( Ho Jung Kim ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.1
Purpose: Hyperphosphatemia and renal osteodystrophy increase the mortality and morbidity in chronic kidney disease. We compared the effects of lanthanum carbonate (LC) and calcium carbonate (CC) on phosphate homeostasis and bone bio-markers in hemodialysis patients. Methods: The Korean dialysis patients with serum phosphorus more than 5.6mg/dL were randomized to LC (n=12) or CC (n=11). Serum calcium, phosphorus, intact PTH, bone alkaline phosphatase, and osteocalcin were checked at regular intervals for 6 months. Results: The reduction of serum phosphorus and calcium x phosphorus product at 24-week (wk) from baseline values was similar in LC and CC groups (Phosphorus: baseline, 7.28±1.04 mg/dL vs 7.41±1.39 mg/dL, p=NS; at 24-wk, 5.39±1.85 mg/dL vs 5.67±1.43 mg/dL, p=NS) (Calcium x phosphorus product: baseline, 64.5±11.1 mg2/dL2 vs 61.3±11.9 mg2/dL2, p=NS; at 24-wk, 47.9±14.5 mg2/dL2 vs 51.8±14.0 mg2/dL2, p=NS). Despite higher baseline serum calcium levels in LC group, the changes of serum calcium from the baseline at 24-wk were significantly higher in CC group (LC vs CC; 0.23±0.38 mg/dL vs 0.94±0.87 mg/dL, p<0.05). Bone bio-markers, including iPTH, bone ALP, and osteocalcin, were comparable in 2 groups. However, significant gastrointestinal side effects leading to discontinuing the study were predominantly observed in LC (LC vs CC; n=5/12 vs n=0/11). Conclusion: Compared to calcium carbonate, lanthanum carbonate has similar efficacy to reduce serum phosphorus level, but less tendency to increase serum calcium level. However, the high incidence of gastrointestinal side effects in lanthanum carbonate needs further investigation in its correlation to Korean.
김영훈 ( Young Hoon Kim ),노유석 ( You Seok Roh ),김은영 ( Eun Young Kim ),이주학 ( Joo Hark Yi ),손병관 ( Byoung Kwan Son ),한상웅 ( Sang Woong Han ),박문향 ( Moon Hyang Park ),김호중 ( Ho Jung Kim ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2
The cause of IgA nephropathy is unknown, but a mesangial deposition of IgA immune complexes containing antigens from a putative pathogen might be involved in its pathogenesis. We report a case of IgA nephropathy associated with disseminated tuberculosis. A 32-year-old man was presented with sudden onset of edema of both lower legs. The chest X-ray revealed extensive active pulmonary tuberculosis in both lung fields. The abdominal CT, cystoscopy and IVP were compatible with renal tuberculosis and tuberculous cystitis. Besides, the colonoscopic findings with biopsy showed tuberculous colitis. The laboratory data revealed a positive culture for tuberculous bacilli from sputum, 2.7 g of 24-hour urinary protein, and microscopic hematuria. A renal biopsy showed mesangial and segmental endocapillary proliferative glomerulonephritis, consistent with IgA nephropathy. Intense positive stainings for IgA and C3 in the mesangium by Immunofluorescence microscopy. Electron microscopic examination demonstrates segmental endocapillary proliferation, necrosis and mesangiolysis with mild mesangial electron-dense deposits. Treatment with anti-tuberculous medications resulted in gradual disappearance of proteinuria and other various manifestations of the disseminated tuberculosis. Therefore we suggest that IgA nephropathy may be associated with active disseminated tuberculosis.