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대한신장학회> Kidney Research and Clinical Practice(구 대한신장학회지)

Kidney Research and Clinical Practice(구 대한신장학회지) update

  • : 대한신장학회
  • : 의약학분야  >  내과학
  • : KCI등재
  • : SCOPUS
  • : 연속간행물
  • : 계간
  • : 2211-9132
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  • : 대한신장학회지(~2006)→The Korean Journal of Nephrology(2007~)→KINDEY Research and Clinal Practice(2012~)

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수록범위 : 1권1호(1982)~38권1호(2019) |수록논문 수 : 3,684
Kidney Research and Clinical Practice(구 대한신장학회지)
38권1호(2019년 03월) 수록논문
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KCI등재 SCOPUS

1Renal sympathetic nerve activation via α2-adrenergic receptors in chronic kidney disease progression

저자 : Hee-seong Jang , Jinu Kim , Babu J. Padanilam

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 6-14 (9 pages)

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Chronic kidney disease (CKD) is increasing worldwide without an effective therapeutic strategy. Sympathetic nerve activation is implicated in CKD progression, as well as cardiovascular dysfunction. Renal denervation is beneficial for controlling blood pressure (BP) and improving renal function through reduction of sympathetic nerve activity in patients with resistant hypertension and CKD. Sympathetic neurotransmitter norepinephrine (NE) via adrenergic receptor (AR) signaling has been implicated in tissue homeostasis and various disease progressions, including CKD. Increased plasma NE level is a predictor of survival and the incidence of cardiovascular events in patients with endstage renal disease, as well as future renal injury in subjects with normal BP and renal function. Our recent data demonstrate that NE derived from renal nerves causes renal inflammation and fibrosis progression through alpha-2 adrenergic receptors (α2-AR) in renal fibrosis models independent of BP. Sympathetic nerve activation-associated molecular mechanisms and signals seem to be critical for the development and progression of CKD, but the exact role of sympathetic nerve activation in CKD progression remains undefined. This review explores the current knowledge of NE-α2-AR signaling in renal diseases and offers prospective views on developing therapeutic strategies targeting NE-AR signaling in CKD progression.

KCI등재 SCOPUS

2Disaster preparedness for earthquakes in hemodialysis units in Gyeongju and Pohang, South Korea

저자 : Kyung Don Yoo , Hyo Jin Kim , Yunmi Kim , Jae Yoon Park , Sung Joon Shin , Seung Hyeok Han , Dong Ki Kim , Chun Soo Lim , Yon Su Kim

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 15-25 (11 pages)

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In 2016 and 2017, there were earthquakes greater than 5.0 in magnitude on the Korean Peninsula, which has previously been considered an earthquake-free zone. Patients with chronic kidney disease are particularly vulnerable to earthquakes, as the term “renal disaster” suggests. In the event of a major earthquake, patients on hemodialysis face the risk of losing maintenance dialysis due to infrastructure disruption. In this review, we share the experience of an earthquake in Pohang that posed a serious risk to patients on hemodialysis. We review the disaster response system in Japan and propose a disaster preparedness plan with respect to hemodialysis. Korean nephrologists and staff in dialysis facilities should be trained in emergency response to mitigate risk from natural disasters. Dialysis staff should be familiar with the action plan for natural disaster events that disrupt hemodialysis, such as outages and water treatment system failures caused by earthquakes. Patients on hemodialysis also need to be educated about disaster preparedness. In the event of a disaster situation that results in dialysis failure, patients need to know what to do. At the local and national government level, long-term preparations should be made to handle renal disaster and patient safety logistics. Moreover, Korean nephrologists should also be prepared to manage cardiovascular disease and diabetes in disaster situations. Further evaluation and management of social and national disaster preparedness of hemodialysis units to earthquakes in Korea are needed.

KCI등재 SCOPUS

3The role of senescence of bone marrow cells in acute kidney injury

저자 : Junyong Lee , Yoon Sook Ko , Hee Young Lee , Jihyun Yang , Sewon Oh , Sang-kyung Jo , Wonyong Cho , Myung-gyu Kim

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 25-32 (8 pages)

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Background: The prevalence of acute kidney injury (AKI) in elderly patients has grown considerably. Age-associated changes in the immune system can be one of the critical factors determining AKI outcomes. This study aimed to investigate the role of senescence of bone marrow (BM)-derived cells in the development of AKI, focusing on the immune response.
Methods: Female 7-week-old C57BL/6 mice were irradiated and treated with BM cells from either 48-week-old or 8-week-old male mice. Ischemia-reperfusion injury (IRI) was induced, and their functional deterioration, histological tubular damage, and inflammatory responses were compared. For the in-vitro study, lipopolysaccharide (LPS)- stimulated cytokine production by BM cells from old and young mice were examined.
Results: At 24 hours after IRI, there was no significant difference in the number of circulating immune cells between the mice transplanted with old or young BM cells. However, the mice with old BM cells showed less functional deterioration and histological tubular injury than those with young BM cells. Moreover, macrophage infiltration and renal cytokine interleukin (IL)-12 levels were lower in the mice with old BM cells at 24 hours post-IRI. Consistently, the in vitro study showed that LPS-induced production of cytokines interferon-γ, monocyte chemoattractant protein-1, and IL-10 was attenuated in cultured old BM cells, suggesting that age-related functional changes in these cells may lead to reduced inflammation in IRI.
Conclusion: Immunosenescence could affect the susceptibility and response to renal IRI. Further studies specifically addressing age-related alterations can help in the development of treatment strategies for elderly patients with AKI.

KCI등재 SCOPUS

4Diastolic dysfunction and acute kidney injury in elderly patients with femoral neck fracture

저자 : Woori Cho , Tae Yeon Hwang , Yoon Kyung Choi , Ji Hyun Yang , Myung-gyu Kim , Sang-kyung Jo , Won Yong Cho , Se Won Oh

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 33-41 (9 pages)

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Background: Femoral neck fracture is common in the elderly population. Acute kidney injury (AKI) is an important risk factor for mortality in patients who have had such fracture. We evaluated the incidence of AKI in patients who had femoral neck fracture and identified risk factors for AKI and mortality.
Methods: This was an observational cohort study including 285 patients who were ≥ 65 years of age and who underwent femoral neck fracture surgery between 2013 and 2017.
Results: The mean age was 78.63 ± 6.75 years. A total of 67 (23.5%) patients developed AKI during the hospital stay: 57 (85.1%), 5 (7.5%), and 5 (7.5%) patients were classified as having stage 1, 2, and 3 AKI, respectively. Patients with AKI had a lower baseline estimated glomerular filtration rate and higher left atrial dimension, left ventricular mass index, pulmonary artery pressure, and the ratio of early mitral inflow velocity to early diastolic mitral annulus velocity (E/e') and were more likely to have diabetes or hypertension (HTN) (P < 0.05). The presence of HTN (odds ratio [OR], 4.570; 95% confidence interval [CI], 1.632-12.797) higher E/e' (OR, 1.105; 95% CI, 1.019-1.198), and lower hemoglobin (OR, 0.704; 95% CI, 0.528-0.938) were independently associated with a higher risk for developing AKI. Severe AKI (OR, 24.743; 95% CI, 2.822-212.401) was associated with a higher risk of mortality.
Conclusion: Elderly patients with femoral neck fracture had a high incidence of AKI. Diastolic dysfunction was associated with AKI. Severe AKI was associated with in-hospital mortality.

KCI등재 SCOPUS

5Retroperitoneal fibrosis in the era of immunoglobulin G4-related disease

저자 : Yoon Kyung Choi , Ji Hyun Yang , Shin Young Ahn , Gang Jee Ko , Se Won Oh , Myung Gyu Kim , Won Yong Cho , Sang Kyung Jo

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 42-48 (7 pages)

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Background: Retroperitoneal fibrosis (RPF) is a rare disease characterized by fibroinflammatory tissue in the periaortic or periiliac retroperitoneum, where it frequently encases ureters. There is emerging evidence that a subset of this disease is part of a spectrum of multisystemic autoimmune diseases collectively referred to as “immunoglobulin G4 (IgG4)-related disease”.
Methods: We retrospectively analyzed 27 idiopathic RPF patients and identified a subset as IgG4-related RPF, which we categorized according to recently published comprehensive diagnostic criteria. We compared clinical and laboratory characteristics and response to treatment between the two groups.
Results: Of 27 total patients, 16 (59.3%) were diagnosed as having IgG4-related RPF, and these were predominantly male. They were also significantly older and more likely to have other organ involvement, hydronephrosis, and postrenal acute kidney injury (AKI) compared to those with idiopathic RPF. However, there was no difference in response rate to systemic steroid treatment.
Conclusion: IgG4-related RPF accounts for a substantial portion of RPF cases previously identified as “idiopathic RPF” in Korea. Clinical and laboratory characteristics of IgG4-related RPF are similar to those of idiopathic RPF except for a striking male predominance, older age, and higher incidence of postrenal AKI in IgG4-related RPF. More comprehensive, prospective studies are needed to clearly distinguish IgG4-related RPF from idiopathic RPF based on clinical manifestation and to further assess treatment response and long-term prognosis.

KCI등재 SCOPUS

6Framingham risk score and risk of incident chronic kidney disease: A community-based prospective cohort study

저자 : Changhyun Lee , Hae-ryong Yun , Young Su Joo , Sangmi Lee , Joohwan Kim , Ki Heon Nam , Jong Hyun Jhee , Jung Tak Park , Tae-hyun Yoo , Shin-wook Kang , Seung Hyeok Han

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 49-64 (16 pages)

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Background: Cardiovascular disease and chronic kidney disease share several common risk factors. The Framingham risk score is hypothesized to predict chronic kidney disease development. We determined if the Framingham risk scoring system can correctly predict incident chronic kidney disease in the general population.
Methods: This study included 9,080 subjects who participated in the Korean Genome and Epidemiology Study between 2001 and 2014 and had normal renal function. The subjects were classified into low- (< 10%), intermediate- (10-20%), and high- ( > 20%) risk groups based on baseline Framingham risk scores. The primary endpoint was de novo chronic kidney disease development (estimated glomerular filtration rate [eGFR], < 60 mL/min/1.73 m2).
Results: During a mean follow-up duration of 8.9 ± 4.3 years, 312 (5.3%), 217 (10.8%), and 205 (16.9%) subjects developed chronic kidney disease in the low, intermediate, and high risk groups, respectively (P < 0.001). Multivariable analysis after adjustment for confounding factors showed the hazard ratios for the high- and intermediate risk groups were 2.674 (95% confidence interval [CI], 2.197-3.255) and 1.734 (95% CI, 1.447-2.078), respectively. This association was consistently observed irrespective of proteinuria, age, sex, obesity, or hypertension. The predictive power of this scoring system was lower than that of renal parameters, such as eGFR and proteinuria, but increased when both were included in the prediction model.
Conclusion: The Framingham risk score predicted incident chronic kidney disease and enhanced risk stratification in conjunction with traditional renal parameters in the general population with normal renal function.

KCI등재 SCOPUS

7Risk of cancer in pre-dialysis chronic kidney disease: A nationwide population-based study with a matched control group

저자 : Sehoon Park , Soojin Lee , Yaerim Kim , Yeonhee Lee , Min Woo Kang , Kyungdo Han , Seoung Seok Han , Hajeong Lee , Jung Pyo Lee , Kwon Wook Joo , Chun Soo Lim , Yon Su Kim , Dong Ki Kim

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 60-76 (17 pages)

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Background: Cancer risk and epidemiology in pre-dialysis chronic kidney disease (CKD) warrant further investigation in a large-scale cohort.
Methods: We performed a nationwide population-based study using the national health insurance database of Korea. We screened records from 18,936,885 individuals who received a national health examination ≥ 2 times from 2009 to 2016. Pre-dialysis CKD was identified based on serum creatinine and dipstick albuminuria results. Individuals with preexisting cancer history, renal replacement therapy, or transient CKD were excluded. A control group without evidence of kidney function impairment and matched for age, sex, low-income status, and smoking history was included. Risk of cancers, as identified in the claims database, was investigated using a multivariable Cox regression model including matched variables and other unmatched clinical characteristics as covariates.
Results: A total of 471,758 people with pre-dialysis CKD and the same number of matched controls were included. Urinary (adjusted hazard ratio [HR], 1.97; 95% confidence interval [95% CI], 1.82-2.13) and hematopoietic (adjusted HR, 1.53; 95% CI, 1.38-1.68) malignancy risk was increased in pre-dialysis CKD and all CKD stages. However, the risk of digestive cancer was lower in the pre-dialysis CKD group (adjusted HR, 0.89; 95% CI, 0.87-0.92). The risk of digestive, respiratory, thyroid, and prostate malignancy demonstrated a non-linear association with CKD stage, with stage 1 or stage 4/5 CKD without dialysis demonstrating relatively lower risk.
Conclusion: Cancer risk varied in pre-dialysis CKD compared to controls, and the association between cancer risk and CKD stage varied depending on the cancer type.

KCI등재 SCOPUS

8Evaluation of different bioimpedance methods for assessing body composition in Asian non-dialysis chronic kidney disease patients

저자 : Sean Wy Lee , Clara Lee Ying Ngoh , Horng Ruey Chua , Sabrina Haroon , Weng Kin Wong , Evan Jc Lee , Titus Wl Lau , Sunil Sethi , Boon Wee Teo

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 71-80 (10 pages)

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Background: Chronic kidney disease (CKD) is associated with fluid retention, which increases total body water (TBW) and leads to changes in intracellular water (ICW) and extracellular water (ECW). This complicates accurate assessments of body composition. Analysis of bioelectrical impedance may improve the accuracy of evaluation in CKD patients and multiple machines and technologies are available. We compared body composition by bioimpedance spectroscopy (BIS) against multi-frequency bioimpedance analysis (BIA) in a multi-ethnic Asian population of stable, non-dialysis CKD patients.
Methods: We recruited 98 stable CKD patients comprising 54.1% men and 70.4% Chinese, 9.2% Malay, 13.3% Indian, and 8.2% other ethnicities. Stability was defined as no variation in serum creatinine > 20% over three months. Patients underwent BIS analyses using a Fresenius body composition monitor, while BIA analyses employed a Bodystat Quadscan 4000.
Results: Mean TBW values by BIS and BIA were 33.6 ± 7.2 L and 38.3 ± 7.4 L; mean ECW values were 15.8 ± 3.2 L and 16.9 ± 2.7 L; and mean ICW values were 17.9 ± 4.3 L and 21.0 ± 4.9 L, respectively. Mean differences for TBW were 4.6 ± 1.9 L (P < 0.001), for ECW they were 1.2 ± 0.5 L (P < 0.001), and for ICW they were 3.2 ±1.8 L (P < 0.001). BIA and BIS measurements were highly correlated: TBW r = 0.970, ECW r = 0.994, and ICW r = 0.926. Compared with BIA, BIS assessments of fluid overload appeared to be more associated with biochemical and clinical indicators.
Conclusion: Although both BIA and BIS can be used for body water assessment, clinicians should be aware of biases that exist between bioimpedance techniques. The values of body water assessments in our study were higher in BIA than in BIS. Ethnicity, sex, body mass index, and estimated glomerular filtration rate were associated with these biases.

KCI등재 SCOPUS

9Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis

저자 : Minah Kim , Chang Seong Kim , Eun Hui Bae , Seong Kwon Ma , Soo Wan Kim

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 81-91 (11 pages)

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Background: Compared to the general population, patients with end-stage renal disease have more gastrointestinal symptoms and a higher prevalence of peptic ulcer. Risk factors for peptic ulcer disease in patients with end-stage renal disease, however, remain poorly defined. This study aims to better identify those risk factors.
Methods: We analyzed 577 patients with end-stage renal disease from 2004 to 2016. We excluded patients with lifethreatening conditions. All patients underwent upper endoscopy. We analyzed patient medical records, medication history, and endoscopic findings. Independent sample t test, chi-square test, Fisher's exact test, and multiple logistic regression analysis were used in statistical analyses.
Results: Of the 577 patients with end-stage renal disease, 174 had peptic ulcer disease (gastric or duodenal ulcer). Patients on hemodialysis had a higher prevalence of peptic ulcer disease than those on peritoneal dialysis. Patients with peptic ulcer disease had lower serum albumin level and higher blood urea nitrogen level than those without peptic ulcer disease. Positive scores on two or more nutritional indices (albumin, serum cholesterol, uric acid, and creatinine levels) were associated with peptic ulcer disease in end-stage renal disease.
Conclusion: Hemodialysis, hypoalbuminemia, and multiple malnutrition indices were associated with the prevalence of peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

KCI등재 SCOPUS

10Time-varying effects of body mass index on mortality among hemodialysis patients: Results from a nationwide Korean registry

저자 : Sejoong Kim , Jong Cheol Jeong , Shin Young Ahn , Kibbeum Doh , Dong-chan Jin , Ki Young Na

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 38권 1호 발행 연도 : 2019 페이지 : pp. 90-100 (11 pages)

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Background: Unlike patterns observed in the general population, obesity is associated with better survival among hemodialysis patients, which could be explained by reverse causation or illness-related weight loss. However, the time-varying effect of body mass index (BMI) on hemodialysis survival has not been investigated. Therefore, this study investigated the time-varying effect of BMI on mortality after starting hemodialysis.
Methods: In the present study, we examined Korean Society of Nephrology data from 16,069 adult patients who started hemodialysis during or after the year 2000. Complete survival data were obtained from Statistics Korea. Survival analysis was performed using Cox regression and a non-proportional hazard fractional polynomial model.
Results: During the median follow-up of 8.6 years, 9,272 patients (57.7%) died. Compared to individuals with normal BMI (18.5-24.9 kg/m2), the underweight group (< 18.5 kg/m2) had a higer mortality hazard ratio (HR, 1.292; 95% confidence interval [CI], 1.203-1.387; P < 0.001) and the overweight group (25.0-29.9 kg/m2) had a lower mortality HR (0.904; 95% CI, 0.829-0.985; P = 0.022). The underweight group had increasing HRs during the first 3 to 7 years after starting hemodialysis, which varied according to age group. The young obese group (< 40 years old) had a U-shaped temporal trend in their mortality HRs, which reflected increased mortality after 7 years.
Conclusion: The obese hemodialysis group had better survival during the early post-dialysis period, although the beneficial effect of obesity disappeared 7 years after starting hemodialysis. The young obese group also had an increased mortality HR after 7 years.

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