논문 상세보기

대한신장학회> Kidney Research and Clinical Practice(구 대한신장학회지)> B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교

KCI등재SCOUPUS

B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교

Comparison between Lamivudine alone and Lamivudine and Steroid Combination in Treatment of Nephrotic Syndrome Associated with Hepatitis B

신석균 ( Sug Kyun Shin ) , 류동렬 ( Dong Ryeol Ryu ) , 황재하 ( Jae Hwa Hwang ) , 송현용 ( Hyun Yong Song ) , 강신욱 ( Hyun Jin Noh ) , 최규헌 ( Shin Wook Kang ) , 한광협 ( Kyu Hun Choi ) , 하성규 ( Kwang Hyub Han ) , 한대석 ( Sung Kyu Ha ) , 노현진 ( Dae Suk Han ) , 이호영 ( Ho Yung Lee )
  • : 대한신장학회
  • : Kidney Research and Clinical Practice(구 대한신장학회지) 18권4호
  • : 연속간행물
  • : 1999년 07월
  • : 550-559(10pages)

DOI


목차


					

키워드 보기


초록 보기

Treatment of nephrotic syndrome associated with hepatitis B are controversial, but some patients may respond to interferon therapy. Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing viral burden and may convert patients from HBsAg and HBeAg positive to negative. But there was no report for the usefulness of lamivudine in treatment of these patients. We performed a randomized comparative study to assess the usefulness of lamivudine and the effect of steroid in the use of lamivudine in treatment of B-viral associated nephrotic syndrome. Twelve patients(M:F=1:0.2, mean age 34.3 years, MCD 1, MPGN 5, MGN 6 patients) suspected to have the acute viral replication with nephrotic syndrome were included. They were randomly assigned to receive lamivudine and steroid combination therapy(group I, 150mg of lamivudine with high-dose steroid, 1mg/kg/day, orally once daily in 6 patients) or lamivudine alone therapy(group Ⅱ, 150 mg of lamivudine orally once daily alone in 6 patients). The duration of lamivudine use was 6 months in both groups, and that of steroid use was 6 weeks in group 1. Then, lamivudine and steroid were tapered according to the amount of proteinuria and serum HBV-DNA titer. All patients were closely monitored every 2 months with clinical, bioche
mical, and serological parameters for 10 months. The rate of negative sero-conversion of HBV- DNA were 91.7%(11/12) at 2 months of lamivudine therapy in all patients, and there was no difference between group Ⅰ and Ⅱ(83.3% vs. 100%, p>0.05). In group I, there were a significant decreases of mean serum HBV-DNA values(899.2±711.9 vs. 31.4±32.7, 12.7±27.6, and 137.2±278.1pg/ml, p<0.05, respectively), proteinuria(11.0±3.6 vs. 3.9±2.3, 2.1±2.3, and 2.5±3.1g/d, p<0.05, respectively), and SGPT (57.7±18.9 vs. 30.5±12.4, 23.8±10.2, and 26.0±10.4 IU/L, p<0.05, respectively) measured at 2, 6, and 10months compared to before therapy, and serum albumin levels were significantly increased at 2, 6, and 10months compared to before therapy(2.2±0.5 vs. 3.1±0.5, 3.9±0.8, and 3.9±0.9g/dL, p<0.05, respectively). In group Ⅱ, serum HBV-DNA was significantly decreased at 2, 6, and 10 months compared to before therapy(358.8±369.3 vs. 19.1±27.0, 0.0±0.0, and 0.0±0.0pg/ml, p<0.05, respectively), and proteinuria and SGPT were significantly decreased at 6 and 10 months compared to before therapy(8.5±5.5 vs. 2.6±1.3 and 2.1±2.3g/d, p<0.05; 67.5±43.0 vs. 25.3±11.6 and 31.5±9.2IU/L, p<0.05, respectively). Serum albumin levels were significantly increased at 10 months compared to before therapy(2.8±0.8 vs. 4.3±0.1g/dL, p<0.05). Serum HBV-DNA levels rebounded in two patients of group Ⅰ, but none was observed in group Ⅱ. No serious adverse events were observed in all the patients. In conclusion, lamivudine and steroid combination therapy may more rapidly decrease proteinuria than lamivudine alone in B-viral associated nephrotic syndrome, but may induce the rebound of serum HBV-DNA.

UCI(KEPA)

I410-ECN-0102-2009-510-004802712

간행물정보

  • : 의약학분야  > 내과학
  • : KCI등재
  • : SCOPUS
  • : 계간
  • : 2211-9132
  • :
  • : 학술지
  • : 연속간행물
  • : 1982-2020
  • : 3778


저작권 안내

한국학술정보㈜의 모든 학술 자료는 각 학회 및 기관과 저작권 계약을 통해 제공하고 있습니다.

이에 본 자료를 상업적 이용, 무단 배포 등 불법적으로 이용할 시에는 저작권법 및 관계법령에 따른 책임을 질 수 있습니다.

발행기관 최신논문
| | | | 다운로드

1배양된 메산지움세포에서 고농도 포도당, 안지오텐신 II 및 안지오텐신 전환효소 억제제가 TGFβ 유전자 발현에 미치는 효과

저자 : 강민모 ( Min Mo Kang ) , 이소영 ( So Young Lee ) , 한상엽 ( Sang Yup Han ) , 곽재영 ( Jae Young Guahk ) , 조상경 ( Sang Kyoung Jo ) , 윤종우 ( Jong Woo Yoon ) , 조원용 ( Won Yong Cho ) , 김형규 ( Hyoung Kyu Kim ) , 임천규 ( Chun Gyoo Ihm ) , 차대룡 ( Dae Ryong Cha )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 513-522 (10 pages)

다운로드

(기관인증 필요)

초록보기

Objective:Diabetic nephropathy is an important cause of end stage renal disease in Korea and associated with major morbidity and mortality. The precise pathogenic mechanism of this disease is still controversial, but it has been considered that multiple factors are contribute to the development and progression of diabetic nephropathy.
One of these factors, renin-angiotensin system has been proven to be a major mediator of this disease via activation of angiotensin Ⅱ, which has multiple functions such as induction of production of extracellular matrix protein and various intraglomerular cells, tubulointerstital component and increment of intraglomerular pressure.
Transforming growth factor(TGFβ) is a multifunctional cytokine with major profibrotic character, which stimulates the production of extracellular matrx(ECM) protein, inhibit the degradation of ECM and induce the interaction of mesangial cells with ECM via integrin receptors. This study was done to evaluate the role of angiotensin Ⅱ and angiotensin converting enzyme inhibitor in expression of TGFβ mRNA which is a main mediator in the pathogenesis of diabetic nephropathy.   Methods:Human mesangial cells(MCs) were cultured by standard culture techniqne. For this study, cells in the 5th to 7th passage were used. To make a different glucose concentration in culture medium, normal(100mg/dl) or high glucose(450mg/dl) concentrations of D-glucose were added, and cultured in 17% heat inactivated fetal bovine serum. Angiotensin Ⅱ and ACE inhibitor(captopril) were administered to the culture medium at final concentration of 10-6M. After 72 hours, MCs were harvested to measure the expression of TGFβ mRNA. To measure the mRNA expression of TGFβ in each condition, semi quantitative PCR was done and all results were corrected by β-actin gene.   Results:mRNA expression of TGFβ was significantly increased in the high glucose medium(30 mM) compared to normal glucose medium(5.5mM) (3.82±0.465 vs 2.27±0.13, p<0.05). Administration of angiotensinⅡ(10-6M) in high glucose medium induced a further increase in the TGFβ expression to 4.29±0.476(p<0.05). AngiotensinⅡ(10-6M) in normal glucose medium also showed a significant increase in TGFβ expression as 3.40±1.88(p<0.05). Administration of ACE inhibitor(Captopril, 10-6M) in high glucose medium prevented the increse of TGFβ expression(1.20±0.18 vs 3.82±0.465, p<0.05).  Conclusion:From these findings, it suggest that angiotensinⅡ is an important mediator in the pathogenesis of diabetic nephropathy. ACE inhibitor may have a role in the progress of this disease via direct suppression of TGFβ system as well as beneficial intraglomerular hemodynamic effect.

2신혈관성 고혈압 흰쥐 신장과 간자에서 Renin-Angiotensin계 유전자 발현 변화

저자 : 이종은 ( Jong Un Lee ) , 안미라 ( Mi Ra An ) , 남상채 ( Sang Chae Nam ) , 김원재 ( Won Jae Kim )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 523-529 (7 pages)

다운로드

(기관인증 필요)

초록보기

The present study was aimed at investigating the molecular regulation of the renin- angiotensin system (RAS) in two-kidney, one clip (2K1C) hypertension. The expression of renin, angiotensinogen and angiotensin II receptor genes was determined by Northern blot analysis in rats made 2K1C hypertensive for 2 or 4 weeks. The expression of renin gene was increased in the clipped kidney and decreased in the contralateral non-clipped kidney at weeks 2 and 4. The expression of angiotensinogen gene was not significantly altered at week 2, but increased at week 4 in the clipped kidney. However, it was not significantly altered in the contralateral kidney either at week 2 or 4. Nor was the expression of angiotensinogen gene significantly altered in the liver either at week 2 or 4. On the other hand, the expression of angiotensin II receptor gene was decreased at week 2, and increased at week 4 in the clipped kidney, whereas it was not significantly changed in the contralateral kidney either at week 2 or 4. In the liver, the expression of angiotensin II receptor gene was not significantly altered at week 2, but decreased at week 4. These results suggest that the components of RAS are transcriptionally regulated in 2K1C hypertension in a manner dependent on tissues and duration of hypertension.

3신성고혈압 유발시 반대측 신동맥의 수축 및 이완반응

저자 : 최승옥 ( Seung Ok Choi ) , 윤영욱 ( Young Wook Yoon ) , 이무열 ( Moo Yeol Lee ) , 남숙현 ( Sook Hyun Nahm )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 530-536 (7 pages)

다운로드

(기관인증 필요)

초록보기

Experimental renovascular hypertensive model was established by clipping left renal artery and the right side of renal artery was taken 1 week and 1 month after the operation. The renal artery ring preparations were made for contractility studies of vascular wall. The relaxing and contractile responses were recorded and compared with the data obtained from control group.  The following results were obtained: 1)One week after the clipping of renal artery, the renovascular hypertensive group showed increased contractility against the various contractile agents (high K+, norepinephrine, caffeine) compared to control group.  2)One month after the clipping of renal artery, the contractile responses to various contractile agents were restored to the level of control group.
3)One week after the clipping of renal artery, the renovascular hypertensive group showed increased responsiveness to acetylcholine treatment, however did not show any remarkable changes to other relaxing agents(sodium nitroprusside, verapamil). 4)One month after the clipping of renal artery, the responses to various relaxing agents showed almost same degree of responsiveness in the renovascular hypertensive group as compared with that of control group. From the above, it is suggested that stenosis- induced renovascular hypertension might induce exaggerated vascular response at early stage in intact renal artery. And the effects may be concerned with endothelium-dependent mechanism.

4사구체신염에서 N-acety1-β-D-glucosaminidase의 예후 인자로서의 유용성

저자 : 김범 ( Beom Kim ) , 김혜영 ( Hye Young Kim ) , 오동진 ( Dong Jin Oh ) , 허우성 ( Wooseong Huh ) , 김윤구 ( Yoon Goo Kim ) , 김대중 ( Dae Joong Kim ) , 김미경 ( Mi Kyung Kim ) , 오하영 ( Ha Young Oh )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 537-542 (6 pages)

다운로드

(기관인증 필요)

초록보기

Backgrounds:N-acetyl-β-D-glucosaminidase (NAG) is one of many enzymes that exist in the renal proximal tubular cells. It is said that functional impairment of renal tubule can be detected by checking NAG in the urine. But, it has never been known whether urinary NAG value can be used as a predictor for the prognosis of patients with glomerulonephritis. In this study, we evaluated the relationship between urinary NAG level and the degree of injury in cortical interstitium which has been known to influence the prognosis of renal function in glomerulonephritis closely.
Methods:Before renal biopsy was performed in each patient, urinary NAG(isoenzyme A and B), urinary β2-microglobulin, serum blood urea nitrogen (BUN), serum creatinine, serum albumin, creatinine clearance and 24 hour urinary protein excretion were measured. Then, we calculated volume density of cortical interstitium〔Vv(i/c)〕 in each specimen using point count morphometry method after getting a confirmative diagnosis from pathologist. Simple correlation analysis and multivariate regression analysis were carried out. Results:The number of total patients was 32(male:16), whose median age was 60(32-80). Vv (i/c) had significant correlation with serum creatinine, creatinine clearance and serum BUN. But it was not correlated well with urinary NAG and urinary β2-microglobulin. Urinary NAG concentration(2.131 2.549unit/mmol Cr) was higher than that of normal control and showed significant correlation with urinary β2-microglobulin, serum albumin and 24 hour urinary protein excretion in patients.  Conclusion:Urinary NAG had no significant correlation with Vv(i/c) that has been known as an important prognostic factor for the renal function in glomerulonephritis, but had significant correlation with urinary protein excretion. We concluded that urinary NAG was not regarded to be an appropriate marker for predicting the prognosis of renal function in patient with glomerulonephritis.

5무증상의 혈뇨와 무증상의 단백뇨를 보인 성인환자의 장기추적 조사

저자 : 박주현 ( Joo Hyun Park ) , 김형근 ( Hyung Keun Kim ) , 오은숙 ( Eun Sook Oh ) , 박정희 ( Jung Hee Park ) , 양철우 ( Chul Woo Yang ) , 김용수 ( Yong Soo Kim ) , 장윤식 ( Yoon Sik Chang ) , 방병기 ( Byung Kee Bang )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 543-549 (7 pages)

다운로드

(기관인증 필요)

초록보기

To determine the clinical outcome of patients with asymptomatic hematuria and/or proteinuria, the biochemical parameters and renal biopsies were reviewed. The patients with asymptomatic urinary abnormalities(n=193) were followed up in Kangnam St. Mary's hospital between 1981 and 1996 and their mean age was 38.8±14.0 years old, sex ratio of M:F 54:139, mean follow-up period 6.2±4.4 years. They were divided into three groups according to the first dipstick urinalysis findings:82 patients with isolated hematuria(H), 28 patients with isolated proteinuria(P), and 83 patients with concomitant hematuria and proteinuria(H+P). During the follow-up period, in the 82 patiets with H, 68.3% had persistent hematuria without proteinuria, hematuria disappeared in 23.2%, and 8.5% manifested proteinuria, none of the patients showed renal insufficiency. Of the 28 patients with P, 42.9% had persistent proteinuria, proteinuria disappeared in 39.3%, 10.7% manifested hematuria, and 7.1% showed renal insufficiency. Of the 83 patients with H+P, 51.8% had persistent hematuria and proteinuria, hematuria and proteinuria disappeared in 13.3%, 16.9% had persistent hematuria without proteinuria, 9.6% had persistent proteinuria without hematuria, and 8.4% showed renal insufficiency. Renal biopsy was performed in 79 patients. 75.9% of these patients had Ig A nephropathy, 11.4% had mesangial proliferative glomerulonephritis or mesangiopathy, and 8.9% had membranous proliferative glomerulonephritis. In conclusion, the most common cause of asymptomatic urinary abnormalities was Ig A nephropathy(75.9%) and all patients with isolated hematuria kept normal renal function, while some patients with proteinuria(7.1%) or concomitant hematuria and proteinuria(8.4%) progressed to chronic renal failure. Therefore, to monitor progressing to chronic renal failure, the patients with proteinuria(whether or not they showed concomitant hematuria) should be closely followed up.

6B형 간염과 연관된 신증후군 치료에 Lamivudine 단독요법과 Lamivudine 및 Steroid 병합요법의 비교

저자 : 신석균 ( Sug Kyun Shin ) , 류동렬 ( Dong Ryeol Ryu ) , 황재하 ( Jae Hwa Hwang ) , 송현용 ( Hyun Yong Song ) , 강신욱 ( Hyun Jin Noh ) , 최규헌 ( Shin Wook Kang ) , 한광협 ( Kyu Hun Choi ) , 하성규 ( Kwang Hyub Han ) , 한대석 ( Sung Kyu Ha ) , 노현진 ( Dae Suk Han ) , 이호영 ( Ho Yung Lee

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 550-559 (10 pages)

다운로드

(기관인증 필요)

초록보기

Treatment of nephrotic syndrome associated with hepatitis B are controversial, but some patients may respond to interferon therapy. Steroid therapy in these patients could be limited, because it may aggravate hepatitis with the acute viral replication. Lamivudine may also be effective in reducing viral burden and may convert patients from HBsAg and HBeAg positive to negative. But there was no report for the usefulness of lamivudine in treatment of these patients. We performed a randomized comparative study to assess the usefulness of lamivudine and the effect of steroid in the use of lamivudine in treatment of B-viral associated nephrotic syndrome. Twelve patients(M:F=1:0.2, mean age 34.3 years, MCD 1, MPGN 5, MGN 6 patients) suspected to have the acute viral replication with nephrotic syndrome were included. They were randomly assigned to receive lamivudine and steroid combination therapy(group I, 150mg of lamivudine with high-dose steroid, 1mg/kg/day, orally once daily in 6 patients) or lamivudine alone therapy(group Ⅱ, 150 mg of lamivudine orally once daily alone in 6 patients). The duration of lamivudine use was 6 months in both groups, and that of steroid use was 6 weeks in group 1. Then, lamivudine and steroid were tapered according to the amount of proteinuria and serum HBV-DNA titer. All patients were closely monitored every 2 months with clinical, bioche
mical, and serological parameters for 10 months.  The rate of negative sero-conversion of HBV- DNA were 91.7%(11/12) at 2 months of lamivudine therapy in all patients, and there was no difference between group Ⅰ and Ⅱ(83.3% vs. 100%, p>0.05). In group I, there were a significant decreases of mean serum HBV-DNA values(899.2±711.9 vs. 31.4±32.7, 12.7±27.6, and 137.2±278.1pg/ml, p<0.05, respectively), proteinuria(11.0±3.6 vs. 3.9±2.3, 2.1±2.3, and 2.5±3.1g/d, p<0.05, respectively), and SGPT (57.7±18.9 vs. 30.5±12.4, 23.8±10.2, and 26.0±10.4 IU/L, p<0.05, respectively) measured at 2, 6, and 10months compared to before therapy, and serum albumin levels were significantly increased at 2, 6, and 10months compared to before therapy(2.2±0.5 vs. 3.1±0.5, 3.9±0.8, and 3.9±0.9g/dL, p<0.05, respectively). In group Ⅱ, serum HBV-DNA was significantly decreased at 2, 6, and 10 months compared to before therapy(358.8±369.3 vs. 19.1±27.0, 0.0±0.0, and 0.0±0.0pg/ml, p<0.05, respectively), and proteinuria and SGPT were significantly decreased at 6 and 10 months compared to before therapy(8.5±5.5 vs. 2.6±1.3 and 2.1±2.3g/d, p<0.05; 67.5±43.0 vs. 25.3±11.6 and 31.5±9.2IU/L, p<0.05, respectively). Serum albumin levels were significantly increased at 10 months compared to before therapy(2.8±0.8 vs. 4.3±0.1g/dL, p<0.05). Serum HBV-DNA levels rebounded in two patients of group Ⅰ, but none was observed in group Ⅱ. No serious adverse events were observed in all the patients.  In conclusion, lamivudine and steroid combination therapy may more rapidly decrease proteinuria than lamivudine alone in B-viral associated nephrotic syndrome, but may induce the rebound of serum HBV-DNA.

7성인 급성 신부전 환자의 예후인자 분석

저자 : 유기동 ( Ki Dong Yu ) , 김영곤 ( Young Gon Kim ) , 정종훈 ( Jong Hoon Chung )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 560-569 (10 pages)

다운로드

(기관인증 필요)

초록보기

Background:Acute renal failure(ARF) is characterized by rapid decline in glomerular filtration rate and retension of nitrogenous waste products. This syndrome occurs in approximately 5 percent all hospital admissions and up to 30 percent of admissions to intensive care units. ARF is diagnosed when screening of hospital patients reveals a recent increase in serum BUN(blood urea nitrogen) and creatinine. The mortality rate for ARF is approximate 40-60% and has changed little in past three decades. This lack of improvement in outcome, despite significant advances in medicine. The reasons of high mortality rate is not certain. This study intend to identify prognostic risk factors influencing survivals.  Methods:We retrospectively analyzed 60 patients with ARF during 2 years period from Oct. 1996 to Oct. 1998 at chosun university hospital. Multiple factors which may influence mortality were evaluated.  Results:  1)Of the 60 patients, 34 were male and 26 were female. The mean age was 55.8±15.9 years.
2)The cause of ARF is Drug, toxin, dehydration, infection, trauma, surgery, urinary tract obstruction, HFRS, rhabdomyolysis and bleeding. 3)Underline disease is observed in 52 case. DM, Hypertension, Malignancy, Pulmonary disease, Liver disease, Renal disease  4)The mortality rate is 31.7%. The major cause of deaths is DIC, infection and hepatic failure.   5)Based on the unpaired t-test, chi-squre analysis, albumin, total bilirubin, hemoglobin, thrombocytopenia, APACHE Ⅱ score, serum sodium, urine creatinine, number of multiple organ failure, cause of acute renal failure, pH, vital sign on admission, sepsis, DIC, oilguria, and hemodialysis were significant factors between survivors and nonsurvivors(p< 0.05).   6)APACHE Ⅱ score on admission is good prognostic factor for patients with acute renal failure (p<0.001).  Conclusion:This results suggest that the evaluation of patients symptom, sign, laboratory data, APACHE Ⅱ score is important for patients with acute renal failure. the discriminant score by multiple analysis and APACHE Ⅱ score could relatively predict the mortality of ARF patients. however further evaluation and clinical apply of prognostic factors is required to confirm these results.

8말기 신부전 환자에서 안지오텐신 전환효소 유전자형에 대한 연구

저자 : 차대룡 ( Dae Ryong Cha ) , 권현민 , 조상경 ( Sang Kyung Jo ) , 윤종우 ( Jong Woo Yoon ) , 조원용 ( Won Yong Cho ) , 김형규 ( Hyoung Kyu Kim )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 569-577 (9 pages)

다운로드

(기관인증 필요)

초록보기

An Insertion/deletion polymorphism in angiotensin converting enzyme gene has been considered the important regulator of ACE activity in plasma and tissue. The deletion allele of this gene is associated with higher ACE activity, which ultimately increased angiotensin Ⅱ formation. It is possible that alteration of ACE polymorphism might be contribute to development of end stage renal disease and cardiovascular disease where RAS system is implicated in disease process. This study determined the distribution of ACE genotype in 122 end stage renal disease patients and in a group of 101 healthy controls. Also we evaluated the difference of allele frequency in the hemodialysis patients with or without cardiovascular disease.  ACE genotype was determined by polymerase chain reaction technique from the PBMC leukocytes of the patients. The results were as follows;
1)Patients population consisted of 122 hemodialysis patients and male to female ratio was 66:56, mean age was 54.3±12.8 years old. Mean duration of dialysis treatment was 52.5±37.5 months and the underlying disease of ESRD were diabetic nephropathy in 78 cases, chronic glomerulonephritis in 29 cases, hypertension in 8 cases, other disease in 7 cases. 2)In the contol patients, male to female ratio was 52:49, mean age was 46.1±15.1 years old. The age and sex distribution between ESRD and control group was not significantly different. 3)Of the total hemodialysis patients, 26.2% showed the Ⅱ genotype, 35.2% of ID genotype and 38.6% of DD genotype. In the contol group, the frequency of each genotype was 20.8% of Ⅱ, 55.4% of ID and 23.8% of DD genotype. The frequency of DD genotype was significantly higher in ESRD group than control group(p<0.05).  4)In the ESRD patients, 72 patients(59%) had the LVH and 23 patients(18%) had the ischemic heart disease. The genotype distribution in ESRD patients according to the presence of LVH or ischemic heart disease did not show any significant difference. The frequency of each genotype in the patients with LVH showed 22.2%(Ⅱ), 43.1%(ID), 34.7%(DD), and 32.8%(Ⅱ), 37.5%(ID), 29.7%(DD) in the patients without LV
¡ªDae Ryong Cha, et al.:Angiotensin Converting Enzyme Polymorphism in Patients with End Stage Renal Disease―
H. In the aspect of ischemic heart disease, the frequency of ACE genotype was 27.3%(Ⅱ), 45.5% (ID), 27.3%(DD) in the group of ischemic heart disease, compared with the ditribution of 31.5 %(Ⅱ), 40%(ID), 32.6%(DD) in the patients without ischemic heart disease.  From the above results, it was concluded that insertion/deletion polymorphism in angiotensin converting enzyme gene, especially DD genotype, may be important in the pathogenesis of progression to end stage renal disease. There was no significant difference in I/D polymorphism according to the presence or absence of cardiovascular complications

다운로드

(기관인증 필요)

초록보기

Objective:The accurate evaluation of dry weight followed by hemodialysis is very important. So far, dry weight has been clinically estimated by using diagnostic parameters such as weight changes during dialysis, blood pressure, extremity edema, pulmonary edema, and chest X-rays. However, these methods result in frequent trials and errors because of the low accuracy. Recently, new methods have been attempted in a non-invasive way of determining dry weight. Bioelectric impedance method has been reported to be highly related to hemodynamic parameters before and after hemodialysis, and plasma atrial natriuretic peptide(ANP) and cyclic guanosine 3', 5'-monophosphate(cGMP) concentrations have been known to represent the amount of blood. In this study, we compared and analyzed the method of dry weight evaluation followed by hemodialysis by using multifrequency bioelectric impedance method(BIA method) and biochemical index(ANP method and cGMP method).
Methods:Subjects consisted of seventeen patients who had received maintenance hemodialysis. Using multifrequency bioelectric impedance method before and after hemodialysis, a RTBW/RECF ratio in the right lower extremity was measured. Plasma ANP and cGMP concentrations were measured by collecting blood in arterial port. Results: 1)Changes before and after hemodialysis: Post- dialysis weight decreased by 2.1±0.22kg. A RTBW/ RECF ratio significantly decreased from 0.3525±0.004 pre-dialysis to 0.3292±0.002 post-dialysis(p< 0.01). Plasma cGMP concentration(pmol/mL) significantly decreased from 23.9±4.4 pre-dialysis to 8.8±3.4 post-dialysis(p<0.01), and plasma ANP concentration(pg/mL) significantly decreased from 315±64 pre-dialysis to 222±71 post-dialysis(p<0.05). The extent of weight loss was not associated with above three parameters after dialysis.
2)The relationship between RTBW/RECF ratios and biochemical parameters:No relationship was noted between two parameters before dialysis, while a significant relationship was observed with plasma cGMP concentrations or plasma ANP concentrations after dialysis(r=0.705, p<0.01; r=0.653, p<0.01, respectively).
3)The measure of agreement in estimation of dry weight after dialysis(kappa value):Although the consistencies of a BIA method and a cGMP method were good(κ=0.64), the consistency between a BIA method and an ANP method was low(κ=0.21), and the consistency between a cGMP method and an ANP method was almost negligible(κ=0.09).  Conclusion:In conclusion, RTBW/RECF ratio or plasma cGMP concentration can be used, but plasma ANP concentration is not suitable for evaluating dry weight after dialysis.

10혈액 투석 중인 만성 신부전증 환자에서 소양증과 호산구증다증의 연관성

저자 : 강광영 ( Kwang Young Kang ) , 유민영 ( Min Young You ) , 이준상 ( Jun Sang Lee ) , 임철완 ( Chull Wan Ihm ) , 문치영 ( Chi Young Moon ) , 박성광 ( Sung Kwang Park )

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 18권 4호 발행 연도 : 1999 페이지 : pp. 585-591 (7 pages)

다운로드

(기관인증 필요)

초록보기

Background:Pruritus is one of the most common complaints of patients with chronic renal failure undergoing hemodialysis. But its etiology is not clear, and there is no universally effective treatment. Recently we have experienced eosinophilia in hemodialysis patients suffering from pruritus. Objective:The purpose of the this study was to evaluate the relationship between pruritus and eosinophilia in patients on hemodialysis. Methods:We examined degree of pruritus and eosinophilia in 65 patients with end stage renal disease who were on hemodialysis from September 1996 to August 1997 in artificial kidney center of Chonbuk National University Hospital. The study was conducted by means of personal interview, physical examination, and review of medical records. The degree of pruritus was measured by scores from minimal 0 point to maximal 48 points and more than 5% or 500/mm3 eosinophils in peripheral blood was regarded as eosinophilia.  Results:
1)Incidence of each cutaneous symptoms were pruritus(61.5%), xerosis(35.4%), hyperpigmentation (30.8%), easy bruising(16.9%), nail change(12.3%), decreasing in sweating(10.8%), hypotrichosis(7.7%), and acne(4.6%).  2)Forty(61.5%) of 65 patients undergoing hemodialysis had pruritus, 32.3% in mild, 20% in moderate, and 9.2% in severe degree by pruritus score. 3)Nineteen(29.2%) of the 65 patients had eosinophilia:23.8%(5/21) of patients with mild pruritus, 30.7%(4/13) of patients with moderate pruritus, and 66.7%(4/6) of severe pruritus. It could be said that prevalence of eosinophilia was related to the severity of pruritus. 4)With repeated hemodialysis the severity of pruritus increased in 65%(26/40), decreased in 22.5% (9/40), did not change in 12.5%(5/40) of patients with pruritus.  5)Pruritus was not related to the serum calcium (Ca), inorganic phosphorus(PO4), Ca×PO4 product, BUN, or creatinine. There was, however, significant correlations with the serum alkaline phohphatase. 
Conclusion:There was a positive correlation bet- ween the prevalence of eosinophilia and severity of pruritus in patients on hemodialysis.

123
주제별 간행물
간행물명 수록권호

KCI등재

Allergy asthma & respiratory disease
8권 4호 ~ 8권 4호

KCI등재 SCOUPUS

Intestinal research (Intest Res)
18권 4호 ~ 18권 4호

대한당뇨병학회 학술발표논문집
2020권 0호 ~ 2020권 0호

KCI등재 SCI SCOUPUS

Journal of Neurogastroenterology and Motility
26권 4호 ~ 26권 4호

KCI등재 SCOUPUS

Clinical and Molecular Hepatology(대한간학회지)
26권 4호 ~ 26권 4호

KCI등재 SCI

The Korean Journal of Internal Medicine
35권 6호 ~ 35권 6호

KCI등재 SCOUPUS

대한소화기학회지
76권 4호 ~ 76권 4호

KCI등재 SCI SCOUPUS

Diabetes and Metabolism Journal (DMJ)
44권 5호 ~ 44권 5호

KCI등재 SCOUPUS

Clinical Endoscopy
53권 5호 ~ 53권 5호

춘·추계 학술대회 (KASL)
2020권 1호 ~ 2020권 1호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재 SCOUPUS

Kidney Research and Clinical Practice(구 대한신장학회지)
39권 3호 ~ 39권 3호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재 SCI SCOUPUS

Gut and Liver
14권 5호 ~ 14권 5호

KCI등재

대한간암학회지
20권 2호 ~ 20권 2호

KCI등재 SCI SCOUPUS

Endocrinology and Metabolism(구 대한내분비학회지)
35권 3호 ~ 35권 3호

Postgraduate Courses (PG)
2020권 1호 ~ 2020권 1호

당뇨병(JKD)
21권 3호 ~ 21권 3호

Korean Journal of Medicine(구 대한내과학회지)
95권 5호 ~ 95권 5호
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기