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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
  • : 격월
  • : 2211-9132
  • : 2211-9140
  • : 대한신장학회지(~2006) → The Korean Journal of Nephrology(2007~) → KINDEY Research and Clinal Practice(2012~)

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수록범위 : 1권1호(1982)~41권5호(2022) |수록논문 수 : 3,930
Kidney Research and Clinical Practice(구 대한신장학회지)
41권5호(2022년 09월) 수록논문
최근 권호 논문
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KCI등재 SCOPUS

저자 : Jun-ya Kaimori , Yusuke Sakaguchi , Yoshitaka Isaka

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 310-312 (3 pages)

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KCI등재 SCOPUS

저자 : Yong-jin Kim

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 524-532 (9 pages)

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Thrombotic microangiopathy (TMA) refers to a condition caused by microvascular injury that includes thrombosis, hemolytic anemia, and thrombocytopenia. There are two classic TMAs, hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura, as well as an atypical HUS (aHUS). aHUS includes a broad spectrum of disorders with diverse etiologies and shares clinical manifestations with classic TMA; however, it frequently lacks typical clinical and laboratory findings. These traits can confuse clinicians and pathologists in terms of renal pathologic diagnosis, especially in cases where TMA is associated with other glomerulopathies or hypertensive renal disease. In this review, new paradigms for classifying TMA and the diversity of histopathologic changes including associated renal diseases are discussed. Renal biopsy is an important and useful diagnostic tool for diagnosing TMA and identifying TMA changes in other renal diseases, including hypertension. Adopting the term “TMA features” for TMA-like changes in glomerulus or artery/ arteriole in addition to the pathological diagnosis of glomerulopathy would be informative to clinicians for a prompt diagnosis and treatment of aHUS.

KCI등재 SCOPUS

저자 : Verdiana Ravarotto , Giovanni Bertoldi , Lucia Federica Stefanelli , Federico Nalesso , Lorenzo A. Calò

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 533-544 (12 pages)

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The high prevalence of cardiovascular disease in patients with chronic kidney disease indicates significant interactions between pathogenic pathways operating in the kidney and heart. These interactions involve all cell types (endothelial cells, smooth muscle cells, macrophages, and others), components of the vasculature, glomeruli, and heart that are susceptible to oxidative damage and structural alterations. A vicious cycle occurs whereby harmful factors such as reactive oxygen species and inflammation damage of vascular structures that themselves become sources of additional dangerous/toxic components released into the local environment. The evidence of this vicious cycle in chronic kidney disease should therefore lead to add other factors to both traditional and nontraditional risk factors. This review will examine the processes occurring during progressive kidney dysfunction with regard to vascular injury, renal remodeling, cardiac hypertrophy, and the transversal role of oxidative stress in the development of these complications.

KCI등재 SCOPUS

저자 : Taeyeong Kim , Yooujin Kwak , Jun Young Lee , Hanwul Shin , Jae Seok Kim , Jae Won Yang , Minseob Eom

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 545-555 (11 pages)

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Background: Diabetic nephropathy (DN) accounts for approximately half of all cases of chronic kidney disease (CKD) and end-stage kidney disease worldwide. The Renal Pathology Society (RPS) classification has been used to predict the renal prognosis in DN. In 2018, the Japanese Renal Pathology Society (JRPS) proposed a comprehensive classification system that included pathological changes in the kidney. The clinical significance of the JRPS classification system was comparatively evaluated in the present study.
Methods: A total of 93 cases diagnosed with DN from 2009 to 2019 were enrolled. JRPS scores (J-scores) were calculated by scoring the pathological factors in the JRPS classification system and comparing them with clinical parameters.
Results: Most pathological factors constituting the J-score were significantly correlated with clinical factors. Laminated nodules were inversely correlated with estimated glomerular filtration rate. After adjusting for age, sex, body mass index, hemoglobin A1c, diabetes duration, and hypertension, CKD stage was significantly correlated with JRPS grade, nodular lesions, and exudative lesions in the multivariate logistic regression analysis. However, receiver operating characteristic curve analysis revealed that the J-score (area under the curve [AUC] = 0.639) had lower clinical significance than the traditional RPS classification system (AUC = 0.675).
Conclusion: The JRPS classification can more comprehensively reflect renal changes than the RPS classification and is correlated with renal survival. When creating a new pathological classification, arteriolar hyalinosis should not be included, whereas laminated nodules should be included.

KCI등재 SCOPUS

저자 : Young Su Joo , Hyung Woo Kim , Chung Hee Baek , Jung Tak Park , Hajeong Lee , Beom Jin Lim , Tae-hyun Yoo , Kyung Chul Moon , Ho Jun Chin , Shin-wook Kang , Seung Hyeok Han

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 556-566 (11 pages)

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Background: The International IgA Nephropathy Prediction Tool has been recently developed to estimate the progression risk of immunoglobulin A nephropathy (IgAN). This study aimed to evaluate the clinical performance of this prediction tool in a large IgAN cohort in Korea.
Methods: The study cohort was comprised of 2,064 patients with biopsy-proven IgAN from four medical centers between March 2012 and September 2021. We calculated the predicted risk for each patient. The primary outcome was occurrence of a 50% decline in estimated glomerular filtration rate (eGFR) from the time of biopsy or end-stage kidney disease. The model performance was evaluated for discrimination, calibration, and reclassification. We also constructed and tested an additional model with a new coefficient for the Korean race.
Results: During a median follow-up period of 3.8 years (interquartile range, 1.8-6.6 years), 363 patients developed the primary outcome. The two prediction models exhibited good discrimination power, with a C-statistic of 0.81. The two models generally underestimated the risk of the primary outcome, with lesser underestimation for the model with race. The model with race showed better performance in reclassification compared to the model without race (net reclassification index, 0.13). The updated model with the Korean coefficient showed good agreement between predicted risk and observed outcome.
Conclusion: In Korean IgAN patients, International IgA Nephropathy Prediction Tool had good discrimination power but underestimated the risk of progression. The updated model with the Korean coefficient showed acceptable calibration and warrants external validation.

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Background: Certain pharmacotherapies have shown to be effective for both cardiac and kidney outcomes. Although risk prediction is important in treatment decision-making, few studies have evaluated prediction models for composite cardiovascular and kidney outcomes.
Methods: This study included 2,195,341 Korean adults from a nationwide cohort for chronic kidney disease and a representative sample of the general population, with a 9-year follow-up. This study evaluated prediction models for a composite of major cardiovascular events or kidney disease progression that included albuminuria and estimated glomerular filtration rate (eGFR) and/or traditional cardiovascular disease predictors.
Results: The addition of albuminuria and eGFR to a model for the composite outcome that included age, sex, and traditional predictors increased a C statistic by 0.0459, while the addition of traditional predictors to age, sex, albuminuria, and eGFR increased a C statistic by 0.0157. When age and sex-adjusted incidence rates were calculated across the combined Pooled-Cohort-Equations (PCEs) and Kidney Disease: Improving Global Outcomes (KDIGO) risk categories in diabetic or hypertensive participants, the incidence of ≥10 per 1,000 person-years was observed among all categories with high or very high KDIGO risk and among categories with moderate (or low) KDIGO risk and a PCEs 10-year risk of ≥10% (or ≥20%), accounting for 36% of diabetic and 18% of hypertensive populations.
Conclusion: This study strongly supports the utility of the KDIGO risk matrix combined with a conventional cardiovascular risk score for the prediction of composite cardiovascular and kidney outcome and provides epidemiologic data relevant to the development of efficient treatment strategies.

KCI등재 SCOPUS

저자 : Jung Nam An , Jwa-kyung Kim , Hyung-seok Lee , Sung Gyun Kim , Hyung Jik Kim , Young Rim Song

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 580-590 (11 pages)

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Background: Sarcopenia is a prevalent complication in patients with chronic kidney disease and is associated with poor quality of life, morbidity, and mortality. Several candidate biomarkers have been evaluated for this condition. This study assessed the serum cystatin C to creatinine (serum cystatin C/Cr) ratio as a potential biomarker for sarcopenia in patients with non-dialysis-dependent chronic kidney disease.
Methods: This study enrolled 517 outpatients. Muscle mass (lean tissue index) was measured using a bioimpedance spectroscopic device, and muscle strength (handgrip strength) was also measured. Sarcopenia was defined as a combination of low muscle strength and low muscle mass.
Results: Sarcopenia was observed in 25.5% of patients, and the mean serum cystatin C/Cr ratio was significantly higher in patients with sarcopenia than in those without it (1.14 ± 0.26 vs. 1.01 ± 0.27, p < 0.001). The prevalence of sarcopenia and low lean tissue index increased as the cystatin C/Cr ratio increased. The negative predictive value of the cystatin C/Cr ratio for sarcopenia or low lean tissue index was ≥80%. Multivariate analyses revealed that when the serum cystatin C/Cr ratio increased by 1, the risk of sarcopenia, low lean tissue index, and low handgrip strength increased by 4.6-, 7.2-, and 2.6-fold, respectively (p = 0.003, p < 0.001, and p = 0.048). The association was maximized in patients with an estimated glomerular filtration rate of <30 mL/min/1.73 m2.
Conclusion: Calculating the serum cystatin C/Cr ratio could be helpful for detecting and managing sarcopenia in patients with chronic kidney disease.

KCI등재 SCOPUS

저자 : Hayne Cho Park , Young-ki Lee , Eunsil Ko , Sungbong Yu , Ajin Cho , Do Hyoung Kim , Jinseog Kim , Jang-hee Cho , Jeonghwan Lee , Dong Ki Kim , Seong Nam Kim , Chul-woo Yang

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 591-600 (10 pages)

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Background: Hemodialysis (HD) patients are more vulnerable to viral epidemics, experiencing higher mortality rates compared to individuals without chronic kidney disease (CKD). This retrospective cohort study sought to demonstrate clinical outcomes and associated factors among coronavirus disease 2019 (COVID-19) confirmed Korean HD patients.
Methods: From February 2020 to November 2021, the COVID-19 Task Force Team collected clinical data for HD patients with confirmed COVID-19 via a self-report survey of nephrologists. The composite outcome included in-hospital mortality, admission to the intensive care unit (ICU), and use of mechanical ventilation. Risk factors associated with clinical outcomes were analyzed among HD patients and compared to those of individuals without CKD using the COVID-19 database from the Korea Disease Control and Prevention Agency.
Results: A total of 380 HD patients from 206 facilities were diagnosed with COVID-19. Fever (49.5%) and cough (25.7%) were the two most common initial symptoms. The overall in-hospital fatality rate was 22.4% and even higher among ICU admission cases (64.7%). Non-survivors were older, more frequently developed shortness of breath, and were more likely to come from a nursing hospital. Compared to the age- and sex-matched non-CKD population, HD patients showed greater risk of in-hospital mortality (hazard ratio, 2.07; 95% confidence interval, 1.56-2.75; p < 0.001) and composite outcome (hazard ratio, 3.50; 95% confidence interval, 2.56-4.77; p < 0.001).
Conclusion: HD patients have a greater risk of in-hospital mortality and morbidity from COVID-19. Special attention should be paid to COVID-19 HD patients when they are older or present with symptoms.

KCI등재 SCOPUS

저자 : Hyuk Huh , Ejin Kim , Una Amelia Yoon , Mun Jeong Choi , Hyewon Lee , Soie Kwon , Clara Tammy Kim , Dong Ki Kim , Yon Su Kim , Chun Soo Lim , Jung Pyo Lee , Ho Kim , Yong Chul Kim

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 601-610 (10 pages)

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Background: Growing evidence suggests that environmental air pollution adversely affects kidney health. To date, the association between carbon monoxide (CO) and mortality in patients with end-stage renal disease (ESRD) has not been examined.
Methods: Among 134,478 dialysis patients in the Korean ESRD cohort between 2001 and 2014, 8,130 deceased hemodialysis patients were enrolled, and data were analyzed using bidirectional, unidirectional, and time-stratified case-crossover design. We examined the association between short-term CO concentration and mortality in patients with ESRD. We used a two-pollutant model, adjusted for temperature as a climate factor and for nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and particulate matter less than 10 μm in diameter as air pollution variables other than CO.
Results: Characteristics of the study population included age (66.2 ± 12.1 years), sex (male, 59.1%; female, 40.9%), and comorbidities (diabetes, 55.6%; hypertension, 14.4%). Concentration of CO was significantly associated with all-cause mortality in the three case-crossover designs using the two-pollutant model adjusted for SO2. Patients with diabetes or age older than 75 years had a higher risk of mortality than patients without diabetes or those younger than 75 years.
Conclusion: Findings presented here suggest that higher CO concentration is correlated with increased all-cause mortality in hemodialysis patients, especially in older high-risk patients.

KCI등재 SCOPUS

저자 : Hyung Eun Son , Ji Young Ryu , Kyunghoon Lee , Young Il Choi , Myeong Sung Kim , Inwhee Park , Gyu Tae Shin , Heungsoo Kim , Curie Ahn , Sejoong Kim , Ho Jun Chin , Ki Young Na , Dong-wan Chae , Soyeon

발행기관 : 대한신장학회 간행물 : Kidney Research and Clinical Practice(구 대한신장학회지) 41권 5호 발행 연도 : 2022 페이지 : pp. 611-622 (12 pages)

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Background: Patients undergoing hemodialysis are susceptible to sarcopenia. As intracellular reservoirs of water, skeletal muscles are important contributors to intradialytic hypotension. This study was designed to determine the role of skeletal muscle mass in intradialytic hypotension.
Methods: In a cross-sectional study, the body composition of 177 patients was measured immediately after hemodialysis using bioelectrical impedance analysis. The parameters measured were skeletal muscle mass, intracellular and extracellular water contents, total body water, and cell-membrane functionality (in phase angle at 50 kHz). Data from laboratory tests, chest radiography, measurements of handgrip strength and mid-arm circumference, and questionnaires were collected. The main outcome was intradialytic hypotension, defined as more than two episodes of hypotension (systolic blood pressure of <90 mmHg) with intervention over the 3 months following enrollment. Logistic regression models including each parameter related to sarcopenia were compared with a clinical model.
Results: Patients with a low ratio of skeletal muscle mass to dry body weight (SMM/WT) had a higher rate of intradialytic hypotension (40.7%). Most low-SMM/WT patients were female, obese, diabetic, and had a lower handgrip strength compared with the other patients. In the high-SMM/WT group, the risk of intradialytic hypotension was lower, with an odds ratio of 0.08 (95% confidence interval [CI], 0.02-0.28) and adjusted odds ratio of 0.06 (95% CI, 0.01-0.29).
Conclusion: Measurement and maintenance of skeletal muscle can help prevent intradialytic hypotension in frail patients undergoing hemodialysis.

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