This study was designed to investigate the mole- cular mechanism of chemokine induction by lipopoly-saccharide(LPS) of E. coli. Chemokine gene expression was evaluated by the reverse transcriptase-polymerase chain reaction(RT-PCR) assay using RNAs isolated either from kidneys of LPS-injected inice or from the mesangial cells stimulated with LPS, IFN-r or TNF-a. LPS was shown to induce interferon gamma(IFN- 7 ) inducible protein 10 (IP-10) and monokine induced by interferon gamma (MIG) in kidney. IP-10 gene expression was induced by LPS and IFN-r, but MIG gene expression was induced by IFN-r in mesangial cell. Chemokines induced by LPS increased splenocyte migration. Sodium salicylate, wortmanin and piperazine blocked LPS mediated chemokine induction suggesting the activation of nuclear factor-a B pathway. It is concluded from this study that mesangial cells are the target of LPS in the renal failure resulting from the systemic infections. LPS induces chemokines directly and/or indirectly in the mesan- gial cells, and these chemokines may associated with renal inflammation.
Chemokines ; Gene Expression* ; Inflammation ; Interferons ; Kidney ; Mesangial Cells* ; Renal Insufficiency ; RNA ; Sodium Salicylate

BACKGROUND: Handgrip and cold pressor test may increase the afterload of the heart. And in left ventricular hypertrophy, it is known that mitral flow pattern is affected by decreased left ventricular compliance. We investigated the effects of handgrip and cold pressor test on mitral flow pattern in patients with left ventricular hypertrophy. METHODS: Handgrip and cold pressor test were performed in 12 subjects with left ventricular hypertrophy and in 14 healthy normal subjects. In supine position, blood pressure, heart rate and Doppler echocardiographic parameters(early peak flow velocity : E, atrial peak flow velocity : A) were obtained at rest, 1 and 3 minutes after the onset of tests respectively. RESULTS: In both groups, handgrip and cold pressor test increased blood pressure slightly without a statistical significance. In left ventricular hypertrophy group, there were significant increments in heart rates at 1 minute of handgrip (78+/-12min-1, p<0.001) and cold pressor test(77+/-7min-1, p<0.05) as compared to that at rest (73+/-12min-1). Mitral flow velocities did not show significant change after the tests in control group. A waves after 1 minute of handgrip(85.2+/-18.4cm/sec, p<0.05) and cold pressor test (87.3+/-17.8cm/sec, p<0.001) showed significant increases as compared to that at rest (79.1+/-14.9cm/sec) in left ventricular hypertrophy group whereas E waves did not. CONCLUSION: Although handgrip and cold pressor tests did not affect the mitral flow significantly in control group, each test raised A waves in left ventricular hypertrophy group. These results suggest that increased A waves may be due to a rise in afterload and decreased left ventricular compliance caused by handgrip and cold pressor test in left ventricular hypertrophy group.
Blood Pressure ; Compliance ; Echocardiography ; Heart ; Heart Rate ; Humans ; Hypertrophy, Left Ventricular* ; Supine Position

Bartter syndrome is characterized by markedly reduced or absent salt transport by the thick ascending limb of Henle. The phenotype of Bartter syndrome is renal salt wasting, hypokalemic metabolic alkalosis, increased renin-angiotensin-aldosterone system, with normal or low blood pressure. Most of the cases have been noted in the pediatric age group and adult-onset cases are rare. Nephrocalcinosis is common in antenatal Bartter syndrome. We report a case of adult-onset Bartter syndrome associated with nephrocalcinosis.
Alkalosis ; Bartter Syndrome* ; Extremities ; Humans ; Hypokalemia ; Hypotension ; Nephrocalcinosis* ; Phenotype ; Renin-Angiotensin System

Renal osteodystrophy (ROD) is an early complication in chronic kidney disease (CKD). Irreversible skeletal complications and deformities in children are already present before CKD progresses to end stage renal disease; therefore, the early detection of coexisting ROD is important in children with CKD. In the present work, we present a case of ROD in a 14-year-old female patient with chronic renal failure. The patient had already suffered bilateral femoral neck fractures before starting extracorporeal dialysis. On the 21st day after dialysis, external fixations of the femoral neck were performed.
Adolescent ; Child ; Congenital Abnormalities ; Dialysis ; Female ; Femoral Neck Fractures ; Femur Neck ; Humans ; Kidney Failure, Chronic ; Renal Dialysis ; Renal Insufficiency, Chronic ; Renal Osteodystrophy ; Renal Replacement Therapy

BACKGROUND: Although native radiocephalic arteriovenous fistula provides the best possible vascular access for hemodialysis, available veins for this fistula are limited. Ulnobasilic arteriovenous fistula (UBF) is alternative method for native fistula of forearm. But this method is not commonly used because detection of the vein is difficult and cannulation for hemodialysis id uncomfortable. This study was performed to evaluate clinical usefulness of UBF. METHODS: From June 1999 to April 2000 and from September 2001 to February 2002, 256 arteriovenous fistulae were made in 239 patients with chronic renal failure and among them, 26 UBF were made by one surgeon. At April 2002, a total of 26 UBF were reviewed. RESULTS: The results were as follows : There were 17 men and 9 women, aged 31 to 72 years. There were 7 diabetic patients. 22 patients of them had previous history of arteriovenous fistula operation. There were six failures : one delayed occlusion; one venous hypertension due to proximal stenosis during hemodialysis; four inadequate maturation. The 20 patients showed good patency. CONCLUSION: This study shows that UBF can be useful method in patients with failed radiocephalic arteriovenous fistula or poor cephalic vein and preserve upper arm vein for future operation.
Arm ; Arteriovenous Fistula* ; Catheterization ; Constriction, Pathologic ; Female ; Fistula ; Forearm ; Humans ; Hypertension ; Kidney Failure, Chronic ; Male ; Renal Dialysis* ; Veins

PURPOSE: In recent years, cystatin C (CysC) was proposed as a new marker for evaluating the glomerular filtration rate due to a constant serum level. The aim of this study was to measure serum CysC values of healthy young Korean men in assessment of kidney function and compare it with other reports until now in male populations, using nephelometric immunoassay. METHODS: CysC and creatinine levels were measured by particle enhanced nephelometric immunoassay and Jaffe method, respectively, in 145 young Korean men without evidence of kidney disease. Medline was searched for CysC reference values in healthy male populations. RESULTS: CysC values showed a normal distribution (Kolmogorov-Smirnov, K-S, p=0.2). The CysC reference interval for healthy young Korean men (age 19-29) was 0.58 to 0.94 mg/L (0.76+/-0.09 mg/ L, X+/-2SD, range 0.60 to 1.25 mg/L). Reference intervals for creatinine was 0.79 to 1.27 mg/dL (1.03+/-0.12 mg/dL, X+/-2SD, range 0.8 to 1.3 mg/dL) in subjects. Creatinine serum values did not show a normal distribution (K-S, p=0.001). The correlation coefficient for CysC and creatinine was only 0.308. (p=0.0001) Nephelometric CysC reference intervals we determined were consistent among different male populations. CONCLUSION: We determined reference intervals for CysC values in healthy young Korean men, and CysC reference values established by nephelometric immunoassay were consistent among different men population. This information could be useful in assessing renal function in healthy young Korean men.
Creatinine ; Cystatin C ; Glomerular Filtration Rate ; Humans ; Immunoassay ; Kidney ; Kidney Diseases ; Male ; Nephelometry and Turbidimetry ; Reference Values

PURPOSE: This study investigated the effect of reducing cisplatin induced nephrotoxicity with DWP-04 that is the compound of Schizandrin C derivative biphenyldimethyl dicarboxylate (DDB), glutathione and selenium. For the purpose of observation is that how DWP-04 has influence on mechanism of reducing cisplatin induced nephrotoxicity with renal function test, free radical formation and detoxification enzyme system in renal tissue. METHODS: Five groups of rats were dosed with vehicle, cisplatin (2 mg/kg i.p.), cisplatin+DWP-04 (100, 200 mg/kg po), or cisplatin+sodium thiosulfate (200 mg/kg i.p.) daily for 4 weeks. RESULTS: Serum creatinine, lactate dehydrogenase and activity of hydroxy radical increased in the cisplatin group and suppressed in the cisplatin+DWP-04 group compared to the cisplatin group. The renal tissue concentration of lipid peroxidase and lipofuscin were increased in the cisplatin group compared to the other groups. The activity of aminopyrine N-demethylase, aniline hydroxylase, aldehyde oxidase and xanthine oxidase, of which free radical formation system in kidney was also decreased in the cisplatin+DWP-04 group compared to the cisplatin and cisplatin+sodium thiosulfate group. The activity of detoxification system of free radical, such as glutathione S-transferase, superoxide dismutase, catalase and glutathione peroxidase were markedly increased in the cisplatin+DWP-04 group than the cisplatin and the cisplatin+sodium thiosulfate group (p<0.05). CONCLUSION: It can be concluded that the mechanism of decreasing cisplatin-induced nephrotoxicity by DWP-04 is that the decreasing of the amount of lipid peroxide and lipofuscin in the renal tissue by increasing activity of the antioxidant defense system and the decreasing of reactive oxygen species by increasing detoxification enzyme activity.
Aldehyde Oxidase ; Aminopyrine N-Demethylase ; Aniline Compounds ; Aniline Hydroxylase ; Animals ; Antioxidants ; Catalase ; Cisplatin ; Creatinine ; Cyclooctanes ; Glutathione ; Glutathione Peroxidase ; Glutathione Transferase ; Kidney ; L-Lactate Dehydrogenase ; Lignans ; Lipofuscin ; Peroxidase ; Polycyclic Compounds ; Rats ; Reactive Oxygen Species ; Renal Insufficiency ; Selenium ; Superoxide Dismutase ; Xanthine Oxidase

PURPOSE: Depression is common in patients with chronic renal failure on maintenance hemodialysis, though success rate of treatment is low. This study aimed to investigate the features and severity of the depressive symptoms and nutritional indices, and significant changes after antidepressant treatment. METHODS: The authors assessed 45 patients. Diagnosis of depression was made using DSM-IV-TR and the depressive symptoms were evaluated using Hamilton Rating Scale for Depression via semi- structured interview. Subjective global assessment, anthropometric measurements and nutritional indices such as Kt/V, nPCR were examined. Depressive patients were treated for 8 weeks with SSRI (citalopram), and all the variables were examined again after the treatment. RESULTS: 19 (42.2%) patients were diagnosed as depression. Nutritional status was not different between patients with depression and those without depression. Compared to non-depressed patients, depressed patients showed significantly higher depressed mood, guilty feeling, suicide idea, psychic and somatic anxiety, lower work and activities, psychomotor retardation, sleep disturbances, general somatic symptoms and hypochondriasis. After antidepressant treatment, depressed mood, guilty feeling, suicide idea, psychic anxiety, initial insomnia, middle insomnia, early awakening, work and activities and general somatic symptoms were improved significantly. TSF (p<0.05), handgrip strength (p<0.01) and hematocrit (p<0.05) were significantly increased. CONCLUSION: Antidepressant treatment is helpful not only for the improvement of depressive symptoms such as sleep and somatic symptoms but for the improvement of quality of life. Proper treatment should be more actively attempted for the hemodialytic patients with depression.
Anxiety ; Depression ; Hematocrit ; Humans ; Hypochondriasis ; Kidney Failure, Chronic ; Nutrition Assessment ; Nutritional Status ; Quality of Life ; Renal Dialysis ; Sleep Initiation and Maintenance Disorders ; Suicide ; Tosyl Compounds

PURPOSE: In the passive Heymann nephritis (PHN) rat model of membranous nephropathy, complement induces glomerular epithelial cell injury and proteinuria, which is partially mediated by reactive oxygen species (ROS), TGF-beta, and COX-2. In the current study, we determined the effect of a selective COX-2 inhibitor (celecoxib) and vitamin C on the enzyme system associated with ROS, TGF-beta, and COX-2 in PHN. METHODS: Four groups of rats with PHN were dosed with polyethylene glycol vehicle (P; n=4), celecoxib (COXi; n=8), vitamin C (VC; n=8), or celecoxib and vitamin C (COXi+VC; n=8) from days 7-21. Each group was then divided into 2 subgroups reflecting the day of the experiment (day-14 and -21 subgroups). RESULTS: The urine protein was significantly reduced in the VC and COXi+VC groups (subgroup day- 14) compared to the P group (p<0.05). The glomerular TGF-beta expression was reduced in the COXi+ VC group (subgroup day-21) compared to the P group (p<0.05). Glomerular COX-2 expression was increased in the COXi, VC, and COXi+VC groups compared to the P group (p<0.05). The COXi, VC, and COXi+VC groups (subgroup day-21) had decreased activity of lipid peroxide and xanthine oxidase and increased activity of xanthine dehydrogenase, superoxide dismutase, GSH-Px, and catalase. This antioxidant activity was highest in the COXi+VC group (p<0.05). CONCLUSION: Selective COX-2 inhibitors possess antioxidant effects. The combination of a COX-2 inhibitor and vitamin C was more effective than COX-2 inhibitor or vitamin C alone in increasing antioxidant activity and decreasing TGF-beta.
Animals ; Antioxidants ; Ascorbic Acid ; Catalase ; Complement System Proteins ; Cyclooxygenase 2 ; Cyclooxygenase 2 Inhibitors ; Epithelial Cells ; Glomerulonephritis, Membranous ; Polyethylene Glycols ; Proteinuria ; Pyrazoles ; Rats ; Reactive Oxygen Species ; Sulfonamides ; Superoxide Dismutase ; Transforming Growth Factor beta ; Vitamins ; Xanthine Dehydrogenase ; Xanthine Oxidase

Mitomycin (MMC) is a naturally ocurring alkylating agent, introduced for clinical use as early as 1958. This drug is useful in the therapy of gastrointestinal carcinomas when used in combination with 5-fluorouracil. Nephrotoxicity among toxicities from MMC is unusual with cumulative doses less than 30 mg/m2. In large studies in which the incidence of MMC nephrotoxicity were assessed, 3-15% of patients developed total dose related renal dysfunction. Three patients in our clinical practice have developed thrombotic microangiopathy clearly related to MMC. We report the clinical and pathologic features of our cases. In view of the probable dose-related and delayed toxicity of MMC, it seems necessary to monitor regularly after initiation of chemotherapy. Early detection of the renal impairment and withdrawal of MMC might halt further progression of renal failure.
Drug Therapy ; Fluorouracil ; Humans ; Incidence ; Mitomycin* ; Renal Insufficiency ; Thrombotic Microangiopathies*