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

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

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

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

Bartter syndrome is a renal tubular defect in electrolyte transport characterized by hypokalemia, metabolic alkalosis, hyperreninemia, hyperaldosteronism, normal blood pressure, and other clinical symptoms. As a clinical and genetical heterogeneous disorder, this syndrome can be classified into two clinical variants, antenatal Bartter syndrome and classic Bartter syndrome according to the onset age. Nephrocalcinosis is common in antenatal Bartter syndrome, but is rare in classic Bartter syndrome. It can also be classified into five genetic subtypes by the underlying mutant gene, all of which are expressed in the tubular epithelial cells of the thick ascending limb of the loop of Henle. Patients with Bartter syndrome type 1, 2 and 4 present at a younger age than classic Bartter syndrome type 3. We have experienced a case of Bartter syndrome with nephrocalcinosis in a 42-year-old woman diagnosed by biochemical and radiologic studies. We had successful response with potassium chloride and spironolactone.
Adult* ; Age of Onset ; Alkalosis ; Bartter Syndrome* ; Blood Pressure ; Epithelial Cells ; Extremities ; Female ; Humans ; Hyperaldosteronism ; Hypokalemia ; Loop of Henle ; Nephrocalcinosis* ; Potassium Chloride ; Spironolactone

The cirrhotic patients with ascites present unique challenge to the renal caregiver. Hydrothorax in a cirrhotic patient treated with PD poses a diagnostic dilemma. Proposed mechanisms for the development of a pleuro-peritoneal communication include congenital diaphragmatic defects, acquired weakening of diaphragmatic fibers caused by high intra-abdominal pressures during peritoneal dialysis, and impairments in lymphatic drainage. Pleural fluid analysis and diagnostic imaging assist in differentiation from other causes of pleural effusion. We report a case of hydrothorax in a compensated cirrhotic patient after recent introduction to peritoneal dialysis.
Ascites* ; Caregivers ; Diagnostic Imaging ; Drainage ; Humans ; Hydrothorax* ; Liver Cirrhosis* ; Peritoneal Dialysis ; Pleural Effusion

Renal thromboembolism almost always occurs in the setting of cardiac disease. Acute renal infarction may occur rarely in middle-aged patients without apparent risk factors for cardiac thromboembolism. We report a 40-year-old man who developed bilateral renal infarction and had no cardiovascular risk factors, except smoking. In middle-aged healthy patients with renal colic without lithiasis, the diagnosis of idiopathic renal infarction should be considered, especially if lactate dehydrogenase is elevated.
Adult ; Heart Diseases ; Humans ; Infarction ; Kidney ; L-Lactate Dehydrogenase ; Lithiasis ; Renal Colic ; Risk Factors ; Smoke ; Smoking ; Thromboembolism