2.Clinical and genetic characteristics of Korean autosomal dominant polycystic kidney disease patients
Yun Kyu OH ; Hayne Cho PARK ; Hyunjin RYU ; Yong-Chul KIM ; Kook-Hwan OH
The Korean Journal of Internal Medicine 2021;36(4):767-779
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. It is characterized by cyst growth in the kidneys, resulting in kidney enlargement and end-stage kidney disease. The polycystic kidney disease 1 (PKD1) and PKD2 have been identified as genes related to ADPKD and their significance in the molecular pathology of the disease has been studied. A disease-modifying drug has been approved; therefore, it has become important to identify patients at a high risk of kidney disease progression. Genetic tests, image analysis methods, and clinical factors for kidney disease progression prediction have been established. This review describes genetic and clinical characteristics, and discusses ongoing studies in Korean ADPKD patients.
3.Clinical and genetic characteristics of Korean autosomal dominant polycystic kidney disease patients
Yun Kyu OH ; Hayne Cho PARK ; Hyunjin RYU ; Yong-Chul KIM ; Kook-Hwan OH
The Korean Journal of Internal Medicine 2021;36(4):767-779
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease. It is characterized by cyst growth in the kidneys, resulting in kidney enlargement and end-stage kidney disease. The polycystic kidney disease 1 (PKD1) and PKD2 have been identified as genes related to ADPKD and their significance in the molecular pathology of the disease has been studied. A disease-modifying drug has been approved; therefore, it has become important to identify patients at a high risk of kidney disease progression. Genetic tests, image analysis methods, and clinical factors for kidney disease progression prediction have been established. This review describes genetic and clinical characteristics, and discusses ongoing studies in Korean ADPKD patients.
4.Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities.
Hayne Cho PARK ; Young Ki LEE ; Kyung Don YOO ; Hee Jung JEON ; Seung Jun KIM ; Ajin CHO ; Jacob LEE ; Yang Gyun KIM ; Sang Ho LEE ; Sang Oh LEE
Kidney Research and Clinical Practice 2018;37(1):8-19
Patients receiving hemodialysis are vulnerable to infectious diseases due to their impaired immunity and high risk of exposure to pathogens. To protect patients, staff, and visitors from potential infections, each hemodialysis unit should establish and follow standard infection control and prevention measures. Therefore, clinical practice guidelines were developed by a working group of nephrologists and infection control specialists to provide evidence-based guidance for dialysis physicians and nurses, with the aim of preventing infection transmission and controlling infection sources in hemodialysis facilities. The areas of infection control covered by these guidelines include standard precautions, isolation strategies, vascular access, water treatment, cleaning/disinfecting/sterilizing, and vaccination. This special report summarizes the key recommendations from the Korean clinical practice guidelines for preventing the transmission of infections in hemodialysis facilities.
Communicable Diseases
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Dialysis
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Disease Transmission, Infectious
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Humans
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Infection Control
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Renal Dialysis*
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Specialization
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Vaccination
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Water Purification
5.Successfully Treated Escherichia coli-Induced Emphysematous Cyst Infection with Combination of Intravenous Antibiotics and Intracystic Antibiotics Irrigation in a Patient with Autosomal Dominant Polycystic Kidney Disease.
Hyunsuk KIM ; Hayne CHO PARK ; Sunhwa LEE ; Jungsil LEE ; Chungyun CHO ; Dong Ki KIM ; Young Hwan HWANG ; Kook Hwan OH ; Curie AHN
Journal of Korean Medical Science 2013;28(6):955-958
A 62-yr-old woman with an autosomal dominant polycystic kidney disease (ADPKD) was admitted to our hospital for further evaluation of intermittent fever, nausea and left flank discomfort. The computed tomography (CT) scan revealed a gas-forming, infectious cyst of approximately 8.1 cm in size in left kidney lower pole. Escherichia coli was identified from the cyst fluid culture examination. Her symptoms improved only after the concomitant use of intravenous ciprofloxacin and an intracystic irrigation of ciprofloxacin through a percutaneous cystostomy drainage. Our case presents the successfully treated emphysematous cyst infection with combination of intravenous antibiotics and intracystic antibiotic therapy instead of surgical management.
Anti-Bacterial Agents/*therapeutic use
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Ciprofloxacin/*therapeutic use
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Cystostomy
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Cysts/microbiology
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Escherichia coli Infections/complications/*drug therapy
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Female
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Humans
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Injections, Intravenous
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Middle Aged
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Polycystic Kidney, Autosomal Dominant/complications/*diagnosis
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Therapeutic Irrigation
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Tomography, X-Ray Computed
6.The paradoxical effect of aldosterone on cardiovascular outcome in maintenance hemodialysis patients
Sun Ryoung CHOI ; Young-Ki LEE ; Hayne Cho PARK ; Do Hyoung KIM ; AJin CHO ; Juhee KIM ; Kyu Sang YUN ; Jung-Woo NOH ; Min-Kyung KANG
Kidney Research and Clinical Practice 2022;41(1):77-88
Patients with end-stage kidney disease face increased risk of cardiovascular events, and left ventricular diastolic dysfunction (LVDD) contributes to the high occurrence of cardiovascular mortality (CM). Although a high serum aldosterone (sALD) level is involved in the development of cardiovascular complications in the general population, this association is unclear in patients undergoing hemodialysis. We aimed to determine the impact of sALD on LVDD and CM among hemodialysis patients (HDPs). Methods: We performed a prospective cohort study of maintenance HDPs without cardiovascular disease. The patients were divided into two groups according to the median level of sALD. All patients underwent baseline echocardiography to evaluate diastolic dysfunction (E/e’ ratio > 15). The LVDD and CM rates were compared between the high and low aldosterone groups. Results: We enrolled a total of 60 adult patients (mean age, 57.9 ± 12.1 years; males, 30.0%). The low aldosterone group had an increased left ventricular diastolic dimension compared with the high aldosterone group (52.2 ± 8.4 mm vs. 50.3 ± 5.2 mm, respectively; p = 0.03). Low log-aldosterone (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.19–0.86) and large left atrial dimension (OR, 1.31; 95% CI, 1.11–1.54) were independent risk factors for LVDD at baseline. In addition, Cox regression analysis demonstrated that low sALD was an independent predictor of CM in HDPs (hazard ratio, 0.46; 95% CI, 0.25–0.85; p = 0.01) during follow-up. Conclusion: Low sALD was not only associated with LVDD but was also an independent predictor of CM among HDPs regardless of their interdialytic weight gain.
7.Effects of the route of erythropoietin administration on hemoglobin variability and cardiovascular events in hemodialysis patients
Do Hyoung KIM ; Young-Ki LEE ; Juhee KIM ; Hayne Cho PARK ; Kyu Sang YUN ; AJin CHO ; Jong-Woo YOON ; Ja-Ryong KOO ; Jung-Woo NOH
Kidney Research and Clinical Practice 2021;40(4):724-733
Methods:
This is a post hoc analysis of a prospective, controlled, randomized, unblinded study with 78 Korean hemodialysis patients receiving intravenous (n = 40) or subcutaneous (n = 38) erythropoietin therapy. We evaluated hemoglobin variability by calculating the frequency of hemoglobin measurements outside the target range during all visits. The high-frequency group was defined by those with hemoglobin variability over the median value (25%) while the low-frequency group was defined by those with hemoglobin variability of <25%.
Results:
In this analysis, 37 patients (51.1%) were men, and the mean age was 50.6 ± 12.5 years. Twenty-five patients (35.2%) had diabetes mellitus. The frequency of the value being outside the target hemoglobin range was higher in the subcutaneous group compared to the intravenous group (0.36 ± 0.19 vs. 0.27 ± 0.12/visit, p = 0.03). The low-frequency group required significantly lower erythropoietin doses compared to the high-frequency group. In the adjusted Cox analysis, the parameter high-frequency group was a significant independent risk factor for cardiovascular events (hazard ratio, 3.53; 95% confidence interval, 1.15–10.83; p = 0.03).
Conclusion
The risk of missing the target hemoglobin range increased with subcutaneous administration compared with intravenous erythropoietin administration in hemodialysis patients. An increased frequency of the value being outside the target hemoglobin range was also associated with an increased risk of cardiovascular events.
9.Effectiveness of regdanvimab on mortality in COVID-19 infected patients on hemodialysis
Youn Kyung KEE ; Hayne Cho PARK ; Su Jin YOON ; Sungbong YU ; Eunsil KO ; AJin CHO ; Do Hyoung KIM ; Jinseog KIM ; Young-Ki LEE ;
Kidney Research and Clinical Practice 2024;43(1):111-121
Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (COVID-19), there are lack of effective and proven treatments for end-stage renal disease (ESRD). The present study aims to evaluate the effectiveness of regdanvimab on mortality in COVID-19–infected patients on hemodialysis (HD). Methods: We conducted an observational retrospective study in 230 COVID-19–infected patients on HD, of whom 77 (33.5%) were administered regdanvimab alone or in combination with dexamethasone or remdesivir during hospitalization (regdanvimab group) and 153 patients (66.5%) were not (no regdanvimab group). The primary outcome was in-hospital mortality. We compared mortality rates according to the use of regdanvimab and investigated the factors associated with mortality. Results: Fifty-nine deaths occurred during hospitalization, 49 in the no regdanvimab group (32.0%) and 10 in the regdanvimab group (13.0%), and the mortality rate was significantly higher in the no regdanvimab group than that in the regdanvimab group (p = 0.001). Multivariate Cox regression analysis showed that malignancy (p = 0.001), SPO2 of <95% at admission (p = 0.003), and administration of antibiotics and regdanvimab (p = 0.007 and p = 0.002, respectively) were significantly associated factors with mortality. Conclusion: Regdanvimab administration is beneficial in improving prognosis in hospitalized COVID-19 patients on HD. Considering the vulnerability to infection and high mortality of ESRD patients, regdanvimab may be considered as a therapeutic option in COVID-19 patients on HD.
10.A Case of Encapsulating Peritoneal Sclerosis Significantly Improved after Enterolysis.
Hyun Bae YOON ; Hayne Cho PARK ; Hajeong LEE ; Seung Suk HAN ; Kyu Joo PARK ; Ju Young MOON ; Curie AHN ; Kook Hwan OH
Korean Journal of Nephrology 2008;27(3):407-411
Encapsulating peritoneal sclerosis (EPS) is a rare but fatal complication of continuous ambulatory peritoneal dialysis (CAPD). There are some reports on the effect of immunosuppressant therapy including steroid, but the results have not always been promising. Recently, owing to the advance of surgical techniques, there are some reports of the EPS cases significantly improved after successful surgery. A 30-year old man developed EPS after 9 years of peritoneal dialysis, and switched to hemodialysis. In spite of repetitive conservative management and immunosuppressant therapy, there was no improvement. His body weight decreased from 50 kg to 40 kg (BMI 14.2 kg/m2) due to severe malnutrition, so we decided to perform surgery. Total intestinal enterolysis was done successfully without concomitant enterectomy, and his general condition improved dramatically. Four months after surgery, the serum albumin concentration increased from 3.1 g/dL to 4.3 g/dL, cholesterol from 92 mg/dL to 208 mg/dL, and hemoglobin from 9.2 g/dL to 12.5 g/dL. His body weight increased to 61 kg (BMI 21.6 kg/m2), and there was not any fluid collection or bowel obstruction seen on the abdominal CT scan. We experienced a case of EPS which was significantly improved after enterolysis. We report this case with review of the literature.
Body Weight
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Cholesterol
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Hemoglobins
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Malnutrition
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Peritoneal Dialysis
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Peritoneal Dialysis, Continuous Ambulatory
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Peritoneal Fibrosis
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Peritonitis
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Renal Dialysis
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Serum Albumin