Blood levels of phosphorus and calcium were quantified in 151 subjects including 30 healthy subjects in control group, and 121 patients of chronical kidney failure of the stage I-IV and the age ranged from 18 to 50. Results demonstrated a reduce of kidney failure of the stage I-II in comparing with control, leading to secondary hyperparathyroid and a hypertrophy of parathyroid gland. The more kidney failure, the higher level of blood calcium, this is an important factor of dystrophy of bone in the patient
Blood ; Kidney Failure ; patients ; Kidney Failure, Chronic ; calcium ; Phosphorus

By study calcium - phosphorus bilan and concentration of PTH in 173 patients with chronic renal failure in different stages showed that: Hyperphosphoremia is very common and this is an important symptom of disorders calcium - phosphorus bilan. This occurs from stage II of CRF (moderate renal failure) and becomes severe in ESRD. Concentration of PTH is really high in ESRD but it's also elevated in stages II and IIIa. The rate of elevated - PTH is 48.6% for all of studied patients.
Kidney Failure, Chronic ; Calcium ; Blood ; Phosphorus ; Parathyroid Hormone

Hypertension affects the majority of patients with chronic kidney disease (CKD) and increases the risk of cardiovascular disease, end-stage renal disease and mortality. Previously, many hypertension guidelines have suggested blood pressure targets in patients with CKD. Recently, the American College of Cardiology/American Heart Association 2017 Guideline for Hypertension suggests a new definition for hypertension and therapeutic targets, which were equally applicated to patients with CKD. These changes reflect the results of the Systolic Blood Pressure Intervention Trial (SPRINT) study, but the renal outcome of intensive blood pressure control was not good. Furthermore, the majority of hypertension guidelines including those of the Korean Society of Hypertension and the European Society of Hypertension have retained the traditional definition. Herein, we intend to analyze in detail the effect of intensive blood pressure control on kidney through the post-hoc analyses of the SPRINT study.
Blood Pressure ; Cardiovascular Diseases ; Diagnosis ; Heart ; Humans ; Hypertension ; Kidney ; Kidney Failure, Chronic ; Mortality ; Renal Insufficiency, Chronic

Kidney transplantation is the best treatment for end-stage renal disease patients. However, the relative shortage of organs for transplantation has led to ABO-incompatible kidney transplantation as an accepted method to expand the pool of kidney donors. Recent advances in immunosuppression and antibody removal methods have made ABO-incompatible kidney transplantation more feasible, and have increased the opportunities for patients to receive kidney transplantation, as well as for special patients with ABO-compatible donor. Indeed, the outcome of ABO-incompatible kidney transplantation has shown remarkable developments and is now comparable to that of ABO-compatible kidney transplantation during last decade. However, there are still some uncertain issues to be addressed in ABO-incompatible kidney transplantation. In this article, we reviewed the current status and protocol of ABO-incompatible kidney transplantation and listed the concerns to be addressed in near future.
Antibodies ; Blood Group Incompatibility ; Humans ; Immunosuppression ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation* ; Tissue Donors

BACKGROUND: Non-dipper hypertension is defined as an improper nocturnal blood pressure falling less than 10/5 mmgHg or 10% in systolic and diastolic. Clinical studies have shown that target organ damages tend to be more frequent in non-dipper hypertensives. Author tried to elucidate whether non-dippers in untreated mild to moderate hypertension has more evidence of early renal damage or not. METHODS: Total 141 untreated mild to moderate Korean essential hypertensives including borderline hypertensives and 47 controls were subjected. Diabetes, chronic renal failure, heart failure, severe hypertension (above stage-III by JNC-VI criteria), isolated systolic hypertension and macroproteinuric cases (UAER >200 microgram/mL/min) were excluded to profit this study purpose. Subject was defined as non-dipper when nocturnal blood pressure fall was less than 10/5 mmHg. Urine microalbumin was analyzed by radioimmunoassay, and their excretion rate was calculated according to 24 hr urine volume. All data were compared and analyzed statistically by using of SPSS package. RESULT: Prevalence of non-dipper is not different between both groups (hypertension vs control ; 21.3% vs 25.5%, p>0.05). In hypertensive group, incidence of significant UAER and mean UAER were not different between dipper and non-dipper (all p>0.05). CONCLUSION: In this study, evidence of early renal damage in non-dipper hypertensive was not differ from dipper hypertensives. Long-term study would be necessary to observe for further renal damage in non-dipper hypertensives.
Blood Pressure ; Heart Failure ; Hypertension ; Incidence ; Kidney Failure, Chronic ; Prevalence* ; Radioimmunoassay

Diabetic nephropathy is a common complication of diabetes mellitus and is the leading cause of chronic kidney disease. Glycemic and blood pressure control constitute the main strategies of diabetic nephropathy prevention and treatment. However, despite current therapies, nephropathy progresses to renal failure and end-stage renal disease in many patients. Therefore, new therapeutic strategies targeting different pathophysiological mechanisms are needed. This review article briefly summarizes the standard therapy for diabetic nephropathy and also describes recent advances in potential renoprotective agents that could be used to prevent the development or progression of diabetic nephropathy.
Blood Pressure ; Diabetes Mellitus ; Diabetic Nephropathies* ; Humans ; Kidney Failure, Chronic ; Renal Insufficiency ; Renal Insufficiency, Chronic

Organ shortage is a critical issue in Korea as well as in other countries. In Korea, in 2013, the number of end-stage renal disease patients on the waiting list was 14,600; however, only 1,759 patients received transplantation during 2013. Recent advances in immunosuppression and antibody removal protocols have made ABO-incompatible kidney transplantation (ABO IKT) feasible, and have increased the opportunities for patients to undergo transplantation, especially for patients who do not have an ABO-compatible donor. The first ABO IKT was reported in 1955, but was unsuccessful due to the absence of an effective preparation protocol for antibody removal. In the 1980s, Alexandre used a protocol for removal of anti-ABO antibodies for the first time; however, the outcome was still inferior to that of ABO-compatible KT. Since 2000, with the advancement of immunosuppression and plasmapheresis, the outcome of ABO IKT has shown significant improvement and is now comparable to that of ABO-compatible KT. However, there are still several undetermined issues in ABO IKT. For example, issues regarding anti-ABO antibody titer, pretransplant desensitization method, immune suppressant regimen, and the role of C4d have still not been established. In this article, we reviewed the current status and protocol of ABO IKT and addressed to the undetermined issues in this field.
ABO Blood-Group System ; Antibodies ; Humans ; Immunosuppression ; Kidney Failure, Chronic ; Kidney Transplantation* ; Kidney* ; Korea ; Plasmapheresis ; Rituximab ; Tissue Donors ; Waiting Lists

Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease in Korea and worldwide, and is a risk factor for the development of cardiovascular complications. The conventional treatments for DKD are control of blood glucose and blood pressure levels by inhibiting the renin-angiotensin system. However, the prevalence of DKD continues to increase and additional therapies are required to prevent or ameliorate the condition. Many drugs have been, or are being, developed to target the molecular mechanisms in play in DKD. This review focuses on DVD treatment, considering current and emerging therapeutic targets and the clinical trial-based evidence.
Blood Glucose ; Blood Pressure ; Diabetic Nephropathies* ; Kidney ; Kidney Failure, Chronic ; Korea ; Prevalence ; Renin-Angiotensin System ; Risk Factors

PURPOSE: There were several reports showing that combined therapy of steroid and cyclophosphamide (PSL+CPA) was effective on progressive IgA nephropathy, but it remains inconclusive. METHODS: Patients with IgA nephropathy who showed more than 1.5 mg/dL of serum creatinine (SCr) and proteinuria and who were treated with the combined therapy in the Kyung hee University Hospital. RESULTS: The subjects were fifteen patients whose age was 40.3+/-10.8 yr, and the follow-up period was 39.1+/-24.6 months. Proteinuria levels declined from 4.08+/-2.58 g/gCr baseline to 1.80+/-1.72 g/ gCr 6 months after the treatment (p<0.0001). The comparison between the levels before & 6 months after the delta eGFR showed the improvement from -1.16+/-6.29 mL/min/1.73m2/month to 0.84+/-1.63 mL/ min/1.73m2/month (p=0.21), while these differences did not reach the level of statistical significance. According to delta eGFR, when the subjects were divided into the responder group (8 patients) and the non-responder group (7 patients), the former was 1.69+/-1.88 mL/min/1.73m2/month and the latter was -0.14+/-0.15 mL/min/1.73m2/month with significant difference (p=0.0014). According to UPCR, the responder group (12 patients) and the non-responder group (3 patients), systolic pressure, glomerulosclerosis and proteinuria after 6 months were significantly different (p=0.0115). Also, according to progressing ESRD, the CKD group (7 patients) and ESRD group (8 patients), age and SCr have shown a significant difference (p=0.0064). CONCLUSION: The combined therapy on progressive IgA nephropathy effectively reduced proteinuria and had protective effects on renal function in some patients. However, proteinuria and others were insufficient to be predictive factors on therapeutic responses. Large-scale prospective controlled studies may be necessary in the future.
Blood Pressure ; Creatinine ; Cyclophosphamide ; Follow-Up Studies ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Kidney Failure, Chronic ; Proteinuria

The effect of food consumption on blood pressure during hemodialysis was examined in relatively younger 10 nondiabetic patients with end stage renal disease who were free from autonomic dysfunction. A balanced diet(300 Cal) was given after 1 hour of hemodialysis. Fed and fasting treatments were randomly assigned, three times respectively, in each patient. Systolic(p=0.006), diastolic(p=0.08) and mean blood pressures fell faster in the 30-minute postprandial period in the fed treatments compared with those of equivalent times in the fasting treatments. For each of these changes, two-way repeated measures analysis of variance revealed neither significant time effect, nor significant treatment effect, nor significant interaction between time(before vs. after meal) and treatment(fed vs. fasting). These results suggest that food ingestion during hemodialysis dose not cause significant hypotension in relatively younger patients with end stage renal failure on chronic hemodialysis in the absence of autonomic dysfunction.
Blood Pressure* ; Eating ; Fasting ; Humans ; Hypotension ; Kidney Failure, Chronic ; Postprandial Period ; Renal Dialysis* ; Renal Insufficiency