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Performance comparison of estimated glomerular filtration rate equations.

Beom Seok KIM

Kidney Research and Clinical Practice.2014;33(3):168-169. doi:10.1016/j.krcp.2014.07.002

No abstract available.
Glomerular Filtration Rate*

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Improvement of Erdheim-Chester disease-related renal failure after treatment with anakinra.

Manuel Alfredo PODESTA ; Giorgio GRAZIANI ; Francesco REGGIANI ; Michele BUEMI ; Salvatore BADALAMENTI ; Claudio PONTICELLI

Kidney Research and Clinical Practice.2014;33(3):165-167. doi:10.1016/j.krcp.2014.07.007

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis characterized by infiltrates of lipid-laden CD68+/CD1- histiocytes, affecting heart, lungs, central nervous system, and bones. Kidney and adjacent structures can also be affected, leading to renal failure in about 30% of cases. The diagnosis is challenging, and treatment is generally based on administration of interferon-alpha (IFNalpha), but preliminary results also showed the therapeutic efficacy of anakinra, an antagonist of the receptor of interleukin-1 (IL-1). We report the case of an elderly patient with ECD and severe involvement of the heart and kidneys who was successfully treated with anakinra.
Aged ; Central Nervous System ; Diagnosis ; Erdheim-Chester Disease ; Heart ; Histiocytes ; Histiocytosis ; Humans ; Interferon-alpha ; Interleukin 1 Receptor Antagonist Protein* ; Interleukin-1 ; Kidney ; Lung ; Renal Insufficiency*

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Nephrotic syndrome complicated with portal, splenic, and superior mesenteric vein thrombosis.

Bong Soo PARK ; Sihyung PARK ; Kyubok JIN ; Gibok CHOI ; Kang Min PARK ; Kyeong Min JO ; Yang Wook KIM

Kidney Research and Clinical Practice.2014;33(3):161-164. doi:10.1016/j.krcp.2014.07.001

Thromboembolism is a major complication of nephrotic syndrome. Renal vein thrombosis and deep vein thrombosis are relatively common, especially in membranous nephropathy. However, the incidence of portal vein and superior mesenteric vein (SMV) thrombosis in patients with nephrotic syndrome is very rare. To date, several cases of portal vein thrombosis treated by anticoagulation therapy, not by thrombolytic therapy, have been reported as a complication of nephrotic syndrome. Here, we report a case of portal, splenic, and SMV thrombosis in a patient with a relapsed steroid dependent minimal change disease who was treated successfully with anticoagulation and thrombolytic therapy using urokinase. Radiologic findings and his clinical conditions gradually improved. Six months later, a complete remission of the nephrotic syndrome was observed and the follow-up computed tomography scan showed the disappearance of all portal vein, splenic vein, and SMV thrombi.
Follow-Up Studies ; Glomerulonephritis, Membranous ; Humans ; Incidence ; Mesenteric Veins* ; Nephrosis, Lipoid ; Nephrotic Syndrome* ; Portal Vein ; Renal Veins ; Splenic Vein ; Thromboembolism ; Thrombolytic Therapy ; Thrombosis* ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis

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Remission of secondary membranous nephropathy in a patient with Kimura disease after surgical resection.

Sunhwa LEE ; Yong Jin YI ; Hyung Ah JO ; Hyuk HUH ; Kyung Hwan KIM ; Dong Ki KIM ; Hajeong LEE

Kidney Research and Clinical Practice.2014;33(3):157-160. doi:10.1016/j.krcp.2014.06.002

Kimura disease (KD) is an eosinophilic, granulomatous, benign, chronic inflammatory disease with an unknown etiology. A 33-year-old woman visited our hospital because of a palpable, left subclavian mass, a left scapulo-anterior pseudoaneurysm, and nephrotic syndrome. Her subclavian lymph node biopsy examination result was consistent with KD, and results of a renal biopsy indicated secondary membranous nephropathy. After renal histological examination confirmed nephropathy, treatment with prednisolone and cyclosporine was initiated, which was maintained for over 1 year. However, this therapy only provided a transient improvement in proteinuria. One year after commencing the treatment, both proteinuria and azotemia aggravated as the left axillary mass doubled in size. Finally, the mass was surgically excised, following which the azotemia rapidly normalized and proteinuria resolved within 1 month. This case shows that tumor resection in a patient with KD with secondary nephropathy may resolve secondary renal manifestations. Furthermore, reversible renal dysfunction may be caused by unknown secreted molecules.
Adult ; Aneurysm, False ; Angiolymphoid Hyperplasia with Eosinophilia* ; Azotemia ; Biopsy ; Cyclosporine ; Eosinophils ; Female ; Glomerulonephritis, Membranous* ; Humans ; Lymph Nodes ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Surgical Procedures, Operative

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A new connecting technique in partial replantation of a ruptured peritoneal dialysis catheter.

Yaeni KIM ; Prashant C DHEERENDRA ; Yong Soo KIM

Kidney Research and Clinical Practice.2014;33(3):154-156. doi:10.1016/j.krcp.2014.06.001

Peritoneal dialysis catheter ruptures have been managed by immediate removal and subsequent reinsertion of the catheter which inevitably entails interruption in peritoneal dialysis and a need for vascular access. A 36-year-old man on continuous ambulatory peritoneal dialysis complaining of dialysate leakage was found to have a small rupture near the outer cuff of the peritoneal dialysis catheter. Rather than employing the traditional method of exchanging the whole catheter, a partial replantation procedure to salvage the still-functioning conduit was performed. Two peritoneal dialysis adaptors were used to connect the end of the remaining old catheter to a new extraperitoneal segment of a new catheter and a piece of a transfer set to connect the adaptors. A novel, yet simple and safe, means of partial peritoneal dialysis catheter replantation when managing catheter injuries is suggested.
Adult ; Catheters* ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis* ; Peritoneal Dialysis, Continuous Ambulatory ; Replantation* ; Rupture

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Emphysematous pyelonephritis initially presenting as a spontaneous subcapsular hematoma in a diabetic patient.

Ji Won MIN ; Soon Kyu LEE ; Yu Mi KO ; Ki Wook KWON ; Jeong Uk LIM ; Yeong Bok LEE ; Hye Won LEE ; Yoo Dong WON ; Young Ok KIM

Kidney Research and Clinical Practice.2014;33(3):150-153. doi:10.1016/j.krcp.2014.05.001

Emphysematous pyelonephritis (EPN) is a life-threatening infection characterized by the formation of gas. Complications of EPN include septic shock, acute renal failure, and disseminated intravascular coagulation. Spontaneous subcapsular hematoma (SCH) has also been reported as a rare complication of EPN, although there have been no reports to date of this occurring prior to the presentation of EPN. We report a case of EPN that initially presented as spontaneous SCH. The patient was admitted for left flank pain, and initial computed tomography revealed SCH without any air shadows. Laboratory findings and clinical symptoms suggested the presence of urinary tract infection and the patient was started on antibiotics. Fever developed 24 hours after admission. On follow-up computed tomography 7 days later, EPN was newly observed, and a percutaneous drain was inserted. Blood, urine, and drainage fluid cultures all revealed growth of extended-spectrum beta-lactamase-negative Escherichia coli.
Acute Kidney Injury ; Anti-Bacterial Agents ; Disseminated Intravascular Coagulation ; Drainage ; Emphysema ; Escherichia coli ; Fever ; Flank Pain ; Follow-Up Studies ; Hematoma* ; Humans ; Pyelonephritis* ; Shock, Septic ; Urinary Tract Infections

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Antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding.

Miyeon KIM ; Young Uck KIM ; Sun Jin BOO ; So Mi KIM ; Hyun Woo KIM

Kidney Research and Clinical Practice.2015;34(3):180-184. doi:10.1016/j.krcp.2014.11.005

A 61-year-old woman was admitted to hospital because of generalized edema and proteinuria. Her renal function deteriorated rapidly. Serum immunoglobulin and complement levels were within normal ranges. An autoantibody examination showed negative for antinuclear antibody and antineutrophil cytoplasmic antibody. Histologic examination of a renal biopsy specimen revealed that all of the glomeruli had severe crescent formations with no immune deposits. The patient was treated with steroid pulse therapy with cyclophosphamide followed by oral prednisolone. Fifteen days later, she experienced massive recurrent hematochezia. Angiography revealed an active contrast extravasation in a branch of the distal ileal artery. We selectively embolized with a permanent embolic agent. On the 45th hospital day, the patient suddenly lost consciousness. Brain computed tomography showed intracerebral hemorrhage. We report a case of antineutrophil cytoplasmic antibody-negative pauci-immune glomerulonephritis with massive intestinal bleeding and cerebral hemorrhage.
Angiography ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antinuclear ; Arteries ; Biopsy ; Brain ; Cerebral Hemorrhage ; Complement System Proteins ; Consciousness ; Cyclophosphamide ; Cytoplasm* ; Edema ; Female ; Gastrointestinal Hemorrhage ; Glomerulonephritis* ; Hemorrhage* ; Humans ; Immunoglobulins ; Middle Aged ; Prednisolone ; Proteinuria ; Reference Values ; Vasculitis

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Current progress in ABO-incompatible kidney transplantation.

Tai Yeon KOO ; Jaeseok YANG

Kidney Research and Clinical Practice.2015;34(3):170-179. doi:10.1016/j.krcp.2015.08.005

ABO-incompatible kidney transplantation (ABOi KT) was introduced to expand the donor pool and minimize shortage of kidneys for transplantation. Because improved outcomes of ABOi KT were reported in Japan in the early 2000s, the number of ABOi KTs has been increasing worldwide. In addition, a better understanding of immune pathogenesis and subsequent aggressive immunosuppression has helped to make effective desensitization protocols. Current strategies of ABOi KT consist of pretransplant antibody removal using plasmapheresis or immunoadsorption to prevent hyperacute rejection and potent maintenance immunosuppression, such as tacrolimus and mycophenolate mofetil, to inhibit antibody-mediated rejection. Recent outcomes of ABOi KT are comparable with ABO-compatible KT. However, there are still many problems to be resolved. Very high anti-ABO antibody producers are difficult to desensitize. In addition, ABOi KT is associated with an increased risk of infection and possibly malignancy due to aggressive immunosuppression. Optimization of desensitization and patient-tailored immunosuppression protocols are needed to achieve better outcomes of ABOi KT. This review provides an overview of the history, immune mechanism, immunosuppressive protocol, outcomes, current obstacles, and future perspectives in ABOi KT.
Blood Group Incompatibility ; Humans ; Immunosuppression ; Japan ; Kidney Transplantation* ; Kidney* ; Plasmapheresis ; Tacrolimus ; Tissue Donors

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Organ-on-a-chip and the kidney.

Sejoong KIM ; Shuichi TAKAYAMA

Kidney Research and Clinical Practice.2015;34(3):165-169. doi:10.1016/j.krcp.2015.08.001

Traditional approaches to pathophysiology are advancing but still have many limitations that arise from real biologic systems and their associated physiological phenomena being too complicated. Microfluidics is a novel technology in the field of engineering, which provides new options that may overcome these hurdles. Microfluidics handles small volumes of fluids and may apply to various applications such as DNA analysis chips, other lab-on-a-chip analyses, micropropulsion, and microthermal technologies. Among them, organ-on-a-chip applications allow the fabrication of minimal functional units of a single organ or multiple organs. Relevant to the field of nephrology, renal tubular cells have been integrated with microfluidic devices for making kidneys-on-a-chip. Although still early in development, kidneys-on-a-chip are showing potential to provide a better understanding of the kidney to replace some traditional animal and human studies, particularly as more cell types are incorporated toward the development of a complete glomerulion-a-chip.
Animals ; DNA ; Humans ; Kidney* ; Lab-On-A-Chip Devices ; Microfluidics ; Nephrology ; Physiological Phenomena

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The impact of early and late acute rejection on graft survival in renal transplantation.

Eun Hee KOO ; Hye Ryoun JANG ; Jung Eun LEE ; Jae Berm PARK ; Sung Joo KIM ; Dae Joong KIM ; Yoon Goo KIM ; Ha Young OH ; Wooseong HUH

Kidney Research and Clinical Practice.2015;34(3):160-164. doi:10.1016/j.krcp.2015.06.003

BACKGROUND: Advances in immunosuppression after kidney transplantation have decreased the influence of early acute rejection (EAR) on graft survival. Several studies have suggested that late acute rejection (LAR) has a poorer effect on long-term graft survival than EAR. We investigated whether the timing of acute rejection (AR) influences graft survival, and analyzed the risk factors for EAR and LAR. METHODS: We performed a retrospective cohort study involving 709 patients who underwent kidney transplantation between 2000 and 2009 at the Samsung Medical Center, Seoul, Korea. Patients were divided into three groups: no AR, EAR, and LAR. EAR and LAR were defined as rejection before 1 year and after 1 year, respectively. Differences in graft survival between the three groups and risk factors of graft failure were analyzed. RESULTS: Of the 709 patients, 198 (30%) had biopsy-proven AR [EAR=152 patients (77%); LAR=46 patients (23%)]. A total of 65 transplants were lost. The 5-year graft survival rates were 97%, 89%, and 85% for patients with no AR, EAR, and LAR, respectively. These differences were significant (P<0.001 for both by log-rank test). In time-dependent Cox regression analysis, EAR (hazards ratio, 3.37; 95% confidence interval, 1.90-5.99) and LAR (hazards ratio, 5.32; 95% confidence interval, 2.65-10.69) were significantly related to graft failure. When we set LAR as standard and compared it with EAR, there was no statistical difference between EAR and LAR (P=0.21). CONCLUSION: AR, regardless of its timing, significantly worsened graft survival. Treatments to reduce the incidence of AR and improve prognosis are needed.
Cohort Studies ; Ear ; Graft Survival* ; Humans ; Immunosuppression ; Incidence ; Kidney Transplantation* ; Korea ; Prognosis ; Retrospective Studies ; Risk Factors ; Seoul ; Transplants*

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