• Title/Summary/Keyword: Renal failure cases

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Acute Renal Failure Following Trauma and Surgery (외상 및 수술적 처치 후에 발생한 급성 신부전증에 관한 임상보고)

  • Park, Jae-Gil;Lee, Hong-Kyun
    • Journal of Chest Surgery
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    • v.14 no.4
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    • pp.319-323
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    • 1981
  • To clarify the clinical spectrum of non-oliguric acute renal failure, we undertook a retrospective study of 16 cases of acute renal failure following trauma and surgery, 6 of whom were non-oliguric throughout their periods of azotemia. With the clinical symptoms, BUN, creatinine and some urinary diagnostic indexes, we analyzed the differences between non-oliguric and oliguric renal failure. And the results were: 1. The nonoliguric form [10 cases] was more common than oliguric [6 cases], especially post-traumatic failure. 2. The both types belonged to parenchymal renal failure by the U/P UN ratio and urinary Na concentration [Vertal, 1967]. 3. The non-oliguric form was lesser severe in urinary diagnostic indexes and clinically. The non-oliguric renal failure has better clinical course and prognosis, the failure to diagnose it is as dangerous as the failure oliguric renal failure.

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Two Cases of Acute Renal Failure Caused by Acute Paraquat Poisoning (급성 Paraquat 중독 후 발생한 급성 신부전 환자 2예)

  • 장통영;정용준;김관식;서관수;한명아;신선호;김동웅
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.276-285
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    • 2000
  • Paraquat is a very potent herbicide which causes fatal toxicity when ingested, and there is no specific antidote against it. Human ingestion induces acute renal failure, hepatic dysfunction and progressive respiratory failure with high mortality rate. Clinical investigation and medical treatment were done on two cases of acute renal failure caused by paraquat poisoning admitted to the Department of Internal Medicine, Wonkwang University Oriental Chonju Medical Hospital. We report two cases of patients who survived after acute paraquat intoxication, by means of oriental medicine such as Gamdutang, a typical antidote of toxins, chinese ink as an absorbent and burned powder of Rhei Radix et Rhizoma for laxative and so on, western medicine such as gastric lavage, diuretics and fluid therapy. We suggest more experiments and studies related to such treatment for paraquat poisoning be conducted.

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Clinical study on Renal Replacement Therapy for Acute Renal Failure following Cardiopulmonary Bypass (체외순환후 급성 심부전에 대한 신대체요법의 임삼적 검토)

  • 서경필
    • Journal of Chest Surgery
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    • v.25 no.3
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    • pp.232-239
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    • 1992
  • Acute renal failure is a well known serious complication following open heart surgery and is associated with a significant increase in morbidity and mortality rate. From 1984 to 1990, 33 patients who had acute renal failure following cardiopulmonary bypass received renal replacement therapy. PD[Peritonial dialysis] was employed in 11 patients and CAVH[continous arteriovenous hemofiltration] was employed in 22 patients. Their age ranged from 3 months to 64 years[mean 25.5$\pm$7.8 years]. The disease entities included congenital cardiac anomaly in 18, valvular heart disease in 15 and aorta disease in 2 cases. Low cardiac output was thought as a primary cause of ARF except two redo valve cases who showed severe Aemolysis k depressed renal function preoperatively. Mean serum BUN and creatinine level at the onset renal replacement therapy were 65$\pm$8 mg/dl and 3.5$\pm$0.4 mg/dl respectively, declining only after reaching peak level 7&10 days following the onset of therapy. Overall hospital mortality was 72.7%[24/33]; 81%[9/11] in PD group and 68.2% [15/22] in CAVH group respectively. The primary cause of death was low cardiac output & hemodynamic depression in all the cases. The fatal complications included multiorgan failure in 7, disseminated intravascular coagulation and sepsis in 6, neurologic damage in 4 and mediastinitis in 3 cases. No measurable differences were observed between CAVH and PD group upon consequence of acute renal failure and disease per se. The age at operation, BUN/Cr level at the onset of bypass and highest BUN/Cr level and the consequence of low output status were regarded as important risk factors, determining outcome of ARF and success of renal replacement therapy. Thus, we concluded that althoght the prognosis is largely determined by severity of low cardiac output status and other organ complication, early institution of renal replacement therapy with other intensive supportive measures could improve salvage rate in established ARF patients following CPB.

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Successful Transplantation of 3 Cases of Oligomeganephronia (신장이식 수술로 치험한 Oligomeganephronia 3례)

  • Bae Hyun-Chul;Kim Ji-Hong;Kim Pyung-Kil;Kim Yoo-Seon;Park Ki-Il;Jeong Hyun-Ju;Choi In-Jun
    • Childhood Kidney Diseases
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    • v.1 no.2
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    • pp.189-194
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    • 1997
  • Oligomeganephronia is a rare congenital form of bilateral renal hypoplasia histologically characterized by reduction in number and hypertrophy of nephrons. Clinically, this condition is presented in early infancy with vomiting, polyuria, polydipsia and dehydration. The problems are readily corrected, but slowly progressive renal failure follows accompanied by failure to thrive, short stature, and renal osteodystrophy. We experienced three cases of oligomeganephronia. Case 1. : A 3 2/12 years old female child was incidentally diagnosed as renal failure at age of 2 months when she was hospitalized due to pneumonia. She had open renal biopsy and was diagnosed as bilateral dysplastic kidney. On OPD follow-up, she progressed to end-stage renal failure (BUN/Cr 114/4.6 mg/dl) and had renal transplantation. The specimen was shrunk remarkably and light microscopy showed oligomeganephronia. Case 2. : A 14 8/12 years old female child with proteinuria was detected in an annual urine screening program for school children, she was diagnosed as renal failure (BUN/Cr 33.9/4.1 mg/dl), and had $5{\times}4{\times}3\;cm$ sized mass on abdominal CT scan. She had renal biopsy, and the specimen showed oligomeganephronia. She had hemodialysis for six months, and renal transplantation along with bilateral nephrectomy was performed. Case 3. : A 14 8/12 years old male child was diagnosed having chronic nephritis and chronic renal failure at 3 years old, progressed to end-stage renal failure (BUN/Cr 87/9.6 mg/dl) on OPD follow-up, and had a rephrectomy and renal transplantation. The biopsy specimen showed oligomeganephronic hypoplasia, secondary focal segmental glomerolosclerosis, and chronic interstitial nephritis. We report 3 cases of oligomeganephronia that progressed to end-stage renal failure and had successful renal transplantation with a brief review of related literatures.

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The Cases of Oriental diagnosis and treatment at the patients considering of the Chronic renal failure (만성신부전으로 의심되는 환자에서 주증에 따른 한의학적 변증치료의 예(例))

  • Lee Kyung-Hwan;Kim Yong-Seung;Kwark Jung-Jin;Ryu Hyung-Chun;Kim Haeng-Jin
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1046-1054
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    • 2003
  • Renal Failure is called a disorder of kidney excretion induced by glomerulus filtration rate(GFR) decrease. GFR is measured by Blood Urea Nitrogen(BUN) and Cretinine in blood. This study is about Oriental diagnosis and treatment of Chronic renal failure(CRF) patients. We treated five cases which were diagnosed as CRF by using methods used in oriental medicine, the application of Youkmijihwang-tang(六味地黃湯加減). In most such cases, we concluded that the results turns better as the symptoms like fatigue and digestive disorder decreases and the decrease of BUN and Creatinine in blood as well.

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A Clinical Study of Arteriovenous Shunts and Arteriovenous Fistula for Hemodialysis (혈액투석을 위한 동정맥연결술에 대한 임상적 고찰)

  • 김근호
    • Journal of Chest Surgery
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    • v.11 no.2
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    • pp.227-231
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    • 1978
  • Since January 1973 we have performed 47 arteriovenous shunts and 22 arteriovenous fistulas for 57 patients with acute or chronic renal failure. Of these 57 cases, 50 cases had chronic renal failure and the other 7 cases had acute renal failure. The most frequent complications after operations were thrombosis, bleeding and infection. Less frequently dislodgement of shunt and aneurysmal change of the fistula were found. After 47 arteriovenous shunts, 21 those complications [44%] were found. On the other hand after 22 arteriovenous fistulas, 5 complications were found. Now we are using the arteriovenous shunt only for the patients who need emergency short term hemodialysis and temporary dialysis until arteriovenous fistula could be used.

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Two Cases of Acute Renal Failure due to Rhabdomyolysis Complicating Doxylamine Succinate Intoxication (독시라민 과다복용에 의한 횡문근 용해 및 급성 신부전 2례)

  • Jung Jae Kwon;Kim Sung Ho;Kim In Seek;Kim Seon Woong;Ju Dong Wook;Lee Duk Hyun;Kim Jong Kun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.1
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    • pp.15-19
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    • 2004
  • Doxylamine succinate is an antihistamine used primarily as a sleep-induction. It can be gotten without a doctor's prescription in Korea, so it' s overdoses were frequently encountered. There were several reports that the overdoses of doxylamine might cause rhabdomyolysis, but few cases have been reported that it is related to acute renal failure (ARF). In cases that ARF occur, most of them are not severe enough to require hemodialysis. We experienced two cases of severe rhabdomyolysis complicating ARF after doxylamine overdose and treated with hemodialysis. Clinicians should be aware of the potentially lethal complications of rhabdomyolysis in patients who ingest doxylamine succinate and the needs for prompt intervention and careful assessment of renal function.

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clinical evaluation of chest trauma (흉부손상에 대한 임상적 고찰)

  • 문경훈
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.123-133
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    • 1989
  • A clinical evaluation was done on 182 cases of chest trauma which experienced at the Department of Thoracic and Cardiovascular Surgery, National Medical Center, from Sep. 1980 to Dec. 1987. 1] Of 182 cases, 125 cases resulted from non-penetrating chest trauma and 57 cases from penetrating wound. 2] The ratio of male to female was 4.87:1, and age groups between 3rd and 6th decade were 71.9%. 3] The most common causes of chest trauma were traffic accident in non-penetrating and stab wound by knife in penetrating cases. 4] Left thorax was the preferred site of chest injury. 5] The incidences of hemothorax, pneumothorax, and hemopneumothorax were 69.6% in non-penetrating and 91% in penetrating. 6] Rib fractures between 4th rib and 8th rib were 68.8% of total rib fracture cases and left side was preferred site. 7] Methods of treatment were conservative management in 24.7%, closed thoracostomy in 54.9%, open thoracotomy in 14.3%, and etc. 8] The incidence of complications, were 11.5% of total cases, and they were atelectasis [8 cases], empyema [3 cases], pneumonia [3 cases], acute renal failure [2 cases], lung abscess [1 case], and etc. 9] The overall mortality was 6%, and causes of death were hypovolemic shock, renal failure, hepatic failure, respiratory failure, septic shock, and etc.

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Two Cases of $Senior-L\ddot{o}ken$ Syndrome in Siblings (남매에서 발견 된 $Senior-L\ddot{o}ken$ 증후군 2례)

  • Choi, Jung-Youn;Kim, Yong-Jin;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.112-117
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    • 2007
  • Although juvenile nephronophthisis(NPHP) is one of the most frequent genetic causes of chronic renal failure, it has very rarely been reported in Korean children. Most NPHP patients are found to have chronic renal failure, since there are no distinct clinical symptoms for NPHP except polydipsia, polyuria and enuresis in the early stage of disease. Ten percent of NPHP patients manifest retinitis pigmentosa, called $Senior-L\ddot{o}ken$ syndrome. We experienced 2 cases of $Senior-L\ddot{o}ken$ syndrome that occurred in siblings(a 10 year-old boy and a 14-year-old girl) who were diagnosed with Leber's amaurosis. They were found to have severe renal impairment without polydipsia and polyuria. However, no large homogenous deletion of the NPHPI(2q13) gene was not identified in these patients. We report here on these cases and we review the literature to emphasize the association between Leber's amaurosis and the development of chronic renal failure.

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"Off-pump" Coronary Artery Bypass Graft in the Chronic Renal Failure Patients -3 Cases Report- (만성 신부전증을 동반한 협심증 환자에서 심폐바이패스를 사용하지 않는 관상동맥우회술 -3예 보고-)

  • 김태헌;김기봉
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.835-839
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    • 1999
  • Since the first report of coronary artery bypass grafting (CABG) in patients with end-stage renal disease in 1974, numerous reports have documented the feasibility of CABG in patients with chronic renal diseases. Patients with chronic renal failure often have comorbid disorders such as hypertension, and diabetes mellitus, each with their own complications and associated impact on both short and long-term survivals. In addition, infection and sepsis have been identified as significant causes of morbidity and mortality in most series of patients with end-stage renal disease undergoing cardiac surgical procedure. As a result of these and other factors such as perioperative volume and electrolyte disturbances, patients with chronic renal failures are at an increased risk of complication and mortality after CABG. We report 3 cases of "Off-pump" CABG in the chronic renal failure patients. patients.

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