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Jeon J, Lee K, Jang HR, Yang KE, Lee CJ, Ahn H, Park WY, Lee JE, Kwon GY, Kim YG, Huh W. Effects of poly (ADP-ribose) polymerase inhibitor treatment on the repair process of ischemic acute kidney injury. Sci Rep 2024; 14:159. [PMID: 38167603 PMCID: PMC10761972 DOI: 10.1038/s41598-023-50630-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
Excessive activation of poly (ADP-ribose) polymerase (PARP) contributes to ischemic acute kidney injury (AKI). PARP inhibition has been shown to be beneficial in renal ischemia-reperfusion injury (IRI) in the early phase, but its role in the repair process remains unclear. The effects of JPI-289, a novel PARP inhibitor, during the healing phase after renal IRI were investigated. IRI was performed on 9-week-old male C57BL/6 mice. Saline or JPI-289 100 mg/kg was intraperitoneally administered once at 24 h or additionally at 48 h after IRI. Hypoxic HK-2 cells were treated with JPI-289. Renal function and fibrosis extent were comparable between groups. JPI-289 treatment caused more prominent tubular atrophy and proinflammatory intrarenal leukocyte phenotypes and cytokines/chemokines changes at 12 weeks after unilateral IRI. JPI-289 treatment enhanced gene expressions associated with collagen formation, toll-like receptors, and the immune system in proximal tubules and endothelial cells after IRI. JPI-289 treatment at 3 or 6 h after hypoxia facilitated proliferation of hypoxic HK-2 cells, whereas further treatment after 24 h suppressed proliferation. Delayed inhibition of PARP after renal IRI did not facilitate the repair process during the early healing phase but rather may aggravate renal tubular atrophy during the late healing phase in ischemic AKI.
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Affiliation(s)
- Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeong Eun Yang
- Division of Scientific Instrumentation and Management, Korea Basic Science Institute, Daejeon, Republic of Korea
| | - Cheol-Jung Lee
- Division of Scientific Instrumentation and Management, Korea Basic Science Institute, Daejeon, Republic of Korea
| | - Hyeonju Ahn
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Woong-Yang Park
- Samsung Genome Institute, Samsung Medical Center, Seoul, Republic of Korea
- Innovative Institute for Precision Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Song SM, Jeon J, Jang HR, Kim K, Huh W, Kim YG, Lee JE. Acute kidney injury in bortezomib-treated patients with multiple myeloma. Nephrol Dial Transplant 2023; 38:2077-2085. [PMID: 36662030 DOI: 10.1093/ndt/gfad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The nephrotoxicity of bortezomib, a proteasome inhibitor, has not yet been elucidated, although tumor lysis syndrome (TLS) associated with multiple myeloma (MM) has been reported to increase after introduction of the drug. This study compared the incidence and risk factors for acute kidney injury (AKI) and TLS in patients with MM after bortezomib-based chemotherapy to investigate drug-related nephrotoxicity. METHODS From 2006 to 2017, 276 patients who underwent a first cycle of bortezomib-based chemotherapy for MM were identified in a single tertiary hospital. Laboratory TLS was defined according to the Cairo-Bishop definition. Development of AKI was assessed by AKI Network criteria within 7 days of the first chemotherapy. RESULTS The median (interquartile range) age was 65 (56-72) years, and baseline estimated glomerular filtration rate (eGFR) was 61.3 (34.1-89.1) mL/min/1.73 m2. The incidences of AKI and laboratory TLS were 17% (n = 47) and 13% (n = 36), respectively. Ten (3.6%) subjects met both AKI and TLS criteria. Multivariate analyses showed that lower eGFR category [30-59, odds ratio (OR) 3.005 (95% confidence interval 1.163-7.976); 15-29, OR 4.225 (1.183-15.000); <15, OR 16.154 (3.831-70.920) vs ≥60, P < .001], lower serum albumin level [per 1 increase, OR 0.479 (0.256-0.871), P = .018], renal amyloidosis [OR 13.039 (4.108-44.041), P < .001] and use of acyclovir during bortezomib treatment [OR 3.689 (1.133-14.469), P = .042] were predictors of AKI. MM stages and β-2-microglobulin were not associated with increased risk of AKI. Regarding laboratory TLS, MM stage and β-2-microglobulin were higher in those with TLS than in others. In multivariate analyses, β-2-microglobulin level [OR 1.204 (1.005-1.461), P = .038] and absence of high-risk chromosome abnormalities [OR 0.143 (0.022-0.588), P = .016] were associated with higher risk of TLS. CONCLUSIONS Development of AKI was often observed in the absence of TLS in patients with MM after treatment with bortezomib. In addition, the risk factors for AKI and TLS varied widely. These findings indicate the potential nephrotoxicity of bortezomib irrespective of TLS in patients with decreased kidney function.
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Affiliation(s)
- Seung Min Song
- Nephrology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Junseok Jeon
- Nephrology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Nephrology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kihyun Kim
- Hematology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Nephrology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Nephrology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Lee
- Nephrology Division; Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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3
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Albanese R, Alexandrov A, Alicante F, Anokhina A, Asada T, Battilana C, Bay A, Betancourt C, Biswas R, Blanco Castro A, Bogomilov M, Bonacorsi D, Bonivento WM, Bordalo P, Boyarsky A, Buontempo S, Campanelli M, Camporesi T, Canale V, Castro A, Centanni D, Cerutti F, Chernyavskiy M, Choi KY, Cholak S, Cindolo F, Climescu M, Conaboy AP, Dallavalle GM, Davino D, de Bryas PT, De Lellis G, De Magistris M, De Roeck A, De Rújula A, De Serio M, De Simone D, Di Crescenzo A, Donà R, Durhan O, Fabbri F, Fedotovs F, Ferrillo M, Ferro-Luzzi M, Fini RA, Fiorillo A, Fresa R, Funk W, Garay Walls FM, Golovatiuk A, Golutvin A, Graverini E, Guler AM, Guliaeva V, Haefeli GJ, Helo Herrera JC, van Herwijnen E, Iengo P, Ilieva S, Infantino A, Iuliano A, Jacobsson R, Kamiscioglu C, Kauniskangas AM, Khalikov E, Kim SH, Kim YG, Klioutchnikov G, Komatsu M, Konovalova N, Kovalenko S, Kuleshov S, Lacker HM, Lantwin O, Lasagni Manghi F, Lauria A, Lee KY, Lee KS, Lo Meo S, Loschiavo VP, Marcellini S, Margiotta A, Mascellani A, Miano A, Mikulenko A, Montesi MC, Navarria FL, Ogawa S, Okateva N, Ovchynnikov M, Paggi G, Park BD, Pastore A, Perrotta A, Podgrudkov D, Polukhina N, Prota A, Quercia A, Ramos S, Reghunath A, Roganova T, Ronchetti F, Rovelli T, Ruchayskiy O, Ruf T, Sabate Gilarte M, Samoilov M, Scalera V, Schneider O, Sekhniaidze G, Serra N, Shaposhnikov M, Shevchenko V, Shchedrina T, Shchutska L, Shibuya H, Simone S, Siroli GP, Sirri G, Soares G, Soto Sandoval OJ, Spurio M, Starkov N, Timiryasov I, Tioukov V, Tramontano F, Trippl C, Ursov E, Ustyuzhanin A, Vankova-Kirilova G, Verguilov V, Viegas Guerreiro Leonardo N, Vilela C, Visone C, Wanke R, Yaman E, Yazici C, Yoon CS, Zaffaroni E, Zamora Saa J. Observation of Collider Muon Neutrinos with the SND@LHC Experiment. Phys Rev Lett 2023; 131:031802. [PMID: 37540851 DOI: 10.1103/physrevlett.131.031802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 08/06/2023]
Abstract
We report the direct observation of muon neutrino interactions with the SND@LHC detector at the Large Hadron Collider. A dataset of proton-proton collisions at sqrt[s]=13.6 TeV collected by SND@LHC in 2022 is used, corresponding to an integrated luminosity of 36.8 fb^{-1}. The search is based on information from the active electronic components of the SND@LHC detector, which covers the pseudorapidity region of 7.2<η<8.4, inaccessible to the other experiments at the collider. Muon neutrino candidates are identified through their charged-current interaction topology, with a track propagating through the entire length of the muon detector. After selection cuts, 8 ν_{μ} interaction candidate events remain with an estimated background of 0.086 events, yielding a significance of about 7 standard deviations for the observed ν_{μ} signal.
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Affiliation(s)
- R Albanese
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | | | - F Alicante
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Anokhina
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - T Asada
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - C Battilana
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - A Bay
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - C Betancourt
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - R Biswas
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - A Blanco Castro
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - M Bogomilov
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria
| | - D Bonacorsi
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - W M Bonivento
- Università degli Studi di Cagliari, 09124 Cagliari, Italy
| | - P Bordalo
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - A Boyarsky
- University of Leiden, 2300 RA Leiden, The Netherlands
- Taras Shevchenko National University of Kyiv, 01033 Kyiv, Ukraine
| | | | - M Campanelli
- University College London, WC1E 6BT London, United Kingdom
| | - T Camporesi
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - V Canale
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Castro
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - D Centanni
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli Parthenope, 80143 Napoli, Italy
| | - F Cerutti
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Chernyavskiy
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - K-Y Choi
- Sungkyunkwan University, 16419 Suwon-si, Gyeong Gi-do, Korea
| | - S Cholak
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - F Cindolo
- Sezione INFN di Bologna, Bologna, Italy
| | - M Climescu
- Institut für Physik and PRISMA Cluster of Excellence, Johannes Gutenberg Universität Mainz, 55099 Mainz, Germany
| | - A P Conaboy
- Humboldt-Universität zu Berlin, 12489 Berlin, Germany
| | | | - D Davino
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università del Sannio, 82100 Benevento, Italy
| | - P T de Bryas
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - G De Lellis
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - M De Magistris
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli Parthenope, 80143 Napoli, Italy
| | - A De Roeck
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - A De Rújula
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M De Serio
- Sezione INFN di Bari, 70126 Bari, Italy
- Università di Bari, 70126 Bari, Italy
| | - D De Simone
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - A Di Crescenzo
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Donà
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - O Durhan
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - F Fabbri
- Sezione INFN di Bologna, Bologna, Italy
| | - F Fedotovs
- University College London, WC1E 6BT London, United Kingdom
| | - M Ferrillo
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - M Ferro-Luzzi
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - R A Fini
- Sezione INFN di Bari, 70126 Bari, Italy
| | - A Fiorillo
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Fresa
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università della Basilicata, 85100 Potenza, Italy
| | - W Funk
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - F M Garay Walls
- Departamento de Física, Pontificia Universidad Católica de Chile, 4860 Santiago, Chile
| | - A Golovatiuk
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Golutvin
- Imperial College London, SW7 2AZ London, United Kingdom
| | - E Graverini
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - A M Guler
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - V Guliaeva
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - G J Haefeli
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - J C Helo Herrera
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Departamento de Física, Facultad de Ciencias, Universidad de La Serena, Avenida Cisternas 1200, La Serena, Chile
| | | | - P Iengo
- Sezione INFN di Napoli, 80126 Napoli, Italy
| | - S Ilieva
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria
| | - A Infantino
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - A Iuliano
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Jacobsson
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - C Kamiscioglu
- Middle East Technical University (METU), 06800 Ankara, Turkey
- Ankara University, 06100 Ankara, Turkey
| | - A M Kauniskangas
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - E Khalikov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - S H Kim
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - Y G Kim
- Gwangju National University of Education, 61204 Gwangju, Korea
| | - G Klioutchnikov
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Komatsu
- Nagoya University, 464-8602 Nagoya, Japan
| | - N Konovalova
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - S Kovalenko
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Center for Theoretical and Experimental Particle Physics, Facultad de Ciencias Exactas, Universidad Andrés Bello, Fernandez Concha 700, Santiago, Chile
| | - S Kuleshov
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Center for Theoretical and Experimental Particle Physics, Facultad de Ciencias Exactas, Universidad Andrés Bello, Fernandez Concha 700, Santiago, Chile
| | - H M Lacker
- Humboldt-Universität zu Berlin, 12489 Berlin, Germany
| | - O Lantwin
- Affiliated with an institute covered by a cooperation agreement with CERN
| | | | - A Lauria
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - K Y Lee
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - K S Lee
- Korea University, 02841 Seoul, Korea
| | - S Lo Meo
- Sezione INFN di Bologna, Bologna, Italy
| | - V P Loschiavo
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università del Sannio, 82100 Benevento, Italy
| | | | - A Margiotta
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - A Mascellani
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - A Miano
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Mikulenko
- University of Leiden, 2300 RA Leiden, The Netherlands
| | - M C Montesi
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - F L Navarria
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - S Ogawa
- Toho University, 274-8510 Funabashi, Chiba, Japan
| | - N Okateva
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - M Ovchynnikov
- University of Leiden, 2300 RA Leiden, The Netherlands
| | - G Paggi
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - B D Park
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - A Pastore
- Sezione INFN di Bari, 70126 Bari, Italy
| | | | - D Podgrudkov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - N Polukhina
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - A Prota
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - A Quercia
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - S Ramos
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - A Reghunath
- Humboldt-Universität zu Berlin, 12489 Berlin, Germany
| | - T Roganova
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - F Ronchetti
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - T Rovelli
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - O Ruchayskiy
- Niels Bohr Institute, University of Copenhagen, 2100 Copenhagen, Denmark
| | - T Ruf
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Sabate Gilarte
- European Organization for Nuclear Research (CERN), 1211 Geneva, Switzerland
| | - M Samoilov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - V Scalera
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli Parthenope, 80143 Napoli, Italy
| | - O Schneider
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | | | - N Serra
- Physik-Institut, Universität Zürich, 8057 Zürich, Switzerland
| | - M Shaposhnikov
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - V Shevchenko
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - T Shchedrina
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - L Shchutska
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - H Shibuya
- Toho University, 274-8510 Funabashi, Chiba, Japan
- Constructor University, Campus Ring 1, Bremen 28759, Germany
| | - S Simone
- Sezione INFN di Bari, 70126 Bari, Italy
- Università di Bari, 70126 Bari, Italy
| | - G P Siroli
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - G Sirri
- Sezione INFN di Bologna, Bologna, Italy
| | - G Soares
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - O J Soto Sandoval
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Departamento de Física, Facultad de Ciencias, Universidad de La Serena, Avenida Cisternas 1200, La Serena, Chile
| | - M Spurio
- Sezione INFN di Bologna, Bologna, Italy
- Università di Bologna, Bologna, Italy
| | - N Starkov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - I Timiryasov
- Niels Bohr Institute, University of Copenhagen, 2100 Copenhagen, Denmark
| | - V Tioukov
- Sezione INFN di Napoli, 80126 Napoli, Italy
| | | | - C Trippl
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - E Ursov
- Affiliated with an institute covered by a cooperation agreement with CERN
| | - A Ustyuzhanin
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Constructor University, Campus Ring 1, Bremen 28759, Germany
| | | | - V Verguilov
- Faculty of Physics, Sofia University, 1164 Sofia, Bulgaria
| | | | - C Vilela
- Laboratory of Instrumentation and Experimental Particle Physics (LIP), 1649-003 Lisbon, Portugal
| | - C Visone
- Sezione INFN di Napoli, 80126 Napoli, Italy
- Università di Napoli "Federico II", 80126 Napoli, Italy
| | - R Wanke
- Institut für Physik and PRISMA Cluster of Excellence, Johannes Gutenberg Universität Mainz, 55099 Mainz, Germany
| | - E Yaman
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - C Yazici
- Middle East Technical University (METU), 06800 Ankara, Turkey
| | - C S Yoon
- Department of Physics Education and RINS, Gyeongsang National University, 52828 Jinju, Korea
| | - E Zaffaroni
- Institute of Physics, École Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland
| | - J Zamora Saa
- Millennium Institute for Subatomic physics at high energy frontier-SAPHIR, Fernandez Concha 700, 7591538 Santiago, Chile
- Center for Theoretical and Experimental Particle Physics, Facultad de Ciencias Exactas, Universidad Andrés Bello, Fernandez Concha 700, Santiago, Chile
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4
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Hwang S, Lee K, Park J, Kim DH, Jeon J, Jang HR, Hur KY, Kim JH, Huh W, Kim YG, Lee JE. Prognostic significance of albuminuria in elderly of various ages with diabetes. Sci Rep 2023; 13:7079. [PMID: 37127663 PMCID: PMC10151322 DOI: 10.1038/s41598-023-32305-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/25/2023] [Indexed: 05/03/2023] Open
Abstract
It remains uncertain whether albuminuria can identify elderly patients with diabetes at a high risk of incident end-stage kidney disease (ESKD) or mortality. 3065 patients (aged ≥ 65 years) with type 2 diabetes were included. We examined the association between albuminuria stages (normoalbuminuria, A1; microalbuminuria, A2; and macroalbuminuria, A3) and the risk of incident ESKD and all-cause mortality for each age group (65-69, 70-74, and ≥ 75 years). A2 and A3 were observed in 25.5% and 9.4% of the subjects, respectively. For A1, A2, and A3, the probabilities of ESKD at 8 years were 1.0%, 6.3%, and 29.7% (P < 0.001 for all), and the all-cause mortality was 13.1%, 27.4%, and 31.7% (P < 0.001 for A1 vs A2, P < 0.001 for A1 vs A3), respectively. Albuminuria stages were independently associated with an increased risk of ESKD [fully adjusted hazard ratios (HR): 3.650 (1.987-6.702) for A2, 10.404 (5.706-18.972) for A3 vs. A1]. The HRs of all-cause mortality were 1.742 (1.411-2.153) for A2 and 1.810 (1.344-2.441) for A3. The associations between albuminuria stages and the risk of ESKD and all-cause mortality were consistent across all age groups. Even microalbuminuria is also a risk factor for incident ESKD and mortality in elderly patients with diabetes.
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Affiliation(s)
- Subin Hwang
- Division of Nephrology, Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Kyungho Lee
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeeeun Park
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Do Hee Kim
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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5
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Jeon J, Lee K, Jang HR, Lee JE, Kwon GY, Kim YG, Huh W. Delayed treatment with poly (ADP-Ribose) polymerase inhibitor during healing phase of ischemic acute kidney injury. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-1589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Junseok Jeon
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Kyungho Lee
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Hye Ryoun Jang
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Jung Eun Lee
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Seoul, Korea
| | - Yoon-Goo Kim
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Wooseong Huh
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
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6
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Jeon J, Lee K, Lee JE, Huh W, Kwon GY, Kim YG, Jang HR. Fat and protein modification affects the repair process in ischemic acute kidney injury. Korean Journal of Transplantation 2022. [DOI: 10.4285/atw2022.f-1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Junseok Jeon
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Kyungho Lee
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Jung Eun Lee
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Wooseong Huh
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Seoul, Korea
| | - Yoon-Goo Kim
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
| | - Hye Ryoun Jang
- Department of Nephrology, Samsung Medical Center, Seoul, Korea
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Jeong J, Choi JI, Kim YG, Choi YY, Min KJ, Roh SY, Shim JM, Kim JS, Kim YH. Late ventricular potential for risk prediction of sudden cardiac death risk: a valuable tool or an unnecessary step? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Signal-averaged electrocardiography (SA-ECG) is a high-resolution electrocardiography that can detect late ventricular potential, which known to be a noninvasive tool for risk stratification of sudden cardiac death (SCD) by predicting reentrant ventricular tachyarrhythmia. There is a paucity of data with SA-ECG on SCD survivors without structural heart disease, whereas majority of previous studies had been focused on post myocardial infarction survivors.
Purpose
This study assessed the clinical utility of SA-ECG as a risk stratification modality for lethal arrhythmic event in patients at risk of SCD without definite structural heart disease.
Methods
Total 629 patients who experienced or had potential risk of SCD were studied with SA-ECG. Among them, 48 patients who were found to have significant structural heart disease were excluded, except arrhythmogenic right ventricular cardiomyopathy. Major arrhythmic event (MAE) was defined as composite of all-cause death, aborted SCD, and sustained VT during any time either before visit of clinic or during follow up period. Syncope and non-sustained VT was defined as non-major arrhythmic event. SA-ECG was defined positive when fulfilling three or more criterion: (1) unfiltered QRS duration ≥114ms, (2) filtered QRS duration ≥114ms, (3) duration of terminal QRS <40uV exceeding 40ms, and (4) root mean square voltage in the terminal 40ms of ≤20ms.
Results
Among total 581 patients, 145 patients with positive SA-ECG showed higher incidence of MAE compared to patients with negative SA-ECG (21.4% vs. 6.7%, OR 3.816 [95% CI 2.208–6.597], p<0.001, Table). As the number of positive SA-ECG criteria increases, incidence of MAE tended to increase sequentially, which was markedly noted from 2 positive to 3 positive criteria (10.7% to 20.8%, p<0.001, Figure). In particular, patient with inherited arrhythmia showed higher rate of positive late potential compared to those with non-inherited arrhythmia (51.0% vs. 19.3%, p<0.001).
Conclusion
This study showed that at least 3 out of 4 diagnostic criteria in SA-ECG can independently predict lethal arrhythmic events and the positive late potential was associated with lethal arrhythmic event that leads to SCD, suggesting risk prediction for SCD using SA-ECG in patients even without structural heart disease including inherited arrhythmias.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Jeong
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J I Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y G Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y Y Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - K J Min
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - S Y Roh
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - J M Shim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J S Kim
- Korea University Ansan Hospital , Ansan , Korea (Democratic People's Republic of)
| | - Y H Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
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Jeong J, Choi JI, Kim YG, Choi YY, Min KJ, Roh SY, Shim JM, Kim JS, Kim YH. Clinical role of genetic testing for overlapping between Brugada syndrome and arrhythmogenic right ventricular cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Brugada syndrome (BrS) and arrhythmogenic right ventricular cardiomyopathy (ARVC) are inherited arrhythmias that may predispose to sudden cardiac arrest. Although its pathogenetic mechanisms differ, overlapping features between BrS and ARVC have been demonstrated previously. However, it remains to be determined whether genetic testing for ARVC-related gene is needed in patients with BrS.
Purpose
This study is aimed to analyze genetic profiles of BrS patients using next generation sequencing (NGS) based multigene panel including ARVC related genes.
Methods
Patients who were confirmed as BrS or clinically suspected as BrS with type 2 or 3 Brugada pattern electrocardiography were studied. Genetic testing using NGS panels (Illumina Inc., San Diego, CA, USA) included 30 genetic variants associated with inherited arrhythmia and genetic cardiomyopathy.
Results
Among the total 119 patients from BrS registry, 63 patients were confirmed as BrS and 56 patients were clinically suspected as BrS without fulfilling diagnostic criteria. One-hundred-fourteen patients (95.8%) were male, and mean age of onset was 43.6 year-old. Genetic variants were identified in 25 of 42 patients who received genetic testing. Six out of 25 patients (24.0%) showed ARVC-related genotypes (2 PKP2, 1 DSG2, 1 TMEM43, 1 JUP, and 1 DSP) (Figure 1 and Table 1). None of the patients showed structural or electrocardiographic features that fulfill diagnostic criteria of ARVC. It is notable that ARVC-related genotypes were mostly frequently accounted for BrS patients, following SCN5A and SCN10A.
Conclusion
In the clinic setting, ARVC-related genetic variants were identified in significant proportion of BrS patients, supporting that genetic testing of ARVC-overlapping is needed. This study suggests that follow-up including imaging study should be considered in BrS patients with ARVC-related genotypes to monitor disease progression as ARVC.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Jeong
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J I Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y G Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - Y Y Choi
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - K J Min
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - S Y Roh
- Korea University Guro Hospital , Seoul , Korea (Democratic People's Republic of)
| | - J M Shim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
| | - J S Kim
- Korea University Ansan Hospital , Ansan , Korea (Democratic People's Republic of)
| | - Y H Kim
- Korea University Anam Hospital , Seoul , Korea (Republic of)
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Baeg SI, Jeon J, Kang D, Na SJ, Cho J, Kim K, Yang JH, Chung CR, Lee JE, Huh W, Suh GY, Kim YG, Kim DJ, Jang HR. Impact of protocolized fluid management on electrolyte stability in patients undergoing continuous renal replacement therapy. Front Med (Lausanne) 2022; 9:915072. [PMID: 36117982 PMCID: PMC9471083 DOI: 10.3389/fmed.2022.915072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveContinuous renal replacement therapy (CRRT) is the standard treatment for critically ill patients with acute kidney injury (AKI). Electrolyte disturbance such as hypokalemia or hypophosphatemia occurs paradoxically in patients undergoing CRRT due to high clearance. We developed a fluid management protocol for dialysate and replacement fluid that depends on serum electrolytes and focuses on potassium and phosphate levels to prevent electrolyte disturbance during CRRT. The impact of our new fluid protocol on electrolyte stability was evaluated.MethodsAdult patients who received CRRT between 2013 and 2017 were included. Patients treated 2 years before (2013–2014; pre-protocol group) and 2 years following development of the fluid protocol (2016–2017; protocol group) were compared. The primary outcomes were individual coefficient of variation (CV) and abnormal event rates of serum phosphate and potassium. Secondary outcomes were frequency of electrolyte replacement and incidence of cardiac arrhythmias. Individual CV and abnormal event rates for each electrolyte were analyzed using the Wilcoxon rank-sum test and Chi-square test with Yates’ continuity correction.ResultsA total of 1,448 patients was included. Both serum phosphate and potassium were higher in the protocol group. The CVs of serum phosphate (pre-protocol vs. protocol, 0.275 [0.207–0.358] vs. 0.229 [0.169–0.304], p < 0.01) and potassium (0.104 [0.081–0.135] vs. 0.085 [0.064–0.110], p < 0.01) were significantly lower in the protocol group. The abnormal event rates of serum phosphate (rate [95% CI], 0.410 [0.400–0.415] vs. 0.280 [0.273–0.286], p < 0.01) and potassium (0.205 [0.199–0.211] vs. 0.083 [0.079–0.087], p < 0.01) were also significantly lower in the protocol group.ConclusionThe protocolized management of fluid in CRRT effectively prevented hypophosphatemia and hypokalemia by inducing excellent stability of serum phosphate and potassium levels.
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Affiliation(s)
- Song In Baeg
- Division of Nephrology, Department of Internal Medicine, Myongji Hospital, Hanyang University Medical Center, Goyang, South Korea
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
- Center of Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
| | - Soo Jin Na
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
- Center of Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
| | - Kyunga Kim
- Statistics and Data Center, Samsung Medical Center, Seoul, South Korea
| | - Jeong Hoon Yang
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Gee Young Suh
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Hye Ryoun Jang,
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10
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Jun J, Park K, Lee HS, Lee KW, Lee JE, Park JB, Kim K, Huh W, Kim YG, Kim DJ, Jang HR. Clinical relevance of postoperative proteinuria for prediction of early renal outcomes after kidney transplantation. Kidney Res Clin Pract 2022; 41:707-716. [DOI: 10.23876/j.krcp.21.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/18/2022] [Indexed: 11/04/2022] Open
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11
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Kim S, Jeon J, Lee YJ, Jang HR, Joo EY, Huh W, Kim YG, Kim DJ, Lee JE. Depression is a main determinant of health-related quality of life in patients with diabetic kidney disease. Sci Rep 2022; 12:12159. [PMID: 35842489 PMCID: PMC9288542 DOI: 10.1038/s41598-022-15906-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/30/2022] [Indexed: 11/26/2022] Open
Abstract
Low health-related quality of life (HRQOL) is associated with adverse outcomes in diabetic kidney disease (DKD) patients. We examined the modifiable factors associated with low HRQOL in these patients. We enrolled 141 DKD patients. HRQOL was assessed with the Short Form 36 (SF-36) questionnaire. Low HRQOL was defined as a score > one standard deviation below the mean. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS-D and HDAS-A, respectively). The patients’ median age was 65 years, and 73% were men. The prevalence rates of anxiety and depression were 8% (n = 11) and 17% (n = 24), respectively. Forty (28%) patients were identified as poor sleepers, and 40 (28%) had low physical activity levels. Anxiety, depression, and poor sleep quality were negatively correlated with SF-36 scores. Higher levels of physical activity and the estimated glomerular filtration rate (eGFR) were correlated with higher SF-36 scores, which indicated better health status. Higher depression scores (HADS-D scores) were associated with low HRQOL, independent of factors including age, sex, smoking status, comorbidities, eGFR, anemia, sleep quality, anxiety levels, and physical activity levels (odds ratio, 1.43; 95% confidence interval, 1.17–1.75). Among the clinical and psycho-physical factors, depression was a main determinant of low HRQOL in DKD patients.
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Affiliation(s)
- Suhyun Kim
- Division of Nephrology, Department of Medicine, Hanil General Hospital, Seoul, Republic of Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Yu-Ji Lee
- Division of Nephrology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Paryong-ro, Masanhoewon-gu, 51353, Changwon, Republic of Korea.
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Eun Yeon Joo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea.
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12
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Jeon J, Park J, Boo HJ, Yang KE, Lee CJ, Lee JE, Kim K, Kwon GY, Huh W, Kim DJ, Kim YG, Jang HR. Clinical value of urinary cytokines/chemokines as prognostic markers in patients with crescentic glomerulonephritis. Sci Rep 2022; 12:10221. [PMID: 35715470 PMCID: PMC9205991 DOI: 10.1038/s41598-022-13261-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 04/26/2022] [Indexed: 11/09/2022] Open
Abstract
Crescentic glomerulonephritis (CrGN) usually requires urgent immunosuppressive treatment. However, aggressive immunosuppressive treatment is often difficult because of the patients' medical conditions or comorbidities. Prognostic markers including urinary cytokines/chemokines as noninvasive biomarkers were explored in CrGN patients. This prospective cohort study included 82 patients with biopsy-confirmed CrGN from 2002 to 2015 who were followed up for 5 years. Urine and serum cytokines/chemokines on the day of kidney biopsy were analyzed in 36 patients. The median age was 65 years and 47.6% were male. Baseline estimated glomerular filtration rate (eGFR) and interstitial fibrosis and tubular atrophy (IFTA) scores were identified as significant prognostic factors. Among patients with cytokines/chemokines measurement, increased IL-10 level was identified as an independent predictor of good prognosis, and increased levels of urinary MCP-1 and fractalkine tended to be associated with good prognosis after adjusting for baseline eGFR and IFTA score. However, semiquantitative analysis of intrarenal leukocytes did not show prognostic value predicting renal outcome or correlation with urinary cytokines/chemokines. This study supports the clinical importance of baseline eGFR and IFTA scores and suggests potential usefulness of urinary IL-10, MCP-1, and fractalkine as prognostic markers for predicting renal outcomes in patients with CrGN.
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Affiliation(s)
- Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeeeun Park
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyo Jin Boo
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeong Eun Yang
- Division of Scientific Instrumentation & Management, Korea Basic Science Institute, Daejeon, Republic of Korea
| | - Cheol-Jung Lee
- Division of Scientific Instrumentation & Management, Korea Basic Science Institute, Daejeon, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Boo HJ, Lee JE, Chung SM, Jang HR, Huh W, Kim DJ, Kim YG. The presence of simple renal cysts is associated with an increased risk of albuminuria in young adults. Korean J Intern Med 2022; 37:425-433. [PMID: 34865415 PMCID: PMC8925965 DOI: 10.3904/kjim.2020.576] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/04/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS The prevalence of simple renal cysts increases with age; however, they are occasionally found in adults aged < 40 years. This cross-sectional study evaluated the clinical significance of simple cysts in young adults, focusing on their associations with hematuria and albuminuria. METHODS Adults aged < 40 years who underwent comprehensive medical examination between January 2005 and December 2013 were included. Simple renal cysts were identified by ultrasonography. RESULTS Renal cysts were found in 276 of the 5,832 subjects (4.7%). Subjects with medullary sponge kidney (n = 1) or polycystic kidney disease (n = 5) were excluded. A single cyst and multiple cysts were found in 234 (4.0%) and 42 (0.7%) subjects, respectively. Age, high systolic blood pressure, and history of hypertension were independent risk factors for the presence of simple cysts. Simple cysts were not associated with an increased prevalence of hematuria. However, subjects with cysts showed a higher prevalence of albuminuria than those without (11.3% vs. 4.5%, p < 0.001). Multivariate analysis revealed that the existence of simple renal cysts was associated with a 2.30-fold increased prevalence of albuminuria (95% confidence interval, 1.512 to 3.519; p < 0.001) independent of other risk factors. CONCLUSION In young adults, the presence of simple renal cysts was independently associated with an increased prevalence of albuminuria. The causal relationship needs to be elucidated in further studies.
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Affiliation(s)
- Hyo Jin Boo
- Division of Nephrology, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Jung Eun Lee
- Division of Nephrology, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Son Mi Chung
- Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Wooseong Huh
- Division of Nephrology, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Dae Joong Kim
- Division of Nephrology, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
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14
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Lee K, Jang HR, Jeon J, Yang KE, Lee JE, Kwon GY, Kim DJ, Kim YG, Huh W. Repair phase modeling of ischemic acute kidney injury: recovery vs. transition to chronic kidney disease. Am J Transl Res 2022; 14:554-571. [PMID: 35173874 PMCID: PMC8829619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 12/07/2021] [Indexed: 06/14/2023]
Abstract
The repair mechanism after ischemic acute kidney injury (AKI) involves complex immunologic processes, which determine long-term renal outcomes. Through investigating two murine ischemia-reperfusion injury (IRI) models: bilateral IRI (BIRI) and unilateral IRI (UIRI), we aimed to determine an appropriate murine model that could simulate the recovery phase of ischemic AKI. Changes in renal function, phenotypes of kidney mononuclear cells, renal fibrosis, and intrarenal cytokine/chemokine expression were serially analyzed up to 12 weeks after IRI. Plasma creatinine and BUN concentrations increased and remained elevated in the BIRI group until 7 days but decreased to comparable levels with the sham control group at 2 weeks after surgery and thereafter, whereas plasma creatinine and BUN concentrations remained unchanged in the UIRI group. Intrarenal total leukocytes, and effector memory and activated phenotypes of CD4 and CD8 T cells markedly increased in the postischemic kidneys in both IRI groups. Expression of proinflammatory cytokines/chemokines and TGF-β1 was enhanced in the postischemic kidneys of both IRI groups with a higher degree in the UIRI group. Importantly, intrarenal immunologic changes of the BIRI group persisted until 6 weeks despite full functional recovery. The postischemic kidneys of the UIRI group showed earlier and more pronounced proinflammatory conditions as well as more severe atrophic and fibrotic changes compared to the BIRI group. These findings support the utility of longer follow-ups of BIRI and UIRI models for investigating the adaptive repair process, which facilitates recovery of ischemic AKI and maladaptive repair process may result in AKI to CKD transition, respectively.
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Affiliation(s)
- Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Kyeong Eun Yang
- Division of Scientific Instrumentation & Management, Korea Basic Science InstituteDaejeon, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineSeoul, Republic of Korea
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15
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Jeon J, Park H, Kim Y, Kang D, Lee JE, Huh W, Kim YG, Kim DJ, Cho J, Jang HR. Prognostic factors of renal outcomes after heart transplantation: a nationwide retrospective study. Korean Journal of Transplantation 2021. [DOI: 10.4285/atw2021.po-1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Junseok Jeon
- Department of Internal Medicine-Nephrology, Samsung Medical Center, Seoul, Korea
| | - Hyejeong Park
- Department of Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Youngha Kim
- Department of Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Danbee Kang
- Department of Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Jung Eun Lee
- Department of Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Wooseong Huh
- Department of Internal Medicine-Nephrology, Samsung Medical Center, Seoul, Korea
| | - Yoon-Goo Kim
- Department of Internal Medicine-Nephrology, Samsung Medical Center, Seoul, Korea
| | - Dae Joong Kim
- Department of Internal Medicine-Nephrology, Samsung Medical Center, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Epidemiology, Samsung Medical Center, Seoul, Korea
| | - Hye Ryoun Jang
- Department of Internal Medicine-Nephrology, Samsung Medical Center, Seoul, Korea
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16
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Jeon J, Jang HR, Huh W, Kim YG, Kim DJ, Lee JE. Predialysis predictors for identifying patients requiring dialysis at a higher glomerular filtration rate. Ren Fail 2021; 43:1087-1093. [PMID: 34219598 PMCID: PMC8259870 DOI: 10.1080/0886022x.2021.1940202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Current evidence suggests that the initiation of maintenance hemodialysis should not be based on a specific glomerular filtration rate (GFR) but on symptoms or signs attributable to kidney disease. However, it is difficult to predict the time point at which overt uremic syndrome develops in individuals. The estimated GFR is poorly correlated with occurrence of uremic symptoms, and some patients require dialysis at a higher eGFR than others. In this case, patients are more likely to be improperly prepared for dialysis. We investigated the predialysis characteristics of patients who require dialysis at a higher eGFR. Methods A total of 453 incident dialysis patients being monitored by a nephrologist from January 2013 to December 2018 were included. The predialysis characteristics when eGFR decreased to 20 mL/min/1.73 m2 were obtained. Results The mean age was 61 years, and 65.7% were men. Overall, the median eGFR at the first dialysis was 5.8 (interquartile range 4.6–7.3) mL/min/1.73 m2 and initiation of dialysis at the first quintile (≥7.8 mL/min/1.73 m2) was defined as ‘early initiation of dialysis’ Among the predialysis characteristics, heart failure (adjusted odds ratio 3.68; 95% confidence interval, 1.59–8.03), serum albumin <4.0 mg/dL (2.22; 1.30–3.77), blood urea nitrogen (BUN)/creatinine (Cr) ratio >15 mg/mg (1.92, 1.16–3.18), and hyperuricemia (1.84; 1.05–3.23) were independent predictors of early initiation. Diabetes mellitus and the causes of kidney disease were not independent predictors of early initiation. The early initiation group was less likely to initiate dialysis with a permanent vascular access than the late initiation group. Conclusions For patients with heart failure, low serum albumin level, high BUN/Cr ratio, or hyperuricemia, clinicians can provide predialysis counseling in advance and consider early creation of vascular access.
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Affiliation(s)
- Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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17
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Baeg SI, Jeon J, Yoo H, Na SJ, Kim K, Chung CR, Yang JH, Jeon K, Lee JE, Huh W, Suh GY, Kim YG, Kim DJ, Jang HR. A Scoring Model with Simple Clinical Parameters to Predict Successful Discontinuation of Continuous Renal Replacement Therapy. Blood Purif 2021; 50:779-789. [PMID: 33735858 DOI: 10.1159/000512350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Continuous renal replacement therapy (CRRT) is the standard treatment for severe acute kidney injury in critically ill patients. However, a practical consensus for discontinuing CRRT is lacking. We aimed to develop a prediction model with simple clinical parameters for successful discontinuation of CRRT. METHODS Adult patients who received CRRT at Samsung Medical Center from 2007 to 2017 were included. Patients with preexisting ESRD and patients who progressed to ESRD within 1 year or died within 7 days after CRRT were excluded. Successful discontinuation of CRRT was defined as no requirement for renal replacement therapy for 7 days after discontinuing CRRT. Patients were assigned to either a success group or failure group according to whether discontinuation of CRRT was successful or not. RESULTS A total of 1,158 patients were included in the final analyses. The success group showed greater urine output on the day before CRRT discontinuation (D-1) and the discontinuation day (D0). Multivariable analysis identified that urine output ≥300 mL on D-1, and mean arterial pressure 50∼78 mm Hg, serum potassium <4.1 mmol/L, and BUN <35 mg/dL (12.5 mmol/L) on D0 were predictive factors for successful discontinuation of CRRT. A scoring system using the 4 variables above (area under the receiver operating curve: 0.731) was developed. CONCLUSIONS Scoring system composed of urine output ≥300 mL/day on D-1, and adequate blood pressure, serum potassium <4.1 mmol/L, and BUN <35 mg/dL (12.5 mmol/L) on D0 was developed to predict successful discontinuation of CRRT.
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Affiliation(s)
- Song In Baeg
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Heejin Yoo
- Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Soo Jin Na
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyunga Kim
- Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Hoon Yang
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeongman Jeon
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gee Young Suh
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea,
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18
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Jeon J, Lee K, Yang KE, Lee JE, Kwon GY, Huh W, Kim DJ, Kim YG, Jang HR. Dietary Modification Alters the Intrarenal Immunologic Micromilieu and Susceptibility to Ischemic Acute Kidney Injury. Front Immunol 2021; 12:621176. [PMID: 33777001 PMCID: PMC7991094 DOI: 10.3389/fimmu.2021.621176] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/22/2021] [Indexed: 12/28/2022] Open
Abstract
The versatility of the intrarenal immunologic micromilieu through dietary modification and the subsequent effects on susceptibility to ischemic acute kidney injury (AKI) are unclear. We investigated the effects of high-salt (HS) or high-fat (HF) diet on intrarenal immunologic micromilieu and development of ischemic AKI using murine ischemic AKI and human kidney-2 (HK-2) cell hypoxia models. Four different diet regimens [control, HF, HS, and high-fat diet with high-salt (HF+HS)] were provided individually to groups of 9-week-old male C57BL/6 mice for 1 or 6 weeks. After a bilateral ischemia-reperfusion injury (BIRI) operation, mice were sacrificed on day 2 and renal injury was assessed with intrarenal leukocyte infiltration. Human kidney-2 cells were treated with NaCl or lipids. The HF diet increased body weight and total cholesterol, whereas the HF+HS did not. Although the HF or HS diet did not change total leukocyte infiltration at 6 weeks, the HF diet and HF+HS diet increased intrarenal CD8 T cells. Plasma cells increased in the HF and HS diet groups. The expression of proinflammatory cytokines including TNF-α, IFN-γ, MCP-1, and RANTES was increased by the HF or HS diet, and intrarenal VEGF decreased in the HS and HF+HS diet groups at 6 weeks. Deterioration of renal function following BIRI tended to be aggravated by the HF or HS diet. High NaCl concentration suppressed proliferation and enhanced expression of TLR-2 in hypoxic HK-2 cells. The HF or HS diet can enhance susceptibility to ischemic AKI by inducing proinflammatory changes to the intrarenal immunologic micromilieu.
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Affiliation(s)
- Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyeong Eun Yang
- Division of Scientific Instrumentation and Management, Korea Basic Science Institute, Daejeon, South Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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19
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Jang HR, Cho HJ, Zhou Y, Shao NY, Lee K, Le HHT, Jeon J, Lee JE, Huh W, Ong SG, Lee WH, Kim YG. Modeling Uremic Vasculopathy With Induced Pluripotent Stem Cell-Derived Endothelial Cells as a Drug Screening System. Front Cell Dev Biol 2021; 8:618796. [PMID: 33511129 PMCID: PMC7835337 DOI: 10.3389/fcell.2020.618796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 12/08/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Cardiovascular complications are the leading cause of mortality in patients with chronic kidney disease (CKD). Uremic vasculopathy plays a crucial role in facilitating the progression of cardiovascular complications in advanced CKD. However, the improvement of conventional research methods could provide further insights into CKD. Objectives: In this study, we aimed to develop a novel model of uremic vasculopathy as a potential drug screening system. Methods and Results: The effects of uremic serum and different combinations of uremic toxins on induced pluripotent stem cell (iPSC)-derived endothelial cells (ECs) of a normal control and a CKD patient were investigated using several functional assays. We found that a mixture of uremic toxins composed of high urea, creatinine, uric acid, and indoxyl sulfate exerted deleterious effects on normal control iPSC-ECs that were comparable to uremic serum by increasing reactive oxygen species and apoptosis, as well as suppression of tube formation. Additional characterization revealed a potential involvement of dysregulated TGF-β signaling as treatment with either losartan or TGF-β inhibitors led to the attenuation of adverse effects induced by uremic toxins. Importantly, impaired wound healing potential seen in CKD patient-specific iPSC-ECs was rescued by treatment with losartan and TGF-β inhibitors. Conclusion: Our study demonstrated that simplified uremic toxin mixtures can simulate the uremic micromilieu reproducibly and CKD patient-specific iPSC-ECs can potentially recapitulate susceptibility to uremic vasculopathy. This novel model of uremic vasculopathy may provide a new research tool as a drug screening system.
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Affiliation(s)
- Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Stem Cell & Regenerative Medicine Institute(SCRMI), Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyung Joon Cho
- School for Engineering of Matter, Transport & Energy, Arizona State University, Tempe, AZ, United States
| | - Yang Zhou
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Ning-Yi Shao
- Health Sciences, University of Macau, Macau, China
| | - Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Stem Cell & Regenerative Medicine Institute(SCRMI), Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hoai Huong Thi Le
- Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Stem Cell & Regenerative Medicine Institute(SCRMI), Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Stem Cell & Regenerative Medicine Institute(SCRMI), Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Stem Cell & Regenerative Medicine Institute(SCRMI), Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang-Ging Ong
- Department of Pharmacology & Regenerative Medicine, University of Illinois College of Medicine, Chicago, IL, United States.,Division of Cardiology, Department of Medicine, University of Illinois College of Medicine, Chicago, IL, United States
| | - Won Hee Lee
- Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ, United States
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Stem Cell & Regenerative Medicine Institute(SCRMI), Sungkyunkwan University School of Medicine, Seoul, South Korea
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20
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Chin HJ, Chae DW, Kim YC, An WS, Ihm C, Jin DC, Kim SG, Kim YL, Kim YS, Kim YG, Koo HS, Lee JE, Lee KW, Oh J, Park JH, Jiang H, Lee H, Lee SK. Comparison of the Efficacy and Safety of Tacrolimus and Low-Dose Corticosteroid with High-Dose Corticosteroid for Minimal Change Nephrotic Syndrome in Adults. J Am Soc Nephrol 2021; 32:199-210. [PMID: 33168602 PMCID: PMC7894664 DOI: 10.1681/asn.2019050546] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/08/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Tacrolimus is used as a steroid-sparing immunosuppressant in adults with minimal change nephrotic syndrome. However, combined treatment with tacrolimus and low-dose steroid has not been compared with high-dose steroid for induction of clinical remission in a large-scale randomized study. METHODS In this 24-week open-label noninferiority study, we randomized 144 adults with minimal change nephrotic syndrome to receive 0.05 mg/kg twice-daily tacrolimus plus once-daily 0.5 mg/kg prednisolone, or once-daily 1 mg/kg prednisolone alone, for up to 8 weeks or until achieving complete remission. Two weeks after complete remission, we tapered the steroid to a maintenance dose of 5-7.5 mg/d in both groups until 24 weeks after study drug initiation. The primary end point was complete remission within 8 weeks (urine protein: creatinine ratio <0.2 g/g). Secondary end points included time until remission and relapse rates (proteinuria and urine protein: creatinine ratio >3.0 g/g) after complete remission to within 24 weeks of study drug initiation. RESULTS Complete remission within 8 weeks occurred in 53 of 67 patients (79.1%) receiving tacrolimus and low-dose steroid and 53 of 69 patients (76.8%) receiving high-dose steroid; this difference demonstrated noninferiority, with an upper confidence limit below the predefined threshold (20%) in both intent-to-treat (11.6%) and per-protocol (17.0%) analyses. Groups did not significantly differ in time until remission. Significantly fewer patients relapsed on maintenance tacrolimus (3-8 ng/ml) plus tapered steroid versus tapered steroid alone (5.7% versus 22.6%, respectively; P=0.01). There were no clinically relevant safety differences. CONCLUSIONS Combined tacrolimus and low-dose steroid was noninferior to high-dose steroid for complete remission induction in adults with minimal change nephrotic syndrome. Relapse rates were significantly lower with maintenance tacrolimus and steroid compared with steroid alone. No clinically-relevant differences in safety findings were observed.
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Affiliation(s)
- Ho Jun Chin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong-Wan Chae
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Won Suk An
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea
| | - ChunGyoo Ihm
- Department of Nephrology, Kyunghee University Medical Center, Seoul, South Korea
| | - Dong-Chan Jin
- Department of Internal Medicine, St Vincent Hospital, Suwon, South Korea
| | - Sung Gyun Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Yong-Lim Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Yong-Soo Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, South Korea
| | - Yoon-Goo Kim
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ho Seok Koo
- Department of Internal Medicine, Inje University Seoul Paik Hospital, Seoul, South Korea
| | - Jung Eun Lee
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kang Wook Lee
- Department of Nephrology, Chungnam National University Hospital, Daejeon, South Korea
| | - Jieun Oh
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Jung Hwan Park
- Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Hongsi Jiang
- Medical Affairs Asia Oceania, Astellas Pharma Singapore Pte. Ltd., Singapore
| | - Hyuncheol Lee
- Clinical Research, Astellas Pharma Korea Inc., Seoul, South Korea
| | - Sang Koo Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan, Seoul, South Korea
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21
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Jang HR, Lee K, Jeon J, Kim JR, Lee JE, Kwon GY, Kim YG, Kim DJ, Ko JW, Huh W. Poly (ADP-Ribose) Polymerase Inhibitor Treatment as a Novel Therapy Attenuating Renal Ischemia-Reperfusion Injury. Front Immunol 2020; 11:564288. [PMID: 33178190 PMCID: PMC7597449 DOI: 10.3389/fimmu.2020.564288] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/14/2020] [Indexed: 01/17/2023] Open
Abstract
Intrarenal robust inflammatory response following ischemia-reperfusion injury (IRI) is a major factor in the pathogenesis of renal injury in ischemic acute kidney injury (AKI). Although numerous studies have investigated various agents of immune modulation or suppression for ischemic AKI, few showed reproducible effects. We hypothesized that poly (ADP-ribose) polymerase (PARP) inhibitor may favorably change post-ischemic intrarenal immunologic micromilieu by reducing damage-associated molecular pattern (DAMP) signals and improve renal outcome in ischemic AKI. The effects of JPI-289 (a PARP inhibitor) on early renal injury in a murine IRI model and hypoxic HK-2 cell model were investigated. Bilateral IRI surgery was performed in three groups of 9-week-old male C57BL/6 mice (control, JPI-289 50 mg/kg, and JPI-289 100 mg/kg; n = 9–10 in each group). Saline or JPI-289 was intraperitoneally injected. Renal function deterioration was significantly attenuated in the JPI-289 treatment groups in a dose-dependent manner. Inflammatory cell infiltration and proinflammatory cytokine/chemokine expressions in the post-ischemic kidneys were also attenuated by JPI-289 treatment. JPI-289 treatment at 0.5 and 0.75 μg/ml facilitated the proliferation of hypoxic HK-2 cells. PARP inhibition with JPI-289 treatment showed favorable effects in ischemic AKI by attenuating intrarenal inflammatory cascade in a murine model and facilitating proliferation of hypoxic HK-2 cells.
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Affiliation(s)
- Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung-Ryul Kim
- Department of Clinical Pharmacology and Therapeutics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae-Wook Ko
- Department of Clinical Pharmacology and Therapeutics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Clinical Pharmacology and Therapeutics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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22
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Kim S, Boo HJ, Jeon J, Jang HR, Huh W, Kim YG, Kim DJ, Lee JE. P1023DEPRESSION IS A MAJOR DETERMINANT OF HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH DIABETIC KIDNEY DISEASE. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Poor health-related quality of life (HRQOL) is associated with increased cardiovascular risk and mortality in patients with kidney disease. Therefore, it is critical to identify and modify clinical contributors of poor HRQOL. This study examined modifiable factors associated with poor HRQOL in patients with diabetic kidney disease (DKD) focusing on depression, anxiety, sleep quality, and physical activity.
Method
Between April 2017 and March 2018, 141 adults (aged ≥18 years) with DKD were recruited in single tertiary hospital. HRQOL was assessed at baseline with the Short Form 36 of life Health Survey Question (SF-36) questionnaire. Poor HRQOL was defined as a score below the median value at baseline. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. Sleep quality and physical activity were measured using Korean version of the Pittsburgh Sleep Quality Index and International Physical Activity Questionnaire respectively.
Results
The age was 65 [57-72] years old, and 73% (n=103) of participants were men. Prevalence of anxiety and depression were 8% (n=11) and 17% (n=24) respectively. Forty-eight (34%) subjects corresponded to poor sleepers and 40 (28%) subjects showed low physical activity. SF-36 scores were decreased with advanced CKD stages (stage 3, 79 [71-82]; stage 4, 71 [56-82]; stage 5, 70 [57-82]; p = 0.029 for trend) progressively. Anxiety, depression, and poor sleep quality were negatively correlated with SF-36 scores (p < 0.05). eGFR and physical activity were positively correlated with HRQOL scores (p < 0.05). In multivariable logistic analysis, depression scores were associated poor HRQOL independently of age, sex, comorbidity, eGFR, anemia, sleep quality, anxiety and physical activity (odds ratio per 1-score increment, 1.51; 95% confidence interval, 1.27-1.80, p < 0.001).
Conclusion
In patients with DKD, depression was a major determinant of poor HRQOL among the modifiable clinical factors such as anxiety and sleep. Active surveillance of depression and psychosocial intervention should be considered to improve the well-being of these patients.
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Affiliation(s)
- Suhyun Kim
- Hanil General Hospital, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Hyo jin Boo
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Jeunseok Jeon
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Hye Ryoun Jang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Wooseong Huh
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Yoon-Goo Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Dae Joong Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
| | - Jung Eun Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Nephrology Division; Department of Internal Medicine, Korea, Rep. of South
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SONG SEUNGMIN, Boo HJ, Jang HR, Huh W, Kim DJ, Kim YG, Lee JE. P0568INCIDENCE AND RISK FACTORS OF ACUTE KIDNEY INJURY AND TUMOR LYSIS SYNDROME IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH BORTEZOMIB. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
Nephrotoxicity of bortezomib, a proteasome inhibitor, has not yet been described frequently, while tumor lysis syndrome (TLS) associated with multiple myeloma (MM) has been increased after introduction of the drug. This study compared the incidence and risk factors of acute kidney injury (AKI) and TLS in patients with MM after bortezomib-based chemotherapy to investigate the drug-related nephrotoxicity.
Method
From 2006 to 2017, 276 patients who underwent first cycle of bortezomib-based chemotherapy for MM were identified in single tertiary hospital. Laboratory TLS was defined according to the Cairo-Bishop definition. Development of AKI was assessed by AKI Network (AKIN) criteria within 7 days after first chemotherapy.
Results
The age was 65 [56-72] years old, and 47% (n=131) of participants were female and baseline estimated glomerular filtration rate (eGFR) was 61.3 [34.1-89.1] mL/min/1.73m2. The incidences of AKI and laboratory TLS were 17% (n=47) and 13% (n=36), respectively. Ten (3.6%) subjects corresponded to the both AKI and TLS criteria. Multivariate analyses showed that lower eGFR category (30∼59, odds ratio [OR]=3.063 [1.278-7.339]; 15∼29, OR=3.417 [1.088-10.726]; <15, OR=10.080 [2.677-37.951] vs ≥ 60), lower serum albumin level (OR=0.491 [0.278-0.868], P=0.0144) and renal amyloidosis (OR=11.174 [3.974-31.420], P<0.0001) were predictors of development of AKI. MM stages and β2-microglobulin were not associated with AKI occurrence.
Regarding laboratory TLS, MM stage and β2-microglobulin were higher in those with TLS. In multivariate analyses, β2-microglobulin levels (OR=1.194 [1.066-1.337], P=0.0021) and any chromosomes abnormalities at high risk (OR=0.115 [0.026-0.503], P=0.0041) were associated with higher risk of TLS.
Conclusion
Development of AKI was often observed without being accompanied by TLS in patients with MM after treatment of bortezomib. In addition, risk factors of AKI and TLS were widely different. These findings implicated the potential nephrotoxicity of bortezomib besides TLS in patients with decreased kidney function. The efforts to prevent bortezomib associated AKI are needed in patients at high risk.
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Affiliation(s)
- SEUNGMIN SONG
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
| | - Hyo jin Boo
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
| | - Hye Ryoun Jang
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
| | - Wooseong Huh
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
| | - Dae Joong Kim
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
| | - Yoon-Goo Kim
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
| | - Jung Eun Lee
- Samsung Medical Center, Nephrology, Seoul, Korea, Rep. of South
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Boo HJ, SONG SEUNGMIN, Lee JE, Jang HR, Huh W, Kim DJ, Kim YG. P0225THE PRESENCE OF SIMPLE RENAL CYST IS ASSOCIATED WITH INCREASED RISK OF ALBUMINURIA IN YOUNG ADULTS. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
It is well-known that the prevalence of simple renal cyst increases with age. However, simple cysts are occasionally found in adults younger than 40 years of age. This cross-sectional study evaluated the clinical significance of simple renal cysts in young adults, focusing on the associations with hematuria and albuminuria.
Method
Adults younger than 40 years who received a comprehensive medical checkup from January 2005 to December 2013 were included. Simple renal cysts were identified by ultrasonography.
Results
Among 5832 subjects, renal cysts were found in 276 (4.7%). Subjects diagnosed with polycystic kidney disease (n=5) or medullary sponge kidney (n=1) were excluded from the analyses. A single cyst and multiple cysts were found in 234 (4.0%) and 42 (0.7%) subjects, respectively. The locations of single cyst were cortex in 187, medulla in 26, and parapelvic region in 21. Age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.12 per 1-year increment, P = 0.002), systolic BP (OR, 1.01; 95% CI, 1.00-1.02 per 1-mmHg increment, P = 0.006), and hypertension (OR, 1.85; 95% CI, 1.24-2.76, P = 0.003) were independent predictors of the presence of simple cyst. The presence of cysts was not associated with increased prevalence of hematuria. While, the subjects with cysts had higher prevalence of albuminuria than those without cysts (11.3% vs. 4.5%, P <0.001). Multivariate analyses of albuminuria revealed that the presence of simple renal cyst was associated with a 2.30-fold increase in the prevalence of albuminuria (95% CI 1.512-3.519, P <0.001) independently of other risk factors. The location of the cysts was not related to the prevalence of albuminuria.
Conclusion
The presence of simple renal cysts was independently associated with increased prevalence of albuminuria. The causal relationship between renal cysts and albuminuria needs to be elucidated in further studies.
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Affiliation(s)
- Hyo Jin Boo
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
| | - SEUNGMIN SONG
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
| | - Jung Eun Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
| | - Hye Ryoun Jang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
| | - Wooseong Huh
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
| | - Dae Joong Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
| | - Yoon-Goo Kim
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Medicine
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Jeon J, Kim DH, Jang HR, Lee JE, Huh W, Kim HY, Kim DJ, Kim YG. Urinary angiotensinogen as a surrogate marker predicting the antiproteinuric effects of angiotensin receptor blockers in patients with overt proteinuria: a multicenter prospective study. BMC Nephrol 2020; 21:180. [PMID: 32410703 PMCID: PMC7227290 DOI: 10.1186/s12882-020-01825-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 04/22/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although urinary angiotensinogen (AGT) and renin reflect intrarenal renin-angiotensin system activity and are enhanced in proteinuric chronic kidney disease, the clinical value of urinary AGT and renin levels during antiproteinuric treatment has yet to be determined. We investigated the clinical usefulness of initial urinary AGT or renin to determine the antiproteinuric effects of angiotensin receptor blockers (ARBs). METHODS This multicenter, prospective, single-arm study included 205 patients with overt proteinuria (urinary protein/creatinine ratio [uPCR] ≥ 1 mg/mg) enrolled between April 2009 and December 2011. All patients were treated with valsartan. The urinary AGT/creatinine ratio (uAGT/Cr) was measured at the baseline and 24 weeks, and the renin/creatinine ratio (uR/Cr) was measured at the baseline. Fifty-six patients were followed-up for 5 years. RESULTS The mean age was 47.6 years and 51.2% were male. The mean uPCR was 2.32 mg/mg and the mean eGFR was 63.2 mL/min/1.73m2. Natural logarithms (ln) (uAGT/Cr), ln(uR/Cr), and diabetes mellitus were associated with proteinuria decrement (decrease in uPCR ≥1 mg/mg). Ln(uAGT/Cr) was an independent predictor for proteinuria decrement (OR 1.372, 95% CI, 1.068-1.762, P = 0.013). Among the 56 patients followed-up for 5 years, Δln(uAGT/Cr) at 24 weeks was an independent predictor for uPCR < 1 mg/mg at 5 years (OR 0.379, 95% CI, 0.20-0.715, P = 0.003). CONCLUSIONS Our study demonstrates the potential role of both baseline urinary AGT and changes in urinary AGT during the initial 24 weeks as surrogate markers predicting the antiproteinuric effects of ARBs in patients with overt proteinuria.
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Affiliation(s)
- Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Do Hee Kim
- Division of Nephrology, Department of Medicine, Chungbuk National University Hospital, Cheongju, 28644, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Hye-Young Kim
- Division of Nephrology, Department of Medicine, Chungbuk National University Hospital, Cheongju, 28644, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
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Kim S, Kim MJ, Jeon J, Jang HR, Park KB, Huh W, Do YS, Kim YG, Kim DJ, Oh HY, Lee JE. Effects of percutaneous angioplasty on kidney function and blood pressure in patients with atherosclerotic renal artery stenosis. Kidney Res Clin Pract 2019; 38:336-346. [PMID: 31234613 PMCID: PMC6727892 DOI: 10.23876/j.krcp.18.0148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/14/2019] [Accepted: 03/28/2019] [Indexed: 12/11/2022] Open
Abstract
Background Previous randomized controlled trials of revascularization for atherosclerotic renal artery stenosis (ARAS) were not successful. We investigated the effects of percutaneous transluminal angioplasty with stent insertion (PTA/S) on kidney function and blood pressure (BP) control in patients with ARAS. Methods From 2000 to 2017, 47 subjects who underwent PTA/S for ARAS were identified. A high-risk group was defined, composed of patients having one or more of the following clinical presentations: pulmonary edema, refractory hypertension, and rapid deterioration of kidney function. Subjects who met the criteria of 'kidney function improvement' or 'hypertension improvement' after PTA/S were classified as responders. Results Twenty-one (44.7%) subjects were classified into the high-risk group. Two subjects (8.0%) in the low-risk group (n = 25) and 5 subjects (27.8%) in the high-risk group (n = 18) showed improvement in kidney function after PTA/S (P = 0.110). In patients with rapid decline of kidney function, estimated glomerular filtration rate improved from 28 (interquartile range [IQR], 10-45) mL/min/1.73 m2 to 41 (IQR, 16-67) mL/min/1.73 m2 at 4 months after PTA/S, although the difference was not significant (P = 0.084). Regarding BP control, 9 (36.0%) and 14 (77.8%) subjects showed improvement after PTA/S in the low- (n = 25) and high-risk (n = 18) groups, respectively (P = 0.007). In patients with refractory hypertension, the systolic BP dropped from 157 (IQR, 150-164) mmHg to 140 (IQR, 131-148) mmHg at 4 months after PTA/S (P = 0.005). Twenty-five subjects were defined as responders and comprised a significant proportion of the high-risk group (P = 0.004). Conclusion PTA/S might improve BP control and kidney function in patients with ARAS presenting with high-risk clinical features. The optimal application of PTA/S should be based on individual assessment of the clinical significance of renal artery stenosis.
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Affiliation(s)
- Suhyun Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Jeoung Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Internal Medicine, Incheon Sarang Hospital, Incheon, Korea
| | - Jeunseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Bo Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Soo Do
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim S, Hwang S, Jang HR, Sohn I, Ahn HS, Park HD, Huh W, Jin DC, Kim YG, Kim DJ, Oh HY, Lee JE. Creatinine- and cystatin C-based estimated glomerular filtration rate slopes for the prediction of kidney outcome: a comparative retrospective study. BMC Nephrol 2019; 20:214. [PMID: 31185945 PMCID: PMC6558736 DOI: 10.1186/s12882-019-1403-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many studies have evaluated the usefulness of creatinine- (eGFRcr) and cystatin C-based estimated glomerular filtration rate (eGFRcys) at specific time points in predicting renal outcome. This study compared the performance of both eGFR changing slopes in identifying patients at high risk of end-stage renal disease (ESRD). METHODS From 2012 to 2017, patients with more than three simultaneous measurements of serum creatinine and cystatin C for 1 year were identified. Rapid progression was defined as eGFR slope < - 5 mL/min/1.73 m2/year. The primary outcome was progression to ESRD. RESULTS Overall, 1323 patients were included. The baseline eGFRcr and eGFRcys were 39 (27-48) and 38 (27-50) mL/min/1.73 m2, respectively. Over 2.9 years (range, 2.0-3.8 years) of follow-up, 134 subjects (10%) progressed to ESRD. Both the eGFRcr and eGFRcys slopes were associated with a higher risk of ESRD, independently of baseline eGFR (hazard ratio [HR] = 0.986 [0.982-0.991] and HR = 0.988 [0.983-0.993], respectively; all p < 0.001). The creatinine- and cystatin C-based rapid progressions were associated with increased risk of ESRD (HR = 2.22 [1.57-3.13], HR = 2.03 [1.44-2.86], respectively; all p < 0.001). In the subgroup analyses, the rapid progression group, defined on the basis of creatinine levels (n = 503), showed no association between the eGFRcys slope and ESRD risk (p = 0.31), whereas the eGFRcr slope contributed to further discriminating higher ESRD risk in the subjects with rapid progression based on eGFRcys slopes (n = 463; p = 0.003). CONCLUSIONS Both eGFR slopes were associated with future ESRD risk. The eGFRcr slope was comparable with the eGFRcys slope in predicting kidney outcome.
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Affiliation(s)
- Suhyun Kim
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Subin Hwang
- Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Insuk Sohn
- Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyeon Seon Ahn
- Statistics and Data Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyung-Doo Park
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Dong-Chan Jin
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351, Seoul, Republic of Korea.
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Baeg SI, Jeon J, Lee JE, Huh W, Kim DJ, Kim YG, Jang HR. FP311PREDICTION MODEL FOR SUCCESSFUL DISCONTINUATION OF CONTINUOUS RENAL REPLACEMENT THERAPY IN ACUTE KIDNEY INJURY PATIENTS. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Song In Baeg
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
| | - Junseok Jeon
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
| | - Jung Eun Lee
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
| | - Dae Joong Kim
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Samsung Medical Center, Sungkyunkwan university school of medicine, Seoul, Republic of Korea
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Kwon HJ, Jeon J, Kim DH, Jang HR, Sung HH, Han DH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Clinical Impact of a Protocolized Kidney Donor Follow-up System. Transplant Proc 2019; 51:692-700. [PMID: 30979452 DOI: 10.1016/j.transproceed.2018.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adequate kidney donor management after donation is increasingly emphasized due to concerns of renal function impairment after nephrectomy with increasing life expectancy. In this study, the clinical impact of a protocolized kidney donor follow-up system by nephrologists was evaluated. METHODS A total of 427 living kidney donors underwent nephrectomy from January 2010 to December 2014 and were followed for at least 2 years at the Samsung Medical Center. Donors were followed-up by nephrologists after the establishment of a donor clinic with systemized protocols in January 2013. The primary outcomes were incidence of post-donation low estimated glomerular filtration rate (eGFR) and renal function adaptability. Secondary outcomes were changes in compliance and incidence of hyperuricemia and microalbuminuria. RESULTS The patients were divided into 2 groups according to the time of nephrectomy: the pre-donor clinic period (n = 182) and the donor clinic period (n = 172). Preoperative eGFR in patients in the pre-donor clinic period was higher than that in patients in the donor clinic period. After donation, poor renal adaptation was less frequent in the donor clinic period compared to the pre-donor clinic period. Low eGFR tended to be less common during the donor clinic period. Shorter mean outpatient clinic visit intervals with more visits within 6 months after donation and earlier detection of de novo hyperuricemia were found during the donor clinic period. CONCLUSION A protocolized donor clinic run by nephrologists may improve post-nephrectomy renal outcomes and compliance and facilitate better management of potential risk factors of chronic kidney disease in donors.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Park J, Kim J, Hwang S, Lee MK, Jang HR, Eun Lee J, Park YJ, Huh W, Kim YG, Oh HY, Joong Kim D. Arteriovenous graft patency outcomes and prognostic factors. Vascular 2018; 27:128-134. [PMID: 30360702 DOI: 10.1177/1708538118807844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Arteriovenous graft for hemodialysis shows poorer outcomes than arteriovenous fistula, due to frequent stenosis and thrombosis. We investigated arteriovenous graft patency outcomes and prognostic factors for these outcomes. METHODS We included a single-center cohort of patients receiving arteriovenous graft for hemodialysis access from 2010 to 2014. Demographics, laboratory data, comorbidities, and medications were collected from medical records. Surgical factors related to graft operation including the type and diameter of connected vessels, graft location, and type of operation (elective or emergency) were also recorded. Outcomes included primary and secondary patency. Survival analysis was conducted using the Kaplan-Meier method; univariate and multivariate analyses were used to evaluate the prognostic factors. RESULTS Data from 225 grafts were analyzed. During the follow-up period (mean: 583 days, range: 1-1717 days), 138 (61%) grafts required intervention and 46 (20%) permanently failed. Primary patency at one, two, and three years was 42%, 20%, and 16%, respectively. Secondary patency at one, two, and three years was 85%, 72%, and 64%, respectively. Multivariate analysis showed that primary patency was negatively associated with increasing age and location of vessel anastomosis (reference-brachiobrachial anastomosis; brachiobasilic - HR, 0.569; 95% CI, 0.376-0.860; p = 0.007; brachioaxillary anastomosis - HR 0.407; 95% CI, 0.263-0.631; p < 0.0001); secondary patency was positively associated with diastolic blood pressure, serum albumin level, and hemoglobin over 10 g/dL. Adverse events other than stenosis or thrombosis, such as infection/inflammation or pseudoaneurysm were observed in approximately 20% of grafts. CONCLUSIONS Factors associated with diminished primary arteriovenous graft patency included increased patient age and location of vessel anastomosis (brachiobrachial type compared to brachiobasilic or brachioaxillary type); diminished secondary patency was associated with low diastolic blood pressure, low serum albumin, and hemoglobin level under 10 g/dL. Among these factors, diastolic blood pressure, serum albumin, and hemoglobin level may be modifiable and could improve arteriovenous graft patency outcomes.
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Affiliation(s)
- Jeeeun Park
- 1 Division of Nephrology, Department of Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Gangwon-do, South Korea
| | - Jinhae Kim
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Subin Hwang
- 3 Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Mi Kyoung Lee
- 4 Dialysis Unit, Samsung Medical Center, Seoul, South Korea
| | - Hye Ryoun Jang
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jung Eun Lee
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yang-Jin Park
- 5 Division of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Wooseong Huh
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yoon-Goo Kim
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ha Young Oh
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dae Joong Kim
- 2 Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Jeon J, Kim DH, Baeg SI, Lee EJ, Chung CR, Jeon K, Lee JE, Huh W, Suh GY, Kim YG, Kim DJ, Oh HY, Jang HR. Association between diuretics and successful discontinuation of continuous renal replacement therapy in critically ill patients with acute kidney injury. Crit Care 2018; 22:255. [PMID: 30305122 PMCID: PMC6180655 DOI: 10.1186/s13054-018-2192-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/12/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Despite aggressive application of continuous renal replacement therapy (CRRT) in critically ill patients with acute kidney injury (AKI), there is no consensus on diuretic therapy when discontinuation of CRRT is attempted. The effect of diuretics on discontinuation of CRRT in critically ill patients was evaluated. METHODS This retrospective cohort study enrolled 1176 adult patients who survived for more than 3 days after discontinuing CRRT between 2009 and 2014. Patients were categorized depending on the re-initiation of renal replacement therapy within 3 days after discontinuing CRRT or use of diuretics. Changes in urine output (UO) and renal function after discontinuing CRRT were outcomes. Predictive factors for successful discontinuation of CRRT were also analyzed. RESULTS The CRRT discontinuation group had a shorter duration of CRRT, more frequent use of diuretics after discontinuing CRRT, and greater UO on the day before CRRT discontinuation [day minus 1 (day - 1)]. The diuretics group had greater increases in UO and serum creatinine elevation after discontinuing CRRT. In the CRRT discontinuation group, continuous infusion of furosemide tended to increase UO more effectively. Multivariable regression analysis identified high day - 1 UO and use of diuretics as significant predictors of successful discontinuation of CRRT. Day - 1 UO of 125 mL/day was the cutoff value for predicting successful discontinuation of CRRT in oliguric patients treated with diuretics following CRRT. CONCLUSIONS Day - 1 UO and aggressive diuretic therapy were associated with successful CRRT discontinuation. Diuretic therapy may be helpful when attempting CRRT discontinuation in critically ill patients with AKI, by inducing a favorable fluid balance, especially in oliguric patients.
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Affiliation(s)
- Junseok Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Do Hee Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Song In Baeg
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun Jeong Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chi Ryang Chung
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyeongman Jeon
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gee Young Suh
- Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Yoo BH, Kim JC, Kim YG, Hwang DY, Lee JH, Lee HG. Investigation of multifilament MgB 2 superconducting joint technique for development of MRI magnets. Rev Sci Instrum 2018; 89:094701. [PMID: 30278739 DOI: 10.1063/1.5040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 08/18/2018] [Indexed: 06/08/2023]
Abstract
This study presents the investigation of superconducting joints fabricated using multifilament magnesium diboride (MgB2) wires for the development of persistent-current mode magnetic resonance imaging (MRI) magnets. The critical current of the jointed samples decreased with increasing cutting angle because the smaller cutting angle allowed greater exposure of the MgB2 filament, thereby increasing the contact area for the wire-bulk-wire connection. In addition, an appropriate pressing pressure (300 MPa) was necessary to establish the multifilament MgB2 joint without significant degradation of superconducting properties. The resistance of the optimal MgB2 joint, measured using the field-decay technique, was <1.5 × 10-14 Ω. Therefore, the proposed joint technique can be employed for developing multifilament MgB2 MRI magnets operating in the persistent-current mode.
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Affiliation(s)
- B H Yoo
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - J C Kim
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - Y G Kim
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - D Y Hwang
- Kiswire Advanced Technology Co., Ltd., Daejeon 34026, South Korea
| | - J H Lee
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - H G Lee
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
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Kim J, Park J, Hwang S, Yoo H, Kim K, Park JB, Jang HR, Lee JE, Kim SJ, Kim YG, Kim DJ, Oh HY, Huh W. Ten-year observational follow-up of a randomized trial comparing cyclosporine and tacrolimus therapy combined with steroid withdrawal in living-donor renal transplantation. Clin Transplant 2018; 32:e13372. [PMID: 30080284 DOI: 10.1111/ctr.13372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/20/2018] [Accepted: 07/28/2018] [Indexed: 12/31/2022]
Abstract
Although various strategies for steroid withdrawal after transplantation have been attempted, there are few reports of the long-term results of steroid withdrawal regimens in kidney transplantation. Earlier, we reported on a 5-year prospective, randomized, single-center trial comparing the safety and efficacy of cyclosporine (CsA) plus mycophenolate mofetil (MMF) with that of tacrolimus (TAC) plus MMF, when steroids were withdrawn 6 months after kidney transplantation in low-risk patients. We now report the 10-year observational data on the study population. We collected data from the database of the Organ Transplantation Center, Samsung Medical Center for 5 years after completion of the original study (TAC group n = 62; CsA group n = 55). The 10-year patient survival, death-censored graft survival, and acute rejection-free survival did not differ between groups (98% vs 96%; P = 0.49, 78% vs 85%; P = 0.75 and 84% vs 76%; P = 0.14 in the TAC group vs CsA group, respectively). In low-risk patients, there was no difference in long-term patient and graft survival between TAC- and CsA-based late steroid withdrawal regimens that included MMF treatment. More long-term randomized clinical trials are needed to clarify the benefits of late steroid withdrawal in kidney transplantation.
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Affiliation(s)
- Jinhae Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeeeun Park
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Subin Hwang
- Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Heejin Yoo
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Kyunga Kim
- Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Jae Berm Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung-Joo Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Yun WJ, Kim YG, Lee YM, Lim JY, Kim HJ, Khan MUK, Chang S, Park HS, Kyung CM. Depth extraction with offset pixels. Opt Express 2018; 26:15825-15841. [PMID: 30114838 DOI: 10.1364/oe.26.015825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Numerous depth extraction techniques have been proposed in the past. However, the utility of these techniques is limited as they typically require multiple imaging units, bulky platforms for computation, cannot achieve high speed and are computationally expensive. To counter the above challenges, a sensor with Offset Pixel Apertures (OPA) has been recently proposed. However, a working system for depth extraction with the OPA sensor has not been discussed. In this paper, we propose the first such system for depth extraction using the OPA sensor. We also propose a dedicated hardware implementation for the proposed system, named as the Depth Map Processor (DMP). The DMP can provide depth at 30 frames per second at 1920 × 1080 resolution with 31 disparity levels. Furthermore, the proposed DMP has low power consumption as for the aforementioned speed and resolution it only requires 290.76 mW. The proposed system makes it an ideal choice for depth extraction systems in constrained environments.
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Lee K, Shin J, Park J, Hwang S, Jang HR, Huh W, Kwon GY, Kim YG, Oh HY, Lee JE, Kim DJ. First-year GFR slope and long-term renal outcome in IgA nephropathy. Eur J Clin Invest 2018; 48:e12936. [PMID: 29660832 DOI: 10.1111/eci.12936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 04/09/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND IgA nephropathy (IgAN) is the most frequent primary glomerular disease and the leading cause of end-stage renal disease. We investigated clinicopathologic predictors of renal survival in patients with IgAN with a focus on glomerular filtration rate (GFR) decline slope. MATERIALS AND METHODS We screened all patients with primary IgAN between 1995 and 2012. Renal progression was defined as doubling of serum creatinine. Using serial serum creatinine levels during the first-year, we calculated the GFR decline slopes. Further, we defined patients in the steepest GFR slope quartile as rapid decliners and those in the second steepest GFR slope quartile as slow decliners. Others were defined as nondecliners. RESULTS Of 214 participants, baseline GFR was 81 (62, 100) mL/min/1.73 m2 , which was not different among the 3 groups. Rapid decliners and slow decliners had higher levels of urinary protein/creatinine ratio (0.88, 0.89 and 0.58 g/gCr, respectively, P < .001). Five-year renal survival was 76% in rapid decliners, 91% in slow decliners and 100% in nondecliners (P < .001, rapid or slow decliners vs nondecliners). After adjustment for clinicopathologic variables, slow decliners were associated with an 8.8-fold higher risk of progression (P = .011), and rapid decliners were associated with a 10.2-fold increased risk of progression (P = .007) compared with nondecliners. CONCLUSIONS First-year GFR slope was associated with increased risk of renal progression, independent of proteinuria and histologic findings. Further studies are needed to investigate whether early GFR change can identify high-risk patients who benefit from immunosuppressive treatment in IgAN.
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Affiliation(s)
- Kyungho Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungho Shin
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jeeeun Park
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Subin Hwang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jeon J, Kim SH, Park S, Kim Y, Jang HR, Kim DK, Huh W, Kim YG, Kim DJ, Oh HY, Lee JE. SP231RISK PREDICTION OF CONTRAST INDUCED NEPHROPATHY IN CANCER PATIENTS UNDERGOING CONTRAST ENHANCED COMPUTED TOMOGRAPHY UNDER PREVENTIVE MEASURES. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Junseok Jeon
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Su Hyun Kim
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Sehoon Park
- Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Yaerim Kim
- Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Hye Ryoun Jang
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Dong Ki Kim
- Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, Republic of
| | - Wooseong Huh
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Yoon-Goo Kim
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Dae Joong Kim
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Ha Young Oh
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Jung Eun Lee
- Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
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Kim S, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Lee JE. FP325EARLY CHANGE IN ESTIMATED GFR AND RENAL OUTCOME IN PATIENT WITH CHRONIC KIDNEY DIEASE: COMPARISON OF CREATININE-BASED AND CYSTATIN C-BASED ESTIMATED GFR SLOPE. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Suhyun Kim
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Hey Ryoun Jang
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Wooseung Huh
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Yoon-Goo Kim
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Dae joong Kim
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Ha Young Oh
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
| | - Jung Eun Lee
- Nephrology Division; Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
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Kim DH, Jeon J, Jang HR, Lee JE, Huh W, Kim DJ, Oh HY, Kim YG. SP283URINARY RENIN AND ANGIOTENSINOGEN FOR PREDICTING ANTIPROTEINURIC EFFECT OF ANGIOTENSIN RECEPTOR BLOCKER. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Do Hee Kim
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Junseok Jeon
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Hye Ryoun Jang
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Jung Eun Lee
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Wooseong Huh
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Dae Joong Kim
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Ha Young Oh
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
| | - Yoon-Goo Kim
- Medicine, Nephrology, Samsung Medical Center, Seoul, Korea, Republic of
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Shim J, Min KJ, Kim YG, Oh SK, Park HS, Lee KN, Choi JI, Kim YH. P861Outcomes of catheter ablation for longstanding persistent atrial fibrillation with unsuccessful electrical cardioversion. Europace 2018. [DOI: 10.1093/europace/euy015.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Shim
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - K J Min
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - Y G Kim
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - S K Oh
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - H S Park
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - K N Lee
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - J I Choi
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
| | - Y H Kim
- Korea University Anam Hospital, Cardiology, Seoul, Korea Republic of
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40
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Kim YG, Shim JM, Choi JI, Kim YH. P868Clinical and echocardiographic characteristics associated with future risk of ischemic stroke in atrial fibrillation patients undergoing radio-frequency catheter ablation. Europace 2018. [DOI: 10.1093/europace/euy015.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y G Kim
- Korea University Anam Hospital, Cardiovascular Center, Seoul, Korea Republic of
| | - J M Shim
- Korea University Anam Hospital, Cardiovascular Center, Seoul, Korea Republic of
| | - J I Choi
- Korea University Anam Hospital, Cardiovascular Center, Seoul, Korea Republic of
| | - Y H Kim
- Korea University Anam Hospital, Cardiovascular Center, Seoul, Korea Republic of
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Hwang S, Park J, Kim J, Jang HR, Kwon GY, Huh W, Kim YG, Kim DJ, Oh HY, Lee JE. Tissue expression of tubular injury markers is associated with renal function decline in diabetic nephropathy. J Diabetes Complications 2017; 31:1704-1709. [PMID: 29037450 DOI: 10.1016/j.jdiacomp.2017.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/28/2017] [Accepted: 08/20/2017] [Indexed: 12/17/2022]
Abstract
AIMS The pathogenesis of diabetic kidney disease (DKD) is complex and multifactorial; increasing evidence suggests that tubular injury and inflammatory process are involved in disease progression. We investigated the potential association of renal expression of tubular injury markers, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and inflammatory markers, tumor necrosis factor receptor (TNFR) 1 and 2 with renal progression in pathologically proven diabetic nephropathy (DN). METHODS We identified 122 patients with confirmed DN. After excluding patients with other coexisting renal disease or estimated glomerular filtration rate (eGFR) <30mL/min/1.73m2, 35 patients were included. Annual decline of (GFR decline slope) was calculated using linear regression analysis. Tissue tubular and glomerular expressions of NGAL, KIM-1, TNFR1, and TNFR2 were assessed using immunohistochemistry. RESULTS Median baseline urinary protein to creatinine ratio (uPCR) was 6.76 (2.18-7.61) mg/mg Cr, median baseline eGFR was 50 (43-66) mL/min per 1.73m2, and median GFR decline slope was 15.6 (4.4-35.1) mL/min per 1.73m2 per year. Positive correlations were observed between tubular expressions of NGAL and KIM-1, and GFR decline slopes (r=0.601, p<0.001; r=0.516, p=0.001, respectively), and between tubular expressions of KIM-1 and uPCR (r=0.596, p<0.001), and between NGAL and interstitial fibrosis and tubular atrophy (IFTA) score (r=0.391, p=0.024). No correlations were found between glomerular or tubular expressions of TNFRs, and clinical parameters including GFR decline slopes. On multivariate analysis, the association between tubular expressions of KIM-1 and GFR decline slopes was dependent on uPCR. Tubular expressions of NGAL were independently associated with GFR decline slopes, with an adjusted coefficient factor of 0.290 (95% confidence interval, 0.009-0.202, p=0.038). CONCLUSIONS These findings suggest that tubular injury plays a key role in the pathogenesis of DKD in high-risk patients. Further studies are warranted to determine whether tubular injury could be a therapeutic target in DKD.
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Affiliation(s)
- Subin Hwang
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeeeun Park
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jinhae Kim
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hye Ryoun Jang
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Wooseong Huh
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon-Goo Kim
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dae Joong Kim
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ha Young Oh
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Lee
- Nephrology Division, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Lee YJ, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Joo EY, Lee JE. Independent Contributions of Obstructive Sleep Apnea and the Metabolic Syndrome to the Risk of Chronic Kidney Disease. J Clin Sleep Med 2017; 13:1145-1152. [PMID: 28760190 DOI: 10.5664/jcsm.6758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/30/2017] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This retrospective study was conducted to evaluate the associations and interactions among obstructive sleep apnea (OSA), chronic kidney disease (CKD), and metabolic syndrome (MS). METHODS This study included 1,732 subjects (1,482 male and 250 female) in whom OSA was diagnosed by polysomnography. The severity of OSA was defined as mild, moderate, or severe with an apnea-hypopnea index (AHI) score of 5 to < 15, 15 to < 30, and ≥ 30 events/h, respectively. CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 or albuminuria. RESULTS The prevalence of MS was 29.2% (n = 505). One hundred twenty-nine subjects (7.4%) had CKD. In subjects with MS, CKD prevalence increased progressively with OSA severity: 7.4%, 12.5%, and 15.8% in those with mild, moderate, or severe OSA, respectively (P = .025). Each 10-point increment in AHI score was independently associated with a 1.15-fold higher prevalence of CKD [95% confidence interval (CI), 1.036-1.280; P = .009] after adjustment for all individual components of MS. On the contrary, in those without MS, AHI was not associated with increased odds for CKD [odds ratio, 1.054; 95% CI, 0.930-1.195]. CONCLUSIONS The independent association between OSA severity and CKD prevalence was observed only in subjects with MS. Further studies are needed to ascertain if OSA contributes to the development of CKD in subjects with MS.
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Affiliation(s)
- Yu-Ji Lee
- Division of Nephrology, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Joong Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim YG, Song JB, Kim JC, Kim JM, Yoo BH, Yun SB, Hwang DY, Lee HG. Note: Progress on the use of MgB 2 superconducting joint technique for the development of MgB 2 magnets for magnetic resonance imaging (MRI). Rev Sci Instrum 2017; 88:086105. [PMID: 28863663 DOI: 10.1063/1.4997257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This note presents a superconducting joint technique for the development of MgB2 magnetic resonance imaging (MRI) magnets. The MgB2 superconducting joint was fabricated by a powder processing method using Mg and B powders to establish a wire-bulk-wire connection. The joint resistance measured using a field-decay method was <10-14 Ω, demonstrating that the proposed joint technique could be employed for developing "next-generation" MgB2 MRI magnets operating in the persistent current mode.
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Affiliation(s)
- Y G Kim
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - J B Song
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - J C Kim
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - J M Kim
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - B H Yoo
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
| | - S B Yun
- Kiswire Advanced Technology Co., Ltd., Daejeon 34026, South Korea
| | - D Y Hwang
- Kiswire Advanced Technology Co., Ltd., Daejeon 34026, South Korea
| | - H G Lee
- Department of Materials Science and Engineering, Korea University, Seoul 02841, South Korea
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Park MS, Kim SK, Park HJ, Seok H, Kang SW, Lee SH, Kim YG, Moon JY, Kim TH, Kim YH, Kang SW, Chung JH, Jeong KH. Association Studies of Bone Morphogenetic Protein 2 Gene Polymorphisms With Acute Rejection in Kidney Transplantation Recipients. Transplant Proc 2017; 49:1012-1017. [PMID: 28583517 DOI: 10.1016/j.transproceed.2017.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Bone morphogenetic proteins (BMP) belong to the transforming growth factor beta superfamily of proteins. This study was performed to evaluate the association of BMP gene polymorphisms with acute renal allograft rejection (AR) and graft dysfunction (GD) in Koreans. METHODS Three hundred thirty-one patients who had kidney transplantation procedures were recruited. Transplantation outcomes were determined in terms of AR and GD criteria. We selected six single nucleotide polymorphisms (SNPs): rs1979855 (5' near gene), rs1049007 (Ser87Ser), rs235767 (intron), rs1005464 (intron), rs235768 (Arg190Ser), and rs3178250 (3; untranslated region). RESULTS Among the six SNPs tested, the rs235767, rs1005464, and rs3178250 SNPs were significantly associated with AR (P < .05). The rs1049007 and rs235768 SNPs also showed an association with GD (P < .05). CONCLUSIONS In conclusion, these results suggest that the BMP2 gene polymorphism may be related to the development of AR and GD in kidney transplant recipients.
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Affiliation(s)
- M-S Park
- Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S K Kim
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - H J Park
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - H Seok
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S W Kang
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S H Lee
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Y G Kim
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - J Y Moon
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - T H Kim
- Department of Nephrology, School of Medicine, In Je University, Busan, Republic of Korea
| | - Y H Kim
- Department of Nephrology, School of Medicine, In Je University, Busan, Republic of Korea
| | - S W Kang
- Department of Nephrology, School of Medicine, In Je University, Busan, Republic of Korea
| | - J-H Chung
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - K H Jeong
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Park J, Lee EJ, Kim J, Hwang S, Jang HR, Lee JE, Kwon GY, Huh W, Kim DJ, Kim YG, Oh HY. MP208CLINICAL VALUE OF URINARY CYTOKINES / CHEMOKINES AS PROGNOSTIC MARKERS IN PATIENTS WITH CRESCENTIC GLOMERULONEPHRITIS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx165.mp208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Park JH, Jang HR, Huh W, Kim DJ, Kim YG, Oh HY, Lee JE. MP264A PREDICTIVE MODEL FOR SUCCESSFUL CONVERSION OF CONTINUOUS RENAL REPLACEMENT THERAPY TO INTERMITTENT HEMODIALYSIS IN CRITICALLY ILL PATIENTS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Hwang S, Lee EJ, Jang HR, Lee JE, Huh W, Kim YG, Kim DJ, Oh HY. MP333THE TISSUE EXPRESSIONS OF TUBULAR INJURY MARKER, NGAL AND KIM-1, ARE ASSOCIATED WITH RENAL FUNCTION DECLINE IN DIABETIC KIDNEY DISEASE. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx169.mp333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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48
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Park JH, Jang HR, Kim DH, Kwon GY, Lee JE, Huh W, Choi SJ, Oh W, Oh HY, Kim YG. Early, but not late, treatment with human umbilical cord blood-derived mesenchymal stem cells attenuates cisplatin nephrotoxicity through immunomodulation. Am J Physiol Renal Physiol 2017; 313:F984-F996. [PMID: 28356286 DOI: 10.1152/ajprenal.00097.2016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/13/2017] [Accepted: 03/23/2017] [Indexed: 11/22/2022] Open
Abstract
Preemptive treatment with mesenchymal stem cells (MSCs) can attenuate cisplatin-induced acute kidney injury (AKI). However, it is uncertain whether MSC treatment after the development of renal dysfunction prevents AKI progression or if MSC immunomodulatory properties contribute to MSC therapy. In this study, human umbilical cord blood (hUCB)-derived MSCs were used to compare the effects and mechanisms of early and late MSC therapy in a murine model. After cisplatin injection into C57BL/6 mice, hUCB-MSCs were administered on day 1 (early treatment) or day 3 (late treatment). With early treatment, cisplatin nephrotoxicity was attenuated as evidenced by decreased blood urea nitrogen (BUN) and reduced apoptosis and tubular injury scores on day 3 Early treatment resulted in downregulation of intrarenal monocyte chemotactic protein-1 and IL-6 expression and upregulation of IL-10 and VEGF expression. Flow cytometric analysis showed similar populations of infiltrated immune cells in both groups; however, regulatory T-cell (Treg) infiltration was 2.5-fold higher in the early treatment group. The role of Tregs was confirmed by the blunted effect of early treatment on renal injury after Treg depletion. In contrast, late treatment (at a time when BUN levels were 2-fold higher than baseline levels) showed no renoprotective effects on day 6 Neither the populations of intrarenal infiltrating immune cells (including Tregs) nor cytokine expression levels were affected by late treatment. Our results suggest that early MSC treatment attenuates renal injury by Treg induction and immunomodulation, whereas a late treatment (i.e., after the development of renal dysfunction) does not prevent AKI progression or alter the intrarenal inflammatory micromilieu.
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Affiliation(s)
- Ji Hyeon Park
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Medicine, National Police Hospital, Seoul, Korea; and
| | - Hye Ryoun Jang
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Hee Kim
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Eun Lee
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wooseong Huh
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Jin Choi
- Biomedical Research Institute, R&D Center, Medipost Company, Gyeonggi-do, Korea
| | - Wonil Oh
- Biomedical Research Institute, R&D Center, Medipost Company, Gyeonggi-do, Korea
| | - Ha Young Oh
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Division of Nephrology, Department of Medicine, Stem Cell and Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;
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Lee HJ, Kim TH, Kang SW, Kim YH, Kim SK, Chung JH, Kim YG, Moon JY, Lee SH, Ihm CG, Lee TW, Jeong KH. Association Interleukin-4 and Interleukin-4 Receptor Gene Polymorphism and Acute Rejection and Graft Dysfunction After Kidney Transplantation. Transplant Proc 2017; 48:813-9. [PMID: 27234743 DOI: 10.1016/j.transproceed.2015.12.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 11/25/2015] [Accepted: 12/30/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cytokine genotypes have previously been studied in patients undergoing solid organ transplantation; certain polymorphisms have been implicated in the development of acute rejection (AR) and graft dysfunction (GD). Allograft outcomes determined, in part, by alloimmune responses is mainly mediated by T-cell responses, activated and driven by cytokines. Interleukin-4 (IL-4) is one such cytokine, which exerts its biological effects through binding to the IL-4 receptor (IL-4R) complex on target cells. In the present study, we investigated whether polymorphisms of the IL-4 and/or IL-4R gene were associated with susceptibility to acute AR and GD after kidney transplantation. METHODS We analyzed 2 single nucleotide polymorphism (SNPs) of IL-4 (rs2243250 and rs2070874) and 3 SNPs of IL-4R (rs1801275, rs2107356, and rs1805010) in 344 kidney transplant recipients. These patients included 62 of whom had developed AR and 215 of whom had GD in 1 year after kidney transplantation. RESULTS The AR group included 62 patients (45 men and 17 women). There was a statistically significant difference in the male-to-female ratio and the use of tacrolimus in the AR group. The GD group included 215 patients. Patients who developed GD were more likely to be older and have an underlying cause of end-stage renal disease that was unknown compared with patients who did not have GD, the cause of which was typically known. Among the SNPs examined, 1 of the SNPs in the IL-4R gene (ie, rs1801275) showed a statistical association with AR (co-dominant model, P = .061; dominant model, P = .019; and log-addictive model, P = .029). In addition, 1 of the IL-4R SNPs (ie, rs2107356) was statistically associated with GD (dominant model, P = .034). No significant difference in the IL-4 genotype was observed between the AR/GD and non-AR/non-GD subjects. CONCLUSIONS One IL-4R gene polymorphism (rs1801275) was associated with AR. In addition, a separate IL-4R SNP (rs2107356) was statistically associated with GD after kidney transplantation.
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Affiliation(s)
- H J Lee
- Department of Nephrology, Seoul Red Cross Hospital, Seoul, Republic of Korea
| | - T H Kim
- Department of Nephrology, School of Medicine, Inje University, Busan, Republic of Korea
| | - S W Kang
- Department of Nephrology, School of Medicine, Inje University, Busan, Republic of Korea
| | - Y H Kim
- Department of Nephrology, School of Medicine, Inje University, Busan, Republic of Korea
| | - S K Kim
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - J-H Chung
- Kohwang Medical Research Institute, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Y G Kim
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - J Y Moon
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - S H Lee
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - C G Ihm
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - T W Lee
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - K H Jeong
- Department of Nephrology, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Lee EJ, Lee SY, Park SY, Kim Y, Choi JS, Kim MJ, Park JH, Lee JE, Kwon GY, Kim YG. Crystalline podocytopathy and tubulopathy without overt glomerular proteinuria in a patient with multiple myeloma. Kidney Res Clin Pract 2016; 35:259-262. [PMID: 27957423 PMCID: PMC5142260 DOI: 10.1016/j.krcp.2016.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 05/31/2016] [Accepted: 06/02/2016] [Indexed: 12/18/2022] Open
Abstract
Crystalline nephropathy is a rare yet well-known condition associated with multiple myeloma and other light chain–secreting disorders. Paraproteins that are resistant to proteolysis crystallize within proximal tubular cells and cause light-chain proximal tubulopathy, which presents clinically as Fanconi syndrome. Podocytes are rarely affected, and the crystalline inclusions within podocytes are typically precipitated, yielding significant glomerular proteinuria. Here we report a case of extensive crystalline inclusions primarily within podocytes and proximal tubules that presented only with Fanconi syndrome and renal insufficiency. Despite the presence of extensive crystalline inclusions in podocytes and diffuse foot process effacement, the patient had no clinical evidence suggestive of podocyte injury.
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Affiliation(s)
- Eun Jeong Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Yeon Lee
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Young Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yonjin Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Shin Choi
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Jeoung Kim
- Graduate School of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hyeon Park
- Department of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Medicine, National Police Hospital, Seoul, Korea
| | - Jung Eun Lee
- Department of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ghee Young Kwon
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon-Goo Kim
- Department of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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