Urinary Concentration Defect and Renal Glycosuria in Cyclosporine-treated Rats.
Authors: Lee JH, Kim SA, Jo CH, Lee CH, Kim GH Abstract Background: Urinary concentration impairment is a major feature of cyclosporine nephrotoxicity. Methods: We explored two possible mechanisms that may underlie cyclosporine-induced polyuria; water, and/or osmotic diuresis. Cyclosporine was subcutaneously injected to normal salt-fed Sprague-Dawley rats at a daily dose of 25mg/kg for 2 weeks (Experiment I) and 7.5mg/kg for 6 weeks (Experiment II). Results: In Experiment I, cyclosporine treatment caused an increase in urine volume (2.7±0.5 vs. 10.3±1.13mL/d/100 g BW, p
Source: Electrolyte and Blood Pressure - July 15, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Voriconazole-induced Severe Hyperkalemia Precipitated by Multiple Drug Interactions.
Authors: Choi JY, Cho SG, Jang KS, Kim GH Abstract Voriconazole, a triazole antifungal agent used to treat serious fungal infections, has a pharmacokinetic characteristic of undergoing hepatic metabolism by the cytochrome P450 system. Few cases of hyperkalemia have been reported, which presented only when the serum voriconazole level was exceptionally elevated by drug-drug interactions. Additionally, azole antifungals may interfere with the biosynthesis of adrenal steroids and therefore can predispose patients to aldosterone deficiency. However, it is unclear whether voriconazole itself can induce hypoaldosteronism...
Source: Electrolyte and Blood Pressure - July 15, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Extremely Severe Hypernatremia Caused by Wrong Belief in a Patient with Cervical Cancer.
Authors: Park MS, Park HJ, Choi HS, Kim CS, Bae EH, Ma SK, Kim SW, Kim M Abstract A 56-year old female patient who was undergoing follow-up for cervical cancer in our oncology center was presented to the emergency center with anxiety and excessive thirst. The initial serum sodium level of the patient exceeded 200mEq/L, rising up to 238mEq/L during hospitalization. The extremely severe hypernatremia was caused by patient's wrong belief that bay salt would cure the cancer. The patient was treated with hypotonic solution and finally with appropriate hydration, she was fully recovered without any neurological complicat...
Source: Electrolyte and Blood Pressure - July 15, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Recurrent Severe Hyponatremia in a Patient with Sj ögren's Syndrome.
Recurrent Severe Hyponatremia in a Patient with Sjögren's Syndrome. Electrolyte Blood Press. 2020 Jun;18(1):19-22 Authors: Kim HD, Lee J, Chung BH, Yang CW, Kim YS, Park CW Abstract Sjögren's syndrome (SS) is an autoimmune disease that presents with exocrine gland dysfunction. Renal involvement is common in SS and often results in tubulointerstitial nephritis, renal tubular acidosis, and Fanconi's syndrome. Electrolyte imbalances are commonly the first symptom of renal involvement of SS. The most common feature of dysnatremia in SS is hypernatremia with diabetes insipidus. However, cases of h...
Source: Electrolyte and Blood Pressure - July 15, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Effect of Renin-Angiotensin System Blockade on Mortality in Korean Hypertensive Patients with Proteinuria.
Conclusion: In this study, we found that RAS blockade was significantly associated with a reduction in mortality but not in the incidence of ESRD. However, 26.3% of the enrolled patients did not use RAS blockade. Physicians need to consider the usefulness of RAS blockade in hypertensive patients with proteinuria. PMID: 31969921 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - January 25, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Association of Blood Pressure at Specific Time-Points with 1-Year Renal Outcomes in Patients with Diabetic Chronic Kidney Disease.
Conclusion: The SBP at 7:00 AM, in addition to the 24-hour mSBP, is also associated with eGFR deterioration in patients with diabetic CKD, particularly in those with CKD stage 3-5. PMID: 31969922 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - January 25, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Incidence of Acute Kidney Injury after Adrenalectomy in Patients with Primary Aldosteronism.
Conclusion: Incidence and risk of postoperative AKI were significantly higher in PA patients after surgical treatment. High ACR on the tumor side and high LI were associated with higher risk of AKI in PA patients compared to pheochromocytoma patients. PMID: 31969923 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - January 25, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Baseline High Blood Pressure is Associated with Clinico-Pathologic Findings and Later Renal Progression in Chronic Glomerulonephritis.
This study was conducted to find the association of baseline blood pressure (BP) with pathophysiologic findings and later renal progression in chronic GN. Methods: Clinico-pathological findings including serum creatinine (Cr), proteinuria, pathological findings, and urinary Na excretion were analyzed in a total of 233 patients with IgA nephropathy from The Kyung-Hee Cohort of GN. Glomerular surface area (GSA) was measured by imaging analysis and urine angiotensinogen (AGT) concentrations by human ELISA kits. Results: Systolic BP was ≥130mmHg in 124 patients (53%). Systolic BP was negatively correlated with follo...
Source: Electrolyte and Blood Pressure - January 25, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Severe Hypophosphatemia-Induced Acute Toxic-Metabolic Encephalopathy in Continuous Renal Replacement Therapy.
Authors: Han SA, Park HY, Kim HW, Choi JI, Kang DY, Kim HL, Chung JH, Shin BC Abstract Acute toxic-metabolic encephalopathy (TME) is an acute condition of global cerebral dysfunction in the absence of primary structural brain disease. Severe hypophosphatemia leads to muscle weakness and involves the diaphragm but hypophosphatemia-induced TME is very rare. Herein, we report the case of a 43-year-old woman with encephalopathy with severe hypophosphatemia during continuous renal replacement therapy. She presented with features of oliguric acute kidney injury on diabetic kidney disease due to volume depletion. At admis...
Source: Electrolyte and Blood Pressure - January 25, 2020 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Pharmacologic Treatment of Chronic Hyperkalemia in Patients with Chronic Kidney Disease.
Authors: Kim GH Abstract Hyperkalemia is frequently complicated in patients with advanced chronic kidney disease (CKD) because kidney is the major route of potassium excretion. Urinary potassium excretion is reduced according to the decline in glomerular filtration rate, and the risk of hyperkalemia is increased in patients with high potassium intake, advanced age, diabetes mellitus, congestive heart failure, and medications such as renin-angiotensin-aldosterone system(RAAS) blockades. On the other hand, the benefits of RAAS blockades and a high-potassium diet should be considered in CKD patients. To overcome these...
Source: Electrolyte and Blood Pressure - July 25, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Delta Neutrophil Index is Useful to Predict Poor Outcomes in Male Patients with Alcoholic Ketoacidosis.
Authors: Kim MK, Shin HW, Kim YJ, Yang JW, Kim JS, Han BG, Choi SO, Lee JY Abstract Background: Alcoholic ketoacidosis (AKA) is known as a benign disease, but the related mortality reported in Korea is high. Acidosis and alcohol change the immunity profile, and these changes can be identified early using the delta neutrophil index (DNI). We aimed to evaluate the use of DNI and other standard laboratory parameters as predictors of prognosis in AKA patients. Methods: One hundred eighteen males with AKA were evaluated at the Wonju Severance Christian hospital between 2009 and 2014. We performed a retrospective ana...
Source: Electrolyte and Blood Pressure - July 25, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Transient Blindness in a Patient with Severe Metformin-Associated Lactic Acidosis (MALA).
Authors: Jeon JW, Choi W, Kim HR, Ham YR, Choi DE, Na KR, Lee KW, Bae SY, Kim SH Abstract A 68-year-old man presented at the emergency room with sudden blindness. The day before, he had eaten sashimi and eel and drank alcohol for dinner. He experienced nausea, vomiting, and dizziness afterward. His medical history included hypertension and diabetes, and the latter was treated with metformin. Initial laboratory tests revealed severe metabolic acidosis (lactic acidosis). Massive hydration and intravenous sodium bicarbonate replacement therapies were initiated, but severe metabolic acidosis (lactic acidosis) did not r...
Source: Electrolyte and Blood Pressure - July 25, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Severe Hypocalcemia in a Patient with Tuberous Sclerosis Complex.
Authors: Kim K, Kim S, Na KY, Chae DW, Chin HJ Abstract Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder affecting multiple organs, including the brain, skin, lung, and kidney. Among the multiple comorbidities in TSC, bone mineral disturbances remain relatively unrecognized, and only a few studies have reported alteration in calcium homeostasis. Hypocalcemia is a serious medical condition in patients with TSC who are at high risk for seizures. Therefore, hypocalcemia should be thoroughly evaluated by obtaining a history of associated medication use and measuring vitamin D levels. Here, we ...
Source: Electrolyte and Blood Pressure - July 25, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Adult Idiopathic Renal Fanconi Syndrome: A Case Report.
Authors: Park DJ, Jang KS, Kim GH Abstract Renal Fanconi syndrome (RFS) is caused by generalized proximal tubular dysfunction and can be divided into hereditary and acquired form. Adult-onset RFS is usually associated with drug toxicity or systemic disorders, and modern molecular genetics may explain the etiology of previous idiopathic cases of RFS. Here, we report the case of a 52-year-old woman with RFS whose etiology could not be identified. She presented with features of phosphaturia, renal glucosuria, aminoaciduria, tubular proteinuria, and proximal renal tubular acidosis. Her family history was unremarkable, ...
Source: Electrolyte and Blood Pressure - March 23, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Long-term Tolvaptan Treatment of Autosomal Dominant Polycystic Kidney Disease in Korea.
Authors: Kim HY, Lee SJ, Kim BK, Kim M, Bae EH, Ma SK, Kim SW Abstract A 22-year-old male patient was diagnosed with autosomal dominant polycystic kidney disease (ADPKD). He received conservative treatment with an angiotensin-converting enzyme inhibitor. Two years later, oral therapy, consisting of 60 mg tolvaptan per day, was initiated. Compared with height-adjusted total kidney volume, the rate of kidney growth reduced significantly from 7.33% to 0.66% annually, since commencement of the tolvaptan therapy. The liver enzyme profile and serum sodium level and osmolality were constantly within normal ranges. In Kore...
Source: Electrolyte and Blood Pressure - March 23, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Case of Peritoneal Dialysis-related Peritonitis Caused by Aeromonas Hydrophila in the Patient Receiving Automated Peritoneal Dialysis.
We report a case of A. hydrophila peritonitis in a 56-year-old male on automated PD. Peritonitis may have been caused by contamination of the Set Plus, a component of the automated peritoneal dialysis device. Although Set Plus is disposable, the patient reused the product by cleansing with tap water. He was successfully treated with intraperitoneally-administered ceftazidime and has been well without recurrence for more than 2 years. PMID: 30899312 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - March 23, 2019 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

The Different Expression Patterns of HSP22, a Late Embryogenesis Abundant-like Protein, in Hypertrophic H9C2 Cells Induced by NaCl and Angiotensin II.
Conclusion: The results showed that NaCl significantly decreased HSP22. Decreased HSP22, due to the hypernatremic condition, affected the Ca2+ homeostasis in the H9C2 cells. Therefore, hypernatremia induces cellular hypertrophy via impaired Ca2+ homeostasis. The additional mechanisms of HSP22 need to be explored further. PMID: 30046328 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - July 27, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Esophageal Artery Pseudoaneurysm and Takayasu Arteritis in a Patient with Autosomal Dominant Polycystic Kidney Disease.
Authors: Kim H, Yu Y, Shim KE, Kim JE, Koh J, Yoon JW, Ahn C, Oh YK Abstract A 47-year-old female previously diagnosed with ADPKD visited the hospital due to sudden pain in her upper abdomen and back. Esophagogastroduodenoscopy, contrast-enhanced abdominal computed tomography (CT), and CT angiography identified an esophageal artery pseudoaneurysm and hematoma in the esophagus. Urgent angiography and embolization were performed. After the procedure, CT angiography and positron emission tomography were performed due to differences in blood pressure between the arms. The patient was also found to have Takayasu arterit...
Source: Electrolyte and Blood Pressure - July 27, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Interstitial Nephritis Caused by Anorexia Nervosa in Young Male; A Case Report and Literature Review.
Authors: Choi JW, Kwon SK, Kim SM, Cho H, Lee HC, Kim HY Abstract Severe eating disorders characterized by repetitive episodes of purging and vomiting can occasionally trigger acute kidney injury. However, interstitial nephritis induced by episodes of repeated vomiting has rarely been reported, and the pathophysiology of this entity remains unknown. A 26-year-old man was admitted to our hospital because of known hypokalemia. His serum electrolyte profile showed: sodium 133 mEq/L, potassium 2.6 mEq/L, chloride 72 mEq/L, total carbon dioxide 50 mEq/L, blood urea nitrogen/creatinine ratio (BUN/Cr) 21.9/1.98 mg/dL, and...
Source: Electrolyte and Blood Pressure - July 27, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

25-hydroxyvitamin D Levels was not Associated with Blood Pressure and Arterial Stiffness in Patients with Chronic Kidney Disease.
Authors: Park KM, Jun HH, Bae J, Choi YB, Yang DH, Jeong HY, Lee MJ, Lee SY Abstract Background: We investigated the effect of vitamin D deficiency on cardiovascular risk profiles in an Asian population with chronic kidney disease (CKD). Methods: A total of 210 participants (62 non-dialysis CKD patients and 148 hemodialysis [HD] patients) were enrolled between December 2009 and February 2010. Vitamin D deficiency was determined using the serum 25-hydroxyvitamin D [25(OH)D] concentration. Blood pressure and arterial stiffness were measured. Subjects were divided into groups according to 25(OH)D concentration bas...
Source: Electrolyte and Blood Pressure - February 6, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Edematous Hyponatremia Treated with Tolvaptan in a Patient with Amyotrophic Lateral Sclerosis.
Authors: Kim GH Abstract Amyotrophic lateral sclerosis (ALS) patients rarely present with either syndrome of inappropriate antidiuretic hormone secretion or generalized edema. Tolvaptan is a selective vasopressin V2 receptor antagonist that produces effective aquaresis, and its use in ALS patients has not been previously reported. A 50-year-old male ALS patient was admitted because of both generalized edema and dilutional hyponatremia. These manifestations were refractory to conventional diuretics and fluid therapy, but a very brisk diuresis was induced by tolvaptan administration. Edema and hyponatremia were also ...
Source: Electrolyte and Blood Pressure - February 6, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Associated with Mediastinal Schwannoma.
Authors: Song SH, Sim GA, Baek SH, Seo JW, Shim JW, Koo JR Abstract Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hypo-osmotic hyponatremia. There are several etiologies of SIADH including neuroendocrine tumor, pulmonary disease, infection, trauma, and medications. Here, we report a case of SIADH associated with a schwannoma involving the mediastinum in a 75-year-old woman who presented with nausea, vomiting, and general weakness. Laboratory testing showed hypo-osmolar hyponatremia, with a serum sodium level of 102mmol/L, serum osmolality of 221mOsm/kg, urine...
Source: Electrolyte and Blood Pressure - February 6, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Case of Ethylene Glycol intoxication with Acute Renal Injury: Successful Recovery by Fomepizole and Renal Replacement Therapy.
Authors: Song CH, Bae HJ, Ham YR, Na KR, Lee KW, Choi DE Abstract Ethylene glycol is a widely used and readily available substance. Ethylene glycol ingestion does not cause direct toxicity; however, its metabolites are highly toxic and can be fatal even in trace amounts. Poisoning is best diagnosed through inquiry, but as an impaired state of consciousness is observed in most cases, poisoning must be suspected when a significantly elevated osmolar gap or high anion gap metabolic acidosis is found in blood tests. Hemodialysis and alcohol dehydrogenase inhibitors such as ethanol and fomepizole are a part of the basic...
Source: Electrolyte and Blood Pressure - February 6, 2018 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Vitamin D and Hypertension.
Authors: Jeong HY, Park KM, Lee MJ, Yang DH, Kim SH, Lee SY Abstract Vitamin D has the pleiotropic effects in multiple organ systems, and vitamin D deficiency was suggested to be associated with high blood pressure according to previous reports. Several interventional studies have examined the effect of vitamin D supplementation on high blood pressure patients, but the results have been inconsistent. In this article, we examined the literature that have proposed a mechanism involving vitamin D in the regulation of blood pressure and review previous observational and interventional studies that have shown the relati...
Source: Electrolyte and Blood Pressure - October 19, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Unusual Case of Posterior Reversible Encephalopathy Syndrome in a Patient with Anti-glomerular Basement Membrane Antibody Glomerulonephritis: A Case Report and Review of the Literature.
Authors: Cha B, Kim DY, Jang H, Hwang SD, Choi HJ, Kim MJ Abstract Posterior reversible encephalopathy syndrome (PRES) is characterized by a clinical and radiological entity with the sudden onset of seizures, headache, altered consciousness, and visual disturbances in patients with the findings of reversible vasogenic subcortical edema without infarction. Hypertension, renal disease, and autoimmune disease are co-morbid conditions of PRES. Nevertheless, there have only been a few case reports of PRES in a patient with anti-glomerular basement membrane antibody glomerulonephritis (anti-GBM GN). This paper presents t...
Source: Electrolyte and Blood Pressure - October 19, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Renal Tubular Acidosis in Patients with Primary Sj ögren's Syndrome.
Renal Tubular Acidosis in Patients with Primary Sjögren's Syndrome. Electrolyte Blood Press. 2017 Sep;15(1):17-22 Authors: Jung SW, Park EJ, Kim JS, Lee TW, Ihm CG, Lee SH, Moon JY, Kim YG, Jeong KH Abstract Primary Sjögren's syndrome (pSS) is characterized by lymphocytic infiltration of the exocrine glands resulting in decreased saliva and tear production. It uncommonly involves the kidneys in various forms, including tubulointerstitial nephritis, renal tubular acidosis, Fanconi syndrome, and rarely glomerulonephritis. Its clinical symptoms include muscle weakness, periodic paralysis, and bo...
Source: Electrolyte and Blood Pressure - October 19, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Central Diabetes Insipidus Linked to Rathke's Cleft Cyst, Polyuria in a 17-year-old Girl.
Authors: Kim HY, Lee SJ, Bae EH, Ma SK, Kim SW Abstract A 17-year-old girl presented with polyuria (7 L/day) and polydipsia for one year. Initial urine osmolality was 113mOsm/kg H2O. Following 6 h of fluid restriction, serum plasma osmolality reached 300mOsm/kg H2O, whereas urine osmolality was 108mOsm/kg H2O. Urine osmolality was increased by 427% from 108 to 557mOsm/kg after vasopressin challenge. The patient was diagnosed with central diabetes insipidus, possibly derived from the atypical occupation of a Rathke's cleft cyst at the pituitary stalk following magnetic resonance imaging with enhancement. She was dis...
Source: Electrolyte and Blood Pressure - October 19, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Genetic Variations of Tyrosine Hydroxylase in the Pathogenesis of Hypertension.
Authors: Lee YH, Kim YG, Moon JY, Kim JS, Jeong KH, Lee TW, Ihm CG, Lee SH Abstract One of the major pathophysiological features of primary hypertension is an inappropriate activation of the sympathetic nervous system, which is mediated by excessive synthesis and secretion of catecholamine into the blood. Tyrosine hydroxylase (TH), a rate-limiting enzyme in the synthesis of catecholamine, has been highlighted because genetic variations of TH could alter the activity of the sympathetic nervous system activity and subsequently contribute to the pathogenesis of hypertension. Here, we discuss the role of TH as a regula...
Source: Electrolyte and Blood Pressure - March 11, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Severe Hypernatremia Caused by Acute Exogenous Salt Intake Combined with Primary Hypothyroidism.
This report describes a case of severe hypernatremia with a serum sodium concentration of 188.1mmol/L caused by exogenous salt intake. A 26-year-old man diagnosed with Crohn's disease 5 years previously visited our clinic due to generalized edema and personality changes, with aggressive behavior. He had compulsively consumed salts, ingesting approximately 154 g of salt over the last 4 days. Despite careful fluid management that included not only hypotonic fluid therapy for 8 hours but also hypertonic saline administration, his serum sodium level decreased sharply at 40.6 mmol/L; however, it returned to normal within 72-hou...
Source: Electrolyte and Blood Pressure - March 11, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Case Report of Syndrome of Inappropriate Antidiuretic Hormone Induced by Pregabalin.
Authors: Jung YJ, Lee DY, Kim HW, Park HS, Kim B Abstract The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hyponatremia, and many medications have been associated with SIADH. Pregabalin is a drug used for the treatment of neuropathic pain, though common adverse effects include central nervous system disturbance, peripheral edema, and weight gain. However, hyponatremia caused by pregabalin has been rarely reported. Here we report a patient with pregabalin-induced hyponatremia who met the criteria for SIADH; after discontinuation of the drug, his condition rap...
Source: Electrolyte and Blood Pressure - March 11, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Case of Isolated Glycosuria Mediated by an SLC5A2 Gene Mutation and Characterized by Postprandial Heavy Glycosuria Without Salt Wasting.
We report a case of renal glycosuria, which was confirmed by a SLC5A2 mutation via gene sequencing, and compared the postprandial urinary glucose and sodium excretion. A 26-year-old man sometimes experienced glycosuria on routine screening; however, other laboratory findings were normal. His fasting and postprandial urinary glucose excretion levels were 295mg/dL and 2,170mg/dL, respectively. The fasting and postprandial urinary sodium excretion levels were 200mEq/L and 89mEq/L, respectively. In patients with FRG, excessive diuresis might be prevented by a compensatory mechanism that reduces postprandial sodium excretion. ...
Source: Electrolyte and Blood Pressure - March 11, 2017 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Confronting Practical Problems for Initiation of On-line Hemodiafiltration Therapy.
Authors: Kim YW, Park S Abstract Conventional hemodialysis, which is based on the diffusive transport of solutes, is the most widely used renal replacement therapy. It effectively removes small solutes such as urea and corrects fluid, electrolyte and acid-base imbalance. However, solute diffusion coefficients decreased rapidly as molecular size increased. Because of this, middle and large molecules are not removed effectively and clinical problem such as dialysis amyloidosis might occur. Online hemodiafiltration which is combined by diffusive and convective therapies can overcome such problems by removing effective...
Source: Electrolyte and Blood Pressure - July 29, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Rare Case of Polyneuropathy and Monoclonalgammopathy with Recurrent Acute Kidney Injury.
Authors: Kim EJ, Shin DH, Jeon HJ, Rhee SY, Nam ES, Park JY, Oh J Abstract POEMS syndrome is a rare paraneoplastic syndrome and there are few reports of polyneuropathy and monoclonal gammopathy associated with kidney dysfunction. Here, we report a case of POEMS syndrome with recurrent acute kidney injury (AKI). A 52-year-old man presented with bilateral aggravating paresthesia and latermotor weakness of the lower extremities accompanied by repeated elevation of serum creatinine. The patient was finally diagnosed with POEMS syndrome on the basis of fulfilling the two mandatory major criteria (polyneuropathy and mono...
Source: Electrolyte and Blood Pressure - July 29, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Hypokalemic Hypertension Leading to a Diagnosis of Autosomal Dominant Polycystic Kidney Disease.
We report on a 32-year-old woman with secondary aldosteronism. Magnetic resonance imaging of the renal arteries revealed multiple cysts of varying sizes in both the kidneys and the liver, compatible with ADPKD. Increased reninangiotensin-aldosterone system activity was secondary to cyst expansion. After initiation of angiotensin II receptor blocker, her blood pressure was controlled without additional requirement of potassium. PMID: 27453714 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - July 29, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Pedigree with c.179 Cytosine to Threonine Missense Mutation of SLC12A3 Gene Presenting Gitelman's Syndrome.
Authors: Kim Y, Kang SS, Park WY, Jin K, Kim DK, Han S Abstract A 42-year-old man came to the hospital presenting chest discomfort and general weakness. He had come to the hospital with the same symptoms 3 months ago and 12 years prior. His laboratory test showed hypokalemia, hypomagnesemia and hypocalciuria. The arterial blood gas analysis showed hypochloremic metabolic alkalosis. He had an ultrasonography guided renal biopsy, the result was normal at light microscopy and immunofluorescence microscopy. However, a special stain for Na-Cl cotransporter was weakly expressed compared with the control. The patient and ...
Source: Electrolyte and Blood Pressure - July 29, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Hypertension in Chronic Glomerulonephritis.
Authors: Ihm CG Abstract Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioration of renal function. Patients with chronic GN become salt sensitive as renal damage including arteriolosclerosis progresses and the consequent renal ischemia causes the stimulation of the intrarenal renin-angiotensin-aldosterone system(RAAS). Overactivity of the sympathetic nervous system also co...
Source: Electrolyte and Blood Pressure - February 9, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

High Water Intake and Progression of Chronic Kidney Diseases.
Authors: Choi HY, Park HC, Ha SK Abstract Impact of water intake on the courses of chronic kidney and urinary tract diseases, such as urolithiasis, urinary tract infections, chronic kidney diseases (CKD), autosomal dominant polycystic kidney diseases and bladder cancer, has recently been studied. It still remains controversial whether increased water intake slows the progression of CKD or not. However, high water intake suppresses plasma levels of arginine vasopressin (AVP), which is expected to be beneficial for the preservation of the kidney function. Previous studies suggest that water intake suppresses plasma l...
Source: Electrolyte and Blood Pressure - February 9, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

A Case Report of Familial Renal Hypouricemia Confirmed by Genotyping of SLC22A12, and a Literature Review.
Authors: Kim HO, Ihm CG, Jeong KH, Kang HJ, Kim JM, Lim HS, Kim JS, Lee TW Abstract A 24-year-old male visited our hospital because of pain in both flanks. His biochemistry profile showed an elevated serum creatinine level and low serum uric acid level. History taking revealed that he had undertaken exercise prior to the acute kidney injury (AKI) event, and he stated that family members had a history of urolithiasis. His renal profile improved after hydration and supportive care during hospitalization. Although the patient was subsequently admitted again due to AKI, his status recovered with similar treatment. Sinc...
Source: Electrolyte and Blood Pressure - February 9, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Spinning-induced Rhabdomyolysis: Eleven Case Reports and Review of the Literature.
Authors: Kim D, Ko EJ, Cho H, Park SH, Lee SH, Cho NG, Lee SY, Jeong HY, Yang DH Abstract Non-traumatic exertional rhabdomyolysis (exRML) occurs in individuals with normal muscles when the energy supplied to the muscle is insufficient. Here, we report 11 cases of spinning-induced rhabdomyolysis and review related literature. Spinning is a kind of indoor bicycle sport. The 11 patients who were diagnosed with exRML and admitted to CHA Bundang Medical Center were female and their ages ranged from 15 to 46 years. Two to three days prior to the presentation, the patients had attended a spinning class for the first time....
Source: Electrolyte and Blood Pressure - February 9, 2016 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Hypertensive hypokalemic disorders.
Authors: Choi KB Abstract Hypokalemia is a common clinical problem. The kidney is responsible for long term potassium homoeostasis, as well as the serum potassium concentration. The main nephron site where K secretion is regulated is the cortical collecting duct, mainly via the effects of aldosterone. Aldosterone interacts with the mineralocorticoid receptor to increase sodium reabsorption and potassium secretion; the removal of cationic sodium makes the lumen relatively electronegative, thereby promoting passive potassium secretion from the tubular cell into the lumen through apical potassium channels. As a result...
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Metabolic acidosis in maintenance hemodialysis patients: clinical impact and intervention.
Authors: Kim HJ, Han SW Abstract Metabolic acidosis has been considered as one of the reverse epidemiologic factors for the morbidity and mortality in maintenance hemodialysis patients (MHP). Expectedly, in the recent large scale epidemiologic study (The Dialysis Outcome Practice Pattern Study, DOPPS), a mild to moderate degree of predialysis metabolic acidosis has shown better nutritional status and lower relative risk for mortality and hospitalization in MHP. Similarly, another recent study of the largest sample size of MHP of more than 55,000 revealed the lowest unadjusted mortality with mild to moderate degree ...
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

SIADH associated with prostate cancer.
We report a case of SIADH associated with prostate cancer in a 64-year-old male patient with a literature review. PMID: 24459500 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Water intoxication following low-dose intravenous cyclophosphamide.
Authors: Koo TY, Bae SC, Park JS, Lee CH, Park MH, Kang CM, Kim GH Abstract Cyclophosphamide is frequently used for the treatment of severe lupus nephritis, but is very rarely associated with dilutional hyponatremia. Recently we experienced a case of water intoxication following low-dose intravenous cyclophosphamide. Five hours after one dose of intravenous pulse cyclophosphamide 750 mg, the patient developed nausea, vomiting, and general weakness. Serum sodium concentration revealed 114 mEq/L and her hyponatremia was initially treated with hypertonic saline infusion. Then her serum sodium concentration rapidly rec...
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Altered Regulation of type 3 Na(+)/H(+) exchanger, type 1 Na(+)/HCO3 (-) cotransporter, and Na(+),K(+)-ATPase in the Kidney of Rats with Experimental Rhabdomyolysis.
In conclusion, the coordinate up-regulation of NHE3 and NBC1 may play an adaptive role against the metabolic acidosis in glycerol-induced rhabdomyolysis. PMID: 24459502 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Effects of Increased Uric Acid Intake on the Abundance of Urate-anion exchanger and Organic Anion Transporter Proteins in the Rat Kidney.
In conclusion, OAT1 may have a regulatory role in response to the increase in uric acid intake in the rat kidney. The up-regulation of OAT1 would exert stimulation of urinary uric acid excretion and might contribute to protection from hyperuricemia. PMID: 24459503 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Dysregulation of Renal Cyclooxygenase-2 in Rats with Lithium-induced Nephrogenic Diabetes Insipidus.
In conclusion, there is a differential regulation of COX-2 between cortex and inner medulla in Li-NDI and urinary PGE2 excretion is increased in Li-NDI, possibly due to an increased renal production. This may suggest that increased renal production of PGE2 could play a role in modulating water reabsorption in the renal collecting duct in Li-NDI. PMID: 24459504 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Immunolocalization of Protein Kinase C Isoenzymes α, βI, βII and γ in Adult and Developing Rat Kidney.
Immunolocalization of Protein Kinase C Isoenzymes α, βI, βII and γ in Adult and Developing Rat Kidney. Electrolyte Blood Press. 2007 Dec;5(2):75-88 Authors: Kim WY, Lee GS, Kim YH, Park EY, Hwang JS, Kim H, Kim J Abstract Protein kinase C (PKC) plays an important role not only in signal transduction mechanisms in various biological processes, but also in the regulation of growth and differentiation during development. We studied the classical PKCα, βI, βII and γ, with regard to their expression in adult and developing rat kidney. PKCα appeared in the ur...
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Altered Regulation of Type II 11β-hydroxysteroid Dehydrogenase in the Kidney of Rats with Experimental Hypertension.
Altered Regulation of Type II 11β-hydroxysteroid Dehydrogenase in the Kidney of Rats with Experimental Hypertension. Electrolyte Blood Press. 2007 Dec;5(2):89-94 Authors: Kang SS, Kim SW, Lee J Abstract The present study was aimed at investigating the role of type II 11β-hydroxysteroid dehydrogenase (IIβ-HSD II) in the development of hypertension. Two-kidney, one-clip (2K1C), deoxycorticosterone acetate (DOCA)/salt, or N (G)-nitro-L-arginine methyl ester (L-NAME) hypertension was induced in male Sprague-Dawley rats. Four weeks later, the expression of 11β-HSD II mRNA was determined ...
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Varying Dialysate Bicarbonate Concentrations in Maintenance Hemodialysis Patients Affect Post-dialysis Alkalosis but not Pre-dialysis Acidosis.
In conclusion, this study shows that the impact of conventional dialysate bicarbonate concentrations ranging from 25 to 35 mEq/L is not quite different on the mild degree of predialysis acidemia, but the degree of postdialysis alkalemia is more prominent in higher bicarbonate concentrations. Base supply by hemodialysis alone does not seem to be the main factor to determine the predialysis acidosis in end-stage renal disease patients on chronic maintenance hemodialysis. PMID: 24459507 [PubMed] (Source: Electrolyte and Blood Pressure)
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research

Factors associated with Hypokalemia in Continuous Ambulatory Peritoneal Dialysis Patients.
Authors: Kim HW, Chang JH, Park SY, Moon SJ, Kim DK, Lee JE, Han SH, Kim BS, Kang SW, Choi KH, Lee HY, Han DS Abstract Hypokalemia is a frequent problem in patients on continuous ambulatory peritoneal dialysis (CAPD) and is affected by multiple factors. To evaluate factors associated with hypokalemia, we studied 68 patients on maintenance CAPD treatment for at least six months. In univariate analysis, patients with hypokalemia were associated with older age and the presence of diabetes mellitus. Serum albumin, calcium-phosphate product, triglyceride, body mass index, protein nitrogen appearance, and lean body mass ...
Source: Electrolyte and Blood Pressure - December 11, 2015 Category: Internal Medicine Tags: Electrolyte Blood Press Source Type: research