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Electrolyte & Blood Pressure: E & BP

Kyeong Min Kim, Soon Kil Kwon, Hye-Young Kim
Familial renal glycosuria (FRG) is an inherited disorder characterized by persistent glycosuria in the absence of hyperglycemia. It is caused by mutations in the sodium-glucose co-transporter, leading to increase in the renal excretion of glucose and sodium. However, there have been no studies on the role of fasting and postprandial changes in the urinary sodium excretion in patients with FRG. 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...
December 2016: Electrolyte & Blood Pressure: E & BP
Youn Joo Jung, Dong-Young Lee, Hae Won Kim, Hyun Sun Park, Beom Kim
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 rapidly improved...
December 2016: Electrolyte & Blood Pressure: E & BP
Woo Jin Jung, Su Min Park, Jong Man Park, Harin Rhee, Il Young Kim, Dong Won Lee, Soo Bong Lee, Eun Young Seong, Ihm Soo Kwak, Sang Heon Song
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...
December 2016: Electrolyte & Blood Pressure: E & BP
Yu Ho Lee, Yang Gyun Kim, Ju-Young Moon, Jin Sug Kim, Kyung-Hwan Jeong, Tae Won Lee, Chun-Gyoo Ihm, Sang Ho Lee
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 regulator of sympathetic activity and review several studies that investigated the relationship between genetic variations of TH and hypertension...
December 2016: Electrolyte & Blood Pressure: E & BP
Yaerim Kim, Seong Sik Kang, Woo Yeong Park, Kyubok Jin, Dae-Kwang Kim, Seungyeup Han
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...
June 2016: Electrolyte & Blood Pressure: E & BP
Wasawat Vutthikraivit, Montira Assanatham, Chutintorn Sriphrapradang
Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. Hypertension is common and occurs before decline in renal function. However, the coexistence of hypertension and hypokalemia is rare in ADPKD patients. 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...
June 2016: Electrolyte & Blood Pressure: E & BP
Eun Jung Kim, Dong Ho Shin, Hee Jung Jeon, So Yon Rhee, Eun Sook Nam, Ji Young Park, Jieun Oh
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 monoclonal gammopathy), one other major criterion (sclerotic bone lesion), and several minor criteria...
June 2016: Electrolyte & Blood Pressure: E & BP
Yang Wook Kim, Sihyung Park
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 effectively middle and large solutes...
June 2016: Electrolyte & Blood Pressure: E & BP
Daejin Kim, Eun-Jung Ko, HyeJeong Cho, Su Hyung Park, Sang Hwan Lee, Nam-Gil Cho, So-Young Lee, Hye Yun Jeong, Dong Ho Yang
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...
December 2015: Electrolyte & Blood Pressure: E & BP
Hyung Oh Kim, Chun-Gyoo Ihm, Kyung Hwan Jeong, Hyun Joon Kang, Jae-Min Kim, Hyung Suk Lim, Jin Sug Kim, Tae Won Lee
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...
December 2015: Electrolyte & Blood Pressure: E & BP
Hoon Young Choi, Hyeong Cheon Park, Sung Kyu Ha
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...
December 2015: Electrolyte & Blood Pressure: E & BP
Chun-Gyoo Ihm
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)...
December 2015: Electrolyte & Blood Pressure: E & BP
Min Jee Han, Do Hyoung Kim, Young Hwa Kim, In Mo Yang, Joon Hyung Park, Moon Ki Hong
Osmotic demyelination syndrome is a demyelinating disorder associated with rapid correction of hyponatremia. But, it rarely occurs in acute hypernatremia, and it leads to permanent neurologic symptoms and is associated with high mortality. A 44-year-old woman treated with alternative medicine was admitted with a history of drowsy mental status. Severe hypernatremia (197mEq/L) with hyperosmolality (415mOsm/kgH2O) was evident initially and magnetic resonance imaging revealed a high signal intensity lesion in the pons, consistent with central pontine myelinolysis...
June 2015: Electrolyte & Blood Pressure: E & BP
Haifeng Jin, Jun Young Shin, Seung Ho Lee, Joon Ho Song, Moon-Jae Kim, Seoung Woo Lee
BACKGROUND: The relationship between abdominal obesity (AO) and mortality in peritoneal dialysis (PD) patients is controversial. METHODS: The prevalence of AO in 84 PD patients was assessed in a cross-section manner and followed up for 9 years at a single center. AO was defined as a waist circumference (WC) of more than 90 cm in males or more than 80 cm in females. The patients were classified as either with AO(AO group) or without AO(nAO group). RESULTS: The AO group was older, contained more diabetics, more females, and had higher Charlson comorbidity index (aCCI) scores, BMI, and triglyceride and lower serum creatinine than the non-AO subjects...
June 2015: Electrolyte & Blood Pressure: E & BP
Se Won Oh, Sang Youb Han
Diuretics are commonly used to control edema across various clinical fields. Diuretics inhibit sodium reabsorption in specific renal tubules, resulting in increased urinary sodium and water excretion. Loop diuretics are the most potent diuretics. In this article, we review five important aspects of loop diuretics, in particular furosemide, which must be considered when prescribing this medicine: (1) oral versus intravenous treatment, (2) dosage, (3) continuous versus bolus infusion, (4) application in chronic kidney disease patients, and (5) side effects...
June 2015: Electrolyte & Blood Pressure: E & BP
Hoon Young Choi, Hyeong Cheon Park, Sung Kyu Ha
Hypertension is a complex trait determined by both genetic and environmental factors and is a major public health problem due to its high prevalence and concomitant increase in the risk for cardiovascular disease. With the recent large increase of dietary salt intake in most developed countries, the prevalence of hypertension increases tremendously which is about 30% of the world population. There is substantial evidence that suggests some people can effectively excrete high dietary salt intake without an increase in arterial BP, and another people cannot excrete effectively without an increase in arterial BP...
June 2015: Electrolyte & Blood Pressure: E & BP
Eui-Jung Park, Tae-Hwan Kwon
The kidney collecting duct is an important renal tubular segment for the regulation of body water and salt homeostasis. Water reabsorption in the collecting duct cells is regulated by arginine vasopressin (AVP) via the vasopressin V2-receptor (V2R). AVP increases the osmotic water permeability of the collecting duct cells through aquaporin-2 (AQP2) and aquaporin-3 (AQP3). AVP induces the apical targeting of AQP2 and transcription of AQP2 gene in the kidney collecting duct principal cells. The signaling transduction pathways resulting in the AQP2 trafficking to the apical plasma membrane of the collecting duct principal cells, include AQP2 phosphorylation, RhoA phosphorylation, actin depolymerization and calcium mobilization, and the changes of AQP2 protein abundance in water balance disorders have been extensively studied...
June 2015: Electrolyte & Blood Pressure: E & BP
Jiwon Jeong, Soon Kil Kwon, Hye-Young Kim
Current practice guidelines recommend alkali therapy in patients with chronic kidney disease (CKD) and metabolic acidosis to prevent complications. This study aims to investigate the effect of oral sodium bicarbonate supplementation on the progression of renal function and nutritional indices in patients with predialysis advanced CKD. Forty patients with predialysis stage 5 CKD(estimated glomerular filtration rate, eGFR <15mL/min per 1.73m(2)) and 40 patients with stage 4 CKD (eGFR 15 to 30mL/min per 1.73m(2)) who had a total CO2 less than 22mEq/L were assigned into the bicarbonate treatment group or control group for 12 months...
December 2014: Electrolyte & Blood Pressure: E & BP
Sung Jin Moon, Hyun Jung Kim, Sung Bin Cho, Seung Hun Lee, Hoon Young Choi, Hyeong Cheon Park, Sung Kyu Ha
Uremic pruritus is a common problem in patients with end-stage renal disease (ESRD), but the underlying mechanisms are not yet fully understood. We aimed to investigate the association between severity of uremic pruritus and cutaneous serine protease activity, as well as proteinase-activated receptor-2 (PAR-2) expression. Twelve ESRD patients with pruritus, 4 ESRD patients without pruritus, and 6 healthy controls were enrolled. Skin biopsies were obtained from the abdomen. Protease activity and PAR-2 expression in the epidermis were examined by in situ zymography and confocal laser microscopy, respectively...
December 2014: Electrolyte & Blood Pressure: E & BP
Haifeng Jin, Seung Yun Lee, Si Nae Lee, Joon Ho Song, Moon-Jae Kim, Seoung Woo Lee
This retrospective study was performed to determine the ranges of the sodium gradient (SG) between the dialysate sodium concentration (DNa) and serum sodium concentration (SNa) in hemodialysis (HD) patients and to examine the relationships between HD parameters over a 1 year period. Fifty-five clinically stable HD patients, who had been on HD >2 years were enrolled. Monthly HD [ultrafiltration (UF) amount, systolic blood pressure (SBP), frequency of intradialytic hypotension (IDH)] and laboratory data were collected and 12-month means were subjected to analysis...
December 2014: Electrolyte & Blood Pressure: E & BP
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