A Case of Acute Kidney Injury Associated with Rhabdomyolysis after Liposuction / 대한내과학회지

Rhabdomyolysis is defined as a skeletal muscle injury with release of muscle cell constituents into the plasma. It can occur in various diseases and conditions, including muscle strain, drug or alcohol abuse, connective tissue disease, excess exercise, or following surgery. Only one case of rhabdomyolysis has ever been associated with liposuction in Korea. We experienced a case of rhabdomyolysis that developed after liposuction surgery. The patient was a 39-year-old woman presenting with abdominal pain 1 day after liposuction. She was treated with general supportive care, including massive hydration and absolute bed rest. Renal replacement therapy was performed due to pulmonary edema. She, finally, recovered fully. Acute kidney injury caused by liposuction-induced rhabdomyolysis is a rare disease. Therefore, we present this case with a review of the literature.

A Case of Infective Endocarditis with Cytomegalovirus Infection after Kidney Transplantation / 대한내과학회지

Advances in immunosuppressive therapy have increased the survival of kidney transplant recipients, yet suppression of the immune system after transplantation can promote infectious complications. Cytomegalovirus (CMV) infection remains one of the most important complications following kidney transplantation and it is a risk factor for developing superinfections with other organisms. Aspergillus endocarditis is a rare life-threatening complication in kidney transplantation. Coinfection of CMV and Aspergillus endocarditis is rare worldwide and has not been reported in Korea. We report a case of Aspergillus endocarditis that developed in a patient with CMV infection after kidney transplantation. His clinical condition did not improve despite mitral valve replacement and empirical antibiotic treatment, but he was eventually treated successfully with antifungal agents for 6 weeks.

Influences of Dry Weight Adjustment Based on Bioimpedance Analysis on Ambulatory Blood Pressure in Hemodialysis Patients

BACKGROUND: Hypertension is a common problem for hemodialysis patients and is associated with an increased cardiovascular mortality. We analyzed ambulatory blood pressure (ABP) in hemodialysis patients and investigated if an adjustment of dry weight can be used to control blood pressure. METHODS: ABP was measured for twenty-four hours after hemodialysis. A bioimpedance Analysis (BIA) was conducted. Patients were divided into two groups by the edema index. A normohydration (NH) group included patients with the edema index less than 0.40, and an overhydration (OH) group included patients with the edema index 0.40 or more. We accordingly adjusted the dry weight based on BIA results. RESULTS: Thirty-six patients were recruited, comprising twenty-two men and fourteen women. In regard to the ABP, 24-hour systolic and diastolic blood pressures were 140.2 +/- 19.7 mm Hg and 79.0 +/- 10.6 mm Hg, respectively. There was a significant association between 24-hour systolic blood pressure and the edema index (r = 0.501, p = 0.002). Twenty four-hour systolic blood pressure was significantly different between the NH and OH groups (median value, 132.0 vs. 150.5 mm Hg; p = 0.008). In OH group, after adjustment of the dry weight, the edema index was decreased from 0.411 +/- 0.009 to 0.389 +/- 0.047 and office systolic blood pressure was also decreased from 144.7 +/- 32.7 mm Hg to 125.3 +/- 15.4 mm Hg in OH group (p = 0.028 and p = 0.018, respectively). CONCLUSIONS: The edema index obtained by the bioimpedance analysis is significantly correlated with 24-hour systolic blood pressure in hemodialysis patients. Also, an adjustment of dry weight can be used to control blood pressure in hemodialysis patients.