Erratum: Risk Factors Influencing Decline of Residual Renal Function in Patients on Continuous Ambulatory Peritoneal Dialysis / 대한신장학회지

No abstract available.

Technique survival in peritoneal dialysis: A single-center experience / 대한내과학회지

BACKGROUND/AIMS: Continuous ambulatory peritoneal dialysis (CAPD) is an established treatment in patients with end-stage renal disease (ESRD), and innovations in the connection system have improved the survival of peritoneal dialysis patients over the last two decades. We investigated the outcome of CAPD over a 15-year period at our institution. METHODS: Patients who underwent peritoneal dialysis since 1994 were recruited retrospectively. Patients younger than 15 years at the initiation of CAPD and those who had less than 1 month of follow-up or missing data were excluded. The technique survival rate and causes of technique failure were evaluated. RESULTS: In all, 608 CAPD patients (342 males, 56.3%) were analyzed using the Kaplan-Meier method and log-rank test. The mean age at the start of CAPD was 50.7+/-15.1 years and the mean duration of CAPD was 50.2+/-41.5 months. The most common primary renal disease was diabetes (39.6%), followed by chronic glomerulonephritis (37.2%) and hypertension (13.0%). The 1-, 3-, 5-, and 10-year death-censored technique survival rates were 97.3, 91.7, 82.8, and 67.5%, respectively. Sex or diabetic status did not affect the technique survival rate. Patients younger than 60 years at the start of CAPD had a better technique survival than older patients (p=0.005). The main cause of technique failure was peritonitis (71.6%), followed by mechanical malfunction (10.5%), ultrafiltration failure (7.4%), and inadequate dialysis (6.3%). CONCLUSIONS: Complicating peritonitis was the most common cause of CAPD technique failure at our center. To reduce the technique failure in high-risk groups, more intensive management is needed.

Risk Factors Influencing Decline of Residual Renal Function in Patients on Continuous Ambulatory Peritoneal Dialysis / 대한신장학회지

PURPOSE: Preservation of residual renal function (RRF) after initiation of peritoneal dialysis (PD) is beneficial for patient survival. It is unclear that same risk factors of pre-dialysis chronic kidney disease (CKD) patients affect RRF in PD patients. This study was aimed to evaluate factors affecting RRF after commencement of PD. METHODS: Data from 80 patients commencing CAPD at Kyungpook National University Hospital between January 2001 and December 2008 were retrospectively collected. After PD commencement, biochemical and clinical data at baseline (1 month), 6, and 12 month were obtained. RRF was calculated as the average of creatinine clearance and urea nitrogen clearance from 24-hour urine collection and normalized with body surface area and mean RRF decline rate was calculated by dividing RRF difference between baseline to 12 month by period. RESULTS: Mean RRF decline rate (mL/min/1.73m2/month) was negatively correlated with left ventricular posterior wall thickness (LVPWT) (R2=0.097, p=0.023) and proteinuria (R2=0.126, p=0.003), whereas positively correlated with hematocrit (R2=0.076, p=0.013) at baseline. CONCLUSION: Decline of RRF during a year after commencement of PD was associated with baseline proteinuria and LVPWT.

A Case of Inflammatory Fibroid Polyp in the Duodenum / 대한소화기내시경학회지

Inflammatory fibroid polyp is a relatively uncommon, localized benign lesion of the gastrointestinal wall. It is seen mostly as a single entity and the majority of inflammatory fibroid polyps have been reported with pathologic examination in the stomach but rarely in small intestines. A 70-year-old woman was presented with intermittent epigatric discomfort and gastroduodenoscopy showed a polypoid lesion with oval shaped, central depression, and normal mucosal covering. Endoscopic ultrasonography showed 8x6 mm sized hypoechoic tumor which was located mainly in the third layer of the duodenal wall with indistinct margin. The tumor was successfully removed by endoscopic resection after the injection of hypertonic saline solution with epinephrine and banding. The tumor consisted of loose fibrous stroma, small blood vessels and inflammatory cells. We present a case of inflammatory fibroid polyp of the duodenum with review of the literatures.

Ventilatory Dynamics according to Bronchial Stenosis in Bronchial Anthracofibrosis / 결핵및호흡기질환

BACKGROUND: Bronchial anthracofibrosis usually manifest as a form of obstructive airway disease, and can be accompanied by parenchymal diseases such as pneumonia, and pulmonary tuberculosis. This study investigated the ventilatory dynamics according to the severity of bronchial stenosis in patients with bronchial anthracofibrosis. Method : One hundred and thirteen patients with bronchial anthracofibrosis that was confirmed by bronchoscopy and who had undergone a pulmonary function test were enrolled in this study group. The correlation coefficients between the pulmonary functional parameters and the number of lobes with bronchial stenosis were investigated. RESULTS: The incidence of ventilatory dysfunction was 56(49.6%) for obstructive, 8(7.1%) for restrictive, 2(1.8%) for mixed, and 47(41.6%) for a normal pattern. The FEV1/FVC, FEF25~75%, FEF25%, FEF50%, FEF75%, and PEF showed a significant negative correlation (p<0.05) and the Raw had a significant positive correlation with the number of lobes with bronchial stenosis(p<0.001). CONCLUSION: These findings suggest that the most common abnormality of the ventilatory function in bronchial anthracofibrosis is an obstructive pattern with a small airway dysfunction according to the severity of bronchial stenosis.

The Reasons for Use of Temporary Catheter Instead of Arteriovenous Fistula at the Start of Chronic Hemodialysis Therapy / 대한신장학회잡지

PURPOSE: Placement of an arteriovenous fistula (AVF) before initiation of chronic hemodialysis (HD) is recommended to avoid the use of a dialysis catheter. However, many patients use temporary catheter at the start of HD for many reasons. We conducted a study to examine the reasons for use of temporary catheter instead of AVF at initial HD therapy. METHODS: We investigated 61 chronic renal failure (CRF) patients who started HD from January 2001 to August 2004 at Daegu Fatima Hospital. Fourty one of them used temporary catheter (catheter group) and 20 used AVF (AVF group) at initial HD. The causes of CRF, clinical presentation at initial HD, reasons that required start of HD and reasons for use of temporary catheter were investigated. RESULTS: The reasons that required start of HD were dyspnea (23), uremic symptoms (11), severe edema (4) and metabolic abnormalities (3) in catheter group and uremic symptoms (8), progression of CRF with minimal uremic symptoms (8) in AVF group. Those causes of unpreparedness of AVF in catheter group were delayed referral (12), rapid progression of CRF (12), unawareness of CRF (10), and noncompliance (7). The systolic and diastolic blood pressure were higher in catheter group than AVF group (171.3+/-33.5 vs 146.0+/-18.0 mmHg, 94.0+/-18.5 vs 80.6+/-10.8 mmHg, respectively). Serum albumin level was lower (3.0+/-0.6 vs 3.4+/-0.7 g/dL) and serum phosphorus level was higher (6.8+/-1.9 vs 5.7+/-1.7 mg/dL) in catheter group. CONCLUSION: To avoid temporary vascular catheter, early diagnosis of CRF, early referral to nephrologist and preparation of AVF is essential.

A Case of Pulmonary Aspergilloma in Bronchogenic Cyst Associated with An Actinomycosis / 결핵및호흡기질환

Pulmonary aspergilloma usually arises in preexisting lung cavities characterized by recurrent hemoptysis. Although surgical resection of the aspergilloma is the best treatment, most patients are poor candidates for surgery because of far-advanced underlying pulmonary disease. On the other hand, pulmonary actinomycosis is a chronic, indolent bacterial infection and follows aspiration of oropharyngeal material. Bronchiectasis and obstructive lung disease are often associated underlying conditions. We report a case of pulmonary aspergilloma in bronchogenic cyst associated with an actinomycosis in 21-year-old woman treated by thoracoscopic surgery with a review of literature.