• The Journal of Korean Medicine
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• v.44 no.3
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• pp.201-224
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• 2023

Objectives: The purpose of this study was to evaluate the effect of Gwibi-tang (GBT) on renal anemia. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate changes in anemia levels before and after oral administration of GBT in patients with renal anemia. Relevant literature published up to May 25, 2023, was searched in 10 academic electronic databases. Results: Data from 489 patients from 7 RCTs were obtained and analyzed. All participants were receiving erythropoietin-stimulating agent treatment, and most of them were under hemodialysis. Additional administration of GBT to the participants significantly increased the hemoglobin concentration (10.55 g/L, 95% CI 6.99 to 14.11) compared to the control group. Hematocrit, red blood cell count, serum ferritin concentration, transferrin saturation, and the total effective rate for anemia was also significantly higher in the GBT-treated group than in the control group. Conclusions: This study suggests that GBT may be considered to be a promising option for the effective management of patients with renal anemia under conventional treatment. However, the limitations of this study, including the quantitative and qualitative weakness of the RCTs, the lack of safety-related evidence, and the absence of long-term follow-up data, should be taken into account when interpreting the results of this study.

• The Journal of Internal Korean Medicine
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• v.26 no.2
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• pp.498-505
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• 2005

Renal failure means irreversible damage and depression of renal function, represented by glomerular filtration rate(GFR). A renal failure patient with uremia and anemia is presented. Anemia, in this patient, appeared before uremia did. A 55 year-old male patient was treated for renal failure with Weilingtang. Improvement was observed in, not only GFR, blood urea nitrogen(BUN), and creatinine, but also in such symptoms as difficulty in urine excretion, dyspepsia and abdominal swelling. But anemia appeared during treatment, so a mixture of Dangguibuxuetang(當歸補血湯) and Xiongguitang(芎歸湯) was prescribed. After this treatment, improvement in hemoglobin, and hematocrit was observed.

• Childhood Kidney Diseases
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• v.9 no.2
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• pp.275-281
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• 2005

Parvovirus B19(PV B19) is a nonenveloped single-stranded DNA virus that causes a wide variety of diseases ranging from benign childhood infection such as slapped-cheek rash(fifth disease) to life threatening diseases such as hydrous fetalis in fetuses or aplastic anemic crises in patients with hemolytic anemia. In immunocompromised hosts including organ transplant recipients, this infection can cause chronic anemia. Recently, the reports of cases of PV B19 infection have been increasing in transplant recipients and most reported cases of PV B19 infection-associated anemia in renal transplant recipients were successfully treated with intravenous immunoglobulin infusion. We experienced two cases of aplastic anemia caused by PV B19 infection in pediatric renal transplant recipients. The patients were an 8 year-old boy and 12-year-old boy who received allograft kidneys from their mothers. Anemia developed 2 weeks after transplantation and their serum was positive for PV B19 PCR. They were treated with 400 mg/kg of intravenous immunoglobulin(IVIG) for 5 consecutive days. In one of the case, anemia was corrected promptly after the first 5-day course of IVIG therapy but in the other, anemia persisted but responded to the second course of IVIG therapy. One year later, the patients have normal hematocrit levels and stable renal function These are the first cases of PV B19 infection treated successfully with IVIG in pediatric renal transplant recipients in Korea. (J Korean Soc Pediatr Nephrol 2005;9:275-281)

• Parasites, Hosts and Diseases
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• v.54 no.3
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• pp.315-317
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• 2016

Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• The Korean Journal of Nuclear Medicine
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• v.3 no.1
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• pp.19-32
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• 1969

Radioisotope renography was carried out in 564 cases consisting of 150 normal controls, 140 hypertensives, 102 hypertensive nephropathys, 62 chronic renal diseases, non-functioning kidneys. It was aimed to study which parameter of the renogram is most applicable to any definite disease of the kidney. The analytical methods adopted were; Tobe, Spencer, Krueger, Matchida and Takeuchi. In the non-functioning kidney groups, the hemograms and serum nitrogen series were also studied to evaluate the relationships between the renograms and renal anemia. The parameters were; time of maximum amplitude (Tmax), half-time of maximum amplitude ($T\frac{1}{2}$), Kac value calculated from these two parameters in Tobe's method, slopes of Band C phase, B/A and B/C values in Spencer's method, total concentration (T.C.), minute concentration (M.C.) and minute excretion (M.E.) in Krueger's method, Matchida's K value and Takeuchi's renal function Index (R.F.I.). Following were the results: 1. In general, marked differences in the patterns of the renogram were observed between the normal controls and nephropathys. In Tobe's method, each parameter showed statistically significant delay or decrease in patients with hypertensive nephropathys and chronic renal diseases. In Spencer's method, slopes of B and C phase and B/C, also showed the statistically significant decrease in patients with hypertension, hypertensive nephropathys and chronic renal diseases. In Krueger's method, M.C. and ME showed the statistically significant differences between the control and patients with hypertension, hypertensive nephropathys and chronic renal diseases, In Matchida's method, K value showed the statistically significant differences between the control and patients with hypertensive nephropathys and chronic renal diseases. 2. It appeared, therefore, that Tobe's $T\frac{1}{2}$, Kac value, Spencer's slopes of Band C phase, B/A, B/C values, Krueger's T.C., M.C., and M.E. values, Matchida's K value are useful for the differentiation of various renal diseases, however, qualitative analysis of the renogram with one or two parameters is not accurate. 3. In bilateral non-functioning kidney groups, a positive correlation between anemia and nitrogen retention was observed, although the quantitative assessment of the degree of non-functioning was impossible.

• Journal of Yeungnam Medical Science
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• v.15 no.1
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• pp.173-181
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• 1998

Rifampin is common drug to treat tuberculosis. Rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia is rare and severe complication. We have experienced a case of rifampin induced acute renal failure, hemolytic anemia and thrombocytopenia. Forty-six years old male was suffered from reactivation of pulmonary tuberculosis, and had to medicate antituberculosis drugs including rifampin(600mg/day). Seven years ago, antituberdulosis medication were successfully administered to treat pulmonary tuberculosis without any side effects of drugs. But eight days after readministration of rifampin, fever, abdominal pain, vomiting, oliguria, elevated BUN and creatinine were developed. And thrombocytopenia was also identified after administration of rifampin. The patient was recovered slowly after discontinuation of rifampin & intensive medical care. The renal function was normalized at 55 days after cessation of rifampin. The renal pathologic findings were interstitial nephritis and acute tubular necrosis. And, the rifampin dependent antibodies were identified by indirect antiglobulin test in the presence of rifampin. So we report this case with a brief review of literature.

• Journal of Veterinary Clinics
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• v.24 no.1
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• pp.51-55
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• 2007

A 13-year-old male Yorkshire terrier was Presented with Persistent weight loss anorexia and dark brown urine of 3-month duration. On physical examination, a firm oval mass was palpated at left renal region. In hematology and blood chemistry, neutrophilia, anemia, thrombocytopenia and elevation of ALKP were found. Abdominal radiography, ultrasonography and ultrasound-guided percutaneous pyelogram revealed masses originated from left kidney, mildly dilated renal Pelvis and intact ureter. Urinalysis showed hematuria and proteinuria. Because the state of dog became deteriorated during transfusion and the frail renal tumor was suspected to be the cause of inflammation and anemia, nephrectomy was performed. Renal masses, approximately $2{\times}3cm\;and\;5{\times}4cm$ respectively in size, was surrounded by swollen and congested mesentery and ascites. Metastatic lesion was not found in other organs. During recovery, the dog showed cardiopulmonary arrest and did not respond to critical care. Histologically the kidney was affected by necrotic and hemorrhagic change. This hemangiosarcoma most likely arose from the renal parenchyma resulting In diffuse lesions in the kidneys thought to be the cause of chronic anorexia and weight loss.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.86-90
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• 2004

Hemolytic uremic syndrome(HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia and the most common pathogen is Escherichia coli (E. coli) O157 : H7. Ischemic colitis, which rarely occurs in children, is due to the reduced local blood flow to the intestine, tissue necrosis and secondary bacterial infection. We describe a patient who was admitted with abdominal pain, vomiting and hematochezia, and diagnosed as ischemic colitis by barium enema. This patient showed hemolytic anemia, thrombocytopenia and progressive renal failure and was subsequently diagnosed as hemolytic uremic syndrome. After hemodialysis, the patient showed improvement of symptoms and resolution of renal failure and ischemic colitis.

• Childhood Kidney Diseases
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• v.27 no.2
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• pp.89-96
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• 2023

Renal nutcracker syndrome (NCS) is the entrapment of the left renal vein between the abdominal aorta and superior mesenteric artery. Although uncommon in pediatric patients, early diagnosis is crucial to avoid potential severe complications, such as anemia or renal vein thrombosis. NCS presents a variety of symptoms, most commonly including "Triade's symptoms"-hematuria, proteinuria, and flank pain. Diagnosis and treatment include invasive and noninvasive management, although due to a lack of pediatric clinical studies, management is widely variable. Conservative diagnosis and treatment are recommended as a first-line option for pediatric patients; however, invasive surgical treatment may be recommended based on symptom severity. This review aims to provide a comprehensive overview of NCS in children to better understand the widely variable incidence, occurrence, and management from early on to allow for early-onset management.