• Clinical and Experimental Pediatrics
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• v.52 no.9
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• pp.999-1004
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• 2009

Purpose : Glomerular filtration rate (GFR) is a fundamental parameter in assessing renal function and predicting the progression of chronic renal disease. Because the use of serum creatinine has several disadvantages, many studies have investigated the use of cystatin C for estimating GFR. We compared creatinine clearance and GFR with formulas using serum creatinine and cystatin C. Methods : We retrospectively analyzed 211 patients with various renal diseases and classified them into two groups according to creatinine clearance (Group 1: CrCl >$90mL/min/1.73m^2$, Group 2: CrCl <$90mL/min/1.73m^2$). We measured serum creatinine, cystatin C, and creatinine clearance. We calculated GFR using the Schwartz, Counahan, Filler and Lepage, Bokencamp et al, and Grubb et al formulas. Results : GFR determined by the Schwartz formula had the highest correlation to creatinine clearance (r=0.415, P=0.00). GFR determined by various formulas using cystatin C had lower correlation to creatinine clearance (r=0.187, r=0.187, r=0.291). The Schwartz and Counahan formulas showed greater diagnostic accuracy in detecting decreased GFR than cystatin C in group 2 (areas under the curve: Schwartz, 0.596; Counahan, 0.572; Filler, 0.512; Bokencamp, 0.508; and Grubb, 0.514). Conclusion : GFR determined by the Schwartz and Counahan formulas using serum creatinine showed higher correlation coefficient than that determined by formulas using cystatin C. The formulas using cystatin C were not superior to those using serum creatinine in detecting decreased GFR. Cystatin C measurement was not satisfactory for assessing GFR in patients whose renal function was not severely decreased.

• Translational and Clinical Pharmacology
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• v.26 no.3
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• pp.111-114
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• 2018

Adding to the complexity of caring for critically ill patients is the fact that many of them have a creatinine clearance that exceeds $130mL/min/1.73m^2$. This phenomenon, termed augmented renal clearance (ARC), has only recently been widely recognized and its pathogenesis remains incompletely understood. However, ARC has been shown to result in increased dose requirements for drugs that are primarily eliminated by renal excretion, including many antimicrobial agents and enoxaparin. Recognition of ARC is hampered by the fact that the standard creatinine-based equations used to estimate renal function are not accurate in this clinical setting and the diagnosis is best established using both serum and urine creatinine measurements to calculate clearance. So a high index of clinical suspicion and awareness is usually required before this step is taken to confirm the diagnosis of ARC.

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.161-167
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• 2007

Purpose : GFR(glomerular filtration rate) is a fundamental parameter in detecting renal impairment and predicts the progression of renal disease. Because serum creatinine has several disadvantages, serum cystatin C has been recently proposed as a new endogenous marker for GFR. We compared serum cystatin C with creatinine and creatinine clearance to investigate the clinical usefulness of cystatin C. Methods : We retrospectively analyzed 46 patients(60 case numbers) who had various renal diseases and classified them into 3 groups according to creatinine clearance(Group 1 : CrCl <40 mL/min/$1.73m^2$, Group 2 : CrCl 40-60 mL/min/$1.73m^2$, Group 3 CrCl >60 mL/min/$1.73m^2$). We measured serum creatinine, cystatin C and creatinine clearance and also analyzed the correlations among them. Results : Serum cystatin C and creatinine showed a similar correlation to creatinine clearance (r=0.685, r=0.640, respectively) and showed similar diagnostic accuracy in detecting decreased GFR(AUC, cystatin C 0.829 vs. creatinine 0.826, P=0.848). Serum cystatin C showed a greater sensitivity for detecting a decreased GFR than creatinine in Group 2 and 3(Group 1 : 100% vs. 100%, Group 2 : 70% vs. 35%, Group 3 : 46% vs. 15%). Conclusions : Serum cystatin C could be a useful endogenous marker for GFR and would be superior to serum creatinine in early detection of renal impairment in pediatric patients with renal diseases.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.93-100
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• 1988

In clinical practice, creatinine clearance(Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate(GFR) could be obtained from the simple determinations of plasma creatinine(Pcr) and body length(L) : GFR($m{\ell}/min/1.73m^2$=k L(cm)/Pcr(mg/$100m{\ell}$), (k=constant). The subject of this study were ill children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III. from 11 to 15 years old. The results were as following ; 1) Measured creatinine clearance($Ccr_M$, $m{\ell}/min/1.73m^2$) were $109.73{\pm}9.97$ in group I, $108.26{\pm}9.02$ in group II, $96.20{\pm}4.72$ in group III and $105.48{\pm}5.23$ in all age group. 2) Measured k($k_M$) obtained from $Ccr_M=k$ Ht/Pcr were $0.49{\pm}0.03$ in group I, $0.48{\pm}0.02$ in group II, $0.43{\pm}0.02$ in group III, and $0.47{\pm}0.02$ in all age group.(Ht ; height) 3) Linear equations and correlation coefficients between Ht/Pcr(x) and Ccr(y) were y=0.822x-65.63(r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44(r=0.54) in group III and y=0.58x-22.13(r=0.81) in all age group. 4) $Ccr_E$ was again estiamted from linear equations between Ht/Pcr and $Ccr_M$ and $k_E$ was calculated with Ht/Pcr and $Ccr_E$ were $0.48{\pm}0.01$ in group I, $0.49{\pm}0.01$in group II, $0.43{\pm}0.01$ in group III and $0.47{\pm}0.00$ in all age group. 5) Consistant values of $k_E$ and $k_M$ were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k($k_M$) according to the age in easy and rapid way.

• Journal of Pharmaceutical Investigation
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• v.16 no.4
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• pp.152-157
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• 1986

The pharmacokinetics of sulfamethoxazole were investigated in rabbits with folate-induced renal failure. The blood level, area under the blood concentration curve (AUC) and biological half-life were increased significantly, and the urinary excretion was decreased significantly compared with those of normal rabbits. Correlation of serum creatinine concentration and AUC, biological half-life, and correlation of creatinine clearance and renal clearance have linear relationship respectively. From these results, dosage regimen of sulfamethoxazole is considered to be adjusted for effective and safe therapy in renal failure.

• YAKHAK HOEJI
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• v.29 no.4
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• pp.216-219
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• 1985

The phormacokinetics of acetaminophen were investigated in rabbits with folate-induced renal failure. The blood level, the area under the blood concentraction curve(AUC) and the biological half-life were increased significantly, and the urinary excretion was decreased significantly as compared with those of normal rabbits. Serum creatinine concentration and AUC, creatinine clearance and renal clearance have linear relationship respectively. Dosage regimen of acetaminophen was considered to be adjusted in renal failure.

• Journal of Korean Physical Therapy Science
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• v.11 no.1
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• pp.28-35
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• 2004

The purpose of the present study was to investigate the effectiveness of silver spike point (SSP) low frequency electrical stimulation on glomerular filtration rate (GFR), specifically, such as diuretic action in 24 hour urine and in plasma analysis from normal volunteer. The current of 1 Hz continue type (CT) of SSP low frequency electrical stimulation significantly decreased in plasma creatine from normal volunteer. However, the urine creatinine clearance (Ccr) was significantly increased by SSP low frequency electrical stimulation in normal volunteer. These results suggest that the SSP low frequency electrical stimulation, especially current of 1 Hz continue type, significantly regulates urine creatinine clearance and glomerular filtration rate from normal volunteer. Therefore, the SSP low frequency electrical stimulation is a good regulator through a diuretic action of hypertension.

• Journal of Ginseng Research
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• v.21 no.1
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• pp.49-52
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• 1997

There are many mechanisms that mediate progression of renal injury, such as abnormalities of nitric oxide (NO) regulation, increased Platelet aggregatlon, and oxygen free radical injury. Ginseng has been known to have NO dependent vasorelaxant effect and antioxidant effect, also inhibit thrombin stimulated platelet aggregation. And these effects of ginseng may have some roles in prevention of renal injury. So we studied 24 patients with mild pathologic proteinuria and hypertension to evaluate the effect of ginseng on progression of renal injury. After 1 month treatment, creatinine clearance was significantly increased especially in the patient group with normal serum creatinine level without specific side effect. The result of this study suggest that ginseng may pre vent or retard the progression of renal injury especially in early stage.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.49-54
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• 1989

Many previously described nuclear medicine procedures to assess glomerular filtration rate (GFR) required numerous blood samples obtained over a period of several hours to determine plasma concentrations of the injected radiopharmaceuticals. And other indirect methods of determining renal clearance have some problems due to individual variations in volume of distribution of the radionuclides used. Rescently reported Jackson's method have the great advantages that is a direct measurement method requiring less than 40 min of imaging time and single blood sampling. And it correctly accounts for individual variations in volume of distribution of the radiopharmaceuticals and can be done with routine renal scintrgraphy. We measured $^{99m}Tc-DTPA$ renal clearance with Jackson's method during the routine $^{99m}Tc-DTPA$ renal scintigraphy in 63 patients admitted to department of internal medicine in SNUH. In 23 cases among 63 patients creatinine clearence was accounted simultaneously. The range of $Cl_{DPDA}$ was from 19.9 ml/min to 170 ml/min and the correlation of $Cl_{DPDA}$ and creatinine clearance was discribed by Y=16.2570+0.7852 X($X=Cl_{DTPA}$ Y=creatinine clearance). And the correlation coefficient r was 0.88. We concluded that $^{99m}Tc-DTPA$ renal clearance measurement with Jackson's method was clinically useful to account GFR that can be done with routine $^{99m}Tc-DTPA$ renal scintigraphy simultaneously.

• Biomolecules & Therapeutics
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• v.8 no.3
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• pp.241-247
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• 2000

The present study was designed to assess the protective effect of a selective thromboxane $A_2$ receptor antagonist, KT2-962 (KT2) and possible mechanisms of adriamycin(AD)-induced nephrotoxicity in rats. The male Wistar rats were given either of AD (7.5 mg/kg, i.v.) alone in the AD-group (n=5) or in KT2+AD- group (n=5) which is a combination of AD and KT2 (30 mg/kg/day, i.p.) for 10 days from 3 days before and 7 days after AD injection. The body weight, 24-hours urine volume, urine protein and urinary N-acetyl-$\beta$-D-glu-cosaminidase (NAG) activity were measured with an interval of 2 days during 1 week. BUN, serum creatinine and creatinine clearance were measured on the 7th day. KT2 has significantly suppressed AD-induced change of body weight, 24-hours urine volume, urine protein and urinary NAG activity in the KT2+AD-group. The change of BUN, serum creatinine and creatinine clearance were significantly inhibited in the B7T2+AD-group. Based on these results, it is concluded that KT2 prevents AD-induced nephrotoxicity and suggests that endogenous thromboxane A2 may play an important role in AD-induced nephrotoxicity in rats.