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Electrolyte & Blood Pressure: E & BP

Hyun Jin Kim, Hyun Sun Park, Eunsin Bae, Hae Won Kim, Beom Kim, Kyoung Hyoub Moon, Dong-Young Lee
Peritoneal dialysis (PD)-related peritonitis is a major cause of injury and technique failure in patients undergoing PD. Aeromonas hydrophila is ubiquitous in the environment, and is a Gram-negative rod associated with infections in fish and amphibians in most cases; however, it can also cause opportunistic infections in immunocompromised patients. We report a case of A. hydrophila peritonitis in a 56-year-old male on automated PD. Peritonitis may have been caused by contamination of the Set Plus, a component of the automated peritoneal dialysis device...
December 2018: Electrolyte & Blood Pressure: E & BP
Ha Yeon Kim, Seung Jin Lee, Byung Ki Kim, Minah Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
A 22-year-old male patient was diagnosed with autosomal dominant polycystic kidney disease (ADPKD). He received conservative treatment with an angiotensin-converting enzyme inhibitor. Two years later, oral therapy, consisting of 60 mg tolvaptan per day, was initiated. Compared with height-adjusted total kidney volume, the rate of kidney growth reduced significantly from 7.33% to 0.66% annually, since commencement of the tolvaptan therapy. The liver enzyme profile and serum sodium level and osmolality were constantly within normal ranges...
December 2018: Electrolyte & Blood Pressure: E & BP
Dae Jin Park, Ki-Seok Jang, Gheun-Ho Kim
Renal Fanconi syndrome (RFS) is caused by generalized proximal tubular dysfunction and can be divided into hereditary and acquired form. Adult-onset RFS is usually associated with drug toxicity or systemic disorders, and modern molecular genetics may explain the etiology of previous idiopathic cases of RFS. Here, we report the case of a 52-year-old woman with RFS whose etiology could not be identified. She presented with features of phosphaturia, renal glucosuria, aminoaciduria, tubular proteinuria, and proximal renal tubular acidosis...
December 2018: Electrolyte & Blood Pressure: E & BP
Ji Wook Choi, Soon Kil Kwon, Sun Moon Kim, Hyunjeong Cho, Ho-Chang Lee, Hye-Young Kim
Severe eating disorders characterized by repetitive episodes of purging and vomiting can occasionally trigger acute kidney injury. However, interstitial nephritis induced by episodes of repeated vomiting has rarely been reported, and the pathophysiology of this entity remains unknown. A 26-year-old man was admitted to our hospital because of known hypokalemia. His serum electrolyte profile showed: sodium 133 mEq/L, potassium 2.6 mEq/L, chloride 72 mEq/L, total carbon dioxide 50 mEq/L, blood urea nitrogen/creatinine ratio (BUN/Cr) 21...
June 2018: Electrolyte & Blood Pressure: E & BP
Hyunsuk Kim, Yeonsil Yu, Kwang Eon Shim, Jin Eop Kim, Junga Koh, Jong-Woo Yoon, Curie Ahn, Yun Kyu Oh
A 47-year-old female previously diagnosed with ADPKD visited the hospital due to sudden pain in her upper abdomen and back. Esophagogastroduodenoscopy, contrast-enhanced abdominal computed tomography (CT), and CT angiography identified an esophageal artery pseudoaneurysm and hematoma in the esophagus. Urgent angiography and embolization were performed. After the procedure, CT angiography and positron emission tomography were performed due to differences in blood pressure between the arms. The patient was also found to have Takayasu arteritis and subsequently received outpatient follow-up care...
June 2018: Electrolyte & Blood Pressure: E & BP
Jae Hwi Sung, Ahran Song, Taegun Park, Eunyoung Kim, Seunggwan Lee
Background: High-NaCl diet is a contributing factor for cardiac hypertrophy. The role of HSP22 as a protective protein during cardiac hypertrophy due to hypernatremia is unclear. Accordingly, this study aimed to establish a cellular hypernatremic H9C2 model and to compare the expression of HSP22 in Ca2+ homeostasis between a high-NaCl and angiotensin II-induced hypertrophic cellular H9C2 model. Methods: Real-time PCR was performed to compare the mRNA expression...
June 2018: Electrolyte & Blood Pressure: E & BP
Chang Hun Song, Hong Jin Bae, Young Rok Ham, Ki Ryang Na, Kang Wook Lee, Dae Eun Choi
Ethylene glycol is a widely used and readily available substance. Ethylene glycol ingestion does not cause direct toxicity; however, its metabolites are highly toxic and can be fatal even in trace amounts. Poisoning is best diagnosed through inquiry, but as an impaired state of consciousness is observed in most cases, poisoning must be suspected when a significantly elevated osmolar gap or high anion gap metabolic acidosis is found in blood tests. Hemodialysis and alcohol dehydrogenase inhibitors such as ethanol and fomepizole are a part of the basic treatment, and timely diagnosis and treatment are crucial because any delays can lead to death...
December 2017: Electrolyte & Blood Pressure: E & BP
Shin Han Song, Gyeong Ah Sim, Seon Ha Baek, Jang Won Seo, Jung Weon Shim, Ja Ryong Koo
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common cause of euvolemic hypo-osmotic hyponatremia. There are several etiologies of SIADH including neuroendocrine tumor, pulmonary disease, infection, trauma, and medications. Here, we report a case of SIADH associated with a schwannoma involving the mediastinum in a 75-year-old woman who presented with nausea, vomiting, and general weakness. Laboratory testing showed hypo-osmolar hyponatremia, with a serum sodium level of 102mmol/L, serum osmolality of 221mOsm/kg, urine osmolality of 382mOsm/kg, urine sodium of 55 mmol/L, and plasma antidiuretic hormone (ADH) of 4...
December 2017: Electrolyte & Blood Pressure: E & BP
Gheun-Ho Kim
Amyotrophic lateral sclerosis (ALS) patients rarely present with either syndrome of inappropriate antidiuretic hormone secretion or generalized edema. Tolvaptan is a selective vasopressin V2 receptor antagonist that produces effective aquaresis, and its use in ALS patients has not been previously reported. A 50-year-old male ALS patient was admitted because of both generalized edema and dilutional hyponatremia. These manifestations were refractory to conventional diuretics and fluid therapy, but a very brisk diuresis was induced by tolvaptan administration...
December 2017: Electrolyte & Blood Pressure: E & BP
Kyung Mi Park, Hak Hoon Jun, Jinkun Bae, Yu Bum Choi, Dong Ho Yang, Hye Yun Jeong, Mi Jung Lee, So-Young Lee
Background: We investigated the effect of vitamin D deficiency on cardiovascular risk profiles in an Asian population with chronic kidney disease (CKD). Methods: A total of 210 participants (62 non-dialysis CKD patients and 148 hemodialysis [HD] patients) were enrolled between December 2009 and February 2010. Vitamin D deficiency was determined using the serum 25-hydroxyvitamin D [25(OH)D] concentration. Blood pressure and arterial stiffness were measured. Subjects were divided into groups according to 25(OH)D concentration based on a cut-off of 13...
December 2017: Electrolyte & Blood Pressure: E & BP
Ha Yeon Kim, Seung Jin Lee, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
A 17-year-old girl presented with polyuria (7 L/day) and polydipsia for one year. Initial urine osmolality was 113mOsm/kg H2 O. Following 6 h of fluid restriction, serum plasma osmolality reached 300mOsm/kg H2 O, whereas urine osmolality was 108mOsm/kg H2 O. Urine osmolality was increased by 427% from 108 to 557mOsm/kg after vasopressin challenge. The patient was diagnosed with central diabetes insipidus, possibly derived from the atypical occupation of a Rathke's cleft cyst at the pituitary stalk following magnetic resonance imaging with enhancement...
September 2017: Electrolyte & Blood Pressure: E & BP
Su Woong Jung, Eun Ji Park, Jin Sug Kim, Tae Won Lee, Chun Gyoo Ihm, Sang Ho Lee, Ju-Young Moon, Yang Gyun Kim, Kyung Hwan Jeong
Primary Sjögren's syndrome (pSS) is characterized by lymphocytic infiltration of the exocrine glands resulting in decreased saliva and tear production. It uncommonly involves the kidneys in various forms, including tubulointerstitial nephritis, renal tubular acidosis, Fanconi syndrome, and rarely glomerulonephritis. Its clinical symptoms include muscle weakness, periodic paralysis, and bone pain due to metabolic acidosis and electrolyte imbalance. Herein, we describe the cases of two women with pSS whose presenting symptoms involve the kidneys...
September 2017: Electrolyte & Blood Pressure: E & BP
Boram Cha, Dae Young Kim, Hyunil Jang, Seun Deuk Hwang, Huck Jei Choi, Moon-Jae Kim
Posterior reversible encephalopathy syndrome (PRES) is characterized by a clinical and radiological entity with the sudden onset of seizures, headache, altered consciousness, and visual disturbances in patients with the findings of reversible vasogenic subcortical edema without infarction. Hypertension, renal disease, and autoimmune disease are co-morbid conditions of PRES. Nevertheless, there have only been a few case reports of PRES in a patient with anti-glomerular basement membrane antibody glomerulonephritis (anti-GBM GN)...
September 2017: Electrolyte & Blood Pressure: E & BP
Hye Yun Jeong, Kyung Mi Park, Mi Jung Lee, Dong Ho Yang, Sang Hoon Kim, So-Young Lee
Vitamin D has the pleiotropic effects in multiple organ systems, and vitamin D deficiency was suggested to be associated with high blood pressure according to previous reports. Several interventional studies have examined the effect of vitamin D supplementation on high blood pressure patients, but the results have been inconsistent. In this article, we examined the literature that have proposed a mechanism involving vitamin D in the regulation of blood pressure and review previous observational and interventional studies that have shown the relationship between vitamin D and hypertension among various populations...
September 2017: 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
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