Dong Ki Kim

Seoul National University Hospital, Sŏul, Seoul, South Korea

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Publications (80)195.23 Total impact

  • Nutrition 06/2015; DOI:10.1016/j.nut.2015.05.004 · 3.05 Impact Factor
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    ABSTRACT: Contrast-induced nephropathy (CIN) is an important cause of hospital-acquired acute kidney injury. An accurate understanding of the pathogenesis of CIN is crucial. The aim of this study was to evaluate the clinical role of circulating tumor necrosis factor receptors (cTNFRs) in CIN. From May 2013 to February 2014, 262 patients who underwent coronary angiography and/or percutaneous coronary intervention at Seoul National University Boramae Medical Center were enrolled. CIN was defined as either an increase in serum creatinine ≥ 22.1 μmol/L or ≥ 25% within 48 hours after the procedure. Diabetes and chronic kidney disease accounted for 27.5% and 17.6% of the patients, respectively, and the mean age was 65 years. All patients received fluid therapy, and 36.3% underwent percutaneous coronary intervention. A total of 4.2% of the patients developed CIN; younger age, underlying diseases (e.g., stroke and chronic kidney disease), the use of N-acetylcysteine, and elevated concentrations of ln(cTNFRs) were associated with development of CIN. Increased values of ln(cTNFR1) (OR 6.32, 95% CI 2.46-16.28, P < 0.001) and ln(cTNFR2) (OR 3.24, 95% CI 1.26-8.31, P = 0.015) were significantly associated with CIN after adjusting for other risk factors, including baseline renal function. Moreover, an increase of cTNFRs levels was independently correlated with the deterioration of renal function. Markedly elevated concentrations of circulating TNFRs were correlated with the occurrence of CIN and significantly associated with prolonged renal dysfunction regardless of the development of CIN. This article is protected by copyright. All rights reserved.
    Nephrology 03/2015; DOI:10.1111/nep.12448 · 1.86 Impact Factor
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    ABSTRACT: Health-related quality of life (HRQOL) has recently become an important issue. It reportedly affects morbidity and mortality in patients with end-stage renal disease (ESRD). In this study, we investigated whether early referral and planned dialysis improve the HRQOL and depression of patients with ESRD. We prospectively enrolled newly diagnosed patients with ESRD, from 31 hospitals in Korea, who completed questionnaires at 3 months after dialysis. We also got follow-up survey at 1 year after dialysis. To measure HRQOL and depression, Kidney Disease Quality of Life Short Form 36 (KDQOL-36) and Beck's Depression Inventory (BDI) were utilized. A total of 643 patients were analyzed. Referral type did not affect either KDQOL-36 or BDI scores. However, the planned dialysis group showed significantly better scores in 4 of 5 KDQOL-36 domains than did the unplanned group at 3 months after dialysis and partly, the effect was sustained for 1 year after dialysis. The benefit of planned dialysis was significant after adjusting for age, sex, type of dialysis, marital status, educational attainment, occupation, modified Charlson comorbidity index, albumin, and hemoglobin levels. BDI scores were also lower which indicate less depressive mood in planned dialysis group than those in unplanned group both at 3 months and 1 year after dialysis. Not early referral but planned dialysis improved both the short- and long-term HRQOL and depression of patients with ESRD. Nephrologists should try to help patients to initiate dialysis in a planned manner.
    PLoS ONE 02/2015; 10(2):e0117582. DOI:10.1371/journal.pone.0117582 · 3.53 Impact Factor
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    ABSTRACT: Peritoneal dialysis (PD) is one potential treatment option for patients starting dialysis after graft loss (DAGL). However, the infectious outcomes and their associations with steroid use remain undetermined in these patients. A total of 41 DAGL patients undergoing PD were recruited. The patients were divided into low- and high-dose steroid groups according to the median level. Additionally, they were categorized into tapering and nontapering groups, for which the tapering regimen was defined as the withdrawal of steroids within 1 year after starting PD. Primary outcomes, such as peritonitis and exit site infection (ESI), were compared between DAGL and 712 transplant-naive (TN) patients. The overall risk of peritonitis was similar between the TN and DAGL groups. However, when the DAGL group was stratified by the steroid variable, the risk was higher in the high-dose or nontapering steroid groups than in the TN or counterpart steroid groups. The DAGL group had a higher risk of ESI than the TN group, irrespective of steroid dose. When the analysis was stratified by tapering regimen, the difference in ESI risks was seen only in the nontapering group and the TN group; the tapering group had a similar risk of ESI as that of the TN group. The present study first addresses the risks of peritonitis and ESI together and then raises awareness of the high risk that should be considered after using high-dose steroids or the nontapering regimen in the DAGL patients.
    Transplantation 01/2015; DOI:10.1097/TP.0000000000000573 · 3.78 Impact Factor
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    ABSTRACT: Both acute kidney injury (AKI) and chronic kidney disease (CKD) are important issues in patients undergoing coronary artery bypass grafting (CABG), particularly with regard to mortality. However, their synergistic or discrete effects on long-term mortality remain unresolved. A total of 1,899 patients undergoing CABG were retrospectively analyzed. The adjusted hazard ratios for all-cause mortality were calculated after stratifying the timeframes. To evaluate the synergistic effects between AKI and CKD, the relative excess risk due to interaction was applied. The presence of AKI, CKD, or both increased the hazard ratios for mortality, compared with the absence of both: AKI alone, 1.84 (1.464-2.319); CKD alone, 2.46 (1.735-3.478); and AKI and CKD together, 3.21 (2.301-4.488). However, the relationships with mortality were different between AKI and CKD, according to the timeframes: AKI primarily affected early mortality, particularly within 3 years, whereas CKD had a relatively constant effect on both the early and late periods. When the parameters from the relative excess risk due to interaction were obtained, there was a synergistic additive effect on early mortality between AKI and CKD. The relationships with mortality after CABG were different between AKI and CKD. However, their effects were not exclusive but synergistic. Copyright © 2015 Elsevier Inc. All rights reserved.
    American Heart Journal 01/2015; 169(3). DOI:10.1016/j.ahj.2014.12.019 · 4.56 Impact Factor
  • Dong Ki Kim, Kwon-Wook Joo
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    ABSTRACT: Acute kidney injury (AKI) is a common clinical syndrome that carries a poor prognosis even in cases with seemingly mild or reversible renal dysfunction. Although this potentially devastating disease is associated with increased mortality, early detection and timely intervention may improve clinical outcomes. In this regard, a standardized definition and classification of AKI, reflecting prognosis on the basis of evidence, may allow early recognition and stage-based management of the disease. Nevertheless, there has been considerable variability and inconsistency in the definition and classification of AKI, resulting in failure to bridge the gap between research and clinical practice. The definition of AKI has evolved, with the introduction of the "Risk, Injury, Failure, Loss, and End-stage renal disease" (RIFLE), and "AKI Network" (AKIN) criteria. The recent "Kidney Disease Improving Global Outcomes" (KDIGO) guidelines proposed a uniform definition of AKI, essentially merging the RIFLE and AKIN criteria. This review will focus on the definition and classification of AKI, as proposed by KDIGO in 2012, and their use in clinical practice for clinicians.
    01/2015; 88(4):357. DOI:10.3904/kjm.2015.88.4.357
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    ABSTRACT: Background/Aims: An acid-base imbalance precedes renal disease progression in patients with chronic kidney disease (CKD). Little is known about the effects of a low-salt diet (LSD) on net endogenous acid production (NEAP) levels in CKD patients using angiotensin receptor blockade. Methods: We enrolled a total of 202 nondiabetic CKD patients who underwent an 8-week treatment with olmesartan from the original trial [Effects of Low Sodium Intake on the Antiproteinuric Efficacy of Olmesartan in Hypertensive Patients with Albuminuria (ESPECIAL) trial: NCT01552954]. The patients were divided into good- and poor-LSD-compliance groups. Results: During the interventional 8 weeks, the NEAP in the good-compliance group increased compared to the control group (12.9 ± 32.0 vs. -2.0 ± 35.0 mmol/day, p = 0.002). NEAP was positively associated with the good-LSD-compliance group in the fully adjusted analyses (r = 0.135, p = 0.016). The additional reduction of 2.39 g/day of protein intake with a reduction of 1 g/day of salt intake did not increase the NEAP under angiotensin II receptor blockade (ARB) treatment with an LSD (r = 0.546, p < 0.001). Conclusion: We found that an LSD may increase the NEAP in nondiabetic CKD patients using ARB, which suggests that additional acid producing-protein restriction should be required to prevent the NEAP from rising. © 2014 S. Karger AG, Basel.
    Nephron Clinical Practice 12/2014; 128(3-4). DOI:10.1159/000369558 · 1.65 Impact Factor
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    ABSTRACT: Background The clinical benefits of bioimpedance spectroscopy (BIS)-guided fluid management in patients on hemodialysis have been widely demonstrated. However, no previous reports have evaluated the effect of regular and serial BIS-guided fluid management on the residual renal function (RRF) in patients on peritoneal dialysis (PD). Therefore, we will evaluate the clinical efficacy of BIS-guided fluid management for preserving RRF and protecting cardiovascular events in patients on PD. Methods/design This is a multicenter, prospective, randomized controlled trial. A total of 138 participants on PD will be enrolled and randomly assigned to receive either BIS-guided fluid management or fluid management based only on the clinical information for 1 year. The primary outcome is the change in the glomerular filtration rate (GFR) between months 0 and 12 after starting treatment. The secondary outcomes will include GFR at month 12, time to the anuric state (urine volume <100 ml/day), and fatal and nonfatal cardiovascular events during treatment. Discussion This is the first clinical trial to investigate the effect of BIS-guided fluid management on RRF and for protecting against cardiovascular events in patients on PD. Trial registration Clinical Trials.gov number NCT01887262, June 24, 2013.
    Trials 11/2014; 15(1):432. DOI:10.1186/1745-6215-15-432 · 2.12 Impact Factor
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    ABSTRACT: Background and objectives The antiproteinuric effect of a renin-angiotensin-aldosterone system blockade can be magnified by dietary salt restriction. This study sought to determine the effect of intensive low-salt diet education on BP and urine albumin excretion in nondiabetic patients with hypertension and albuminuria. Design, setting, participants, & measurements This study was conducted between March of 2012 and March of 2013 as an open-label, randomized, controlled trial. After a run-in period of 8 weeks, all patients received the angiotensin II receptor blocker olmesartan (40 mg daily). Patients were then divided into two groups. One group was treated for another 8 weeks with angiotensin II receptor blocker plus conventional low-salt diet education, and the other group was treated for 8 weeks with angiotensin II receptor blocker plus intensive low-salt diet education. The final analyses was performed with 245 completed patients. Results The amount of daily albuminuria was significantly decreased from 0 (566.0 [25.0-5398.6] mg/d) to 8 weeks (282.5 [16.1-4898.5] mg/d; P<0.001). From 8 to 16 weeks, the 24-hour urinary sodium excretion was decreased by 36.0 +/- 5.9 mmol/d in the intensive education group and 8.8 +/- 4.9 mmol/d in the conventional education group (interaction P<0.001). Patients who completed intensive low-salt diet education exhibited greater decreases in urinary albumin excretion than the control group (change in albuminuria from 8 to 16 weeks, -154.0 versus 0.4 mg/ d; P=0.01). Urinary albumin excretion tended to decrease as the 24-hour urinary sodium excretion amount decreased (R=0.32; 95% confidence interval, 0.20 to 0.43; P<0.001). Conclusions The 24-hour urinary albumin excretion was decreased more in patients in the intensive low-salt diet education group than patients in the conventional education group. Weekly intensive education on a low-salt diet would be a suitable method for clinical practice.
    Clinical Journal of the American Society of Nephrology 10/2014; 9(12). DOI:10.2215/CJN.01310214 · 5.25 Impact Factor
  • Peritoneal dialysis international: journal of the International Society for Peritoneal Dialysis 09/2014; DOI:10.3747/pdi.2013.00343 · 2.20 Impact Factor
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    ABSTRACT: It is not well described the pathophysiology of renal injuries caused by a high salt intake in humans. The authors analyzed the relationship between the 24-hr urine sodium-to-creatinine ratio (24HUna/cr) and renal injury parameters such as urine angiotensinogen (uAGT/cr), monocyte chemoattractant peptide-1 (uMCP1/cr), and malondialdehyde-to-creatinine ratio (uMDA/cr) by using the data derived from 226 hypertensive chronic kidney disease patients. At baseline, the 24HUna/cr group or levels had a positive correlation with uAGT/cr and uMDA/cr adjusted for related factors (P<0.001 for each analysis). When we estimated uAGT/cr in the 24HUna/cr groups by ANCOVA, the uAGT/cr in patients with ≥200 mEq/g cr was higher than in patients with <100 mEq/g cr (708 [95% CI, 448-967] vs. 334 [95% CI, 184-483] pg/mg cr, P=0.014). Similarly, uMDA/cr was estimated as 0.17 (95% CI, 0.14-0.21) pM/mg cr in patients with <100 mEq/g cr and 0.27 (95% CI, 0.20-0.33) pM/mg cr in patients with ≥200 mEq/g cr (P=0.016). During the 16-week follow-up period, an increase in urinary sodium excretion predicted an increase in urinary angiotensinogen excretion. In conclusion, high salt intake increases renal renin-angiotensin-system (RAS) activation, primarily, and directly or indirectly affects the production of reactive oxygen species through renal RAS activation.
    Journal of Korean Medical Science 09/2014; 29 Suppl 2(Suppl 2):S123-30. DOI:10.3346/jkms.2014.29.S2.S123 · 1.25 Impact Factor
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    ABSTRACT: Kimura disease (KD) is an eosinophilic, granulomatous, benign, chronic inflammatory disease with an unknown etiology. A 33-year-old woman visited our hospital because of a palpable, left subclavian mass, a left scapulo-anterior pseudoaneurysm, and nephrotic syndrome. Her subclavian lymph node biopsy examination result was consistent with KD, and results of a renal biopsy indicated secondary membranous nephropathy. After renal histological examination confirmed nephropathy, treatment with prednisolone and cyclosporine was initiated, which was maintained for over 1 year. However, this therapy only provided a transient improvement in proteinuria. One year after commencing the treatment, both proteinuria and azotemia aggravated as the left axillary mass doubled in size. Finally, the mass was surgically excised, following which the azotemia rapidly normalized and proteinuria resolved within 1 month. This case shows that tumor resection in a patient with KD with secondary nephropathy may resolve secondary renal manifestations. Furthermore, reversible renal dysfunction may be caused by unknown secreted molecules.
    09/2014; 33(3). DOI:10.1016/j.krcp.2014.06.002
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    ABSTRACT: Idiopathic membranous nephropathy (iMN) is a common cause of nephrotic syndrome in adults. A biomarker to accurately indicate the severity of iMN and predict long-term prognosis is insufficient. Here, we evaluated the clinical significance of circulating tumor necrosis factor receptors (cTNFRs) as prognostic biomarkers of iMN with nephrotic syndrome. A total of 113 patients with biopsy-proven iMN and 43 healthy volunteers were enrolled in this study. Ninety patients with iMN had nephrotic range proteinuria. Levels of cTNFRs were measured by using serum samples collected at the time of initial diagnosis. Levels of cTNFRs were higher in the patients with nephrotic syndrome than in those with subnephrotic range proteinuria or in the healthy volunteers (P for trend <0.001). Estimated glomerular filtration rate and proteinuria tended to worsen as the cTNFRs levels increased. Having a cTNFR1 level within the highest tertile was a significant risk factor for renal progression after adjustment, in comparison with the other tertiles (hazard ratio [HR], 3.39; 95% confidence interval [95% CI], 1.48-7.78; P = 0.004). The cTNFR2 level within the highest tertile also significantly increased the risk of renal progression (HR, 3.29; 95% CI, 1.43-7.54; P = 0.005). Renal tubular TNFRs expression was associated with cTNFRs level. However, the cTNFRs levels were not associated with autoantibody against phospholipase A2 receptor reactivity/levels or treatment response. This study demonstrated that cTNFRs levels at the time of initial diagnosis could predict renal progression in patients with iMN.
    PLoS ONE 08/2014; 9(8):e104354. DOI:10.1371/journal.pone.0104354 · 3.53 Impact Factor
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    ABSTRACT: The optimal timing for initiating continuous renal replacement therapy (CRRT) remains controversial, and it is not obvious which parameters should be considered during this process. We investigated the predictive value of physiological parameters among critically ill patients receiving CRRT due to acute kidney injury (AKI). A total of 496 patients who started CRRT were prospectively enrolled. The following physiological parameters were significantly associated with mortality even after multivariate adjustments: level of pH [hazard ratio (95% CI): 7.15 < pH ≤ 7.20, 1.971 (1.319-2.946); pH ≤ 7.15, 2.315 (1.586-3.380); reference > 7.25, P-for-trend < 0.001]; bicarbonate level (HCO3(-)) [≤ 14 mmol/L, 2.010 (1.542-2.620); reference > 18 mmol/L, P-for-trend < 0.001]; phosphorus level [> 7 mmol/L, 1.736 (1.313-2.296); reference ≤ 5 mmol/L, P-for-trend < 0.001]; and urine output < 0.3 ml/kg/hr [1.509 (1.191-1.912); reference > 0.3 ml/kg/hour]. Weight gain over 2 kg was associated with mortality exclusively according to univariate analysis [1.516 (1.215-1.892)]. The diagnostic value of the composite of these factors (pH, bicarbonate level, phosphorus level, urine output, weight gain, and potassium levels) [area under the curve (AUC) 0.701, 95% CI 0.644-0.759] was comparable to or higher than the blood urea nitrogen level (AUC 0.571, 95% CI 0.511-0.630), serum creatinine level (AUC 0.462, 95% CI 0.399-0.525), eGFR (AUC 0.541, 95% CI 0.478-0.605), and AKI Network stage (AUC 0.627, 95% CI 0.561-0.692). In conclusion, the physiological parameters are useful in predicting post-AKI mortality and should be considered when initiating CRRT in critically ill patients with AKI.
    The Tohoku Journal of Experimental Medicine 08/2014; 233(4):233-41. DOI:10.1620/tjem.233.233 · 1.28 Impact Factor
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    ABSTRACT: It is known that blood pressure variability (BPV) can independently affect target organ damage (TOD), even with normal blood pressure. There have been few studieson chronic kidney disease (CKD) patients. We evaluated the relationship between BPV and TOD in a cross-sectional, multicenter study on hypertensive CKD patients. We evaluated 1,173 patients using 24-hr ambulatory blood pressure monitoring. BPV was defined as the average real variability, with a mean value of the absolute differences between consecutive readings of systolic blood pressure. TOD was defined as left ventricular hypertrophy (LVH) (by the Romhilt-Estes score ≥4 in electrocardiography) and kidney injury (as determined from an estimated glomerular filtration rate [eGFR]<30 mL/min/1.73 m2 and proteinuria).The mean BPV of the subjects was 15.9±4.63 mmHg. BPV displayed a positive relationship with LVH in a univariate analysis and after adjustment for multi-variables (odds ratio per 1 mmHg increase in BPV: 1.053, P=0.006). In contrast, BPV had no relationship with kidney injury. These data suggest that BPV may be positively associated with LVH in hypertensive CKD patients. Graphical Abstract
    Journal of Korean Medical Science 07/2014; 29(7):957-64. DOI:10.3346/jkms.2014.29.7.957 · 1.25 Impact Factor
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    ABSTRACT: Background Hypokalemia has been suggested to be a risk factor in peritoneal dialysis (PD). Recently in US, a large peritoneal dialysis cohort study showed potassium abnormalities contribute disproportionately to the high death risk in PD patients. This issue was reviewed in Korean ESRD cohort comparing to hemodialysis (HD). Patients and methods A nationwide prospective observational cohort study (CRC-ESRD) was performed between August 2008 and October 2013. Among them, patients had been selected who checked serum potassium level at least twice within 18 months. Overall mortality rate was evaluated as outcome. Patients were divided into following four groups based on time-averaged potassium level: K<3.5, 3.5≤K<4.5, 4.5≤K<5.5, ≥5.5 mg/dL. They were analyzed to determine association of serum potassium with mortality using Cox proportional hazard model. Results Follow-up data were available for 1,686 patients (HD 62.3%, PD 37.7%). The mean age was 58.2±13.9 years, and the ratio of men to women was 57% to 43%. Overall duration of dialysis was 1.9±3.9 years. PD patients significantly had lower serum potassium level comparing to HD patients (p<0.001). Serum potassium was <3.5 mg/dL in 10.7% of PD patients, whereas 2.2% in HD patients. During the mean 2.2 year follow up period, 142 patients died of mainly cardiac arrest and infection. Univariate analysis indicated that older age, history of congestive heart failure or diabetes could be the risk factor for mortality. Multivariate analysis proved PD patients with <3.5 mg/dL of time-averaged serum potassium to have all-cause mortality with adjusted hazard ratio of 2.5 (95% CI, 1.33-4.41) (p=0.004), whereas, HD patients was not. Among adjusted variables, PD patients who had diabetes or congestive heart failure tended to have higher risk of death with adjusted hazard ratio 1.7 (95% CI, 0.99-2.76) and 2.3 (95% CI 1.24-4.19) respectively. Conclusion PD patients with hypokalemia (<3.5 mg/dL) have higher mortality risk. This study confirmed the previous cohort study in different ethnic group. Therefore, regardless of ethnicity, this result could be accepted.
    06/2014; 33(2):A4. DOI:10.1016/j.krcp.2014.05.022
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    ABSTRACT: Sunitinib is an oral multitargeted tyrosine kinase inhibitor used mainly for the treatment of metastatic renal cell carcinoma. The renal adverse effects (RAEs) of sunitinib have not been investigated. The aim of this study was to determine the incidence and risk factors of RAEs (proteinuria [PU] and renal insufficiency [RI]) and to investigate the relationship between PU and antitumor efficacy. We performed a retrospective review of medical records of patients who had received sunitinib for more than 3 months. One hundred and fifty-five patients (mean age, 58.7 ± 12.6 years) were enrolled, and the mean baseline creatinine level was 1.24 mg/dL. PU developed in 15 of 111 patients, and preexisting PU was aggravated in six of 111 patients. Only one patient developed typical nephrotic syndrome. Following discontinuation of sunitinib, PU was improved in 12 of 17 patients but persisted in five of 17 patients. RI occurred in 12 of 155 patients, and the maximum creatinine level was 3.31 mg/dL. RI improved in two of 12 patients but persisted in 10 of 12 patients. Risk factors for PU were hypertension, dyslipidemia, and chronic kidney disease. Older age was a risk factor for RI. The median progression-free survival was significantly better for patients who showed PU. The incidence of RAEs associated with sunitinib was lower than those of previous reports. The severity of RAEs was mild to moderate, and partially reversible after cessation of sunitinib. We suggest that blood pressure, urinalysis, and renal function in patients receiving sunitinib should be monitored closely.
    The Korean Journal of Internal Medicine 01/2014; 29(1):40-8. DOI:10.3904/kjim.2014.29.1.40
  • Kidney Week Posters; 01/2014
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    ABSTRACT: Peritoneal dialysis catheters (PDCs) can be inserted by a percutaneous, open surgical, or laparoscopic approach. Considerable controversy surrounds the mode of catheter placement and its impact on technical success. We compared the complications and survival characteristics of PDCs that were inserted by the open approach versus those inserted percutaneously. We reviewed the outcomes of 167 patients who received PDCs between September 2009 and February 2012. Of these, 89 were placed percutaneously and 78 were placed by open surgical techniques. The mechanical complication rates, including catheter bleeding, wrapping, migration, leakage, and technical failure of intraperitoneal placement were compared between the two groups. Additionally, peritonitis episodes, exit site infection rates, and tunnel infection rates were compared between groups. The incidence of one or more previous intra-abdominal surgeries was significantly higher in the open group (4.5 percutaneous vs 21.7 % open; P = 0.001). Although the overall number of complications did not differ between the two groups, the incidence of early mechanical complications (11.2 vs 0 %; P = 0.002) and the number of catheter removals due to mechanical complications (7.9 vs 1.3 %; P = 0.047) were higher in the percutaneous group. Of the 15 mechanical complications in the percutaneous group, one third were due to technical failures compared to none in the open group (5.6 vs 0 %; P = 0.034). The 1 year survival rate of the PDCs for the percutaneous and open groups was 89.9 and 93.3 %, respectively (P = 0.249). The placement modality did not affect catheter survival. However, early mechanical complications, including technical failures, were more frequent in the percutaneous group, despite the proportion of patients with a history of one or more previous intra-abdominal surgeries being significantly lower in that group. The direct visualized open method of catheter insertion may provide the most reliable and secure access for a PDC.
    World Journal of Surgery 12/2013; 38(5). DOI:10.1007/s00268-013-2346-5 · 2.35 Impact Factor
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    ABSTRACT: Background Periodontitis and chronic kidney disease (CKD) are important health issues; however, the association between periodontitis and CKD markers, especially in Korean adults, remains elusive. Methods Data on 15,729 Korean adults were obtained from the Korean National Health and Nutritional Examination Surveys IV and V. The CKD markers included a decreased estimated glomerular filtration rate (eGFR;<60 mL/min/1.73 m2), proteinuria, and hematuria. Odds ratios (ORs) and 95% confidence intervals were measured using stepwise multivariate logistic regression analyses for CKD markers based on the presence of periodontitis. Results Patients with periodontitis had greater unadjusted ORs for CKD markers compared to those without periodontitis, as follows: decreased eGFR, 4.07 (3.11–5.33); proteinuria, 2.12 (1.48–3.05); and hematuria, 1.25 (1.13–1.39; (all P<0.001). Periodontitis was a significant predictor of decreased eGFR independent of all covariates [1.39 (1.03–1.89), P=0.034]. However, the effect of periodontitis on decreased eGFR seemed to be affected by hypertension and diabetes mellitus. Periodontitis was not an independent predictor of proteinuria; the significance disappeared after adjusting for hypertension and diabetes mellitus. Periodontitis was significantly correlated with hematuria, leading to similar ORs regardless of the adjustment for covariates [1.29 (1.15–1.46), P<0.001]. Conclusion This study confirms the correlation between periodontitis and CKD markers, including decreased eGFR, proteinuria, and hematuria in Korean adults.
    12/2013; 32(4). DOI:10.1016/j.krcp.2013.09.001

Publication Stats

738 Citations
195.23 Total Impact Points

Institutions

  • 2009–2015
    • Seoul National University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2014
    • American Society of Nephrology
      Washington, Washington, D.C., United States
  • 2009–2014
    • Seoul National University
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2013
    • Seoul Medical Center
      Sŏul, Seoul, South Korea
  • 2007–2009
    • Yonsei University
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
    • Chosun University
      • College of Dentistry
      Gwangju, Gwangju, South Korea
  • 2003–2009
    • Yonsei University Hospital
      • Department of Internal Medicine
      Sŏul, Seoul, South Korea
  • 2006
    • Korea University
      • Department of Anatomy
      Seoul, Seoul, South Korea
  • 2000
    • Yeungnam University
      Gyeongsan, Gyeongsangbuk-do, South Korea