5 Mar 2020

신부전증과 투석치료 Renal failure and peritoneal dialysis

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신부전증과 투석치료 Renal failure and peritoneal dialysis

  • 여러 가지 원인으로 신장이 소변을 정상적으로 분비하지 못한다.
  • 이런 경우, 소변이 현저하게 분비되지 않든지, 전혀 분비되지 않을 수 있다.
  • 이때 혈중 요소의 질소화 화합물 즉 BUN이 정상 이상으로 증가되고,
  • 크레이티닌 농도도 정상 이상으로 증가되어 생명을 위협할 수 있을 정도로 신장의 기능이 나빠 진 병을 신부전증이라고 한다.

신부전증의 원인

  • 저혈압, 혈량 감소, 출혈로 인한 피 상실, 탈수, 화상, 용혈성 요독 증후군, 급성 사구체신염, 신괴사증, 선천성 요로기형, 약물 중독으로 인한 신장 독성, 요로 감염 등에 의해 신부전증이 생길 수 있다.

신부전증과 투석치료

  • 원인에 따라 치료하고, 필요에 따라 투석 치료를 한다. 투석 치료에는 혈액 투석과 복막강 투석이 있다.

투석치료는 어떤 경우에 하나 Indications for dialysis

  1. 급성 요독 증후군
  2. 요량 감소와 동시에 액체 과다 공급
  3. 심한 감염병과 소변 량 감소,
  4. 아스피린, Imipramine 등의 약물에 중독
  5. 요소 질소화 화합물(BUN)이 100mg % 이상
  6. 심한 대사성 산혈증 HCO₃⁻이 10mEQ/L 이상
  7. 산혈증 + 7mEQ/L 이상 칼륨 혈증
  8. 20mEQ/L 이하의 저 나트륨증
  9. 외상성 또는 외과적 치료 후 생기는 신부전증
  10. 신장 이식을 하기 전 준비
  11. 그 외

Renal failure and peritoneal dialysis 신부전증과 투석치료

• The kidneys are unable to produce urine normally for a number of reasons.

• In this case, urine may not be excreted significantly or may not be excreted at all.

• At this time, the nitrogenation compound of urea in the blood, that is, BUN is increased above normal

• Renal failure is a disease in which the kidney function has deteriorated to the extent that the creatinine concentration is also higher than normal and can be life-threatening.

Causes of kidney failure

• Low blood pressure, decreased blood volume, blood loss due to bleeding, dehydration, burns, hemolytic uremic syndrome, acute glomerulonephritis, necrosis, congenital urinary tract malformations, renal toxicity due to drug addiction, and urinary tract infections can cause renal failure.

Renal failure and dialysis treatment

• Treatment according to the cause, and dialysis treatment as needed. Dialysis treatment includes hemodialysis and peritoneal dialysis.

Dialysis treatment in some cases Indications for dialysis

1. Acute uremic syndrome

2. Reduction of urine and excessive supply of liquid at the same time

3. Severe infectious diseases and decreased urine volume,

4. Addiction to drugs such as aspirin and imipramine

5. Urea nitrogenated compound (BUN) is more than 100mg%

6. Severe metabolic acidemia HCO₃⁻ more than 10mEQ/L

7. Acidemia + Potassium above 7mEQ/L

8. Hyponatremia below 20mEQ/L

9. Renal failure after traumatic or surgical treatment

10. Preparation before a kidney transplant 11. Others

 

출처 및 참조 문헌 Sources and references

  • NelsonTextbook of Pediatrics 22ND Ed
  • The Harriet Lane Handbook 22ND Ed
  • Growth and development of the children
  • Red Book 32nd Ed 2021-2024
  • Neonatal Resuscitation, American Academy Pediatrics
  • www.drleepediatrics.com 제10권. 소아청소년 신장 비뇨 생식기 질환
  • www.drleepediatrics.com 제7권 소아청소년 감염병
  •  Red book 29th-31st edition 2021
  • Nelson Text Book of Pediatrics 19th — 21st Edition
  • The Johns Hopkins Hospital, The Harriet Lane Handbook, 22nd edition
  • John T. Herrin. M.D.의 Lecture
  • Childhood Emergencies in the Office, Hospital and Community, American Academy of Pediatrics
  • Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
  • Emergency care, Harvey grant, and Robert Murray
  • Emergency Care Transportation of Sick and Injured American Academy of Orthopaedic Surgeons
  • Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
  • Immediate care of the acutely ill and injured, Hugh E. Stephenson, Jr
  • The Critically Ill Child, Diagnosis and Management, Edited by Clement A. Smith
  • Emergency Medical Services for Children: The Role of the Primary Care Provider, America Academy of Pediatrics
  • Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
  • Manual of Emergency Care
  • 응급환자관리 정담미디어
  • 소아가정간호백과–부모도 반의사가 되어야 한다, 이상원
  • Neonatal Resuscitation American heart Association
  • Neonatology Jeffrey J.Pomerance, C. Joan Richardson
  • Pediatric Resuscitation Pediatric Clinics of North America, Stephen M. Schexnayder, M.D.
  • Pediatric Critical Care, Pediatric Clinics of North America, James P. Orlowski, M.D.
  • Preparation for Birth. Beverly Savage and Dianna Smith
  • Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
  • The Harriet Lane Handbook 19th Edition
  • 소아과학 대한교과서
  • 제1권 소아청소년 응급의료 참조문헌과 출처
  • Other

Copyright ⓒ 2015 John Sangwon Lee, MD, FAAP“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”