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￭ S-351 ￭
쇼그렌 증후군에 동반된 원위신세관산증 2예
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
*Eunjeong Kang, Seokwoo Park, Sehoon Park, Hajeong Lee, Kwon Wook Joo, Jin Suk Han
Renal tubular acidosis (RTA) is a syndrome characterized by hyperchloremic metabolic acidosis and an inability to excrete a highly acid urine, in which impairment of acid excretion is out of proportion to reduction of glomerular filtration rate. Distal renal tubular acidosis (dRTA) is frequently associated with immune-mediated disease including Sjïgren’s syndrome. Sjïgren’s syndrome is a systemic autoimmune disease that mainly affects the exocrine glands such as lacrimal and salivary glands, resulting in xerophtalmia and xerostomia. Extrglandular manifestations are frequent and may include renal involvement. Recently, we experienced two cases of renal tubular acidosis in Sjïgren’s syndrome. The 1st case was a patient who had lower extremities weakness and hypokalemia, and the 2nd case was a patient who had nephrocalcinosis. We discussed the frequencies and the pathogenesis of dRTA in Sjïgren’s syndrome. Keywords: Sjïgren’s syndrome; Distal renal tubular acidosis; Hypokalemia; Nephrocalcinosis
￭ S-352 ￭
Procalcitonin as a predictor for the development of acute kidney injury in critica lly ill patients
Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
*Chana Myoung, Ae Jin Kim, Han Ro, Jae Hyun Chang, Hyun Hee Lee, Wookyung Chung, Ji Yong Jung
Background: Procalcitonin (PCT) has been recognized as one of useful markers for the diagnosis of systemic inflammatory response syndrome. In ad- dition, it has been reported that PCT is affected by renal function. However, there are few studies regarding the relationships between PCT and the de- velopment of acute kidney injury (AKI). Hence, we investigated whether serum PCT levels at the time of admission can predict the development of AKI and clinical outcomes. Methods: We retrospectively analyzed data of 790 patients admitted to the intensive care unit of Gachon University Gil Medical Center since January 2009 till December 2013. We attempted to investigate that the serum PCT level at the time of admission could be as a predictor for development of AKI and risk factor for all-cause mortality. Results: The serum PCT levels were significantly higher in patients with AKI than in those without AKI (p＜0.001). After adjustment of confounding factors, PCT still remained an independent risk factor for AKI (odds ratio [OR], 1.006; 95% confidence intervals [CI], 1.000-1.011; p＝0.050), but not for the cumulative 90-day survival rate (p＝0.936). The OR (95% CI) for AKI development among those with and without sepsis were 1.009 (1.001-1.017, p＝0.033) and 1.001 (0.992-1.010, p＝0.777), respectively. Conclusions:
Serum PCT level could be used as a marker topredict the possibility of AKI in critically ill patients admitted to the ICU especially in septic condition.
Further study is needed to elucidate the cutoff value for the development of septic AKI.
