Trends in clinical outcomes of older hemodialysis patients: data from the 2023 Korean Renal Data System (KORDS)

Kim Hyunglae,정선아,Kim Kyeong Min,Hwang Sun Deuk,Choi Sun Ryoung,Lee Hajeong,Kim Ji Hyun,김수현,Kim Tae Hee,Koo Ho-Seok,Yoon Chang-Yun,Kim Kiwon,안선호,윤혜은,Kim Yong Kyun,반태현,홍유아 대한신장학회 2024 Kidney Research and Clinical Practice Vol.43 No.3

With an increasing aging population, the mean age of patients with end-stage kidney disease (ESKD) is globally increasing. However, the current clinical status of elderly patients undergoing hemodialysis (HD) is rarely reported in Korea. The current study analyzed the clinical features and trends of older patients undergoing HD from the Korean Renal Data System (KORDS) database. The patients were divided into three groups according to age: <65 years (the young group), n = 50,591 (35.9%); 65–74 years (the younger-old group), n = 37,525 (26.6%); and ≥75 years (the older-old group), n = 52,856 (37.5%). The proportion of older-old group undergoing HD significantly increased in incidence and decreased in prevalence from 2013 to 2022. The median levels of hemoglobin, serum creatinine, albumin, calcium, phosphorus, and intact parathyroid hormone significantly decreased in the older-old group. The proportions of arteriovenous fistula creation and left forearm placement showed decreased trends with age. Although the utilization of low surface area dialyzers increased with age, the dialysis adequacy, including urea reduction ratio and Kt/V was within acceptable range in the older-old group on HD. Over the past 20 years, the mortality rate in the older-old group has increased, with cardiovascular diseases decreasing and infectious diseases increasing. The incidence of elderly patients undergoing HD has increased over time, but the high mortality of the older-old group needs to be solved. Therefore, it is imperative to develop holistic strategies based on age and individual needs for patients with ESKD.

Recurrent Vascular Access Dysfunction as a Novel Marker of Cardiovascular Outcome and Mortality in Hemodialysis Patients

Kim, Hyo Jin,Lee, Hajeong,Kim, Dong Ki,Oh, Kook-Hwan,Kim, Yon Su,Ahn, Curie,Han, Jin Suk,Min, Seung-Kee,Min, Sang-Il,Kim, Hyo-Cheol,Joo, Kwon Wook S. Karger AG 2016 American journal of nephrology Vol.44 No.1

<P>Background: Vascular access (VA) is essential for hemodialysis (HD) patients, and its dysfunction is a major complication. However, little is known about outcomes in patients with recurrent VA dysfunction. We explored the influence of recurrent VA dysfunction on cardiovascular (CV) events, death and VA abandonment. Methods: This is a single-center, retrospective study conducted in patients who underwent VA surgery between 2009 and 2014. VA dysfunction was defined as VA stenosis or thrombosis requiring intervention after the first successful cannulation. Patients with >= 2 interventions within 180 days were categorized as having recurrent VA dysfunction. Outcomes were analyzed using Cox proportional hazards model before and after propensity score matching. Results: Of 766 patients (ages 59.6 +/- 14.3 years, 59.7% male), 10.1% were in the recurrent VA dysfunction group. Most baseline parameters after matching were similar between the recurrent and non-recurrent groups. A total of 213 propensity score-matched patients were followed for 28.7 +/- 15.8 months, during which 46 (21.6%), 30 (14.1%) and 14 (6.6%) patients had de novo CV outcomes, died and abandoned VA, respectively. Recurrent VA dysfunction after adjustment remained an independent risk factor for CV events (adjusted hazards ratio (aHR), 2.71; 95% CI 1.48-4.98; p = 0.001). Moreover, recurrent VA dysfunction predicted composite all-cause mortality (ACM)/CV events (aHR 1.99; 95% CI 1.21-3.28; p = 0.007). Conclusions: Recurrent VA dysfunction was a novel independent risk factor for CV and composite ACM/CV events in HD patients, but not for VA abandonment. Patients with recurrent vascular dysfunction should be carefully monitored not only for VA patency but also for CV events. (C) 2016 S. Karger AG, Basel</P>

The Impact of Life Behavior and Environment on Indoor Particulate Matter in Patients with COPD

( Hajeong Kim ),( Geunjoo Na ),( Shinhee Park ),( Seung Won Ra ),( Sung-yoon Kang ),( Ho Cheol Kim ),( Hwan Cheol Kim ),( Sei Won Lee ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-

Background The human health effects of exposure to air pollutants is a global public health concern. To develop the effective strategy to reduce PM exposure, we performed detailed questionnaires about the lifestyle to avoid PM in patients with chronic obstructive pulmonary disease (COPD) and correlated it with the real-time PM concentration during winter season. Methods We enrolled 110 COPD patients of 40 years or older. The detailed questionnaires were taken from participants and IoT based sensors were installed at their home to measure indoor PM2.5 concentration. Indoor PM2.5 was continuously monitored from Dec 2019 to Feb 2020. The associations of PM2.5 concentration, their lifestyles, and their impact on COPD exacerbation were analyzed. Results Mean outdoor PM2.5 concentration was higher than indoor PM2.5 this period (21.28±5.09ug/m3 vs. 12.75±7.64ug/m3) with mean difference of 8.53±7.99ug/m3. Among the various social and practice factors to avoid PM, economic status and six items about practice were confirmed to reduce indoor PM2.5 compared with outdoor one, in other word, make significant difference between outdoor and indoor PM2.5. The higher the household income and economic level, the greater the difference in the PM2.5 concentration. Six practice items to make significant difference in the PM2.5 concentrations between indoor and outdoor were as below; 1) checking air quality forecast (the difference: 13.31±1.35ug/m3 ,p=0.013), 2) indoor air purifier operated (15.43±1.32ug/m3, p <0.001), 3) ventilating home by opening windows (13.14±1.28ug/m3, p=0.013), 4) checking filters of the air purifier (13.95±1.50ug/m3, p=0.002), 5) refraining from going out when outside PM is high (12.52±1.37ug/m3, p=0.039), 6) wearing a mask when going out (13.38±1.32ug/m3, p=0.017). For COPD acute exacerbation, we found that the subjects experienced more exacerbation, as the exposure time of PM2.5≥35ug/m3 or PM2.5≥75ug/m3. Conclusion The lifestyle can affect the indoor PM2.5 concentration, which can also impact the risk of exacerbation in patients with COPD.

Detection of anti-LAD-1 autoantibodies in a case of paraneoplastic pemphigus with invasive thymoma

( Hajeong Kim ),( Jae Yeon Kim ),( Norito Ishii ),( Takashi Hashimoto ),( Jong Hoon Kim ) 대한피부과학회 2023 대한피부과학회 학술발표대회집 Vol.74 No.2

Lifestyle Resulting in Seasonal PM2.5 Reduction and Its Impact on COPD

( Hajeong Kim ),( Geunjoo Na ),( Shinhee Park ),( Seung Won Ra ),( Sung-yoon Kang ),( Ho Cheol Kim ),( Hwan Cheol Kim ),( Sei Won Lee ) 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.-

Background Particulate matter (PM) is a major air pollutant that has been raising global health concerns and it can cause and progress chronic obstructive pulmonary disease (COPD). To provide an effective seasonal strategy to reduce PM diameter < 2.5um (PM2.5) exposure, we performed detailed questionnaire about lifestyles to avoid PM2.5 in patients with COPD and analyzed the relationship between ambient PM2.5 and lifestyles. Methods We enrolled 104 COPD patients prospectively from four hospitals of different areas in Korea. Detailed questionnaire were conducted two times and Internet of things based sensors were installed at their home for continuous measurement of PM2.5 concentration for a year. The relationship between PM2.5 concentration, lifestyles, and COPD exacerbation were analyzed as seasons. Results Except summer, outdoor PM2.5 were higher than indoor, and the difference was the largest in winter (4.31±.02ug/m3) (Figure1). Some lifestyles were effective to reduce indoor PM2.5 compared to outdoor and effect lifestyles were different as seasons. The lifestyles which lowered annual indoor PM2.5 compared to outdoor significantly include 1) indoor air purifier operated (4.69±1.12ug/m3, p=0.001), 2) ventilating home by opening windows (-5.29±0.89ug/m3, p <0.001), 3) checking filters of the air purifier (-4.00±1.01ug/m3, p=0.031), 4) refraining from going out when outside PM2.5 is high (-3.8±1.26ug/ m3, p=0.038), 5) choosing places with little traffic when going out (-3.39±1.09ug/m3, p=0.020), and 6) windows closed while driving (-4.33±0.77ug/m3, p=0.002). The higher the economic status and educational level, the lower indoor PM2.5 was noted compared to outdoor(Figure2). There were lifestyles associated with lower small airway resistance presented as R5-R20 from impulse oscillometry and SGRQ-C and those lifestyles include checking air quality forecast and indoor mopping. Conclusion Lifestyle habits were associated with indoor PM2.5 concentrations, and they can even affect clinical outcomes including small airway resistance and quality of life in COPD.

선박자동식별시스템(AIS) Class A와 Class B의 특성 연구

김하정(Hajeong Kim),김기영(Kiyoung Kim),김귀현(Gwi Hyun Kim),정민아(Min A Jung),이성로(Seong Ro Lee) 한국통신학회 2009 한국통신학회 학술대회논문집 Vol.2009 No.6

Insufficient early renal recovery and progression to subsequent chronic kidney disease in living kidney donors

Yaerim Kim,Eunjeong Kang,Dong-Wan Chae,Jung Pyo Lee,Sik Lee,Soo Wan Kim,Jang-Hee Cho,Miyeun Han,Seungyeup Han,Yong Chul Kim,Dong Ki Kim,Kwon Wook Joo,Yon Su Kim,Hajeong Lee 대한내과학회 2022 The Korean Journal of Internal Medicine Vol.37 No.5

Background/Aims: Renal recovery of a kidney donor after undergoing nephrectomy though challenging is essential. We aimed to examine the effect of estimated glomerular filtration rate (eGFR) percent change at 1-month post-donation on insufficient kidney function after kidney donation. Methods: A total of 3,952 living kidney donors who underwent donor nephrectomy from 1982 to 2019 from eight different tertiary hospitals in Korea were initially screened. Percent changes in the eGFR from baseline to 1-month post-donation were calculated. The degree of percent changes was categorized by quartile, and the 1st quartile was regarded as the group with the lowest decreased eGFR at 1-month after donation. The remaining eGFR less than 60 mL/min/1.73 m2 was the endpoint. The Cox proportional hazard model was used for evaluating the impact of initial eGFR and eGFR percent change at 1-month post-donation on the condition with remaining eGFR < 60 mL/min/1.73 m2. In the multivariate analysis, we used variables with a p < 0.1 in the univariate analysis. Results: A total of 1,585 donors were included in the analysis. During 62.2 ± 49.3 months, 13.7% of donors showed renal insufficiency. The 4th (adjusted hazard ratio [aHR], 10.41; 95% confidence interval [CI], 5.15 to 21.04) and the 3rd (aHR, 4.29; 95% CI, 2.15 to 8.56) quartiles of percent change in eGFR and the pre-donation eGFR (aHR, 0.90; 95% CI, 0.88 to 0.92) were associated with the development of renal insufficiency. Conclusions: The impact of worse initial renal recovery on renal insufficiency was pronounced in donors with lower pre-donation eGFRs. Additionally, worse initial renal recovery of remaining kidney affected the long-term development of renal insufficiency in kidney donors.

Status and trends in epidemiologic characteristics of diabetic end-stage renal disease: an analysis of the 2021 Korean Renal Data System

( Kyeong Min Kim ),( Seon A Jeong ),( Tae Hyun Ban ),( Yu Ah Hong ),( Seun Deuk Hwang ),( Sun Ryoung Choi ),( Hajeong Lee ),( Ji Hyun Kim ),( Su Hyun Kim ),( Tae Hee Kim ),( Ho-seok Koo ),( Chang-yun 대한신장학회 2024 Kidney Research and Clinical Practice Vol.43 No.1

Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.

텍스트 마이닝과 소셜네트워크분석을 통한 AI·빅데이터 기반 제조기술 트렌드 연구

김일중(Iljung Kim),한아람(Aram Han),채희수(Heesu Chae),김하정(Hajeong Kim),유승화(Seunghwa Ryu),김준영(Joonyoung Kim),신민수(Minsoo Shin),김흥남(Heungnam Kim) 한국기술혁신학회 2021 기술혁신학회지 Vol.24 No.5

최근 스마트공장 질적 고도화의 일환으로 제조 생태계에 AI·빅데이터 기술적용에 대한 관심이 고조되고 있다. 그러나 기존 제조기술 트렌드 연구는 스마트공장 구축을 위한 자동화·로봇화에 집중되어 제조 AI·빅데이터 중심의 제조기술 트렌드 연구 및 활용은 미비한 실정이다. 본 연구는 제조업에 적용되는 AI·빅데이터 기술에 대한 최근 6년 동안의 주요 이슈 및 트렌드를 분석하여 제조기업의 AI·빅데이터 기술도입의 방향성을 제시하고자 한다. 분석결과의 적시성과 정확도를 증대하기 위해 특허, 논문, 뉴스, 박람회, 인공지능 중소벤처 제조플랫폼(KAMP) 콘텐츠를 분석 데이터로 통합화하였다. 그리고 수집 데이터의 정제로 Python 3.6과 텍스트 마이닝 및 소셜네트워크분석은 KrKwic 2.0, UCINET 6.721을 활용하였다. 분석 결과, 시간의 흐름에 따라 제조 특화 AI, 딥러닝, 알고리즘 키워드의 연결중심성이 높아지는 것으로 나타났으며 이를 구현하기 위해 고성능 컴퓨팅 기술을 포함한 다수의 제조AI 기술군집이 형성되었다. 제조현장의 AI 적용목적에 따라 보다 다양하고 최적화된 제조 특화 AI 알고리즘 및 제조 빅데이터 융·복합기술의 중요도가 증가하고 있음을 관찰할 수 있었다. Recently, there has been a surge of interest in manufacturing AI and big data technology application. Since current manufacturing technology trend research is focused on automation and robotization for the construction of smart factories, study and utilization of manufacturing technology trends centered on manufacturing AI and big data are insufficient. Therefore, this study examines major issues and trends in AI·big data technologies applied to the manufacturing industry over the last six years. To reflect the timeliness and accuracy of analysis results, patents, theses, news, fairs, and Korea AI Manufacturing Platform(KAMP) contents are integrated into analysis data, and data refinement is performed using Python 3.6, text mining, and social network analysis. KrKwic 2.0 and UCINET 6.721 were utilized for this purpose. It was discovered that the degree centrality of manufacturing AI keywords rose with time, prompting the formation of a number of manufacturing AI technology clusters. The significance of more diverse AI algorithms specialized in manufacturing and high-performance infra resources increases depending on the aim of AI application in the manufacturing site.

Development and Validation of the Modified Charlson Comorbidity Index in Incident Peritoneal Dialysis Patients: A National Population-Based Approach

Cho, Hyunjeong,Kim, Myoung-Hee,Kim, Hyo Jin,Park, Jae Yoon,Ryu, Dong-Ryeol,Lee, Hajeong,Lee, Jung Pyo,Lim, Chun-Soo,Kim, Kyoung Hoon,Oh, Kook-Hwan,Joo, Kwon Wook,Kim, Yon Su,Kim, Dong Ki International Society for Peritoneal Dialysis 2017 Peritoneal dialysis international Vol.37 No.1

<P>Conclusions: Compared with the CCI, the mCCI-IPD showed better performance in mortality prediction for incident PD patients. Therefore, this tool may be used as a preferred index for statistical analysis and clinical decision-making.</P>