Publications by authors named "Sung-Joon Shin"

Purpose: End-of-life decision-making, particularly relating to withholding life-sustaining treatment (LST), is a complex and emotionally charged process involving healthcare professionals, patients, and caregivers.

Methods: This qualitative study explored the decision-making process in South Korea, where cultural norms and ethical considerations influence the dynamics of shared decision-making (SDM). In-depth interviews were conducted with healthcare professionals, patients, and caregivers using a grounded theory approach to elucidate the themes and processes underlying SDM for LST.

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Background: Obesity is a well-known risk factor for chronic kidney disease and its progression. However, the impact of obesity on the renal function of the elderly population is uncertain. We investigated the association between obesity and renal outcomes in the elderly.

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Background: The prevalence of dementia is 2- to 7-fold higher among patients with end-stage kidney disease (ESKD) than among the general population; however, its clinical implications in this population remain unclear. Therefore, this study aimed to determine whether comorbid dementia increases mortality among older patients with ESKD undergoing newly initiated hemodialysis.

Methods: We analyzed data from the Korean Society of Geriatric Nephrology retrospective cohort, which included 2,736 older ESKD patients (≥70 years old) who started hemodialysis between 2010 and 2017.

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The early mortality rate in elderly patients undergoing hemodialysis is more than twice that in young patients, requiring more specialized healthcare. We investigated whether the number of professional dialysis specialists affected early mortality in elderly patients undergoing hemodialysis. This multicenter retrospective cohort study analyzed data from 1860 patients aged ≥ 70 years who started hemodialysis between January 2010 and December 2017.

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Background: Posttransplantation diabetes mellitus (PTDM) is a crucial problem after kidney transplantation. We aimed to determine whether metformin affects cardiovascular and graft outcomes in patients with PTDM.

Methods: This retrospective cohort study included 1,663 kidney transplant recipients without preexisting diabetes mellitus.

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Ethnopharmacological Relevance: Woohwangchungsimwon (WCW) is a traditional medicine used in East Asian countries to treat central nervous system disorders. Reported pharmacological properties include antioxidant effects, enhanced learning and memory, and protection against ischemic neuronal cell death, supporting its use in treating neurodegenerative diseases like Alzheimer's disease (AD).

Aim Of The Study: The study aims to assess the effects of co-treatment with WCW and donepezil on cognitive functions and serum metabolic profiles in a scopolamine-induced AD model.

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Article Synopsis
  • The study analyzed the relationship between low-density lipoprotein cholesterol (LDL-C) levels and mortality in older Korean hemodialysis patients aged over 70 years.
  • Researchers examined data from 2,732 hemodialysis patients, focusing on those who had not been treated with statins, and found that lower LDL-C levels correlated with an increased risk of all-cause mortality.
  • The findings suggest that in this specific patient population, higher LDL-C levels do not contribute to higher mortality, indicating a potential reversal of typical assumptions about cholesterol's relationship with health outcomes.
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Objective: There are several equations for estimating the glomerular filtration rate (GFR), and each method has its limitations. We compared various estimated GFR (eGFR) equations with 24 hours urine creatinine clearance (24u-CCr).

Design: Sample analysis of randomised controlled trial participants.

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This study examined the effects of muscle mass on mortality in patients with acute kidney injury requiring continuous renal replacement therapy. It was conducted in eight medical centers between 2006 and 2021. The data of 2200 patients over the age of 18 years with acute kidney injury who required continuous renal replacement therapy were retrospectively collected.

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Introduction: Patients with acute kidney injury (AKI) receiving renal replacement therapy constitute the subgroup of AKI with the highest risk of mortality. Despite recent promising findings on the neutrophil-to-lymphocyte ratio (NLR) in AKI, studies have not yet addressed the clinical implication of the NLR in this population. Therefore, we aimed to examine the prognostic value of NLR in critically ill patients requiring continuous renal replacement therapy (CRRT), especially focusing on temporal changes in NLR.

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Background: Physical activity (PA) is an important risk factor associated with health outcomes. However, the relationship between PA and kidney function decline in older adults remains unclear. We examined the influence of PA on kidney function decline and mortality in community-dwelling older adults.

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Article Synopsis
  • STAT3 is an important protein that helps with signaling in the body, particularly with kidney injuries that can lead to chronic problems.
  • In a study using mice, researchers tested a STAT3 blocker called Stattic to see if it could help reduce kidney damage and inflammation after injury.
  • The results showed that blocking STAT3 helped protect the kidneys and might lead to new ways to treat serious kidney issues.
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Background: Age-related alterations in renal sodium handling affect blood pressure (BP). We aimed to clarify whether the pressure-natriuresis response changes with age, leading to BP elevation.

Methods: A total of 4,859 participants with normal renal function from the Korean Genome and Epidemiology Study (KoGES) and 235 patients with non-diabetic chronic kidney disease (CKD) from the ESPECIAL trial were included and divided into the younger and older groups.

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  • Kidney fibrosis is a frequent result of chronic kidney disease (CKD), and this study explored the role of the chemokine CCL8 in relation to kidney fibrosis in CKD patients.
  • Serum levels and tissue expression of CCL8 were found to rise significantly with the progression of CKD, correlating with increased protein levels and kidney damage.
  • Blockading CCL8 reduced fibrosis and apoptosis in cell cultures, suggesting that targeting the CCL8 pathway could help mitigate kidney fibrosis in CKD.
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Few large-scale studies have been conducted to show the joint effects of mortality associated with physical activity and sedentarism. Therefore, we examined the relationship between all-cause mortality and behavioral patterns among adults in the United States. Data of 17,730 non-institutionalized US civilians aged ≥20 years were extracted from the 2007-2014 National Health and Nutrition Examination Survey.

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Background: The virtual conference format has become an essential tool for professional development of researchers around the world since the outbreak of the COVID-19 pandemic. This study aims to identify empirical evidence of the benefits and challenges of virtual conferences by investigating participants' experiences with them.

Methods: The study participants were delegates to the 40th annual meeting of the Korean Society of Nephrology, which was held virtually in September, 2020.

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Background: Evidence of the ethical appropriateness and clinical benefits of shared decision-making (SDM) are accumulating. This study aimed to not only identify physicians' perspectives on SDM, and practices related to end-of-life care in particular, but also to gauge the effect of SDM education on physicians in Korea.

Methods: A 14-item questionnaire survey using a modified Delphi process was delivered to nephrologists and internal medicine trainees at 17 university hospitals.

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Article Synopsis
  • Researchers created self-assessment tools to help chronic kidney disease (CKD) patients make informed decisions about dialysis options through shared decision-making with clinicians.
  • The study involved focus groups to gather patient values, leading to a refined survey with 35 self-assessment items across three key areas: health, lifestyle, and dialysis environment.
  • Findings revealed distinct differences between hemodialysis (HD) and peritoneal dialysis (PD) patients in how they perceive their CKD and engage in shared decision-making.
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Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated.

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Purpose: This study aimed to confirm the decision-making patterns for life-sustaining treatment (LST) and analyze medical service utilization changes after enforcement of the Life-Sustaining Treatment Decision-Making Act.

Materials And Methods: Of 1,237 patients who completed legal forms for life-sustaining treatment (hereafter called the LST form) at three academic hospitals and died at the same institutions, 1,018 cancer patients were included. Medical service utilization and costs were analyzed using claims data.

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Article Synopsis
  • Nephrologists in Korea face dilemmas when deciding to withhold or withdraw dialysis and provide palliative care for end-of-life patients, with 87.3% deeming these actions ethically appropriate.
  • A survey of 369 nephrologists revealed that key factors influencing these decisions include dialysis intolerance and poor performance status, with the majority advocating for withdrawal in patients aged 80-90.
  • There is a call for improved palliative care facilities, treatment guidelines, and resources to support nephrologists in managing complex end-of-life care situations.
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Study Design: Retrospective study.

Objective: To analyze proximal junctional kyphosis (PJK) occurrence and surgical outcomes according to degree of lumbar lordosis (LL) correction relative to pelvic incidence (PI). In addition, risk factors of PJK including LL and sagittal vertical axis (SVA) correction were investigated.

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  • * Out of 59 patients, the overall fusion success rate was 61%, with significant differences in sagittal balance observed between those who achieved fusion and those who did not.
  • * Findings suggest that combining iliac screws with interbody fusion using metal cages may enhance the chances of successful fusion and overall spinal balance post-surgery.
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Background Context: Pedicle subtraction osteotomy (PSO) is highly effective as a sagittal correction approach in patients with adult spinal deformity, but relevant issues such as surgical complexity and long-term complications limit its applicability. Recently, minimally invasive techniques have been reported to be useful for surgical treatment of adult spinal deformity; however, few reports have directly compared these techniques with PSO.

Purpose: The purpose of this study was to evaluate the radiological and clinical efficacies of oblique lateral interbody fusion (OLIF) with posterior column osteotomy (PCO) using stiff rods (6.

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