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Article ; Online: Causal impact analysis of weir opening on cyanobacterial blooms and water quality in the Yeongsan River, Korea: A bayesian structural time-series analysis and median difference test.

Kim, Sungjin / Chung, Sewoong

2024 Volume 924, Page(s) 171646

Abstract: The construction of weirs in Korea's Four Major Rivers Project has led to an increase in cyanobacterial blooms, posing environmental challenges. To address this, the government began opening weirs in 2017. However, interpreting experimental results has ... ...

Abstract	The construction of weirs in Korea's Four Major Rivers Project has led to an increase in cyanobacterial blooms, posing environmental challenges. To address this, the government began opening weirs in 2017. However, interpreting experimental results has proven to be complex due to the multifaceted nature of blooms. This study aimed to assess the impact of opening the Juksan Weir on cyanobacterial blooms and water quality in the Yeongsan River. Using a median difference test (MDT) and causal impact analysis (CIA) with Bayesian structural time-series (BSTS) models, changes in cyanobacterial cell density (Cyano) and chlorophyll a concentration (Chl-a) before (January 2013 to June 2017) and after (July 2017 to December 2021) the weir-opening event were analyzed. The MDT revealed no significant change in Cyano post-weir opening (p = 0.267), but Chl-a significantly increased by 48.1 % (p < 0.01). As a result of CIA, Cyano decreased, albeit statistically insignificantly (p = 0.454), while Chl-a increased by 59.0 % (p < 0.01). These findings contradict the expectation that Cyano decrease due to the increased flow velocity resulting from weir opening. The absence of changes in Cyano and the increase in Chl-a can be attributed to several factors, including the constrained and inadequate duration of full weir opening combined with conducive conditions for the proliferation of other algae such as diatoms and green algae. These findings suggest that the effectiveness of weir opening in controlling Cyano may have been compromised by factors influencing the overall aquatic ecosystem dynamics. Further analysis revealed that factors such as elevated water temperatures (≥ 30 °C) and reduced flow rates (< 37 m
MeSH term(s)	Water Quality ; Rivers ; Chlorophyll A ; Ecosystem ; Bayes Theorem ; Cyanobacteria ; Republic of Korea ; Eutrophication ; Lakes ; Environmental Monitoring
Chemical Substances	Chlorophyll A (YF5Q9EJC8Y)
Language	English
Publishing date	2024-03-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2024.171646
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Article ; Online: Recent Update on Acute Kidney Injury-to-Chronic Kidney Disease Transition.

Koh, Eun Sil / Chung, Sungjin

Yonsei medical journal

2024 Volume 65, Issue 5, Page(s) 247–256

Abstract: Acute kidney injury (AKI) is characterized by an abrupt decline of excretory kidney function. The incidence of AKI has increased in the past decades. Patients diagnosed with AKI often undergo diverse clinical trajectories, such as early or late recovery, ...

Abstract	Acute kidney injury (AKI) is characterized by an abrupt decline of excretory kidney function. The incidence of AKI has increased in the past decades. Patients diagnosed with AKI often undergo diverse clinical trajectories, such as early or late recovery, relapses, and even a potential transition from AKI to chronic kidney disease (CKD). Although recent clinical studies have demonstrated a strong association between AKI and progression of CKD, our understanding of the complex relationship between AKI and CKD is still evolving. No cohort study has succeeded in painting a comprehensive picture of these multi-faceted pathways. To address this lack of understanding, the idea of acute kidney disease (AKD) has recently been proposed. This presents a new perspective to pinpoint a period of heightened vulnerability following AKI, during which a patient could witness a substantial decline in glomerular filtration rate, ultimately leading to CKD transition. Although AKI is included in a range of kidney conditions collectively known as AKD, spanning from mild and self-limiting to severe and persistent, AKD can also occur without a rapid onset usually seen in AKI, such as when kidney dysfunction slowly evolves. In the present review, we summarize the most recent findings about AKD, explore the current state of biomarker discovery related to AKD, discuss the latest insights into pathophysiological underpinnings of AKI to CKD transition, and reflect on therapeutic challenges and opportunities that lie ahead.
MeSH term(s)	Humans ; Acute Kidney Injury/epidemiology ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/physiopathology ; Disease Progression ; Glomerular Filtration Rate/physiology ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2024-04-22
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	303740-x
ISSN	1976-2437 ; 0513-5796
ISSN (online)	1976-2437
ISSN	0513-5796
DOI	10.3349/ymj.2023.0306
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Article ; Online: Causal impact analysis of enhanced phosphorus effluent standard on river water quality.

Kim, Sungjin / Chung, Sewoong

Journal of environmental management

2022 Volume 320, Page(s) 115931

Abstract: The effect of environmental policies on water quality is an important factor in evaluating a project's impact and economic feasibility. The aim of this study was to evaluate the causal relationship between strengthening the total phosphorus (TP) ... ...

Abstract	The effect of environmental policies on water quality is an important factor in evaluating a project's impact and economic feasibility. The aim of this study was to evaluate the causal relationship between strengthening the total phosphorus (TP) concentration standard in wastewater treatment plant (WWTP) effluents and river water quality in the Geum River watershed (Rep. of Korea). Data, including precipitation, streamflow, and water quality, were collected for 2005-2020 and temporally divided into "before" and "after" the event of strengthening standards (in 2012). Further, the data were spatially divided into influence sites (impact) affected by the event and control sites (control) unaffected by the event. A median difference test for a before/after and control/impact (BACI) analysis and a causal impact analysis (CIA) based on a Bayesian structural time-series model were performed to evaluate the changes in water quality after the event. The BACI test showed that the TP concentration was reduced significantly (p-value<0.05) at all impact sites after the event, whereas the difference was not significant at the control sites. In contrast, other water quality variables, except TP, showed different statistical significance depending on the site. The CIA was performed by controlling the rainfall, flow rate, suspended solids, water temperature, biochemical oxygen demand, and chemical oxygen demand as covariates, which were selected based on a directed acyclic graph and bi-variable correlation analysis. The CIA results showed that the TP concentration was reduced significantly (p-value<0.05) at all impact sites, except for the control sites after the event, which is consistent with the BACI results. The causal impact of environmental management policies was previously difficult to evaluate by objectively targeting the natural systems because of the confounding bias. Our study demonstrated that strengthening the TP concentration standard from WWTPs majorly contributed to reducing TP in the receiving river, even when confounding factors, such as fluctuations in non-point source pollution loads caused by rainfall and runoff, were excluded. The statistical approaches used in this study can be valuable and practical methods for such evaluations if sufficient prior and posterior data and appropriate covariates are obtained.
MeSH term(s)	Bayes Theorem ; China ; Environmental Monitoring/methods ; Nitrogen/analysis ; Phosphorus/analysis ; Rivers/chemistry ; Water Pollutants, Chemical/analysis ; Water Quality
Chemical Substances	Water Pollutants, Chemical ; Phosphorus (27YLU75U4W) ; Nitrogen (N762921K75)
Language	English
Publishing date	2022-08-07
Publishing country	England
Document type	Journal Article
ZDB-ID	184882-3
ISSN	1095-8630 ; 0301-4797
ISSN (online)	1095-8630
ISSN	0301-4797
DOI	10.1016/j.jenvman.2022.115931
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Article: Therapeutic roles of thiazides and loop diuretics in blood pressure control and renal protection against chronic kidney disease.

Jo, Wonji / Koh, Eun Sil / Chung, Sungjin

Clinical hypertension

2023 Volume 29, Issue 1, Page(s) 14

Abstract: Fluid overload secondary to loss of functional nephron mass can elevate blood pressure, which is characteristic of hypertension shown in chronic kidney disease (CKD). Therefore, it is logical to use diuretics at appropriate dose to lower blood pressure ... ...

Abstract	Fluid overload secondary to loss of functional nephron mass can elevate blood pressure, which is characteristic of hypertension shown in chronic kidney disease (CKD). Therefore, it is logical to use diuretics at appropriate dose to lower blood pressure in patients with CKD and hypertension. Despite the theoretical background on the use of diuretics in CKD, there have been no definitive data on the effectiveness or safety of diuretics as first-line therapy for the management of hypertension in patients with CKD. Results from some clinical trials have demonstrated that diuretics would not lower blood pressure. They could even worsen electrolyte imbalance and kidney function when they are administered in patients with CKD. Major clinical practice guidelines on management of blood pressure or CKD have stated that evidence for benefits of thiazide diuretics is not conclusive yet in patients with advanced CKD, although loop diuretics are often effective for volume control at lower glomerular filtration rate. Recently, evidence for diuretics as effective blood pressure lowering agents in patients with advanced CKD is increasing. Renoprotective effect of thiazide or loop diuretics might represent a consequence of their influence on blood pressure or their ability to potentiate the effect of renin-angiotensin system blockade by making intraglomerular pressure more renin-angiotensin system-dependent, although their direct benefit on renal function remains controversial. This review summarizes recent data on the possible role of diuretics in lowering blood pressure, slowing the progression of kidney disease, and reducing cardiovascular risk in CKD patients.
Language	English
Publishing date	2023-05-15
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2806585-2
ISSN	2056-5909
ISSN	2056-5909
DOI	10.1186/s40885-023-00238-5
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Article ; Online: Intrarenal Mechanisms of Sodium-Glucose Cotransporter-2 Inhibitors on Tubuloglomerular Feedback and Natriuresis.

Koh, Eun Sil / Kim, Gheun-Ho / Chung, Sungjin

Endocrinology and metabolism (Seoul, Korea)

2023 Volume 38, Issue 4, Page(s) 359–372

Abstract: When sodium-glucose cotransporter-2 (SGLT2) inhibitors were first introduced a decade ago, no one expected them to have substantial effects beyond their known glucose-lowering effects, until the emergence of evidence of their robust renal and ... ...

Abstract	When sodium-glucose cotransporter-2 (SGLT2) inhibitors were first introduced a decade ago, no one expected them to have substantial effects beyond their known glucose-lowering effects, until the emergence of evidence of their robust renal and cardiovascular benefits showing that they could attenuate progression of kidney disease, irrespective of diabetes, as well as prevent the development of acute kidney injury. Still, the precise and elaborate mechanisms underlying the major organ protection of SGLT2 inhibitors remain unclear. SGLT2 inhibitors inhibit the reabsorption of sodium and glucose in the proximal tubule of the kidney and then recovers tubuloglomerular feedback, whereby SGLT2 inhibitors reduce glomerular hyperfiltration. This simple demonstration of their beneficial effects has perplexed experts in seeking more plausible and as yet undisclosed explanations for the whole effects of SGLT2 inhibitors, including metabolism reprogramming and the modulation of hypoxia, inflammation, and oxidative stress. Given that the renal benefits of SGLT2 inhibitors in patients with kidney disease but without diabetes were comparable to those seen in patients with diabetes, it may be reasonable to keep the emphasis on their hemodynamic actions. In this context, the aim of the present review is to provide a comprehensive overview of renal hemodynamics in individuals with diabetes who are treated with SGLT2 inhibitors, with a focus on natriuresis associated with the regulation of tubuloglomerular feedback and potential aquaresis. Throughout the discussion of alterations in renal sodium and water transports, particular attention will be given to the potential enhancement of adenosine and its receptors following SGLT2 inhibition.
MeSH term(s)	Humans ; Sodium-Glucose Transporter 2 Inhibitors/pharmacology ; Diabetes Mellitus, Type 2/complications ; Hypoglycemic Agents/pharmacology ; Sodium-Glucose Transporter 2/metabolism ; Natriuresis ; Feedback ; Glucose ; Sodium/metabolism
Chemical Substances	Sodium-Glucose Transporter 2 Inhibitors ; Hypoglycemic Agents ; Sodium-Glucose Transporter 2 ; Glucose (IY9XDZ35W2) ; Sodium (9NEZ333N27)
Language	English
Publishing date	2023-07-24
Publishing country	Korea (South)
Document type	Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2802452-7
ISSN	2093-5978 ; 2093-5978
ISSN (online)	2093-5978
ISSN	2093-5978
DOI	10.3803/EnM.2023.1764
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Article: Urate Transporters in the Kidney: What Clinicians Need to Know.

Chung, Sungjin / Kim, Gheun-Ho

Electrolyte & blood pressure : E & BP

2021 Volume 19, Issue 1, Page(s) 1–9

Abstract: Urate is produced in the liver by the degradation of purines from the diet and nucleotide turnover and excreted by the kidney and gut. The kidney is the major route of urate removal and has a pivotal role in the regulation of urate homeostasis. ... ...

Abstract	Urate is produced in the liver by the degradation of purines from the diet and nucleotide turnover and excreted by the kidney and gut. The kidney is the major route of urate removal and has a pivotal role in the regulation of urate homeostasis. Approximately 10% of the glomerular filtered urate is excreted in the urine, and the remainder is reabsorbed by the proximal tubule. However, the transport of urate in the proximal tubule is bidirectional: reabsorption and secretion. Thus, an increase in reabsorption or a decrease in secretion may induce hyperuricemia. In contrast, a decrease in reabsorption or an increase in secretion may result in hyperuricosuria. In the proximal tubule, urate reabsorption is mainly mediated by apical URAT1 (
Language	English
Publishing date	2021-06-30
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	3017960-9
ISSN	2092-9935 ; 1738-5997
ISSN (online)	2092-9935
ISSN	1738-5997
DOI	10.5049/EBP.2021.19.1.1
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Article: A new opportunity for Kidney Research and Clinical Practice to make a great leap forward as a Science Citation Index Expanded journal.

Lee, Jeonghwan / Chung, Sungjin / Yoo, Tae-Hyun

Kidney research and clinical practice

2021 Volume 40, Issue 1, Page(s) 1–5

Language	English
Publishing date	2021-03-30
Publishing country	Korea (South)
Document type	Editorial
ZDB-ID	2656420-8
ISSN	2211-9132
ISSN	2211-9132
DOI	10.23876/j.krcp.21.001
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Article ; Online: Use of Anti-Diabetic Agents in Non-Diabetic Kidney Disease

Sungjin Chung / Gheun-Ho Kim

Life, Vol 11, Iss 389, p

From Bench to Bedside

2021 Volume 389

Abstract: New drugs were recently developed to treat hyperglycemia in patients with type 2 diabetes mellitus (T2D). However, metformin remains the first-line anti-diabetic agent because of its cost-effectiveness. It has pleiotropic action that produces ... ...

Abstract	New drugs were recently developed to treat hyperglycemia in patients with type 2 diabetes mellitus (T2D). However, metformin remains the first-line anti-diabetic agent because of its cost-effectiveness. It has pleiotropic action that produces cardiovascular benefits, and it can be useful in diabetic nephropathy, although metformin-associated lactic acidosis is a hindrance to its use in patients with kidney failure. New anti-diabetic agents, including glucagon-like peptide-1 receptor (GLP-1R) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium-glucose transporter-2 (SGLT-2) inhibitors, also produce cardiovascular or renal benefits in T2D patients. Their glucose-independent beneficial actions can lead to cardiorenal protection via hemodynamic stabilization and inflammatory modulation. Systemic hypertension is relieved by natriuresis and improved vascular dysfunction. Enhanced tubuloglomerular feedback can be restored by SGLT-2 inhibition, reducing glomerular hypertension. Patients with non-diabetic kidney disease might also benefit from those drugs because hypertension, proteinuria, oxidative stress, and inflammation are common factors in the progression of kidney disease, irrespective of the presence of diabetes. In various animal models of non-diabetic kidney disease, metformin, GLP-1R agonists, DPP-4 inhibitors, and SGLT-2 inhibitors were favorable to kidney morphology and function. They strikingly attenuated biomarkers of oxidative stress and inflammatory responses in diseased kidneys. However, whether those animal results translate to patients with non-diabetic kidney disease has yet to be evaluated. Considering the paucity of new agents to treat kidney disease and the minimal adverse effects of metformin, GLP-1R agonists, DPP-4 inhibitors, and SGLT-2 inhibitors, these anti-diabetic agents could be used in patients with non-diabetic kidney disease. This paper provides a rationale for clinical trials that apply metformin, GLP-1R agonists, DPP-4 inhibitors, and SGLT-2 inhibitors to non-diabetic ...
Keywords	dipeptidyl peptidase-4 inhibitor ; glucagon-like peptide-1 receptor agonist ; inflammation ; metformin ; oxidative stress ; sodium-glucose transporter-2 inhibitor ; Science ; Q
Subject code	616
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Use of Anti-Diabetic Agents in Non-Diabetic Kidney Disease: From Bench to Bedside.

Chung, Sungjin / Kim, Gheun-Ho

Life (Basel, Switzerland)

2021 Volume 11, Issue 5

Abstract	New drugs were recently developed to treat hyperglycemia in patients with type 2 diabetes mellitus (T2D). However, metformin remains the first-line anti-diabetic agent because of its cost-effectiveness. It has pleiotropic action that produces cardiovascular benefits, and it can be useful in diabetic nephropathy, although metformin-associated lactic acidosis is a hindrance to its use in patients with kidney failure. New anti-diabetic agents, including glucagon-like peptide-1 receptor (GLP-1R) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium-glucose transporter-2 (SGLT-2) inhibitors, also produce cardiovascular or renal benefits in T2D patients. Their glucose-independent beneficial actions can lead to cardiorenal protection via hemodynamic stabilization and inflammatory modulation. Systemic hypertension is relieved by natriuresis and improved vascular dysfunction. Enhanced tubuloglomerular feedback can be restored by SGLT-2 inhibition, reducing glomerular hypertension. Patients with non-diabetic kidney disease might also benefit from those drugs because hypertension, proteinuria, oxidative stress, and inflammation are common factors in the progression of kidney disease, irrespective of the presence of diabetes. In various animal models of non-diabetic kidney disease, metformin, GLP-1R agonists, DPP-4 inhibitors, and SGLT-2 inhibitors were favorable to kidney morphology and function. They strikingly attenuated biomarkers of oxidative stress and inflammatory responses in diseased kidneys. However, whether those animal results translate to patients with non-diabetic kidney disease has yet to be evaluated. Considering the paucity of new agents to treat kidney disease and the minimal adverse effects of metformin, GLP-1R agonists, DPP-4 inhibitors, and SGLT-2 inhibitors, these anti-diabetic agents could be used in patients with non-diabetic kidney disease. This paper provides a rationale for clinical trials that apply metformin, GLP-1R agonists, DPP-4 inhibitors, and SGLT-2 inhibitors to non-diabetic kidney disease.
Language	English
Publishing date	2021-04-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life11050389
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Article: Causal impact analysis of enhanced phosphorus effluent standard on river water quality

Kim, Sungjin / Chung, Sewoong

Journal of environmental management. 2022 Oct. 15, v. 320

2022

Abstract	The effect of environmental policies on water quality is an important factor in evaluating a project's impact and economic feasibility. The aim of this study was to evaluate the causal relationship between strengthening the total phosphorus (TP) concentration standard in wastewater treatment plant (WWTP) effluents and river water quality in the Geum River watershed (Rep. of Korea). Data, including precipitation, streamflow, and water quality, were collected for 2005–2020 and temporally divided into “before” and “after” the event of strengthening standards (in 2012). Further, the data were spatially divided into influence sites (impact) affected by the event and control sites (control) unaffected by the event. A median difference test for a before/after and control/impact (BACI) analysis and a causal impact analysis (CIA) based on a Bayesian structural time-series model were performed to evaluate the changes in water quality after the event. The BACI test showed that the TP concentration was reduced significantly (p-value<0.05) at all impact sites after the event, whereas the difference was not significant at the control sites. In contrast, other water quality variables, except TP, showed different statistical significance depending on the site. The CIA was performed by controlling the rainfall, flow rate, suspended solids, water temperature, biochemical oxygen demand, and chemical oxygen demand as covariates, which were selected based on a directed acyclic graph and bi-variable correlation analysis. The CIA results showed that the TP concentration was reduced significantly (p-value<0.05) at all impact sites, except for the control sites after the event, which is consistent with the BACI results. The causal impact of environmental management policies was previously difficult to evaluate by objectively targeting the natural systems because of the confounding bias. Our study demonstrated that strengthening the TP concentration standard from WWTPs majorly contributed to reducing TP in the receiving river, even when confounding factors, such as fluctuations in non-point source pollution loads caused by rainfall and runoff, were excluded. The statistical approaches used in this study can be valuable and practical methods for such evaluations if sufficient prior and posterior data and appropriate covariates are obtained.
Keywords	Bayesian theory ; biochemical oxygen demand ; chemical oxygen demand ; economic feasibility ; models ; nonpoint source pollution ; phosphorus ; rain ; river water ; rivers ; runoff ; stream flow ; time series analysis ; total phosphorus ; wastewater treatment ; water quality ; water temperature ; watersheds ; Korean Peninsula
Language	English
Dates of publication	2022-1015
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	184882-3
ISSN	1095-8630 ; 0301-4797
ISSN (online)	1095-8630
ISSN	0301-4797
DOI	10.1016/j.jenvman.2022.115931
Database	NAL-Catalogue (AGRICOLA)

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