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Background/Aim. Contrast-induced acute kidney injury (CI-AKI) is a common complication after the percutaneous coronary intervention, associated with a prolonged hospital stay, increased medical costs, and risk of adverse clinical outcomes. The aim of this study was to compare changes in levels of serum creatinine (sCr) and cystatin C (sCyC) 24 h after coronary angiography as an early indicator of CI-AKI. Methods. The study included 45 patients with chronic renal failure grade I-III scheduled for coronary angiography. Levels of sCr and sCyC were measured a day before and 24 h after coronary angiography. CI-AKI was defined as a 25% and 10% increase of sCr and sCyC levels from baseline within 24 h from contrast media exposure, in the absence of alternative causes. Results. Mean sCr and sCyC concentrations were 86.4 ± 22.6 µmol/L and 1.18 ± 0.52 mg/dL, respectively before contrast administration, and 90.6 ± 24.1 µmol/L and 1.24 ± 0.65 mg/dL, respectively 24 h after contrast media exposure. sCr-based CI-AKI occurred in 4 patients (8.89%) and sCyC-based CI-AKI was detected in 19 patients (42.22%) after the contrast procedure (p < 0.001). Conclusion. sCyC level measured 24 h a fter c ontrast m edia e xposure i s a m ore s ensitive indicator of CIAKI than sCR level. [ABSTRACT FROM AUTHOR]

Introduction. Polycystic kidney disease is a hereditary kidney disease characterized by the occurrence of cysts (fluid-filled enlargements) in cortex or medula of the kidney, and is inherited in an autosomal dominant or autosomal recessive manner. In addition to multiple cysts in kidneys, there may be many extra-renal manifestations (cysts of the liver, pancreas, lungs, heart, etc.), among which the most serious one is intracranial aneurysms. Case report. A 57-year-old female patient with polycystic kidney disease and stage IV renal failure was hospitalized at our clinic due to decreased renal function, the development of urinary tract infections, headaches and unregulated blood pressure despite the usual treatment. This patient also had a number of associated diseases: obesity, diabetes mellitus (the insulindependent type), hypothyroidism, and depression syndrome. After better regulation of blood pressure, resolved urinary tract infections and improved renal function, there were still persistent headaches (resulting in the excessive use of analgesics). With adequate preparation, multislice computed tomography (MSCT) angiography of blood vessels of the head was performed. As a result, we diagnosed the saccular intracranial aneurysm (IA) with anterior localization. Regarding the symptoms, age and comorbidity, digital subtraction angiography (DSA) was performed, and showed saccular IA (5.2 mm x 4 mm), with wide neck affecting both middle cerebral artery branches (MCA). During the procedure the stent was placed, which filled the aneurysm with spirals, cutting it off from circulation. After the successful procedure and without further complications, the patient no longer had headaches and blood pressure was maintained within the required limits with stable parameters of chronic renal failure. Conclusion. The case of the patient with polycystic kidney disease, stage IV chronic renal failure, with a number of comorbidities (headache, obesity, hypertension, diabetes mellitus, hypothyroidism) and diagnosed with symptomatic intracranial aneurysm was successfully solved with a multidisciplinary approach, emphasizing the importance of teamwork in daily practice. [ABSTRACT FROM AUTHOR]

Background/Aim. Patients with chronic renal failure (CRF) have increased cardiovascular morbidity and mortality. It is unknown which biomarkers best describe the degree of diastolic dysfunction in patients with CRF. The aim of this study was to determine the correlation between B-type natriuretic peptide (BNP), N-terminal prohormone brain natriuretic peptide (NTproBNP) and left ventricular diastolic dysfunction (DD-LV) with the degree of CRF. Methods. The study included 100 adult patients with CRF without major cardiac and cerebral incidents who did not start actively treating CRF. According to the degree of CRF, the patients were divided into two groups: G1 (moderate degree), glomerular filtration rate (GFR) ⩾ 30 mL/min/1.73 m2, and G2 (more severe degree), GFR < 30 mL/min/1.73 m2. Blood concentrations of BNP and NTproBNP were measured and Doppler echocardiographic measurement performed to estimate diastolic dysfunction (DD-LV). According to the degree of DD-LV, all the patients were divided into two groups: DD-LV1 (mild diastolic dysfunction) and DD-LV2 (severe diastolic dysfunction). According to the degree of CRF and DD-LV, the patients were divided into four groups: I (G1, DD-LV1), II (G1, DD-LV2), III (G2, DD-LV1) and IV (G2, DD-LV2). Results. There was a highly significant statistical correlation between BNP and NTproBNP with GFR (p < 0.001) and DD-LV with BNP (p < 0.023) and NTproBNP (p=0.035). In patients with DD-LV2, a statistically significantly higher BNP concentrations were registered in patients with G2 (p<0.001). Unlike BNP in the patients with diastolic dysfunction DD-LV1 and those with diastolic dysfunction DD-LV2, significantly higher concentrations of NTproBNP were registered in the patients with G2 (DD- LV1: p=0.006; DD-LV2: p<0.001). Conclusion. Biomarkers BNP and NTproBNP are not the best predictors in the assessment of diastolic dysfunction because they are correlated with the degree of renal insufficiency. [ABSTRACT FROM AUTHOR]