Acute Kidney Injury Classifications in the Prediction of In-hospital Mortality and Renal Function Non-recovery.

Background: In the last two decades diagnostic criteria for acute kidney injury (AKI) were developed: Risk, Injury, Failure, Loss of Kidney Function, End-Stage Kidney Disease (RIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease: Improving Global Outcomes (KDIGO) classifications. Objective: The study aimed to determine the incidence of AKI based on the RIFLE, AKIN, and KDIGO criteria, as well as analyze their predictive value for mortality and renal function outcome. Methods: This was a single-center prospective study of patients diagnosed with AKI. Acute kidney injury was defined and classified according to the RIFLE, AKIN, and KDIGO criteria. The outcomes were renal function outcome and in-hospital mortality. Results: The incidence rates of AKI based on the RIFLE, AKIN, and KDIGO criteria were 13.4%, 14-36%, and 14.64%, respectively. Multiple regression analysis showed that higher stages of AKI according to the KDIGO criteria were independently associated with non-recovery of renal function (p=0.011). However, the predictive ability of RIFLE, AKIN and KDIGO classifications for renal function recovery was poor (Area Under the Receiver Operating Characteristics-AUROC=0.599, AUROC=0.637, AUROC=0.659, respectively). According to the RIFLE and AKIN criteria, in-hospital mortality was statistically significantly higher in stage Failure/3 (p=0.0403 and p=0.0329, respectively) compared to stages Risk/1 and Injury/2. Receiver Operating Characteristics (ROC) analysis showed that all three classifications had poor predictive ability for in-hospital mortality (AUROC=0.675, AUROC=0.66, AUROC=0.681). Conclusions: KDIGO classification is an independent predictor of renal function non-recovery. However, by ROC analysis, all three classifications have poor predictive ability for renal function outcome and mortality.

Renal artery aneurism.

BACKGROUND: Renal artery aneurysm is very rare and most often incidental finding and we will present it in our case report. CASE REPORT: We report a case of 65 years old women who was sent to our hospital Clinic of Radiology. We detected a renal artery aneurysm on the left side on the ultrasound and later we confirmed it on the CTA of the abdominal aorta and its visceral branches. DISCUSSION: Renal artery aneurysms can be classified in true anaurysm and pseudoaneurysm. They are more often find at females. They can be fusiform or saccular in appearance and are extraparenchymal in 90% of cases. Most are saccular and noncalcified. CONCLUSION: In the case of renal artery aneurysm that we founded we recommended regular Color Doppler ultrasound examinations, consultation from the urologist and CTA control if there is a need.