Introduction. Acute kidney injury represents an important clinical syndrome within nephrology, approximately 5% of hospitalised patients being affected. Establishing a diagnosis for acute kidney injury can be challenging and requires many steps. A complete and correct diagnosis is essential for appropriate therapy and, ultimately, the patient’s prognosis.Methods.An objective of this study is to determine the presentation of certain characteristics for the diagnosis of acute kidney injury. It is also intended to show the therapeutic methods undertaken for patients presenting with acute kidney injury, as well as evolution under therapy.Results. The most common causes of acute kidney injury were medical causes and within that category, cardiovascular diseases were the most common etiological factor (18%). Nephropathies represented a minority, with acute pyelonephritis, responsible for 5% of medical causes, and acute glomerulonephritis accounting for 6%. Hemodialysis was initiated only in 15% of patients. The rest of the patients were treated conservatively and responded favourably to this therapeutic approach. The etiological factors that had the greatest number of patients requiring hemodialysis were Rifampicin administration and leptospirosis (~20% each).Conclusions.The clinical characteristics of acute kidney injury are variable and are usually specific to the etiology of the disease. The most common causes were cardiovascular diseases (18%). The therapeutic approach was rather conservative. Hemodialysis was instituted only in 15% of the patients. Almost 5% of all patients evolved to chronic kidney disease in a variable period of time, and the overall mortality was 18%, mainly due to infections and cardiovascular complications.

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Background and Aims One of the major challenges of our century seems to be the SARS-COV2 virus pandemic that has resulted, at least until now, in over 2 million deaths worldwide. Multiple observational studies showed that patients with chronic kidney disease and especially those on the hemodialysis program have an increased risk of severe morbidity and mortality caused by the novel coronavirus. Aim of study was to determine the prognosis and mortality risk in hemodialysis patients hospitalized for symptomatic COVID-19 infection, using the ALAMA age score and the COVID-GRAM critical illness risk score. Method Prospective and retrospective study that included 74 patients undergoing chronic hemodialysis, hospitalized in the Constanta County Emergency Clinical Hospital between March 2020 - December 2020, confirmed with SARS-CoV 2 infection by RT-PCR testing. Results Out of the total number of 74 hospitalized patients (64.58% M, 35.41% F; mean age = 66.64 years), having moderate and severe forms of the disease. 56.25% needed conventional oxygen therapy, 22.9% non-invasive mechanical ventilation and 12.5% intubation and ventilation. All patients underwent specific treatment according to the national protocols, updated with the rapid changes and increasing informations regarding the disease management. The mean duration of hospitalization was 12.33 days. 94.7 % of patients had additional risk factors (diabetes mellitus-47.56%, arterial hypertension-87.3%, COPD – 7.8%, systemic aterosclerosis – 35.4%, immunosuppression – 11.6%, malignant tumors – 4.8% ). Mean ALAMA score was more than 85 years (p<0.01) and mean COVID-GRAM critical illness risk score was 202 (92.1% risk for critical illness). Fatal outcome affected 37.8% of the patients, mainly due to severe respiratory failure, myocarditis, arrhythmias and stroke. Conclusion Hemodialysis patients with SARS-CoV 2 infection have an unfavorable evolution and a reserved prognosis with a high risk of death, depending especially on the need for ventilatory support. 6.25% of the patients followed had post-COVID syndrome (disseminated intravascular coagulation, severe bacterial infections, enterocolitis), but these long-term complications of the survivors will need further studies.

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Recently, there is an increased interest in the detection of Chronic Kidney Disease (CKD) in the general population, especially . A classification of CKD, based on several stages of the estimated glomerular filtration rate (eGFR), has been established from almost 10 years. In our study we monitored eighthy patients older than 65 years, clinically and biochemically, during one year. A number of 80 clinically stable patients, with a median age of 74 years, recruited between october and december 2010, were followed up during one year. We separated them in two groups: Group 1: 40 patients with serum creatinine < = 1,2 mg/dl (range 0,7- 1,2) and with no proteinuria; and Group 2: 40 patients with serum creatinine > 1.2 mg/dl (range 1,2-3,5) and with proteinuria < 3,5 g/24 hours. We measured serum creatinine and eGFR at the time of recruitment and after one year of follow up using abreviated MDRD equation. Statistical comparisons were made using the general lineal model for repeated measures of the SPSS 11.0 program. The most frequent comorbidities were cardio-vascular(> 75%) and infections (25%). 13.75% of the patients died during the follow up, especially from group 2. Only 25% of group 2 patients needed erithropoietin (EPO) treatment. Estimated GFR and proteinuria remained relatively stable at the end of one year in patients from group 1, but survivors from group 2 registered a median decrease of 9 mL/min.