Introduction: The nutcracker syndrome is a rare clinical entity caused by compression of the left renal vein by the superior mesenteric artery. Epidemiologically opposite, IgA nephropathy is the most common cause of idiopathic glomerulonephritis. A combination of the two diseases has previously been reported in a few cases. Case Report: Herein we report a case of a 22-year-old male patient admitted because of macroscopic hematuria due to excessive oral anticoagulation. He had prior evidence of proteinuria, microhematuria, impaired kidney function, and enlarged left kidney. He presented with fatigue, abdominal pain, nausea, and several instances of vomiting after a meal. A diagnosis of left renal vein compression and IgA nephropathy was made based on clinical, laboratory, radiological findings and kidney biopsy. The vascular anomaly was treated conservatively, while steroids were given to treat glomerulonephritis. The result was complete regression of symptoms, normal laboratory findings, and a significant drop in proteinuria. Conclusion: It is important to evaluate whether patients have nutcracker phenomenon before initiating treatment for IgA nephropathy and vice versa, as hematuria and proteinuria can be overlapping symptoms of both conditions. Renal biopsy should not be hesitated for differential diagnosis, and treatment should be highly individualized.

Hipertenzija predstavlja jedan od najznačajnijih faktora rizika za nastanak kardiovaskularnih bolesti (KVB) na koji se može uticati. Kod određenog broja bolesnika regulisanje hipertenzije se može postići kombinovanjem antihipertenziva-primenom dva leka istovremeno ili primenom fiksne kombinacije dve lekovite supstance u jednom doziranom obliku. Cilj: Cilj rada je bio da se analizira potrošnja fiksnih kombinacija lekovitih supstanci iz podgrupe anatomsko-terapijsko-hemijskog (engl. anatomical-therapeutic-chemical-ATC) sistema klasifikacije lekova C09 (lekovi koji deluju na renin-angiotenzin sistem-RAS), u Republici Srbiji, u periodu od 2010. do 2015. godine. Takođe, cilj je bio i da se dobijeni rezultati uporede sa potrošnjom istih lekova u Kraljevini Norveškoj, Republici Finskoj i Kraljevini Danskoj, za isti vremenski period. Materijal i metode: Pri izradi rada korišćen je koncept ATC klasifikacije i definisane dnevne doze (DDD). Podaci o potrošnji lekova preuzeti su iz godišnjih izveštaja Agencije za lekove i medicinska sredstva Srbije (ALIMS), Norveškog instituta za javno zdravlje-Folkehelseinstituttet, Finske Agencije za lekove-Fimea i Danske Agencije za zaštitu podataka-Sundhedsdatastyrelsen. Količina potrošenih lekova izražavana je kao broj DDD na 1.000 stanovnika na dan (DDD/1.000 stanovnika/dan). Rezultati: Potrošnja fiksnih kombinacija inhibitora angiotenzin konvertujućeg enzima (engl. angiotensin-converting enzyme-ACE) i diuretika (C09BA) u 2010. godini, u Srbiji, iznosila je oko 14%, dok je u poslednjoj posmatranoj godini ABSTRACT Introduction: Hypertension is one of the most significant risk factors for the development of cardiovascular disease (CVD) that can be mitigated. In a certain number of patients, the regulation of hypertension can be achieved by combining antihypertensive drugs-by using two medicines at the same time or by applying a fixed combination of two drugs in single dosage form. Aim: The aim of this study was to analyze the consumption of fixed combinations of drugs from the subgroup of the anatomical-therapeutic-chemical (ATC) system of the C09 drug classification (agents acting on the renin-angiotensin system-RAS), in the Republic of Serbia, in the period from 2010 to 2015. Also, the aim was to compare the obtained results with the consumption of the same drugs in the Kingdom of Norway, the Republic of Finland, and the Kingdom of Denmark, for the same period. menski period. Materials and methods: The concept of ATC classification and defined daily dose (DDD) was applied. Data on drug consumption were taken from annual reports of the Medicines and Medical Devices Agency of Serbia (ALIMS), the Norwegian Public Health Institute-Folkehelseinstituttet, the Finnish Drug Agency-Fimea and the Danish Data Protection Agency-Sundhedsdatastirelsen. The quantity of the drugs consumed was presented as the number of DDD per 1,000 inhabitants per day (DDD/1,000 inhabitants/day). Results: The consumption of fixed combinations of angiotensin-converting enzyme (ACE) inhibitors and diuretics (C09BA) in ...