Introduction. Psoriatic arthritis (PA) is a multi-system inflammatory disorder that involves both musculoskeletal structures (joints, enthesis, tendons) and the skin and nails (psoriasis). Clinical manifestations can be varied from clinically asymptomatic disease to arthritis mutilans and invalidating forms. Purpose. Identification of renal disease in patients with psoriatic arthritis depending on the degree of activity and severity of skin and joint disease. Material and Methods. We conducted a retrospective study of 89 patients diagnosed with psoriatic arthritis in the Rheumatology Department of Clinical Emergency Hospital “Sf. Andrei” in Constanta. We collected demographic and behavioural data (age, sex, ethnicity, smoking), clinical and biological elements of joint and skin disease activity (number of painful and swollen joints, joint pain score - VAS, PASI score, ESR, CRP) and evaluation of renal function (serum creatinine, serum uric acid, urinalysis examination for proteinuria and hematuria). Chronic kidney disease was staged by calculating the value of glomerular filtration rate (GFR) with CKD-EPI 2009 equation. Results. 49 patients have full screening of renal function, especially in disease onset or in case of therapy switch. Proteinuria was found in a significant percentage of patients (32.65%), vary widely between 10-500 mg/dL. Chronic kidney disease (CKD) was commonly found in our patients (42.85%), mostly in women (66.6%). Most cases of CKD were in stage 2 (12.4%). We observed a significant correlation between age and levels of serum creatinine (p = 0.041), caucasians developing more frequently CKD (p <0.0001). The presence of skin psoriasis did not interfere with renal function decline in PA patients, but its severity, measured with PASI score, was correlated with cronic kidney failure stages (p = 0.05) and proteinuria (p = 0.044). The severity of joint pain (TJC, VAS) is directly related to kidney disease (p <0.0001, respectively p = 0.05). The majority of patients with extensive joint erosions also had renal impairment (p = NS) and it can be seen a direct correlation between erosive joint disease and serum creatinine (p = 0.029). Conclusions: Both the severity of psoriasis and articular disease may be involved in worsening of renal function, probably due to the chronic systemic inflammation and to an aggressive therapy imposed by the disease evolution.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disease in humans. It is a multisystemic disorder characterized by progressive cystic dilatation of both kidneys, with variable extrarenal manifestations in the gastrointestinal tract (hepatic cysts), cardiovascular system, reproductive organs and brain. An important issue of patients with hepatorenal cystic disease is the fact that complications can arise due to the growing of the cysts: local kidney complications (intracystic infection, intracystic hemorrhage) and local liver complications (portal hypertension as a result of portal vein compression by cysts, bile duct compression, ruptures and bleedings of the cysts, obstruction of the liver veins).Objective: The main purpose of our case presentation is to emphasize the fact that ADPKD can be an aggressive disease with multiple complications, which requires an early diagnosis in order to properly avoid possible complications.Material and Method: We present the case of a 61 years old male, known with polycystic hepatorenal disease, chronic kidney disease (CKD) in chronic hemodialysis since 2010, renal hypertension, hypertensive cardiomyopathy, renal anemia and stage 1 chronic lymphatic leukemia. The patient was diagnosed with hepatorenal polycystic disease 20 years ago and 9 years ago he started undergoing renal replacement therapy by hemodialysis. Three months ago, the patient presented a suddenly installed ascitic syndrome for which an MRI was performed. The imagistic investigation revealed multiple kidney and liver cysts, with secondary compression of the portal vein and a tumoral mass that may suggest an adenocarcinoma.Results: The investigations performed confi rm the diagnosis of portal hypertension secondary to compression due to cystic formations.Conclusions: Hepatorenal polycystic disease has numerous clinical variations, so it needs to be followed in a multidisciplinary way with rapid therapeutic measures to prevent complications. Further investigations are needed when dealing with suspicious cystic formations with an uncertain substrate.

Polycystic kidney disease is an autosomal dominant genetic disorder (ADPKD) associated with arterial hypertension, as a common and early manifestation. However, the combination of hypertension and hypokalemia is very rare in these patients and may have another cause. We present a case of a 45 years old man with ADPKD associated with primary hyperaldosteronism. Unilateral suprarenal macroadenoma on abdominal CT scan, severe hypokalemia and low activity of plasmatic renin led to diagnosis.

Retroperitoneal tumors, either benign or malignant, usually cause problems both for an accurate diagnosis and for therapeutic approach, due to their reduce incidence, late presentation and anatomical location, in the neighborhood of vital structures from the retroperitoneal space. Materials and methods: Aim of study was to search correlations between, gender, age, and histo-pathological type of retroperitoneal tumors, as well as their impact upon renal function. Results: Sarcomas represented about 30% of retroperitoneal tumors. The most frequent benign retroperitoneal tumors included: neurogenic tumors, paragangliomas, renal angiomyolipomas and benign retroperitoneal lipomas. Renal function was altered in about 55% of the patients, and postsurgical mortality was 8.73%.

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