Faculty of Medicine
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Item type:Publication, Rhabdomyolysis and Acute Kidney Injury in a Patient with Severe Form of Covid-19 Pneumonia- A Case Report(Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs, 2020); ; ; Introduction. The ongoing pandemic with the novel Corona virus poses unprecented challenges for the me- dical professionals worldwide. Acute kidney injury is frequently seen in patients infected with corona virus and often associated with a poor patient outcome. Rhabdo- myolysis has been recognized as one of the possible contributing mechanisms. Case. A 68-year-old man was referred to the emergen- cy department complaining of a dry cough, myalgia, general weakness with devastated energy feeling, chest pain and difficulties in breathing, symptoms he expe- rienced in the past five days. He also noticed that his urine was dark and in reduced amount. Quick antigen test for SARS CoV2 was performed, and the patient found Covid-19 positive. He was admitted at the hos- pital ward in a covid-designated unit. Laboratory findings revealed elevation of the inflammatory markers and elec- trolyte disbalance. Metabolic degradation products were markedly increased, serum urea was 44mmol/L (RF=2.7- 7.8 mmol/L) and serum creatinine 689umol/L (RF=45- 109umol/L), when deterioration of the kidney function was diagnosed. Urgent intermittent hemodialysis treatment was initiated. Patient suffered from a severe form of covid-19 pneumonia and was continuously on high flow oxygen mask. Duration of the patient hospitalization was 30 days, and thereafter, he was transferred to the reha- bilitation center for 28 days. Complete restoration of the physical motion and activity was accomplished, oxygen support was no longer needed, since he main- tained blood oxygen saturation above 95%. Renal func- tion has also been recovered with degradation products maintained within normal ranges. Conclusion. Rhabdomyolysis in covid-19 patients should be always kept in mind. Sometimes it can be an initial clinical manifestation in covid-19 patients [15], but on the other hand it can be presented as a late complication sometimes caused by the therapy itself. Multidiscipli- nary and comprehensive approach in the diagnosis, treat- ment and follow up of the patients can only guarantee timely detection and wide range of therapeutical moda- lity, leading to a better prognosis and outcome. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, INCIDENCE, RISK FACTORS AND OUTCOMES OF ACUTE KIDNEY INJURY IN PRETERM NEWBORNS(Macedonian Association of Anatomists, 2021); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NEONATAL ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT(2017); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NEONATAL ACUTE KIDNEY INJURY ASSOCIATED WITH COMORBID CONDITIONS(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2015)Acute kidney injury (AKI) is a common clinical problem in neonatal intensive care units. Predisposing factors are perinatal asphyxia, prematurity, sepsis, and congestive heart failure. The aim of this study was to determine the contributung conditions associated with neonatal acute kidney injury.Materials and methods. In a clinical prospective sudy we evaluated neonates with acute kidney injury who had been hospitalized in the NICU at University Childrens Hospitals in Skopje, Republic of Macedonia. We studied medical records of neonates with a diagnosis of acute kidney injury in the period 2013-2014. Results. Out of 450 hospitalized neonates, 29(6.4%) with a documented acute kudney injury were analyzed in the study. The male to female ratio was 2.6:1. Most of the neonates involved in the study were term neonates (66%). Prerenal AKI was evaluated in 80% of cases. Perinatal asphyxia was the most common predisposing factor for kidney injury in our study and was evaluated in 56% cases with predomination of term infants and male. Sepsis was present in 44% of cases, prematurity in 34%, and congenital malformations in 27% of cases. Mortality rate was 26% and it was significantly higher in patients with assisted ventilation and sepsis (p<0.05). Conslusion. Early recognition of risk factors and rapid effective tratment of contributing conditions will reduce acute kudney injury in neonatal period. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, SCORE FOR NEONATAL ACUTE PHYSIOLOGY PERINATAL EXTENSION II (SNAPPE II) IN NEONATES WITH ACUTE KIDNEY INJURY(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2019); ; Timovski VObjective: Acute kidney injury is a serious clinical problem in neonatal intensive care unit. It is defined as a sudden decrease in kidney function resulting in derangements in fluid balance, electrolytes, and waste products. SNAPPE 2 score is a useful tool for assessing the severity of the disease that correlates with neonatal mortality. The aim of the study was to determine the incidence of AKI and the role of SNPPE 2 score in predicting mortality and morbidity in AKI in neonates. Materials and Methods. The study was designed as a prospective, clinical, epidemiological investigation conducted in the period of three years, which included 100 newborn infants (50 with AKI and 50 without AKI) hospitalized in NICU of University Children’s Hospital. The severity of the illness of hospitalized newborn infants was estimated with SNAPPE 2 score realized in the first 12 hours of admission in NICU. Medical data records of admitted neonates with AKI were analyzed. The material was statistically processed using methods of descriptive statistics. Results. During the study period 770 newborns were hospitalized in NICU due to various pathological conditions and 50 newborns have been selected with AKI. As the control group, 50 newborns were taken with comparable associated pathological conditions, but without kidney injury. The calculated prevalence of AKI in neonates was 6.4%. Most of involved neonates in the study in both groups (AKI and non AKI) were born at term (64% and 54%) with predominance of male (68% and 60%). The mortality rate was higher in newborns with AKI than control group (36% vs 24%). In half of newborn infants with AKI predominate severe score level, while in control group predominate median score level (42%). There is a significant difference between the mean score value in neonates with AKI and lethal outcome compared to neonates with AKI without lethal outcome (70.73 ± 18.6 vs. 40.2 ± 16.6). Conclusion: Acute kidney injury is a life threatening condition with still high mortality rate. The severity of the illness of hospitalized newborn infants in NICU is estimated by SNAPPE 2 score. The high score level is associated with the severity of the disease and higher mortality. Appropriate treatment of newborns with severe kidney injury improves the outcome and reduces the mortality of the disease. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ACUTE KIDNEY INJURY IN NEONATES AND NEUTOPHILIC GELATINOUS ASSOCIATED LIPOCALIN AS EARLY BIOMARKER(Macedonian Association of Anatomists, 2019); ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Using Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE II) In Neonates with Acute Kidney Injury(ID Design 2012/Scientific Foundation SPIROSKI, 2019);