For the World Kidney Day Steering Committee 2013* *World Kidney Day (WKD) is a joint initiative of the International Society of Nephrology and the International Federations of Kidney Foundations WKD Steering Committee members: Miguel Riella (Brazil, co-chair), John Feehally (UK, co-chair), Timur Erk (Turkey), Paul Beerkens (Netherlands), Guillermo Garcia-Garcia (Mexico), Philip KT Li (Hong Kong), William G Couser (USA), Georgi Abraham (India), Paul Shay (Canada), Luca Segantini (Belgium), Sara Martin (Belgium) Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Anemia in Chronic Kidney Disease aims to provide guidance on diagnosis, evaluation, management and treatment for all CKD patients (non-dialysis, dialysis, kidney transplant recipients and children) at risk of or with anemia. Guideline development followed an explicit process of evidence review and appraisal. The guideline contains chapters addressing diagnosis and evaluation of anemia in CKD and the use of various therapeutic agents (iron, ESAs and other agents) and red cell transfusion as means of treatment. Treatment approaches are addressed in each chapter and guideline recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the GRADE approach. Ongoing areas of controversies and limitations of the evidence are discussed and additional suggestions are also provided for future research.

The review provides the current concept on the efficacy and safety of various schemes of antiviral therapy for viral hepatitis in renal transplant recipients. It also provides a brief overview of the method of double-filtration plasmapheresis the treatment of hepatitis.

Decreased renal function is a prevalent risk factor for unfavorable prognosis in patients with stable and decopmensated heart failure (HF). This review covers epidemiology data and pathophysiology of cardiorenal interactions in stable and decompensated HF. A variety of worsening renal function mechanisms in decompensated HF has been discussed, including «pseudo-cardiorenal syndrome» due to iatrogenesis. The complexities in understating the rapid decrease of GFR and clinical decision making in patients with advanced decompensated HF have been noted.

Calcium binding cooperative parameters by tissue was analysed in 28 kidney recipients (19 men and 9 women, 32 ± 12 years old) with sufficient graft function. Patients received triple immunosuppression (cyclosporine, metipred, azathioprine) under conditions of acute hypercalcaemia followed by a drip IV infusion of calcium gluconate over 2,5 hours. At the end of each 30-minute period the amount of calcium retained by tissue was recorded and the kinetic parameters of calcium binding were determined according to Langmuir and Scatchard. In all recipients there was a segment of binding isotherm with positive cooperativity (direct regression in Scatchard) with normal buffer capacity (b) for calcium in Langmuir. 7 recipients in early and 9- in late date after operation demonstrated cooperativity at [Ca⁺⁺] 1,0–1,3 mmol/l (first variant in health) while 10 recipients in early and 2 in late date – at [Ca⁺⁺] 1,3–1,5 (second variant in health). 6 from 13 kidney recipients showed disturbed tissue structure calcium binding parameters with [Ca⁺⁺] 1 mmol/l namely decreased the association constant (Ka), increased the number of interactive sites (n), reduced calcium exchangeable pool (Me). Additionally, [Ca⁺⁺] at Me = 0 was elevated that means the shift of calcium binding curve to the right that may predispose to hypercalcaemia. Glucocorticoid therapy, hyperparathyreose, hypocalcitoninaemia were not the reasons of these disturbances.

Renal arterial hypertension (AH) is an important medical and social problem. Uncontrolled AH increases the risk of development of cardiovascular diseases causing complications and increasing mortality in affected patients. One of the early cardiovascular complication markers in patients with AH is changes of the arterial wall – thickening of the arterial intima-media (IMT). A number of clinical studies in adults with cardiovascular disease show a high correlation between IMT and coronary and cerebrovascular complications. However, it is not yet clear if children with renal AH have the risk of the cardiovascular complications. The aim of the study was to evaluate the relationship of AH with indicators of blood vessels condition (carotid and femoral arteries) and hemodynamic parameters in children with renal diseases. In this group of children we found significant correlation of IMT of the common carotid and femoral arteries, level of AH and structure of the left ventricle measured with echocardiography. Hereby we suggest that in children with renal AH assessment of the arterial IMT thickening is a useful method for detection of the risk of cardiovascular complication. This method should be included in a comprehensive program of investigation of such children.

The aim of the study was to assess the hydration status in dialysis patients during a year of observation on the basis of clinical, laboratory, echocardiographic parameters and data of bioimpedance analysis with Body Composition Monitor. A comparative assessment of the level of hydration in each group of patients and between dialysis groups was made in 87 dialysis patients with different types of renal replacement therapy. The patients on peritoneal dialysis were more hyperhydrated than haemodialysis patients ( p < 0,05), had higher blood pressure ( p < 0.05), received more hypotensive drugs ( p < 0,05). The decline of mean arterial blood pressure had been reported in both groups due to the "dry weight" correction. In haemodialysis group a decrease in amount of hypotensive drugs without intradialysis complications increase was observed ( p < 0,05). Hydration in PD patients depended on gender, dialysis vintage, residual diuresis and affected on arterial blood pressure, number of hypotensive drugs, the percentage of extracellular fluid, frequency of concentric left ventricular hypertrophy and diastolic dysfunction, as well as on the thickness of the posterior wall of the left ventricle ( p < 0,05). In haemodialysis patients a hydration level was depended on the gender, the percentage of extracellular fluid, body mass, body mass index, lean and fat mass, volume ultrafiltration per session and affected the frequency of diastolic dysfunction, myocardial mass ( p < 0,05). The multifrequency bioimpedance examination seems to be a reliable method for evaluation of the water status in dialysis practice.

A case rare complication of kidney biopsy, arterio-venous fistula, is described. It was diagnosed with the data of ultrasonic and angiography investigation. Indications and possible complications of kidney biopsy are discussed.