Kinetic estimation of glomerular filtration rate (KeGFR) proved its utility in predicting acute kidney injury (AKI) in both adults and children. Our objective is to assess the clinical utility of KeGFR in predicting AKI severity and progression to acute kidney disease (AKD) in patients already diagnosed with AKI and to examine major adverse kidney events at 30 days (MAKE30). We retrospectively calculated the KeGFR in the first 24 hours of identified AKI (KeGFR1) and in the 24 hours prior to AKD (KeGFR2) in all admitted children under 18 years old. The cohort consisted of 803 patients with AKI. We proposed a new classification of KeGFR stages, from 1 to 5, and assessed the predictive value of KeGFR stages for AKD development and MAKE30. AKI severity was associated with lower KeGFRs. KeGFR1 and KeGFR2 predicted AKD with AUC values between 0.777 and 0.841 respectively, p<0.001. KeGFR2 had the best performance in predicting MAKE30 (AUC of 0.819) with a sensitivity of 66.67% and specificity 87.7%. KeGFR1 stage 3, 4 and 5 increased the risk of AKD by 3.07, 6.56 and 28.07 times respectively while KeGFR2 stage 2, 3, 4 and 5 increased the risk of AKD 2.79, 3.58, 32.75 and 80.14 times fold. Stage 5 KeGFR1 and KeGFR2 stages 3, 4 and 5 increased the risk of MAKE30 by 7.77, 4.23. 5.89 and 69.42 times in the adjusted models. KeGFR proved to be a useful tool in AKI settings. KeGFR dynamics can predict AKI severity, duration and outcomes.

Background/Objectives: Urinary tract infections represent a global problem with implications on mortality and morbidity. Published data present different bacterial incidence and different antibiotics resistances. With this study, we aimed to evaluate bacteria distribution and antibiotic resistance in a tertiary care hospital from the Western part of Romania. Methods: we evaluated all the positive urine culture from the year 2021 from the Emergency County Hospital “Pius Brinzeu” from Timisoara, Romania. We evaluated 1264 urine cultures and identified the following bacteria: Escherichia Coli, Klebsiella spp, Proteus spp., Pseudomonas auruginosa, Staphylococcus aureus, Enteroccocus spp., Enterobacter spp., Acinetobacter baumanii, Providencia spp., Corynebacterium spp. Results: Median age was 67 with 65.6% females. Diabetes mellitus incidence was 12%. Most common bacteria was E. coli – 44.1%, followed by Enterococcus spp. – 17.1%, Klebsiella spp. -15.7% and Proteus spp. – 5.4% E. coli presented the highest resistance rate to amoxicillin-clavulanic acid (50%), Enterococcus spp. to ciprofloxacin (71.3%), Klebsiella spp. to piperacillin-tazobactam (43.3%) and Proteus spp. to trimetroprime-sulfometoxazole (33%). The highest incidence of MDR bacteria was among Acinetobacter baumanii (40%), followed by MRSA (31.8%) and Klebsiella spp. (25.3%). Conclusions: Bacteria distribution is similar in all the Romanian regions among the positive urine cultures. Antibiotics resistance differ among regions and the MDR bacteria incidence is rising.

Background: Acute kidney disease (AKD) is a known risk factor for increased mortality and evolution towards chronic kidney disease (CKD) in adults. The data regarding children are scarce. The purpose of our study is to explore the risk factor for AKD and impact of AKD following an acute kidney injury (AKI) episode in children on mortality and new-onset CKD. Methods: We retrospectively evaluated 736 children with ages between 2 and 18 years old with AKI admitted in a tertiary care hospital from the west Romania over a 9 years period. Results: AKD incidence following AKI was 17%. Patients that developed AKD were older, with higher baseline serum creatinine values, urea, C reactive protein and lower proteins, haemoglobin and sodium. They were more often exposed to sepsis, critical illness and nephrotoxic medications and presented certain susceptibilities like CKD, neoplasia, anemia, heart failure, arterial hypertension, stem cell transplant and female gender. AKI causes that increased the risk of AKD were intrinsic ones. AKD increased the overall mortality by three times. The factors that independently increased the risk of evolution towards CKD were AKD, acute tubular necrosis and higher baseline serum creatinine values. Conclusions: AKD is an independent risk factor for mortality and new-onset CKD in children.