ABSTRAKT Akutna bubrežna insuficijencija nakon kontrastnih procedura ili contrast indukovana nefropatija (CIN-Contrast-induced nephropaty) se definiše kao povečanje vrijednosti serum kreatinina najmanje 0,5 % mg/dl ili 25% do 50 % u odnosu na predproceduralne vrijednosti u toku 48 do 72 sata nakon apliciranja kontrasta, u odsustvu drugih objašnjenja za nastanak oštećenja bubrežne funkcije. Ona je odgovorna za pojavu akutne bubrežne insuficijencije u 11 do 14,5 % slućajeva. CILJ STUDIJE: Cilj ove studije je određivanje rizićnih grupa pacijenata i faktora kao I profilaktičkih mjera za kontrastnu nefropatiju nakon koronarografije. U studiju je ukljućeno 200 pacijenata (dijabetičari i nedijabetičari) koji su uradili koronarografiju zbog indikacije na koronarnu bolest. ZAKLJUČAK: Rizićni faktori za nastanak kontrastne nefropatije kod ovih pacijenata su, šećerna bolest, starija životna dob, aplicirana veća kolićina kontrasta, prethodne bolesti bubrega i srćana slabost.

Aim: This study sought to assess whether the volume and osmolarity of contrast media (CM) influences the occurrence of contrast induced nephropathy (CIN) following coronarography procedure. CIN can be defined as an increase in the serum concentration of creatinine greater than a 25% from baseline during the period of 12 to 48 hours after the administration of radiocontrast media. Material and methods: We examined 100 patients without diabetes with serum creatinine concentration from 45 mmol/l to 141 mmol/l and 100 patients with diabetes with serum creatinine concentration from 46 mmol/l to 161 mmol/l who underwent coronary angiography. During procedure they received iso-osmolar contrast medium, Visipaque 320 (iodixanol-320), for group without diabetes from 40 to 340 ml and for group with diabetes from 49 to 310 ml. Results: CIN occurred in 27 (13,5%) of the 200 study patients. There was a trend toward higher prevalence of CIN (16% vs.11%, p = 0.086) in the diabetic group compared with the non-diabetic group. Patient with diabetes received less contrast media, they are younger but number patients with CIN are higher. Conclusion: Increasing contrast media dose is associated with the occurrence of CIN following coronarography. But, another risk factors like diabetes mellitus, old age, male sex and preexisting kidney disease have influence of developing CIN after coronarography.

The newest demographic changes in the world and in our country show slow population increase and accelerated growth of elderly population. Apart from this growth of elderly population today we are experiencing increase in life expectancy. Our goal is to present socioeconomic status, usage of health services and patients satisfaction with those services. Our research includes 120 persons older than 65 years living in rural areas of Vares municipality. The data was collected in the period of 01/04/2007 to 01/05/2007. Municipality register provided us with data for elderly population using random sampling method. Examination was carried out using questionnaire papers especially formulated for our research. Statistical analysis includes elements of descriptive statistics X2 and the test of correlation; results with p<05 will be used in our research. Research variables are: sex, age, education level, salary, profession before retirement, number of visits to MD as well to a specialist, days spent in hospital and overall satisfaction with health care services.