Background: The C-reactive protein (CRP) to albumin ratio (CAR) is a new index calculated by dividing CRP by the albumin level. It has been claimed to have predictive value in determining morbidity and mortality in many critical diseases Aim: In this research, we aimed to elucidate the importance of CRP, albumin, and CAR as parameters that can predict the clinical course in COVID-19 patients.Materials & method: In this retrospective analysis, the clinical, laboratory, and radiological findings of patients over the age of 18 who were diagnosed with SARS-CoV-2 infection with a positive reverse transcription-polymerase chain reaction (RT-PCR) test were evaluated. Age, gender, laboratory examinations at admission, and CRP and albumin values at the time of diagnosis have been recorded. The relationship of these parameters with the requirement for intensive care, exitus, and serious illness in the clinical follow-up of the patients was investigated. The baseline hospitalization parameters of the patients were compared between the severe and non-severe groups.Results: Individuals with severe disease had a higher rate of additional disease than those with non-severe disease. It was observed that the mean laboratory values of patients with severe disease had a statistically higher level of D-dimer, CRP, aspartate aminotransferase (AST), platelet distribution width (PDW), CRPalbumin ratio, and ferritin, compared to mild to moderate cases (p<0.05). The rate of additional disease in deceased patients was higher than in patients who were alive (p<0.05). The CAR value was found to be moderately predictive in our study revealing the severity of the disease, and the possibility that the severity of the disease might be higher in patients with a CAR value above 21.47. Conclusion:The results of this study revealed that CAR is a potential parameter in distinguishing critically ill COVID-19 patients in need of intensive care. Therefore, one can say that CAR is an important biomarker in clinically determining COVID-19.
Each kidney is supplied by a single renal artery, although renal artery variations are common. Variations of the renal artery have become important with the increasing number of renal transplantations. Numerous studies describe variations in renal artery anatomy. Especially the left renal artery is among the most critical arterial variations, because it is the referred side for resecting the donor kidney. During routine dissection in a formalin fixed male cadaver, we have found a bilateral renal artery variation. The presence of multiple renal arteries increases the complexity of the transplant surgery procedures.Keywords: polar artery; renal artery variations; renal transplantation; testicular artery anatomy hilum, and accessory hilar types which supply the kidney after passing through the hilum. [8] Accessory renal arteries are found frequently on the left side.[7] Verma et al. [6] discovered three renal arteries on the left side as a variation. The left main artery and two other arteries from a common trunk were found in their case. This was similar with the case in our report, except the superior renal artery had two branches in this case. [6] Aristotle et al.[1] used 30 kidneys from 15 adult cadavers in their study. The normal pattern of blood supply was observed in 86.6% of their cases. They found an accessory renal artery in four cases (13.3%). In three cadavers, lower polar arteries were dissected. In two cases, they were arising from abdominal aorta as found in the present case.[1]The length of the right polar artery was 6.7 cm in our case. In some specimens, shorter polar renal arteries were determined. Chatzizacharias et al. [9] emphasized the importance of the presence of multiple renal arteries, especially for short polar arteries. The short polar arteries enhance the degree of difficulty, due to segmental renal perfusion. Its injury may produce segmental ischemia with accompanying hypertension. [2,9] Khamanarong et al.[2] dissected 534 kidneys and presented the number and percent of renal arteries and polar arteries in six groups. We determined two of these groups on the left and right sides. On the right side, one hilar artery with one lower polar artery was observed in the present case. Khamanarong et al. [2] determined this variation in 3% of the cases. Khamanarong et al.[2] detected one lower polar artery posterior to ureter in three of 534 cases (0.56%) as in the present case. Two of the three kidneys were on the right side as in the present case and one of these was on the left side. Kumar et al.[10] observed a bilateral vascular variations at the renal hilum. On the right side, renal artery with its normal origin and course from the abdominal aorta divided immediately into two branches. The superior branch pierced the upper pole of the kidney. On the left side, the hilum was wide and situated on the anterior surface of kidney. This bilateral renal hilar pattern with distorted shapes of kidneys was also not reported previously. [10] In our case, two hilar arteries were found on the ...
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