There is a stealthy, time-sensitive and potentially deadly condition that is unfortunately a common complication for critically ill patients. Called acute kidney injury (AKI), this condition impairs the kidneys ability to clear toxins from the blood and produce urine. It may lead to long term renal failure if not treated, managed and addressed expeditiously.
AKI can cause a patient to stay in the hospital longer, with a higher risk of developing long-term complications and even increase the risk of death. AKI kills an estimated 2 million people worldwide annually, and that number continues to grow. As the population ages, septic shock and increased toxicity from prescription drugs are contributing to more cases of AKI.
AKI can progress without symptoms for hours to days, and the standard creatinine blood test can take up to 2 to 3 days to show changes, often after acute kidney damage has occurred. Because of this, AdventHealth Waterman launched a new, first-of-its-kind assessment test to help reduce the risk of developing this devastating disease.
AdventHealth Waterman provides Astute Medicals NephroCheck Test in the intensive care unit (ICU), where it is used on patients to address the threat of AKI. This new, lifesaving technology is the first of its kind to be used in Central Florida.
With NephroCheck Test in our ICU, we can determine if a patients kidneys are stressed and at risk of developing AKI in the next 12 to 24 hours, and then take early action to protect the kidneys and prevent the development of this deadly complication, said Dr. Louis M. Guzzi, intensivist and medical director of AdventHealth Waterman’s intensive care unit. For years, we have been using tests that tell us if a patient is having a heart attack so that we can treat those patients proactively. It's the kidneys turn now: We can diagnose the threat of renal failure before renal failure occurs.
By using the NephroCheck Test at AdventHealth Waterman, we give our medical staff a new tool for the early recognition and management of patients at risk for AKI, said Jeff Higgins, administrative laboratory director at AdventHealth Waterman. It has been very exciting for the laboratory to be involved in pioneering a new tool with such a positive impact on patient care.
The NephroCheck Test quantitatively measures two urinary biomarkers tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7), which have been related to early kidney stress. In high-risk hospital patients, this stress can signal the threat of moderate to severe AKI in the future.
A study published in the journal, Intensive Care Medicine, found that using the NephroCheck Test to identify patients at high risk for AKI after open-heart surgery and providing them treatment recommended by globally-recognized care guidelines, significantly improved outcomes by reducing the occurrence of moderate to severe AKI more than 33 percent.
It is estimated we have reversed acute renal injury earlier and more effectively without incurring risk to patients in over 20-25 patients in the past 12 months, said Dr. Guzzi. The cost savings benefit and ability to return patients to previous care is incredible. We are providing our patients the most up to date standard of care.