Cardiac surgeons at the Washington DC Veterans Affairs Medical Center are ushering in a new era of hospital patient care and safety with the implementation of a ground-breaking test used to predict a patient’s risk for acute kidney injury (AKI), a dangerous and costly complication that can present a greater threat than a heart attack.
The medical center is the first hospital in the Mid-Atlantic Region and the Washington DC Metro Area to deploy the NephroCheck Test made by a San Diego-based company. The novel test detects and measures two biomarkers known as tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7) then produces an AKI Risk Score that can alert physicians to a patient’s risk of developing moderate to severe AKI.
“Patient safety and quality of care are our highest priorities and I hope and expect that this could be a game-changer in terms of protecting our patients from AKI,” said Carlos Palant, M.D., chief of the Renal Section, and professor of medicine at the George Washington University School of Medicine. “This is one more example of the VA taking a leadership role in bringing cutting edge medicine to patients.”
Acute kidney injury often occurs in conjunction with surgery, trauma or infection, however a lack of symptoms can limit physicians’ ability to prevent onset and manage the condition. A 2014 study of hospitalized U.S. Veterans found that those discharged with a diagnosis of AKI had twice the mortality rate of those diagnosed with myocardial infarction (heart attack).
Doctors at the Washington DC Veterans Affairs Medical Center intend to use the test with cardiovascular surgery and intensive care patients.
“Cardiac surgery patients with either chronic kidney disease or dialysis dependence have increased perioperative morbidity and mortality, and half the long-term survival outcome at five years, compared to patients without preoperative renal disease,” said Dr. Gregory Trachiotis, who serves as chief, Cardiac Surgery at the DC Veterans Affairs Medical Center as well as chief of Cardiothoracic Surgery at George Washington University. “As cardiac surgeons, we have attempted to mitigate the risks of developing AKI; yet this most often occurs after the fact.
“Methods of predicting the occurrence of AKI, and implementing therapy to limit or alter the degree of AKI, may not only improve short-term outcomes, but also potentially improve long-term survival. This test may provide cardiac surgeons and others with this ability.”