Preventing Acute Kidney Failure


TAMPA, Fla. (Ivanhoe Newswire) — In about 20 percent of patients who come into a hospital intensive care unit, the kidneys suddenly lose the ability to eliminate waste and clean the blood, which can lead to permanent damage or death. Critical care specialists at one Florida hospital have implemented a new procedure for testing and treating acute kidney failure and it is saving lives.

The last thing Bonnie Corley remembers from last spring was doing some work in her yard.

“Next thing I heard was some kind of screaming and groaning, and she’d come out here and was rolling on the floor,” said John Corley, Bonnie’s husband.

An emergency crew raced Bonnie to the hospital, where her systems began to shut down. The next day, doctors put her on a ventilator to give her body a break. Critical care specialist at AdventHealth Waterman Louis Guzzi, MD, knew without immediate intervention, Bonnie’s kidneys would be at risk.

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Dr. Guzzi told Ivanhoe, “As I would say time for the kidneys is really money for the kidneys. I need to get those kidneys reprofused as soon as possible before they start shutting down.”

Dr. Guzzi and his colleagues used a new approach to determine patient risk of acute kidney failure. First, they used a device called Flowtrack to measure fluids passing through the system. At the same time, a blood test called Nephrocheck lets doctors know if the kidneys are in trouble. Dr. Guzzi said the very early intervention is making a difference.

Dr. Guzzi detailed, “Our rate here was about 9.8, 9.9 percent renal failure. We’re 2.1 right now.”

After 30 days in a medically induced coma, doctors slowly brought Bonnie back.

“I missed my birthday, Mother’s Day, my third son’s birthday,” said Bonnie.

Now, she’s back to visit the medical team who treated her, as she continues to get stronger.

John said, “There’s been some good things that’s happened. We’re closer. We spend more time together. I think you tell me you love me every once in a while.”

Despite Bonnie’s health scare, she no longer needs dialysis. Dr. Guzzi and his colleagues named the protocol after the hospital where they work, AdventHealth Waterman in Tavares, Florida. A paper on the success of the Waterman protocol was published in a major medical journal last year, and since that time, Dr. Guzzi said as many as two dozen other hospitals have begun using the Waterman protocol on their patients.

Contributors to this news report include: Cyndy McGrath, Supervising and Field Producer; Roque Correa, Editor; Kirk Manson, Videographer.

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                                                               RESEARCH SUMMARY


REPORT:       MB #4729

BACKGROUND: Kidney failure is linked to a number of factors, like toxic exposure to environmental pollutants, certain acute and chronic diseases, kidney trauma and severe dehydration. Some of the symptoms that are associated with kidney failure are reduced urine, swelling in the ankles, feet, and legs from retention of fluids, confusion, seizures, and even coma. Kidney failure is mostly caused by loss of blood flow to the kidneys which can be caused by heart disease, dehydration, severe burn, allergic reaction, or sepsis. Urine elimination problems, a blood clot in the kidneys, lupus, scleroderma and for those with cancer,  chemotherapy drugs are also causes of kidney failure. There are five types of kidney failure: acute prerenal, acute intrinsic, chronic prerenal, chronic intrinsic and chronic post-renal.


DIAGNOSING: There are many tests that can be used to determine acute kidney failure. There is urine output measurement that looks at how much a patient urinates in 24 hours. Patients can also take blood tests, imaging tests, or kidney tissue sampling.  With most people already in the hospital, doctors try to use IV fluids to balance the amount of fluids in the blood. Kionex can be used prevent the accumulation of high levels of potassium in the blood. Too much potassium can cause irregular heartbeats. Patients can also be put on dialysis or medication to remove toxins and restore blood calcium levels. They may also recommend lower potassium foods such as apples, peppers and grapes. They may also recommend limiting phosphorus and avoiding products that have added salts.


NEW PROCEDURE: Along with the Waterman Protocol for acute kidney failure, the FDA has approved a new drug created by Johnson and Johnson called INVOKANA. It was approved to reduce the risk of end stage kidney disease and cardiovascular events such as chronic kidney disease. This is also the first treatment for diabetic kidney disease.  Researchers in Dallas are also looking into the effect of N-acetylcysteine on cytokines and markers of oxidant stress after patients get an acute renal failure post liver transplant.



Lindsay Cashio, Director of Communications

AdventHealth Central


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Doctor Q and A

Read the entire Doctor Q&A for Louis Guzzi, MD, Chief critical care medicine

Read the entire Q&A