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Sharp HealthCare provides Astute Medical’s NephroCheck test

Astute Medical announced that Sharp HealthCare, one of Southern California's leading health care providers, has become the first in the state to begin using a first-of-its-kind risk assessment test for acute kidney injury (AKI), a stealthy, unpredictable and potentially deadly condition that is a common complication for patients in intensive care.

Astute Medical's NephroCheck® Test will allow Sharp clinicians to more quickly identify patients at risk of developing AKI so they can intervene earlier and reduce the threat of irreparable kidney damage, said John Videen, M.D., a nephrologist at Sharp Chula Vista Medical Center.

Once patients develop AKI, mortality rate, risk of complications, length of hospital stay, cost1 and readmissions2 can more than double.

"Nephrologists have been waiting decades for a test to help us detect kidney stress that can lead to kidney injury," Dr. Videen said. "I'm excited to start using it, and believe it will help get a jump on the condition."

AKI is as common and life-threatening as a heart attack. But unlike a heart attack, it has no symptoms and can progress silently for hours to days, sometimes causing irreversible damage before it is detected.3

About half of the 5 million4 people admitted to intensive care units in the United States each year will develop AKI.5 About 2 million people worldwide die from AKI annually.6

The NephroCheck® Test helps clinicians determine if certain hospitalized patients are at risk of developing moderate to severe AKI in the 12 hours following test administration.

 Early knowledge that a patient is likely to develop AKI may prompt closer patient surveillance and help prevent permanent kidney damage or death.7

The 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.8

"I've envied cardiologists, who've had many tests for the heart, while we have had so few for the kidneys," Dr. Videen said. "Previously, when we had a patient with kidney dysfunction or abnormal test results, we couldn't tell if the kidneys were showing a normal reaction to stress or if they were headed toward AKI. To me, this is how the test comes in handy."

Sharp nurses will administer the test to patients with sepsis and those receiving cardiac care who are not progressing as expected, he said. Both are high-risk groups for AKI. Sepsis is the most common cause of AKI in critically ill patients (47.5 percent).9 And for cardiac surgery patients, developing AKI increases risk of death during hospitalization by 500 percent.10 A nephrologist will be notified when patients' biomarker levels indicate they are at risk for AKI.

"This will allow us to get a 12-hour head start on the disease," Dr. Videen said. "It may give physicians enough advance warning that they can implement kidney-supportive measures, such as withholding nephrotoxic drugs."  

Prior to the NephroCheck® Test, clinicians could detect AKI only after it had already occurred.3 "By the time I'd get the call about a patient, the only decisions left were whether to start dialysis and what kind of dialysis to use," Dr. Videen said.

According to Dr. Videen, the primary motivation for using the test is to provide the highest quality care and to potentially reduce the rate of complications. "I'm sure administrators also recognized it might have secondary benefits of reducing hospitals costs."

The NephroCheck® Test System is intended to be used in conjunction with clinical evaluation in patients who currently have or have had within the past 24 hours acute cardiovascular and or respiratory compromise and are intensive care unit (ICU) patients as an aid in the risk assessment for moderate or severe AKI within 12 hours of patient assessment.