Acute kidney injury, or AKI, is commonly misdiagnosed in Oregon and nationwide, according to a new study. The results, which were published in the Journal of the American Society of Nephrology in December, could change the way kidney function is assessed by doctors in certain situations.
An estimated 5 to 7 percent of patients admitted to U.S. hospitals are diagnosed with acute kidney injury. That number increases to 30 to 50 percent for patients in critical or intensive care units. Doctors use a blood test to make the diagnosis, but medical experts say the test only provides a snapshot of the kidney's function at a given moment. Factors like a patient's body size or hydration level can skew the numbers.
For the study, researchers from Columbia University Medical Center tried to come up with a more precise and timely method of identifying patients with kidney injury. To that end, they compared the biomarkers of mice with kidney damage with the biomarkers of mice with dehydration that produced a similar spike in creatinine levels. They discovered that more than a thousand biomarkers differentiated AKI from dehydration, with very little overlap. They also reviewed the medical records of 3.8 million emergency and intensive care patients and found that 73 percent of patients who were diagnosed with AKI had creatinine levels that returned to normal. This suggests that the patients did not have kidney damage. The researchers hope their findings can be used to help improve the initial diagnosis of AKI patients in the future.
Failure to diagnose kidney damage can lead to a worsened condition and reduce the chances of recovery. Patients who have been harmed by misdiagnosis may have grounds to file a medical malpractice lawsuit against the responsible doctor.
Source: Medical Xpress, "Kidney damage diagnosis may be inaccurate for many, suggests study," Feb. 24, 2017