Victims of Near-Drowning at Higher Risk of Kidney Injury

It has been found that many people, especially men, who have severe kidney injury have been victims of 
near drowning and suffered a prolonged lack of oxygen.

Drowning is one of the leading causes of accidental death in the world and along Israel’s Mediterranean beaches this happens very often (around sixty drownings per year, more than any other Mediterranean country). 

Doctors have observed that a large number of nearly-drowned patients actually developed a subsequent reduction in kidney function only a few days after being admitted to the hospital. Some of these declines in kidney function were so extreme, they even proved lethal.

As we well know, the kidneys are very important for our health as they remove all wastes from our body to keep a healthy balance of water, salts and minerals in our blood.

In the year 2016, a man, 31 years old, who almost drowned and was submerged in seawater for 4 minutes arrived at the hospital with water in his lungs, respiratory distress, an elevated heart rate, low
blood oxygen concentration and low phosphate levels. He later developed AKI (acute kidney injuryhere. This is the initial case which led to the investigation.

Research was led by Professor Mogher Khamaisi, a senior physician in the Department of Internal Medicine (D) and a member of Rambam’s Clinical Research Institute. Rambam physicians, Doctors Yuri Gorelik and Said Darawshi, also from the Department of Internal Medicine (D), and Hiba Yaseen from the Institute of Diabetes and Metabolism, worked with Prof. Khamaisi on the study, together with
Samuel Heymanat, who serves as Head of the Department of Medicine at Hadassah Hebrew University in Jerusalem.

This study is the largest ever done on the mechanism of kidney damage in near drowning-patients immersed in seawater. The team analyzed the medical records of 95 patients who almost drowned in the Mediterranean Sea and were treated between 2000-2017 and discovered that 45% developed AKI, with 17 of the 95 patients reaching an advanced stage of disease (stage 2/3) as indicated by reduced urine output and a high increase in creatinine levels in the blood.

Creatinine levels normalized within 120 hours in the stage 2/3 group and within 72 hours in the stage 1 group. Patients with stage 2/3 AKI were more likely to require mechanical respiration and treatment in
an intensive care unit (ICU) and had a higher mortality rate, often from multi-organ failure.

It was then concluded that AKI is a common complication of near drowning victims and that it may be more common in males.

This may be due to:

  • Lack of oxygen as well as increased heart rate
  • Very high blood sugar levels
  • Constriction of kidney blood vessels
  • Reduced potassium levels
  • An increased demand for oxygen

The researchers recommend further studies of near-drowning patients at risk for developing AKI, as well as treating and monitoring patients by restoring oxygen levels throughout the body, maintaining proper dilation of kidney blood vessels, and other medical practices to prevent kidney complications.

As horrific as the nightmare of any near-drowning experience can be, a lifetime of kidney problems afterwards is most assuredly worse. So, try your best to follow these safety tips when in any swimming environment

  • Stay in designated areas.
  • When diving into any body of water, feet first is generally accepted as the safer method.
  • Avoid alcohol while swimming.
  • Know CPR or learn it if you don’t.

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