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Technology at Ascension treats heart and kidney disease patients, prevents dialysis

Posted at 5:22 PM, Mar 22, 2022
and last updated 2022-03-22 23:31:15-04

DETROIT (WXYZ) — It's estimated that 940,000 adults in Michigan have chronic kidney disease, and many don't even know it.

But there is new technology being tried at Ascension St. John Hospital for patients suffering from heart and kidney disease that may keep them away from the much-dreaded kidney dialysis.

For one patient, it has given him a renewed spirit about life and what the future holds for him and his lifestyle.

At 76 years old, Dan Kowalski is an avid golfer who before retirement noticed his energy began to wane and he was fearful something was wrong.

“My feet started hurting, my leg started hurting, I started feeling fatigued,” Kowalski said.

He was advised to see Dr. Antonious Attallah, who believed he had a blockage in his heart.

“He said I might have one, might have two, might have three. I got a little alarmed, then I said, 'Hold on, now you're not going to cut my chest open,'” Kowalski explained.

Kowalski’s biggest fear was dialysis after hearing horror stories from a dear friend who told him his kidneys were destroyed during a medical procedure.

“He had to go on dialysis, and he had told me that he would rather die than go on dialysis. He just got very depressed,” Kowalski said about his friend’s situation.

Under normal circumstances, when doctors search for blockages in your heart during a catheterization, they use nearly 100 cc's of contrast dye to locate the blockage that's about this much.

"When a patient is on the table for a diagnostic cauterization or intervention, we calculate the allotted amount of contrast material that we can use without hurting their kidneys," Attallah said.

Attallah uses new technology to map out a patient's arteries like a puzzle. Using an intravascular ultrasound, they pinpoint the location of the blockage to decipher the diameter of the blood vessel and length of the disease.

“We know before the patient gets off the table what kind of results we have,” Attallah said.

Attallah says there has been controversy about whether the contrast dye damages a patient's kidneys. So, he significantly reduces the amount of contrast dye he uses in the cath lab.

“We have to kind of figure out in a way where we minimize injury to the kidney because of the dye,” Attallah said.

During Kowalski's first visit, Attallah did what is called a fractional flow reserve study to get the initial pictures of the blockage.

“The entire first procedure was done with about 12 cc's of dye total,” Attallah said.

Attallah then consults with a nephologist, which is a kidney doctor. Attallah says in the past, a patient like Kowalski with a blockage would have been sent home with medication only instead of intervention for fear his kidneys would be damaged.

Because of the potential for damage, many patients are not allowed to get the procedure even though they need it.

“We have patients who come in with a heart attack and are not taken to the cath lab because of this,” Attallah said.

Now with this new technology, using ultrasound and less contrast dye, the risk for damage to a patient's kidneys and lifelong dialysis is significantly lower and a patient like Kowalski can get back to enjoying life.

“I feel good, I just started my rehab,” Kowalski said.

As for his thoughts on Attallah after another doctor told him he would likely end up on dialysis.

“I feel blessed that I had Dr. Attallah and I didn't have a heart attack,” Kowalski said.