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Health Policy and Practice |
1 From the Radiology Section, Emory Clinic, 1364 Clifton Rd NE, Atlanta, GA 30322. From the 1996 RSNA scientific assembly. Received November 25, 1998; revision requested January 18, 1999; final revision received December 3; accepted December 17. Address correspondence to R.B.T. (e-mail: rtippin@emory.edu).
PURPOSE: To determine the percentage of outpatients with elevated serum creatinine levels (
2.0 mg/dL [177 µmol/L]) and associated reported risk factors for contrast material–induced nephrotoxic reactions (eg, diabetes, renal disease, male, age 60 years, chemotherapy) who undergo computed tomography (CT) and to define a true high-risk population.
MATERIALS AND METHODS: The serum creatinine levels were obtained in a total of 2,034 consecutive outpatients (969 male, 1,065 female) who underwent contrast material–enhanced CT. In addition, selected patient charts were reviewed to determine the presence of risk factors for contrast material–induced nephrotoxic reactions.
RESULTS: Only 66 (3.2%) had an elevated serum creatinine level. Risk factors were identified in 64 of the 66 (97%) patients with an elevated serum creatinine level. Renal disease was present in 62 of the 66 (94%) patients. Two of the 66 patients with an elevated creatinine level had no identifiable risk factors, representing 0.1% of the total number of patients.
CONCLUSION: The data suggest that the majority of patients with a serum creatinine level of at least 2.0 mg/dL (177 µmol/L) will be identified by screening for risk factors. Careful patient screening, especially for renal disease, at the time of scheduling could result in considerable savings in terms of radiology man-hours expended and laboratory costs.
Index terms: Contrast media, complications, 81.12112 • Kidney, CT, 81.12112 • Kidney, failure
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