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. 2024 Oct 7;39(38):e298.
doi: 10.3346/jkms.2024.39.e298.

Outpatient Renal Function Screening Before Contrast-Enhanced CT Examinations

Yunseo Lee  1 , Inpyeong Hwang  1 , Yeon Jin Cho  1 , Seung Seok Han  2 , Soon Ho Yoon  3
Affiliations

Outpatient Renal Function Screening Before Contrast-Enhanced CT Examinations

Yunseo Lee et al. J Korean Med Sci. .

Abstract

Intravascular administration of iodinated contrast media can cause contrast-induced acute kidney injury, especially in patients with an estimated glomerular filtration rate (eGFR) less than 30 mL/min/1.73 m². The American College of Radiology (ACR) and the European Society of Urogenital Radiology (ESUR) guidelines recommend renal function screening based on medical history, but their effectiveness has been under-evaluated. This retrospective study included 2,560 consecutive adult outpatients without eGFR measurements within 180 days before contrast-enhanced computed tomography (CT) at a single tertiary hospital from July through September 2023. On the day of CT, they underwent eGFR tests and 1.1% had an eGFR < 30 mL/min/1.73 m², preferentially with histories of gout and renal disease. According to the ACR and ESUR strategies, 16.9% and 38.8% of all study participants were positive, respectively, identifying 92.6% and 96.3% of patients with renal insufficiency. Both strategies demonstrated high negative predictive values. These results support selective renal function screening before contrast-enhanced examinations.

Keywords: Contrast-Induced Acute Kidney Injury; Estimated Glomerular Filtration Rate; Outpatient; Renal Function Screening; Renal Insufficiency.

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Conflict of interest statement

Activities not related to the present article: Yoon SH holds stocks and stock options of Medical IP. Other authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Timeline for eGFR testing prior to contrast-enhanced CT examinations.
eGFR = estimated glomerular filtration rate, CT = computed tomography.
Fig. 2
Fig. 2. Flow diagram for outpatients with an eGFR less than 30 mL/min/1.73 m2 before contrast-enhanced CT examinations.
CT = computed tomography, eGFR = estimated glomerular filtration rate.
See this image and copyright information in PMC

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