Abstract
Background: Contrast-induced nephropathy (CIN) is a serious complication of the use of iodinated contrast media (CM), and is associated with increased morbidity and mortality. Purpose: To investigate whether radiologists take sufficient measures to prevent CIN in computed tomography (CT). Material and Methods: 2005 survey of 509 European radiologists who had ≥3 years' experience and performed ≥50 CT scans/week. Results: The most common methods used to identify patients at risk of CIN were renal function measurements (64%), clinical judgment (55%), and patient questionnaires (31%); 9% made no routine attempt to identify at-risk patients. The most common preventive protocols used in at-risk patients included: intravenous (i.v.) saline volume repletion (59%) or oral hydration (52%) before/after CT; use of low-osmolar CM (LOCM; 40%) or isosmolar CM (IOCM; 36%); and N-acetylcysteine (20%); 8% used no hydration regimen. While 78% of respondents used ≤100ml of CM in high-risk patients, 14% used ≤150ml, and 9% set no volume limit. For 57% of respondents, osmolality was the most important attribute in choosing an iodinated CM in at-risk patients; 41% agreed that CIN risk is lower with IOCM versus LOCM (31% disagreed). Conclusion: A European radiologist survey identified a need for increased implementation of evidence-based protocols to improve CIN prevention: routine identification of at-risk patients; withdrawal of nephrotoxic drugs; use of volume repletion regimens; lowest possible volume of CM; and appropriate CM.
Original language | English (US) |
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Pages (from-to) | 310-320 |
Number of pages | 11 |
Journal | Acta Radiologica |
Volume | 49 |
Issue number | 3 |
DOIs | |
State | Published - Dec 1 2008 |
Keywords
- Contrast-induced nephropathy
- contrast media
- radiologists
- survey
ASJC Scopus subject areas
- Radiological and Ultrasound Technology
- Radiology Nuclear Medicine and imaging