Published in:
01-03-2014 | Radiological Education
Can a structured questionnaire identify patients with reduced renal function?
Published in: European Radiology | Issue 3/2014
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Objectives
To evaluate a structured questionnaire in identifying outpatients with renal dysfunction before MRI or CT in various age groups.
Methods
All patients completed a questionnaire with five risk factors indicating renal dysfunction: renal disease, renal surgery, hypertension, gout and diabetes. Serum creatinine determined by the point-of-care (POC) technique and estimated glomerular filtration (eGFR) rate was calculated using CKD-EPI equation.
Results
A total of 1,467 patients were enrolled. Thirty-four patients (2 %) had an eGFR <30 ml/min/1.73 m2 and 123 (8 %) had an eGFR <45 ml/min/1.73 m2. Among 55 % of the 1,467 patients reporting at least one risk factor, 30 (4 %) had an eGFR <30 ml/min/1.73 m2 and 105 (13 %) had an eGFR <45 ml/min/1.73 m2. Among 651 patients not reporting a risk factor, 4 (0.6 %) had an eGFR <30 ml/min/1.73 m2 and 18 (3 %) had an eGFR <45 ml/min/1.73 m2. All four patients were >70 years old, and 12 of the 18 patients were >70 years old.
Conclusion
The questionnaire used in patients <70 years old and determination of eGFR in patients >70 years old identified all patients with an eGFR between 30 and 45 ml/min/1.73 m2 except 0.4 %.
Key points
• A questionnaire can adequately identify patients under 70 with renal dysfunction
• 8 % of patients referred to CT/MRI have an eGFR <45 ml/min/1.73 m
2
• 55 % reported risk factors, but renal dysfunction was only found in 13 %
• Patients over 70 years should have eGFR determined before CT
• eGFR determination is not beneficial when stable MRI agents are used