title: Serum creatinine measurements: evaluation of a questionnaire according to the ESUR guidelines.
abstract: BACKGROUND
  The European Society of Urogenital Radiology (ESUR) propose measurements of serum creatinine levels in patients undergoing contrast-enhanced studies with a high probability of impaired renal function and therefore with a higher risk of CIN and NSF.
  
  
  OBJECTIVE
  To determine whether the recommended questionnaire is able to select these patients.
  
  
  METHODS
  Over a time period of 10 months the questionnaire was conducted in 1389 patients (725 women, 654 men) before contrast administration for computed tomography (CT) or magnetic resonance imaging (MRI) examination. Serum creatinine (SCr) measurements and calculation of estimated glomerular filtration rate (eGFR) values were performed when one or more answers were positive. Eighty-one patients were excluded due to incomplete data. Statistical evaluation of the questionnaire was done retrospectively.
  
  
  RESULTS
  Four hundred and ninety-nine patients (38%) gave one or more positive answers to the questionnaire. Of these, 71 (14%) had an eGFR <60 mL/min/1.73 m(2), 31 (6%) had an eGFR <45 mL/min/1.73 m(2), and five (1%) had an eGFR <30 mL/min/1.73 m(2). Only the question concerning previous renal disease showed a significant correlation to an eGFR <60 mL/min/1.73 m(2) (P < 0.05) and <45 mL/min/1.73 m(2). Slight correlations with some other risk factors (renal disease, family history of renal disease, arterial hypertension with medication, analgetic medication with nephrotoxic drugs) were found for either a threshold of 60 or 45 mL/min/1.73 m(2). In addition, there was a positive correlation with patient age.
  
  
  CONCLUSIONS
  We propose to reduce the questionnaire to a smaller number of risk factors and consider a point-of-care (POC) SCr measurement for all patients aged >70 years without a recent eGFR value while referred for CT. For MRI a SCr measurement is not mandatory while using medium and lowest risk contrast agents.
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland Caroline.Zaehringer@usb.ch.
authors.forename: Caroline
authors.initials: C
authors.lastname: Zähringer
authors.affiliation: Department of Radiology, Spital Limmattal, Schlieren, Switzerland.
authors.forename: Silke
authors.initials: S
authors.lastname: Potthast
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Anthony Joseph
authors.initials: AJ
authors.lastname: Tyndall
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Bongartz
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Joachim
authors.initials: J
authors.lastname: Hohmann
mesh_terms: D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D005060:Europe; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D008487:Medical History Taking / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011871:Radiology; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors; D012955:Societies, Medical; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: CT; MR-imaging; contrast agents – intravenous