title: Prediction of presence of kidney disease in patients undergoing intravenous iodinated contrast enhanced computed tomography: a validation study.
abstract: OBJECTIVE
  To validate two previously presented models containing risk factors to identify patients with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2or eGFR <45 ml/min/1.73 m2.
  
  
  METHODS
  In random patients undergoing intravenous contrast-enhanced computed tomography (CECT) the following risk factors were assessed: history of urological/nephrological disease, hypertension, diabetes mellitus, anaemia, congestive heart failure, other cardiovascular disease or multiple myeloma or Waldenström disease. Data on kidney function, age, gender and type and indication of CECT were also registered. We studied two models: model A-diabetes mellitus, history of urological/nephrological disease, cardiovascular disease, hypertension; model B-diabetes mellitus, history of urological/nephrological disease, age >75 years and congestive heart failure. For each model, associations with eGFR <60 ml/min/1.73 m2or eGFR <45 ml/min/1.73 m2was studied.
  
  
  RESULTS
  A total of 1,001 patients, mean age 60.36 years were included. In total, 92 (9.2 %) patients had an eGFR <60 ml/min/1.73 m2and 11 (1.1 %) patients an eGFR <45 ml/min/1.73 m2. Model A detected 543 patients: 81 with eGFR <60 ml/min/1.73 m2(missing 11) and all 11 with eGFR <45 ml/min/1.73 m2. Model B detected 420 patients: 70 (missing 22) with eGFR <60 ml/min/1.73 m2and all 11 with eGFR <45 ml/min/1.73 m2. Associations were significant (p < 0.05).
  
  
  CONCLUSIONS
  Model B resulted in the lowest superfluous eGFR measurements while detecting all patients with eGFR <45 ml/min/1.73 m2and nearly all with eGFR <60 ml/min/1.73 m2.
  
  
  CONCLUSIONS
  • Less than 10% of patients undergoing contrast-enhanced CT have an eGFR of <60ml/min/1.73m2• Four risk factors can be used to detect pre-existent kidney disease • It is safe to reduce eGFR measurements using a four-risk-factor model.
authors.affiliation: Department of Radiology, Academic Medical Centre, G1-212, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. s.m.schreuder@amc.uva.nl.
authors.forename: Sanne M
authors.initials: SM
authors.lastname: Schreuder
authors.affiliation: Department of Radiology, Academic Medical Centre, G1-212, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
authors.affiliation: Department of Radiology, Academic Medical Centre, G1-212, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Shandra
authors.initials: S
authors.lastname: Bipat
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications; D003287:Contrast Media / Q000009:adverse effects; D048909:Diabetes Complications / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007455:Iodine / Q000009:adverse effects; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000379:methods
chemical_list: D003287:Contrast Media; D007455:Iodine
keywords: Acute kidney injury; Computed tomography; Contrast medium; Kidney disease; Risk factors