Assessment of renal function before contrast media injection: right decisions based on inaccurate estimates.
Objectives: Information on renal function required before specified radiological examinations with contrast agents is usually obtained through prediction equations using serum creatinine and anthropometric data. The aim of our study was to demonstrate discrepancy between poor prediction and good dia...
| Publicado en: | European Radiology Vol. 29; no. 6; pp. 3192 - 3200 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jun2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136405160&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136405160 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jun2019 vid: 29 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 136405160 136405160 NLM30413953 10.1007/s00330-018-5753-z NLM30413953 136405160 ppf: 3192 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Assessment of renal function before contrast media injection: right decisions based on inaccurate estimates. aug: au: Ptáčník, Václav Zogala, David Skibová, Daniela Jiskrová, Hana Trnka, Jiří Tesař, Vladimír Ryšavá, Romana Šámal, Martin affil: Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Salmovská 3, 120 00, Praha 2, Czech Republic sug: subj: Creatinine Blood Glomerular Filtration Rate Physiology Renal Insufficiency, Chronic Diagnosis Radiography Methods Kidney Contrast Media Administration and Dosage Female Adult Renal Insufficiency, Chronic Blood Kidney Metabolism Injections, Intravenous Middle Age Aged Male Aged, 80 and Over Kidney Physiopathology Reproducibility of Results Renal Insufficiency, Chronic Physiopathology Young Adult Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: Objectives: Information on renal function required before specified radiological examinations with contrast agents is usually obtained through prediction equations using serum creatinine and anthropometric data. The aim of our study was to demonstrate discrepancy between poor prediction and good diagnostic accuracy of glomerular filtration rate (GFR) estimated by prediction equations.Methods: In 50 patients, reference GFR was measured as plasma clearance of 51-chromium labeled ethylene-diamine-tetraacetic-acid (51Cr-EDTA) and compared with GFR assayed by creatinine clearance (CC) and estimated by Cockcroft-Gault prediction equation (CG). For comparisons, CC and CG were considered as continuous, categorical, and binary variables. Accuracy of the reference GFR prediction was expressed in terms of prediction errors and diagnostic accuracy indices.Results: As continuous variable, CG estimated individual values of GFR with large prediction error exceeding that of CC. As categorical variable, it classified the patient stage of chronic kidney disease (CKD) with medium diagnostic accuracy of 74% (CKD 3) and 62% (CKD 4). As binary variable, CG classified individual patient's GFR below 30 and 60 ml/min/1.73 m2 with good diagnostic accuracy of 80 and 94%, respectively. Performance of other prediction equations did not significantly differ from CG.Conclusions: Despite large variance and poor prediction accuracy of individual GFR estimates, most of them correctly classified individual patient's GFR below specified level. Results of prediction equations thus should be used and reported exclusively as binary variables, while numerical values of GFR, if required, should be measured by more accurate radionuclide or laboratory methods.Key Points: • Radiological guidelines on contrast media require estimation of glomerular filtration rate to assess kidney function before specified contrast examinations. • Estimated glomerular filtration rate is obtained through prediction equations using serum creatinine and anthropometric data as predictors. • While numerical estimates of glomerular filtration rate are inaccurate (their prediction accuracy is poor), diagnostic accuracy of binary estimates (ability to classify patient's glomerular filtration rate below or above a specified level) is very good. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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