• Probability of Reduced Renal Function After Contrast-Enhanced CT: A Model Based on Serum Creatinine Level, Patient Age, and Estimated Glomerular Filtration Rate

    Brian R. Herts, Erika Schneider, Nancy Obuchowski, Emilio Poggio, Anil Jain, Mark E.Baker

    OBJECTIVE. The objectives of our study were to develop a model to predict the prob�ability of reduced renal function after outpatient contrast-enhanced CT (CECT)�based on patient age, sex, and race and on serum creatinine level before CT or directly based on esti�mated glomerular filtration rate (GFR) before CT�and to determine the relationship between patients with changes in creatinine level that characterize contrast-induced nephropathy and patients with reduced GFR after CECT.

    MATERIALS AND METHODS. Of 5,187 outpatients who underwent CECT, 963 (18.6%) had serum creatinine levels obtained within 6 months before and 4 days after CECT. The estimated GFR was calculated before and after CT using the four-variable Modification of Diet in Renal Disease (MDRD) Study equation. Pre-CT serum creatinine level, age, race, sex, and pre-CT estimated GFR were tested using multiple-variable logistic regression models to determine the probability of having an estimated GFR of

    RESULTS. Significant (p

    CONCLUSION. The probability of a reduced estimated GFR after CECT can be pre�dicted by the pre-CT estimated GFR using the four-variable MDRD equation. Furthermore, standard criteria for contrast-induced nephropathy are poor predictors of poor renal function after CECT. Criteria need to be established for what is an acceptable risk to manage patients undergoing CECT.