Hi everyone. In about 2 weeks I am schedule to have an Abdominal CT scan. My Vascular Doctor wants one with and without contrast. I told him I was concerned about the contrast. Although my kidneys are doing well now I of course want the good function to remain, I read there was two types of contrast. I don’t know much more at this time other than that is the course of action.
I think that my Vascular Doctor who asked me to do a current blood test and I am doing that in two days thinks that if all levels are good especially my creatinine that contrast is ok. I can’t help but feel concerned about the contrast. They do feel that the scan should be with and without contrast for accuracy. No they won’t consider an MRI
I did tell my Doctor that I lost some kidney funchtion about 2 years ago and I have worked hard to regain fuction and keep things healthy. I think that s why he wanted to see current renal levels.
Can anyone offer any advice regarding anything I should do to safe guard my kidneys, is that even possible.?
Thanks so much. I wish everyone good health and blessings.
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Dakot
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I’m not sure what your kidney function is but if it’s normal they usually don’t place any contrast contraindication and will proceed with it unless you specifically refuse it. Some people have allergic reactions for instance and inform the imaging center staff they can’t have it. If you have CKD however it’s typically noted and contrast is avoided… regardless of reason it’s always your right to choose ultimately. They’ve tried to schedule my dad for CT’s with contrast numerous times in error, when I caught it on the order and notified the ordering doctors he has impaired renal function they always remove it. Best of luck and health!
Thank you for your reply, my kidney’s are doing very well now. That is what concerns me. It was not so 2 years ago. I have alerted my Vascular Doctor about a possible adverse reaction to the contrast and I will speak to the staff administering the test. I got my blood test yesterday and my EFGR is 69 and creatinine .88 so it all looks like a go to them but there is a history of my kidney’s being sensitive to chemicals we just don’t always know what. One time I dropped down to EFGR 50, creatinine was 1.4 not terrible but not normal either. So I try to be very careful. I am going to speak to the staff in an serious manner about the possibility of the contrast being problematiic. Thank you
Thank you. I did have the test I did speak to the staff and they assured me that the contrast dye has been made safe for the kidney’s. I don’t have my next blood test for 2 more months so I will keep a positive outlook and drink plenty of water. thank you
I would call the Radiology Department (who is doing the CT Scan) and ask about their CKD protocols. They may have special contrast, and you can then request your doctor order it. To assist your kidneys, it's important to be well hydrated BEFORE the test, and then again after, to help flush the contrast. Best wishes!
I have had CT urogram.s.at the Mayo Clinic. They always do a blood test right before the test and then decide to use or not use contrast depending on my creative level.
Good Morning Dakot I just had this same test done , At my hospital they take the creatinine right before the test. I also had Anaphylaxis Shock 26 yrs ago. Ever since, they now give me 12 hours before the test 32 mg Of Steroid and 12 hours before the test another 32 mg of steroids with 2 25 mg benadryl on the way to the test. I have had about 6 different dye tests since the Anaphylaxis. I've Never had a shock since then. The dye is hard on the kidneys, So usually the test would be deemed" Needed" per symptoms you have had. Drink a ton of water to flush your kidneys as soon as you get home. Sherry
Hi Dakot, I had an abdominal CT scan two weeks ago. The caution I received from my transplant center was to avoid intravenous contrast. Oral contrast is okay for me. The gastroenteritis who ordered the CT scan had requested an oral contrast which turned out to be water. I had to drink 32 oz. of water starting two hours before the scan. I was allowed to void as necessary. I am 15 months post-transplant, but I had the same CT scan done pre-transplant with the same oral contrast and had no issues either time. To be safe always, check with your nephrologist or transplant center. Also contact the imaging center and ask what kind of oral contrast they use for CKD patients. Good luck.
Check with your nephrologist. I am 23+ years post transplant and had a CT with contrast a couple months ago. My nephrologist had me drink more fluids than I normally do after the test to get rid of the contrast. I have never had any issues with it affecting my creatinine. I am also 73.
I have had CT scans and never with contrast. My renal transplant team will not allow contrast. check with your team because only they can give you the correct advice. I’d be very cautious.
Thank you so much everyone. I never had a nephrologist as things did not get to that stage. Twice over the last 5 years just twice my EFGR dropped to 56 and I immediately spoke to my gp. Each time I had taken a supplement so it was concluded that I am very sensitive to certain chemicals. We just don’t know what it took several months of alot of work on my part, diet hydration but each time I brought my kidney fuction back to approx EFGR 68 and all other renal levels are all within normal range.
I have good Vascular doctor at the Cleveland Clinic I told him about the two incidents and he said lets check your creatinine just before the CT test but he believes the contrast is necessary I have an aorta aneurism so it is very important to see detail. I told him I prefer no contrast but this is where we are at. I spoke to my GP who has been through the ups and downs of my kidney function she believes it will be ok if I drink lots of water before and after.
I know I can firmly insist on no contrast but I also understand that it is necessary to see what is going on in my abdomen without question.
So I was wondering if there was something natural or anything I can do to safegurard kidney fuction. Thanks so much everyone for your time and thoughts.
I've had emphysema since I had Kidney failure in 2015. The first CT scan I was told you should never have die put in this test. Kidneys and other parts of you body can't process the die. I tend to be very careful anything that "might" damage or put my kidneys in trouble. When I recovered critical care for 10 days I came of with an eGFR of 39. After following my nephrologist orders and learning everything that's proven helpful I'm now at a eGFR of 70. The best thing you can do in my thoughts is drink all the water you can drink every day and be sure you take the correct amount of protein during a 24 hour time.
Thank you for your reply I am very nervous about this contrast stuff but each doctor said well your kidney values are fine. Yes they are cause I worked at it that is the point. But this test is very important and detail must be seen. I will talk to the people doing the test. I am concerned and I don’t want to cause anything to reduce function. But as mentioned this is an important test. And they will be looking at renal values that indicate nothing wrong. I can tell them as I did that it could happen it did happen before. But based on the results of the current labs??? You know I feel like I am damned if I do and damned if I don’t. So I am hoping for the least harmful way….if oral is better I will ask for that and I will drink tons off water. Thank you so much everyonee.
If a doctor says your kidney values are fine ask for the eGFR number. That's what tells you the most about how your kidneys are. I learned everything about kidneys and I keep my eyes on the eGFR. It tells you how well the flow rate is. Just be careful of fools online that are only telling you things they know nothing about how to take care of your kidneys. God bless you!
Thank you I am careful where I get my info. I actually keep a file of my blood test. I go to the patient portal and print it out I want to see everything with my own eyes. I do not rely on a doctors opinions alone. I do keep a very close eye on my eGFR, and my creatinine and potassium heck all of it. Bless you too and thank you. Your are appreciated.
Sorry to be hitting you with a reality bat, but you ARE damned if you do and damned if you don't. From a radiologist's perspective, there's a world of difference between a GFR of above 60 and below 60. Above 60, they'll suggest doing whatever they want you to do. Below 60, and they'll hesitate a bit. If you're lucky, they'll pull out all the stops to minimize the amount of contrast dye they pump into your system and use the latest and greatest automated dispensing equipment (IVUS), no side holes in the cannula, "re-inhale" the excess puffs of dye as they're dispensing it, pump you full of saline hours before and hours after the procedure, keep you at the hospital for at least a full day, and several other protocols. And even if they do all that, there are no guarantees. I have to go in for an angiogram in a several weeks and I've been doing a boatload of research on the topic and I'm still not satisfied. And my GFR is just above 50. I'm scared shirtless. If my GFR were 68, I'd still be scared, but not quite as much. If you're in stage 4 (below 40), they won't even give contrast dye and if you have a condition that demands it, you're pretty much screwed. In general, the radiologists do what they can, but the technology still isn't there to guarantee no kidney damage with a high degree of certainty. Most of us will face this issue because ckd tends to go hand in hand with heart disease over time.
Wow that is a boat load of concern. We are damned if we do or don’t. They don’t get the impact of the history, They will look at the current values.. well it took me 2 years and a wing and a prayer to get things back to normal. Of course I don’t want to go back to that place of worry. I am already in worry about the other condition that is causing this test to be necessary. I certainly won’t allow anything without a lot of questions and doing my best to advocate for my kidneys.
I am not going to a hospital for this test it is a spin off diagnositic center of the Clevelend Clinic. Thank you again and I wish you the best of health everyone here is always so supportive and helpful. I learn more here than I do from the doctors and sometimes I wonder about Dr. Google.
I had an emergency cardiac cath recently, and it uses the same contrast. I had to have the contrast, because that is the only way to do it, but they pushed two bags of IV fluids through me as soon as the cath was completed. It is definitely something that you can request, to have fluids through IV to help flush kidneys. It was actually just before my cath that the cardiologist pointed out that I had CKD, and that started this whole journey for me. So, he was trying to be careful and do what was right. He was who recommended that I get in touch with Neph, and glad I did. If the CT with Contrast if vital, I would do it, but only after discussion with Neph and insist on flush with IV fluids, not just drinking lots of water.
Thank you, I just became aware of the notes for the test showing with contrast. I just contacted my Vascular Doctors office to state again that contrast could be a problem for my kidneys. I hope they are listening. I will differently keep the IV in mind. I don’t have a nephrologist because it never went that far. I managed to get my kidney function back to normal in a few months. Hopefully making my new Vascular Surgeon aware will result in the right decision for my kidneys. Thank you for your time.
Hi Dakot - Several years before my kidney transplant, I was having some abdominal pain. My general practitioner ordered a scan with contrast. I think it was a CT scan. When I got to the hospital and filled out the health questionnaire (on which I included kidney disease), the doctor on duty would not do the scan. Instead I had an ultrasound. Not sure if this helps.
Hi thank you. I did call the diagnostic center they could not find the person who called me a few days ago that is how I learned about the Contrast. I wrote my Vascular Doctor and advised him of my concerns waiting to hear. Thank you so much wish you good health. God bless
Ct conrast is fine, its usually iodine and can be used at a lesser dose , depending on your creatinine , but don't let them do an Mri, with gadolinium, is does not clear the system, from people with reduced renal function.
Thank you very much. I never had a CT scan and when I saw the order for w/contrast I had to question how safe it was. I of course spoke to my doctors. Two say is is fine. I like to hear from the wonderful people on this forum, that have real experience. Thank you so much. If ever an MRI is suggested I will remember your advice/
Thank you I am trying my best to get them to understand my concerns. Two of my doctors say it is ok because my last couple of Renal blood work showed numbers are good. I am going to do what is best for me. Thank you for taking the time to write God bless.
Key Questions and Joint NKF-ACR StatementsWhat Is the Risk of CA-AKI and CI-AKI in Patients Who Have eGFR Less Than 30,
30–44, 45–59, and Greater Than or Equal to 60 mL/Min/1.73 m2 Undergoing Contrast-enhanced CT?Contrast-associated AKI.—
The risk of CA-AKI (coincident AKI of any cause) increases with each stepwise increase in CKD stage (7–11,13,15).
Using stage I KDIGO serum creatinine criteria, the risk of CA-AKI is approximately 5% at eGFR greater than or equal to 60, 10% at eGFR of 45–59, 15% at eGFR of 30–44, and 30% at eGFR less than 30 mL/min/1.73 m2. This risk is much higher than the risk of CI-AKI because it includes any AKI coincident to contrast media administration, regardless of contrast media exposure.Contrast-induced AKI.—The risk of CI-AKI is substantially less than the risk of CA-AKI, but the actual risk remains uncertain in patients with severe kidney disease. Several large controlled observational studies have shown no evidence of CI-AKI regardless of CKD stage (10,11,13), whereas others found evidence of CI-AKI only in patients with severely reduced kidney function (7,8,13). In such studies, the risk of CI-AKI has been estimated to be near 0% at eGFR greater than or equal to 45, 0%–2% at eGFR of 30–44, and 0%–17% at eGFR less than 30 mL/min/1.73 m2. These studies (1–8,10,11,13) are underpowered to establish risk in patients with severe kidney disease, differ in their conclusions about risk in patients with eGFR less than 30 mL/min/1.73 m2 (estimated CI-AKI risk range, 0%–17%), and are observational in design (ie, only known confounders can be addressed). There are no randomized trials differentiating CA-AKI from CI-AKI in patients with eGFR less than 30 mL/min/1.73 m2.What Other Major Patient-related Factors Increase the Risk of CA-AKI or CI-AKI?
Contrast-associated AKI.—Multiple patient-related risk factors have been associated with CA-AKI (15–17,26). The primary risk factor is eGFR, with some studies finding an additive risk of CA-AKI from diabetes mellitus (15–17,26). Additional risk factors include nephrotoxic agents and exposures, hypotension, hypovolemia, albuminuria, and impaired kidney perfusion (eg, congestive heart failure [27]). Although multiple myeloma has long been considered a risk factor for CA-AKI, this is not supported by more recent literature (28–30).Contrast-induced AKI.—Few studies have linked patient-related risk factors with CI-AKI. In studies that found evidence of CI-AKI, the primary risk factor was eGFR (7–11,13,15). No other putative risk factors that increase CI-AKI risk beyond eGFR alone have been confirmed in well-controlled studies of intravenous media.Are There Clinically Relevant Differences in CA-AKI and CI-AKI Risk for Patients with Reduced Kidney Function with Intravenous Iodinated Low-Osmolality Contrast Media Compared with Intravenous Iodinated Iso-Osmolality Contrast Media?
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