If your doctor tells you to have a CT scan to diagnose the cause of your headaches, you likely don’t think about your kidneys. But, to prevent a potentially serious complication, known as contrast-induced acute kidney injury (CIAKI) [1], you should.
Fortunately, doctors and administrators at Baptist Health’s hospitals and outpatient diagnostic testing facilities have your back, and your kidneys, on their minds before you come to have that CT, or MRI, requiring contrast.
According to the National Institute of Diabetes and Digestive and Kidney Diseases [2], the number of hospitalizations from CIAKI increased by 585 percent between 1996 and 2008. Research shows that some patients who receive intravenous (IV) contrast – a liquid dye used to enhance a radiologist’s view of tissue within the body – are more likely to experience kidney injuries as the organs work to eliminate the contrast from the body. Those at highest risk of developing CIAKI have diabetes, congestive heart failure, vascular disease or compromised kidney function due to certain medications, including chemotherapy.
In 2007, a team at Mariners Hospital [3], began evaluating patients’ risks prior to their imaging tests to reduce the chance for developing this dangerous complication that may lead to kidney failure and death. Since then, other Baptist Health hospitals and Diagnostic Centers [4] within Baptist Medical Plazas [5] have also begun assessing risks prior to the tests being administered.
Mariners Hospital’s Imaging Services Director Fran Glick, who was involved in Baptist Health’s initial movement to address the increase in CIAKI complications, explains that several factors including age, sex and race are taken into consideration to determine whether a patient is at risk.
“We also use blood work, which shows serum creatinine [6] levels to determine kidney function,” Ms. Glick said. “The higher those creatinine levels are in your blood, the more we worry, because your kidneys aren’t effectively eliminating creatinine, a waste byproduct of muscle tissue. This increase in creatinine indicates a lower estimated Glomerular Filtration Rate (eGFR) and weaker kidney function.”
Ms. Glick says extra precautions are taken for those patients who are at risk for developing CIAKI based on these measurements and their risk factors.
“The radiologist and the patient’s doctor discuss whether a test with a smaller amount of contrast or without any contrast will suffice,” she explained. “We also advise all our patients who are not on fluid restrictions to drink eight, 8-ounce glasses of clear liquids the day before the study, drink water the day of the study and continue drinking water for 48 hours after the test. This helps the kidneys filter out the contrast before it can do any damage.”
A recently published study [7] out of the Netherlands supports the use of hydration as an effective way to reduce the risk of CIAKI.
Most people, even if their kidneys are injured from contrast, will heal without long-term effects. But for those with compromised kidney function to begin with, Ms. Glick says these preventive measures will help protect them.
“If your kidneys are healthy when you come in for a test,” she said. “We want to send you home with healthy kidneys.”