[Delay in implementation of international guidelines for computed tomographies with iodinated contrast media]

This study was conducted to determine the degree to which the clinical practice concerning computed tomographies (CTs) with iodinated contrast media in patients with lung cancer was in accordance with ESUR international guidelines. Lung cancer is treatable with platinum-based cytostatic drugs, which can be nephrotoxic. According to the ESUR s guidelines this adds to the risk of developing contrast-induced nephropathy.

A retrospective study of lung cancer patients at Hillerød Hospital.

Patients in current treatment with platinum-based cytostatic drugs up to and including 20 Sept. 06 who had undergone an elective CT with iodinated contrast media. A total of 51 patients where included. P-creatinine and other potential risk factors for development of contrast-induced nephropathy were collected.

In 31.4% of the patients included, P-creatinine was measured no earlier than seven days prior to their CT. 43.1% of the patients included had received a platinum-based cytostatic drug after the latest measurement of their P-creatinine prior to their CT scan. 45.1% of the patients received a platinum-based cytostatic 14 days or less before CT scan. 66.7% had additional risk factors. None needed nephrologic assistance.

Significant deviations were found between the clinical practice and ESUR international guidelines covering prevention of contrast-induced nephropathy. This study has led to changes in the guidelines and clinical practice regarding contrast-induced nephropathy at Hillerød Hosipital. Now all elective patients have P-creatinine measured no more than seven days prior to CT with iodinated contrast media.