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Low–Contrast Dose Protection Protocol for Diagnostic Computed Tomography in Patients at High-Risk for Contrast-Induced Nephropathy

Kidoh, Masafumi MD; Nakaura, Takeshi MD; Awai, Kazuo MD; Matsunaga, Yoshinari MD; Tanoue, Kenichirō MD; Harada, Kazunori MD; Uemura, Shouzaburou MD; Yamashita, Yasuyuki MD

Journal of Computer Assisted Tomography: March/April 2013 - Volume 37 - Issue 2 - p 289–296
doi: 10.1097/RCT.0b013e318279bd20
Contrast Agents

Objective To evaluate the safety of a low–contrast dose computed tomography (CT) protocol for patients with renal insufficiency for contrast-induced nephropathy.

Methods One hundred forty-three patients with renal insufficiency who underwent low–contrast dose–enhanced abdominal CT were reviewed. Another group of 327 patients who received unenhanced CT was reviewed as a control group. Baseline serum creatinine and estimated glomerular filtration rate (eGFR) levels were obtained for all patients to determine the contrast dosing (1.6 and 1.0 mL/kg for patients with eGFR levels 30–59 and 15–29). We compared the incidence of acute kidney injury between the groups.

Results There were no significant differences in the incidence of acute kidney injury between the low–contrast dose and unenhanced CT protocols (9.1% vs 8.3%, P = 0.77). None of the patients with renal dysfunction required postprocedure dialysis.

Conclusion The low–contrast dose CT protocol might enable us to perform a contrast-enhanced study without any major safety concerns.

From the *Diagnostic Radiology, Amakusa Medical Center; †Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan ; ‡Department of Diagnostic Radiology, Graduate School of Medicine, Hiroshima University, Hiroshima, Japan; §Department of Urology, ∥Department of Surgery and ¶Department of Neurosurgery, Amakusa Medical Center, Amakusa, Kumamoto, Japan.

Received for publication August 14, 2012; accepted October 12, 2012.

Reprints: Masafumi Kidoh, MD, Diagnostic Radiology, Amakusa Medical Center kameba 854-1, Amakusa, Kumamoto 863-0046, Japan (e-mail:

The authors have no funding or conflicts of interest to disclose.

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