Contrast induced acute kidney injury

Jon Griffin made this Freedom of Information request to East Suffolk and North Essex NHS Foundation Trust

This request has been closed to new correspondence from the public body. Contact us if you think it ought be re-opened.

The request was successful.

Dear Colchester Hospital University NHS Foundation Trust,

The following questions concern patients undergoing radiological investigations or procedures involving iodinated contrast media (this would involve the departments of radiology, vascular, MAU and renal):

1. Does your institution have specific guidelines/policy for the recognition and management of patients at risk of contrast induced acute kidney injury (CI-AKI) for the following procedures:
a. contrast enhanced CT scans
b. angiogram, angioplasty and stenting
c. endovascular aneurysm repair (EVAR)

2. If available please send the guidelines/policy by email.

3. When was this guideline last reviewed and/or revised?

4. What strategies does your institution use to manage patients at risk of CI-AKI?

5. Do you routinely involve a renal physician in the pre and post procedure management of patients at risk of CI-AKI who are having a contrast enhanced investigation or interventional procedure?

6. Do patients at risk of CI-AKI routinely have post procedure serum urea, creatinine, eGFR and electrolytes measured? If so, at what time post procedure does this happen?

Yours faithfully,

Jon Griffin

FOI REQUESTS (RDE) Colchester Hospital University NHS Foundation Tr,

Dear Mr Griffin,

 

Thank you for your email. Your request is being handled under the Freedom
of Information (FOI) Act 2000, and has been passed to the relevant
department for action. Please note that under the FOI legislation the
Trust has 20 working days to provide a response, although we will
endeavour to do so before then.

 

Kind Regards,

 

The FOI Team at Colchester Hospital University NHS Foundation Trust

 

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FOI REQUESTS (RDE) Colchester Hospital University NHS Foundation Tr,

1 Attachment

Dear Mr Griffin,

 

Thank you for your request under the Freedom of Information Act (FOI).

You requested:

1. Does your institution have specific guidelines/policy for the

     recognition and management of patients at risk of contrast induced

     acute kidney injury (CI-AKI) for the following procedures:

     a. contrast enhanced CT scans

     b. angiogram, angioplasty and stenting

     c. endovascular aneurysm repair (EVAR)

             

             Please see the flowchart below regarding the protocol for
intravenous iodine contrast administration.

    

     2. If available please send the guidelines/policy by email.

 

             Please see below.

    

     3. When was this guideline last reviewed and/or revised?

 

             This was checked before being disclosed.

    

     4. What strategies does your institution use to manage patients at

     risk of CI-AKI?

 

             Please see below.

 

     5. Do you routinely involve a renal physician in the pre and post

     procedure management of patients at risk of CI-AKI who are having a

     contrast enhanced investigation or interventional procedure?

 

            Yes, the Trusts Radiologists would involve a Nephrologist if
they knew the patient was at risk.

    

     6. Do patients at risk of CI-AKI routinely have post procedure

     serum urea, creatinine, eGFR and electrolytes measured? If so, at

     what time post procedure does this happen?

 

            Yes, this is done 2 to 5 days post procedure as detailed on
the flowchart below.

 

           For any procedure involving contrast, we check the serum
creatinine and eGFR levels to determine how we are    

           going to deal with the patient and which contrast we are going
to use.

 

          We use the following flow chart to determine how we are going to
deal with the patient.

·         If the creatinine is below 150, we ask the patient to orally
hydrate the day before and for 2 days after the procedure

·         If the patient is receiving dialysis we try to fit their
appointment around their dialysis treatment so that they receive a course
after their procedure. We will advise the nephrologists & dialysis unit of
any such patients as they may want to alter the timings of their
treatment.

·         If the creatine is above 150 we use the following flow chart to
determine how we will treat the patient

 

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