Detection of renal dysfunction by point-of-care creatinine testing in patients undergoing peripheral MR angiography

OBJECTIVE. The objective of our study was to analyze the effectiveness of prestudy questionnaires in identifying at-risk patients and estimate the prevalence of chronic kidney disease (CKD), nephrogenic systemic fibrosis risk factors, and other comorbidities in patients scheduled to undergo lower extremity MR angiography (MRA) studies using gadoliniumbased contrast agents. MATERIALS AND METHODS. Patent demographics, comorbidities, contrast type, and point-of-care (POC) serum creatinine values were recorded from the medical records of consecutive patients undergoing lower extremity MRA examinations in a single year. Patients were divided into groups by CKD stage (non-CKD, stage III, stage IV, or stage V) on the basis of estimated glomerular filtration rate values determined from POC creatinine results. Patient awareness of a history of CKD was noted if patients admitted to any form of CKD on prestudy questionnaires. RESULTS. Of 199 patients, 72 patients (36.2%) had stage III CKD, six patients (3.0%) had stage IV CKD, and seven patients (3.5%) had stage V CKD. Comorbidities - including smoking status, transplant status, and presence of diabetes, hypertension, and coronary artery disease - as well as administered contrast type and dosage showed significant differences among the CKD groups (p < 0.05). Only five stage III patients (7%) were aware of any history of renal dysfunction, whereas three stage IV patients (50%) and seven stage V patients (100%) admitted any history of renal dysfunction via questionnaires. CONCLUSION. Compared with POC creatinine testing, a prestudy questionnaire used alone is ineffective in identifying all patients with histories of CKD who are scheduled to undergo gadolinium-based peripheral MRA studies.