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GFR measurements and contrast

Just wanted to get some thoughts from other sites.

We have historically insisted on a GFR check before giving iodinated contrast or GBCA. However, it is not practical to check the GFR at the hospital lab - the best possible turnaround time is 180 minutes so it just isn't a sensible option.

We have up till now been relying on family doctors to do this, as many of our patients travel 3-4 hours to get to us. We get the request for examination, ask them to check the GFR and forward the result before the appointment.

However, due to Covid - most family doctors are now refusing to do this. We therefore have no way of knowing the GFR at the time of the appointment. We have investigated point-of-care testing, but our regulatory compliance department has told us, none of the hand-portable devices comply with the rules of our diagnostic accreditation, and we would need a proper laboratory analyser and staff would need to be trained and accredited to normal clinical scientist standards to operate it. (We priced this out at more than the cost of a new CT scanner).

Given the difficulty and recent evidence, we are now thinking about abandoning the idea of GFR testing completely. If the order is for a CT with contrast, or an MRI with contrast, then the dose is given regardless.

So, I'm curious to know if any other sites have just stopped GFR testing for contrast.

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source https://www.reddit.com/r/Radiology/comments/hgby3x/gfr_measurements_and_contrast/

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