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GFR measurements and contrast

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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.

submitted by /u/TheWormWhisperer
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source https://www.reddit.com/r/Radiology/comments/hgby3x/gfr_measurements_and_contrast/
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