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The CI-AKI Consensus Working Panel also supported the use of dipstick testing for urine protein as a rapid screen to identify patients who can undergo studies requiring contrast media without SCr measurement.410 Of 310 patients with a negative urine protein test and no history of diseases potentially associated with renal impairment, none had a SCr level > 2.0 mg/dl ( > 177 µmol/l), and only 1% had a level > 1.7 mg/dl ( > 150 µmol/l).
Thus, the Work Group recommends that, when a recent SCr is not available, a simple questionnaire or a dipstick testing for urine protein may be useful for identifying pre-existing kidney disease. Risk stratification hinges on age, baseline kidney function, other comorbidities, and other risk factors.
In the past 3 months have you been told there may have been a change in your kidney function? Y/N
In the past 3 months have you been on any medications? Please list:
Have you used any over-the-counter pain relievers within the last 10 days? Y/N Please list:
In the past 3 months have you had any surgery? Y/N
Describe:
Do you feel dry or thirsty? Y/N
Circle one
| *Have you ever been told you have kidney disease of any type? Please describe: |
Y | N |
| *Have you had kidney surgery? | Y | N |
| *Do you have diabetes? | Y | N |
| Do you use insulin? | Y | N |
| Do you use metformin or glucophage? | Y | N |
| *Do you have hypertension, heart disease, or vascular disease? | Y | N |
| *Do you have gout? | Y | N |
| Do you have multiple myleoma? | Y | N |
| Have you ever had x-ray contrast media (dye) for CT, angiography, or IVP? | Y | N |
| Have you had contrast media within the last 3 days? | Y | N |
| Do you have any allergies to x-ray contrast media (dye)? Please describe: |
Y | N |
| Have you received pretreatment with medication for this study? | Y | N |
| Do you have any allergies or asthma? Please describe: | Y | N |
Figure 13 | Sample questionnaire. Asterisks denote questions with the highest association with abnormal renal function. Adapted from Choyke PL, Cady J, DePollar SL et al. Determination of serum creatinine prior to iodinated contrast media: is it necessary in all patients? Tech Urol 1998; 4: 65–69 with permission.411
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