We are currently in discussion with our Radiologists about using the MDRD eGFR equation which we currenely only report for GP and Outpatients, for Inpatients in order for them to decide whether it is safe to give contrast media to patients undergoing investigations.
Do others restrict the use of the eGFR as we do (following discussion with our renal physicians), based on the original recommendations by the authors that it should not be used in an acute setting?
Also, the 2012 KDIGO document has recommended the use of a different equation, derived in 2009, and using 5 times as many patients, be used instead of the MDRD one. Is anyone in the UK using this equation to calculate the eGFR, or is anyone aware whether the Renal Association etc are looking to recommending changing this in the future?
It does appear to be a more robust equation. But we have seen patients who over a short period have shown an increase in creatinine through the reference range, with eGFR >60 throughout, and if you use the AKI calculations most certainly should not be given these preparations, because of their acute illness/renal impairment.
Thanks,
Gary Mascall
Worcestershire Acute Hospitals NHS Trust.
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