While most physicians rely on serum creatinine levels to determine kidney function, it’s not the most reliable indicator, according to a nephrologist who presented at the International Society for Computed Tomography on May 18. Instead, he suggested providers look at the estimated glomerular filtration rate (eGFR). In acutely ill patients in particular look at the changing serum creatinine (sCR) levels and not the specific values or specific eGFRs, he said.
While most physicians rely on serum creatinine levels to determine kidney function, it’s not the most reliable indicator, according to a nephrologist who presented at the International Society for Computed Tomography on May 18. Instead, he suggested providers look at the estimated glomerular filtration rate (eGFR). In acutely ill patients in particular look at the changing serum creatinine (sCR) levels and not the specific values or specific eGFRs, he said.
It’s important to screen patients prior to getting a contrast-enhanced CT to determine whether they are at risk for acute kidney injury, previously known as acute kidney failure. Acute kidney injury is defined as an abrupt loss of kidney function, usually over days, marked by changing sCR. Contrast administration can exacerbate acute kidney injury.
Dr. Steven D. Weisbord, an assistant professor of medicine in the renal section at VA Pittsburgh Healthcare System, suggests screening patients’ sCR if they have one or more of the following:
A better indication of kidney function, however, is eGFR. For instance, two patients can have the same sCr of 1.5, leading to a misinterpretation, while their eGFRs are 59 mL/min and 36 mL/min.
“Even patients with serum creatinine of 1.2 can have abnormal eGFR,” he said. “Patients can have normal serum creatinine levels and eGFRs that are very abnormal.”
Weisbord cited a study that appeared five years ago and illustrates a pronounced difference in women between sCr and eGFR. The women had sCrs of 0.9 or 1 and eGFRs that put them at the stage III chronic kidney disease, which is an eGFR of 30 to 60 (J Am Soc Nephrol 2005;16:2439-2448). In another example, women with sCr of 1.6 had eGFRs of less than 30, which is stage IV chronic kidney disease.
“Serum creatinine is not a good assessment of what the patient’s renal function is,” he said.
Photon-Counting Computed Tomography: Eleven Takeaways from a New Literature Review
May 27th 2025In a review of 155 studies, researchers examined the capabilities of photon-counting computed tomography (PCCT) for enhanced accuracy, tissue characterization, artifact reduction and reduced radiation dosing across thoracic, abdominal, and cardiothoracic imaging applications.
Can AI Predict Future Lung Cancer Risk from a Single CT Scan?
May 19th 2025In never-smokers, deep learning assessment of single baseline low-dose computed tomography (CT) scans demonstrated a 79 percent AUC for predicting lung cancer up to six years later, according to new research presented today at the American Thoracic Society (ATS) 2025 International Conference.
Can Emerging AI Software Offer Detection of CAD on CCTA on Par with Radiologists?
May 14th 2025In a study involving over 1,000 patients who had coronary computed tomography angiography (CCTA) exams, AI software demonstrated a 90 percent AUC for assessments of cases > CAD-RADS 3 and 4A and had a 98 percent NPV for obstructive coronary artery disease.