Safety of Low Dose IV Contrast CT Scanning in Chronic Kidney Disease
Chronic Kidney Disease, Pulmonary Embolism, Renal Artery Stenosis
About this trial
This is an interventional diagnostic trial for Chronic Kidney Disease
Eligibility Criteria
Inclusion Criteria:
- Subjects with documented stable Chronic Kidney Disease (CKD) defined as a stable eGFR 16-60 ml/min/m^2 for ≥ 12 months; and
- Referred to CT scanning procedure to evaluate pulmonary embolism, pulmonary malignancy, acute aortic syndromes, or renal artery stenosis.
Exclusion Criteria:
- CKD Stages 1, 2 and 5
- Stage 3-4 congestive heart failure (CHF)
- Irregular supraventricular tachycardia
- Allergic to iodinated Radio Contrast Medium (RCM)
- Allergic to Mucomyst
- Pregnancy
- Evidence of acute renal failure (ARF)
- Serum bicarbonate either less than 20 meq/L or greater than 35 meq/L
- Hydration with a bicarbonate solution is contraindicated or considered unsafe by the subject's caring physicians
Sites / Locations
- VA Greater Los Angeles Healthcare System
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
Low Volume Contrast
Control
Subjects in this arm will receive a single intravenous injection of low volume iso-osmolar non-ionic radio contrast medium, prior to undergoing 64-MDCT scanning. The use of low volume radio contrast medium constitutes the intervention. Both experimental and control groups receive a) acetylcysteine inhalation (Mucomyst) 1200 mg po BID x 48 hours starting the day prior to the CT scan; and b) isotonic Sodium Bicarbonate Solution 3ml/kg/hr iv for 1 hour prior to the CT scan and for 6 hours after the CT scan
Subjects in this arm will undergo 64-MDCT scanning without Radio Contrast Medium (RCM). Both experimental and control groups receive a) acetylcysteine inhalation (Mucomyst) 1200 mg po BID x 48 hours starting the day prior to the CT scan; and b) isotonic Sodium Bicarbonate Solution 3ml/kg/hr iv for 1 hour prior to the CT scan and for 6 hours after the CT scan