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IV Contrast

adman's picture
adman
Posts: 267
Joined: Jul 2012

 

I know this topic has been discussed 'ad nauseum' but sometimes it's good to bring things back in view for newbies.

I've been doing a 1/2 dose [ 50ML ] instead of the normal 100ML dose of IV Contrast 'I think' -

On my 1st scan, post-surgery I took N-acetylcysteine but it's hard to find. Now just hydrate very well. I've had 3-4 scans now.

Thoughts on whether they can see well enough or really need the full dose.  I know it's always a risk/ reward scenario.

 

Full Neph 5.0CM RCC Stage 1/ Grade 1 -  07/2012

Srashedb
Posts: 198
Joined: Dec 2013

I asked my husband's doctor that question yesterday. was told that contrast is the best way to see everything and that before using it, the creatinine levels are checked.

if normal range or even a couple of points higher, the contrast makes a significant difference in catching things early.

sarah

adman's picture
adman
Posts: 267
Joined: Jul 2012

Sarah,

Thanks.

It was never a question of 'whether' to have it, but 'how much', but I understand what you're saying.

I guess if we are to get 'scientific' about this - I'm curious what eGFR and/ or creatinine # is good enough to have a full dosage as opposed to taking a 1/2 dosage of 50ML or less.

 

garym's picture
garym
Posts: 1651
Joined: Nov 2009

Creatinine @ 1.5 or lower is the generally accepted number.

GSRon's picture
GSRon
Posts: 1306
Joined: Jan 2013

I am not sure. I had a half dose contrast on my first post op scan. All other scans were without contrast. They were able to find the Mets pretty easy. I was told it is more difficult, but it just takes more time and care reading the scan. Ron

Fran Chandler's picture
Fran Chandler
Posts: 29
Joined: Feb 2010

I have had one kidney since 2/10/2010 and have been told that your GFR needs to be over 60. Mine was down to 30 after I broke my leg and had 2 surgeries. I have watched sodium mostly and lots of drinking water. I have got it up to a 48 so far. So I am still in the stage 3 catagory of kidney failure. But working to get my GFR up. My creatine level runs around 1.25 to 1.5. Trying to keep it at the lower number. Of course 4 months after my kidney removal I was diagnosed with Bladder Cancer and still on survailance at this time with a cysto every 6 months. Life is one big journey with this cancer.

saintmont
Posts: 43
Joined: Feb 2013

Hi. If your creatinine is high and kidney function is low egfr use visipaque 320 by 100 or if really poor visipaque 320 by 50  contrast. It a bit more expensive. But a lot easier on the kidney and drink fluids after the scan over a periopd of time to flush the contrast out of your system.

donna_lee's picture
donna_lee
Posts: 415
Joined: Feb 2009

If you saw my post earlier this month, you know that I've had 19 CT's.  All have been with contrast, and without going back to the reports to check, I don't think they modified the dosage used.  And I only have one kidney.

What I have had (except for the first diagnostic one, at which time I had 2 kidneys) is a liter of Pre and Post Hydration dripped in with each test.  This has been a way to get extra fluid's circulating to flush out the dye.  It does take more time for the whole test process, but my insurance will cover most of it.

The other thing they've change was the use of Acetylcystine (Mucomist).  It is a mucous thinner that aids the kidney flush out.  About 1.5 years ago my PC said the hospital protocol committee was dropping their recommendation that it be used.  Although the oncologists office continued it for another year, but now does not prescribe it for the night and morning prior to the CT.  This drug comes in liquid or pill, although most pharmacies only carry it in liquid.  It is vile...and has to be added to a strong flavored clear juice to get it down.  It's also used as a mucous thinner for lung and other diseases.

My eGFR seems to be the determining factor in having a CT administered.  For the past 2-4 years, my has been pretty stable at 38-44, maybe varying a point at a time.  The October 2013 test was cancelled, but mainly because I'd had acceptable test results three months prior.

The questions you may want to ask your prescribing doctor, who I presume is the oncologist are:

-How may kidney cancer patients have you treated/followed in your career?

-How many are currently under your care?

-What are the protocol test and treatment procedures that you are following in my case?

In all cases, good luck on the test, and let us know the good news.  We won't allow anything bad to happen to you.

Donna

nyisles's picture
nyisles
Posts: 26
Joined: Mar 2013

The only time I had contrast was right before diagnosis.  Since my kidney was removed, I have NOT had any CT scans with contrast.  I was told that it was not safe for my kidney and that was before I had kidney failure (the one that remains) from IL-2.  Every scan I don't take take contrast, don't drink that water cocktail, I just go in, get scanned and am out.  My scans take about 3 minutes. 

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