The Renal Association, the Royal College of Radiologists (RCR) and the British Cardiovascular Intervention Society (1) and the National Institute for Health and Care Excellence (NICE) (2) published UK guidance in 2013 with the aim of providing safer care by managing CI-AKI appropriately. A survey of all UK radiology departments Fig. 1 was performed on behalf of the RCR audit committee in 2015 to assess whether UK Radiology departments have implemented safe protocols to minimize the risk of CI-AKI following contrast enhanced computed tomography (CT)...

Questionnaire to all 172 UK NHS Trusts responsible for managing all 212 acute hospitals. A compliance rate of 95% was set for each standard.

A high response rate of 52% is representative of national practice. Standard Expected Compliance Hospital Protocol Compliance Define stage of chronic kidney disease - necessary to identify patients at high risk of CI-AKI requiring follow up kidney function tests (Fig. 2) 95% 60% Require recent kidney function tests prior to contrast injection (Fig. 3) : For outpatients (within 3 months) For inpatients (within 1 week) 95% 95% 79% 74% Require intravenous volume expansion for high risk patients before contrast injection- necessary to decrease the risk...

Compliance with guidance on CI-AKI is poor. Therefore, departments do not have assurance that the risk of CI-AKI in UK CT practice is minimized, or that CI-AKI is detected and managed appropriately in high risk patients. To inform the decision to prescribe IV contrast the radiologist requires recent kidney function tests as the risk of developing CI-AKI increases with increasing levels of chronic kidney disease. 18% Outpatient scans in a concurrent audit of UK contrast enhanced CT were pre-booked follow up scans where kidney function...

The authors gratefully acknowledge the hard work and enthusiasm of the RCR audit leads who supplied data for this audit. The audit itself was undertaken on behalf of The Royal College of Radiologists (RCR) and the RCR Clinical Audit Committee.

Prevention of Contrast Induced Acute Kidney Injury (CI-AKI) In Adult Patients Ref No: 2013 The Renal Association, the British Cardiovascular Intervention Society and the Royal College of Radiologists. https://www.rcr.ac.uk/publication/prevention-contrast-induced-acute-kidney-injury-ci-aki-adult-patients Acute kidney injury: Prevention, detection and management of acute kidney injury up to the point of renal replacement therapy Clinical guidelines, CG169 - Issued: August 2013 229 http://guidance.nice.org.uk/cg169