1 Assess compliance with current UK guidance on CI-AKI published in 2013 by the Royal College of Radiologists (1) and the National Institute for Health Care and Excellence (NICE) (2). 2 Determine the incidence of clinically significant CI-AKI in modern CT practice.

Audit data requested on 40 consecutive outpatients (OPs) and 40 consecutive unwell / inpatients (IPs) undergoing contrast enhanced CT scan from all UK Hospitals providing acute care. A compliance rate of 95% was set for each standard.

Data submitted on 3590 OPs and 3569 IPs from 91 (43%) of 212 acute UK hospitals. Compliance with audit standards (patients). Recommendation Target OP IP n/N % 95% CI n/N % 95% CI Risk assessment for development of CI-AKI recorded before contrast was administered 95% 2908/3589 81 80-82 2826/3567 79 78-81 eGFR result (<=3 months prior to scan) available and noted at the time of performing the scan 95% 2364/3584 66 64-68 - - - If eGFR <60 ml/min/1.73m2, patient had pre contrast and follow...

1. UK radiology departments do not currently meet the compliance standards for management of CI-AKI and should review their practice. 2. CI-AKI requiring hospital treatment or resulting in death was not seen in 3590 outpatients with an eGFR>30. This finding supports the safety of current European Society of Radiology (ESUR) guidlines (3) which state that patients are not at increased risk of contrast medium-induced nephropathy if the eGFR is >45. The incidence of CI-AKI in the inpatient / acutely unwell cohort was low, but CI-...

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.

1. 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 2. 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 http://guidance.nice.org.uk/cg169 3. European Society of Uroradiology guidelines on contrast media http://www.esur.org/guidelines 4. Contrast Material–induced Nephrotoxicity and Intravenous Low-Osmolality Iodinated Contrast Material: Risk Stratification by Using Estimated Glomerular Filtration...