Radiation dose from medical imaging in end stage renal disease patients: a Nationwide Italian Survey.
Cancer
Haemodialysis
Kidney transplantation
Radiation dosimetry
Journal
Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
received:
21
06
2020
accepted:
11
11
2020
pubmed:
3
1
2021
medline:
19
8
2021
entrez:
2
1
2021
Statut:
ppublish
Résumé
End stage renal disease (ESRD) patients are exposed to the risk of ionizing radiation during repeated imaging studies. The variability in diagnostic imaging policies and the accompanying radiation doses across various renal units is still unknown. We studied this variability at the centre level and quantified the associated radiation doses at the patient level. Fourteen Italian nephrology departments enrolled 739 patients on haemodialysis and 486 kidney transplant patients. The details of the radiological procedures performed over one year were recorded. The effective doses and organ doses of radiation were estimated for each patient using standardized methods to convert exposure parameters into effective and organ doses RESULTS: Computed tomography (CT) was the major contributor (> 77%) to ionizing radiation exposure. Among the haemodialysis and kidney transplant patients, 15% and 6% were in the high (≥ 20 mSv per year) radiation dose groups, respectively. In haemodialysis patients, the most exposed organs were the liver (16 mSv), the kidney (15 mSv) and the stomach (14 mSv), while the uterus (6.2 mSv), the lung (5.7 mSv) and the liver (5.5 mSv) were the most exposed in kidney transplant patients. The average cumulative effective dose (CED) of ionizing radiation among centres in this study was highly variable both in haemodialysis (from 6.4 to 18.8 mSv per patient-year; p = 0.018) and even more so in kidney transplant (from 0.6 to 13.7 mSv per patient-year; p = 0.002) patients. Radiation exposure attributable to medical imaging is high in distinct subgroups of haemodialysis and transplant patients. Furthermore, there is high inter-centre variability in radiation exposure, suggesting that nephrology units have substantially different clinical policies for the application of diagnostic imaging studies.
Sections du résumé
BACKGROUND AND OBJECTIVES
End stage renal disease (ESRD) patients are exposed to the risk of ionizing radiation during repeated imaging studies. The variability in diagnostic imaging policies and the accompanying radiation doses across various renal units is still unknown. We studied this variability at the centre level and quantified the associated radiation doses at the patient level.
METHODS
Fourteen Italian nephrology departments enrolled 739 patients on haemodialysis and 486 kidney transplant patients. The details of the radiological procedures performed over one year were recorded. The effective doses and organ doses of radiation were estimated for each patient using standardized methods to convert exposure parameters into effective and organ doses RESULTS: Computed tomography (CT) was the major contributor (> 77%) to ionizing radiation exposure. Among the haemodialysis and kidney transplant patients, 15% and 6% were in the high (≥ 20 mSv per year) radiation dose groups, respectively. In haemodialysis patients, the most exposed organs were the liver (16 mSv), the kidney (15 mSv) and the stomach (14 mSv), while the uterus (6.2 mSv), the lung (5.7 mSv) and the liver (5.5 mSv) were the most exposed in kidney transplant patients. The average cumulative effective dose (CED) of ionizing radiation among centres in this study was highly variable both in haemodialysis (from 6.4 to 18.8 mSv per patient-year; p = 0.018) and even more so in kidney transplant (from 0.6 to 13.7 mSv per patient-year; p = 0.002) patients.
CONCLUSIONS
Radiation exposure attributable to medical imaging is high in distinct subgroups of haemodialysis and transplant patients. Furthermore, there is high inter-centre variability in radiation exposure, suggesting that nephrology units have substantially different clinical policies for the application of diagnostic imaging studies.
Identifiants
pubmed: 33387337
doi: 10.1007/s40620-020-00911-0
pii: 10.1007/s40620-020-00911-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
791-799Investigateurs
Emilio Balestra
(E)
Diego Bellino
(D)
Roberta Benevento
(R)
Cristina Bregant
(C)
Paola Bregant
(P)
Barbara Cannillo
(B)
Giuseppe Casto
(G)
Doriana Chiarinotti
(D)
Sara Cimolai
(S)
Giacomo Colussi
(G)
Antonio De Agostini
(A)
Fausto Declich
(F)
Maria Grazia Facchini
(MG)
Maria Alessandra Galione
(MA)
Cesare Gavotti
(C)
Ugo Gerini
(U)
Paola Isoardi
(P)
Cristina Izzo
(C)
Fabrizio Levrero
(F)
Eric Lorenzon
(E)
Stefano Maffei
(S)
Stefania Maggi
(S)
Alberto Mari
(A)
Federico Mattana
(F)
Alberto Menegotto
(A)
Ophelia Meniconi
(O)
Nicoletta Paruccini
(N)
Luisa Pierotti
(L)
Federico Pieruzzi
(F)
Giuseppe Pontoriero
(G)
Adele Postorino
(A)
Marco Quaglia
(M)
Osvaldo Rampado
(O)
Andrea Ranghino
(A)
Sonia Reccanello
(S)
Stefania Sabatino
(S)
Giulia Sangalli
(G)
Chiara Sottocornola
(C)
Marina Sutto
(M)
Salvatore Tata
(S)
Alberto Torresin
(A)
Antonio Traino
(A)
Annalisa Trianni
(A)
Letizia Zeni
(L)
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