Trial of VQ Scanning to Reduce Contrast-Induced Nephropathy in Patients Evaluated for Pulmonary Embolism
Alice Mitchell
Primary Investigator
Brief description of study
Detailed description of study
If the patient is determined to be eligible to continue in the study, the following will also happen at his/her standard of care visit:
• Blood draw (if not done already) of up to 4 tablespoons of blood
• Depending on stratification, the 100 patients who are at low risk of kidney problems will have the CT scan of your chest that was ordered by treating doctor.
• Otherwise, 600 patients will be randomly assigned to have either a CT scan of chest, which or a VQ scan. One half will have the CT scan and one half will have the VQ scan.
• Patients will also have an ultrasound (a painless sound wave test of the legs to look for a clot that can cause a clot in the lungs), if the treating doctor thinks one is needed, or if the VQ scan is “intermediate.” Some patients who have a VQ scan that is intermediate, may also need to have a CT scan of their chest to be sure that they do or do not have a clot in their lungs.
• Storage of blood and urine samples for later testing
If the patient is eligible to continue in the study, the following will happen later:
• The subject will be given an appointment to return to the hospital between 2 and 7 days from date of standard of care visit. Reminders will be provided to the patient
• At this appointment, the patient will asked some questions about his/her health, an additional blood test of about 2 4 tablespoons will be taken, and a urine sample will be collected. If these tests do show possible CIN, the patient will be sent a letter to notifying him/her to see a doctor.
• Subjects' medical records will also be reviewed at approximately 7 days, 30 days, and in 1 year from standard of care visit.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Acute kidney injury, AKI
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Age: 18 years - 100 years
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Gender: All
Inclusion Criteria
1. Age≥18 years
2. CTPA ordered by the treating provider to evaluate PE.
3. Pre-test probability of PE ≤20% (defined using the PE Pretest Consult Score (or Well's Score))
4. A lower-risk subset of 100 patients (AKIRisk Score <2) will be enrolled and followed. These patients will complete the CTPA as ordered by their provider (not randomized). Data from this lower-risk subset, along with high-risk patients randomized to CTPA will be used will be used to validate the AKIRisk Score, alone and in combination with NGAL and eGFRCYS (Study Aims 1 and 3).
