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Saturday 28 March 2015

What would be your decision?

A middle aged man  with chronic renal failure, on conservative management is evaluated for a small liver mass, which was discovered accidently.
His symptoms are those of chronic renal failure (fatigue, anorexia, itching, etc).
CT scan of the abdomen was considered
Would you recommend proceeding to CT? and why?

Answer:

Yes.
According to a big Mayo clinic study published January 2015, renal failure should not be a contraindication for IV contrast imaging study like CT scanning.
The study didn't include patients with creatinine clearance less than 15
So IV contrast should not be withheld, unless a renal function is severely impaired.

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