Lung CT with contrast & CKD 3A

My Husband is just in remission from NSCLC, now getting monitoring Chest CTs every 6 months.
He was just diagnosed with Chronic Kidney Disease stage 3A. I have read that contrast negatively impacts CKD. Not sure what to do.

@abob, I merged your 2 discussions into one and posted it in both the Lung Cancer group and the CKD group so that you can get comments from members of both groups in one place.
I'm tagging @gingerw as she may have some experience with having to deal with kidney disease and CT scans for cancer monitoring.

@abob, is your husband's oncologist aware of the new diagnosis of stage 3A kidney disease?

@colleenyoung
Thanks.
Chest CT is to be done just prior to next appt with oncology PA. I will try to contact them for feedback re contrast. I cannot fault their clinical approach, but sadly their patient communucation is lacking.

hi @abob - they can do CT scans without contrast. since your husband is in remission, I bet that would be sufficient for monitoring. I have a slow growing form of lung cancer and I get my scans without contrast.

There are contrast mediums that are not harmful to kidneys- let your doc and techs know your kidney #s and concerns.

When making me was diagnosed they cut the contrast so that only one of my every three month CTs uses it. I need to have at least one as I have an aortic aneurysm and my cardiologist requires it.

@colleenyoung @abob
Group II Gadolinium based contrasts are generally okay for kidney disease patients, as long as their eGFR is greater than 30%. Any time you can get a study done without contrast, opt for that! I realize that it depends on what the study is looking for, but we need to think of how any dye or contrast may affect our kidneys, regardless of their current function level.

I will say that in my case, my kidneys are about 13% eGFR even with dialysis. Some might argue, "hey, you're already on dialysis, how much worse could it be, to have contrast?" At this point, any scans could send me into complete kidney failure. So, my medical team and I discuss every procedure.

It's very important that you keep your team appraised of not only this new kidney concerns, but look into how any medications may affect the kidneys!
Ginger

@nycmusic more info—I believe they are—-iso-osmolar, Visipaque-lodixanol… look these up if you’re interested.

Thanks all.
I looked up my husband’s results based on your comments.
It looks like his recent dx is due to him being on the cusp.
EGFR is 59
ALBUMIN/CREATININE RATIO, RANDOM URINE is 87

So if he drinks lots of water before and afterward, he should be ok.
We will discuss future contrast with oncology at CT review appt.