The results suggest that clinicians should consider scaling back on radiation for purposes of diagnosis in this patient population.
Many kidney disease patients on dialysis suffer from other illnesses that require them to undergo radiation procedures for diagnosis and treatment. This means patients can receive high doses of radiation over an extended period of time, which can increase their risk of developing cancer. Marco Brambilla, PhD, Andreana De Mauri, MD (University Hospital “Maggiore della Carità,” in Novara, Italy), and their colleagues followed a group of 106 dialysis patients for an average of three years and calculated their radiation exposure from hospital records.
On average, patients received the equivalent of approximately 1,000 chest radiograms per year. Computed tomography (CT) scans accounted for 76 percent of the total radiation dose, while accounting for only 19 percent of the total number of radiological procedures. The researchers found that 22 patients received low doses of radiation each year, 51 received moderate doses, 22 received high doses, and 11 received very high doses.
Seventeen patients were exposed to radiation at levels associated with a substantial increase in risk for cancer-related death. The investigators also noted that radiation doses were higher in younger patients and in patients on transplant waiting lists.
“These findings emphasize the need to begin tracking at least the CT-related exposure to develop and implement alternative strategies to reduce patient-specific radiation burden. The retrospective nature of this study does not allow us to draw conclusive inferences about the percentage of CT studies that could have been avoided. However, the significant number of examinations that resulted in non-notable findings or in negative results—about 60 percent—points toward the need of a more stringent process of justification of CT referral,” said Brambilla.
