P107
EXPOSURE TO IONISING RADIATION IN PATIENTS ON HAEMODIALYSIS
Hazara AM, Cathcart T, Saunderson J, Moore C and Bhandari S
Department of Renal Medicine, Hull and East Yorkshire Hospitals NHS Trust
INTRODUCTION: Patients on haemodialysis often carry a large burden of co-morbidities and
are frequently exposed to a variety of radiological and nuclear medicine (NM) examinations.
These examinations deliver ionising radiations which carry increased risks of inducing cancers
and heritable genetic defects. We aimed to evaluate patterns of radiology requests and estimate
overall exposure to ionising radiations in our cohort of haemodialysis patients.
METHOD: Electronic requesting and reporting of investigations started at our hospital in 2002.
All records for completed radiological investigations were obtained using this system. For
investigations prior to 2002, hospital case notes were reviewed. Typical effective doses for each
type of investigation involving ionising radiations were obtained from hospital’s medical
physics department. Supplementary information on typical doses were obtained from Health
Protection Agency (HPA) and other well cited publications.
RESULTS: 51 patients receiving thrice weekly in-centre haemodialysis, approached on
consecutive days of the week at our local haemodialysis unit, were included. A total number of
1225 radiation exposing investigations were found. This included: plain films 755 (62%),
flouroscopy 270 (22%), CT scans 93 (8%), NM scans 92 (8%) and other investigations 14 (1%).
Mean cumulative dose of radiation per patient on haemodialysis was estimated at 631
microsieverts (µSv) per year. This is higher than the estimated dose reported in the general
population of 405 µSv published by HPA. Investigations accounting for highest contribution to
this cumulative exposure are presented in table 1.
Type of investigation
Myocardial Perfusion Scintigraphy
Retrograde Aortogram
PTA Dialysis Fistula
CT Chest +/- contrast
CT Chest, Abdomen and Pelvis +/- Cont
Cardiac Angio Coronary Stent
Intravenous Urogram (IVU)
Total effective dose millisieverts
(% contribution to cumulative exposure)
536.2 (25%)
291.0 (14%)
171.6 (8%)
52.8 (3%)
50.0 (2%)
46.8 (2%)
46.2 (2%)
Table 1: Investigations and their contribution to total cumulative exposure to ionising
radiation in haemodialysis patients
CONCLUSION: Exposure to ionising radiation among patients on haemodialysis is high.
Certain radiological and NM scans deliver a particularly high dose of radiation; their targeted
use must be encouraged in order to reduce this burden.