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Purpose: To assess whether selective use of estimated glomerular filtration rate (eGFR) in patients with risk factors for kidney disease is more cost-effective than measuring eGFR in all patients undergoing contrast-enhanced computed tomography (CECT)., Methods: Risk factors and costs were assessed in consecutive patients. eGFR was evaluated in all patients, considering a tenability of 12 months. For the three-month tenability and the pre-selection strategy based on risk factors for kidney disease, we extrapolated data by assuming equal distribution of patient characteristics., Results: We included 1001 patients, mean age 59.9 ± 13.6 years. Strategy with eGFR in all patients: eGFR measurements specifically performed for CECT in 645/1001 (in 356 patients the eGFR was already known). The total cost including costs of an extra visit to the hospital (49 patients) and absence from work (11 patients) were € 6037.20. Considering a tenability of 3 months, eGFR had to be measured in 786 patients, 60 would have paid an extra visit and 14 would have been absent from work: total cost € 7443.54. Pre-selection strategy: 807 patients had risk factors, necessitating eGFR measurement and an extra visit would be paid by 61. Fourteen patients would have been absent from work: total cost € 7585.16. Of the patients with an eGFR <60 ml/min/1.73 m(2), 94.8% were identified including all with an eGFR <45 ml/min/1.73 m(2)., Conclusion: Determining eGFR based on risk factors for kidney disease is not more cost-effective than eGFR testing in all patients if the eGFR is tenable for 12 months or for 3 months.