Reference: ACR Manual on Contrast Media, 2021
All inpatients require a current (within one week) creatinine level or estimated glomerular filtration rate (eGFR) prior to an IV contrast-enhanced CT.
Outpatients and ED patients being scheduled for a CT with IV contrast will not require a serum creatinine unless they meet one of the following criteria:
- Personal history of renal disease, including:
- Known chronic kidney disease (CKD)
- Remote history of AKI
- Kidney surgery or kidney transplant
- Kidney ablation
- History of diabetes mellitus (optional)
- Metformin or metformin-containing drug combinations
These parameters are intended to serve as guidelines. Obviously, medical necessity may mandate administering contrast without a current measure of renal function.